Paediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) are complex conditions characterized by the sudden onset of neuropsychiatric symptoms in children. While traditional treatments focus on managing symptoms, an integrative approach addressing gut health, immune support and nervous system support can offer additional benefits and potentially full resolution. It is important to note that PANS and PANDAS is not a psychiatric condition, it is an issue with immune dysregulation due to a trigger.  

What are PANS and PANDAS?

PANS is an umbrella term that includes various triggers such as infections, metabolic disturbances, and environmental factors. Children with PANS often exhibit a sudden onset of symptoms like obsessive-compulsive behaviours, eating disorders, anxiety, depression, irritability, and academic decline.

PANDAS is a subset of PANS, specifically triggered by streptococcal infections. The hallmark of PANDAS is the sudden onset of obsessive-compulsive disorder (OCD), tics, and other neuropsychiatric symptoms following a strep infection.

 The Role of Gut Health

The gut-brain axis highlights the connection between the gastrointestinal system and the central nervous system, emphasizing how gut health can influence brain function and behaviour. Inflammation and dysbiosis (an imbalance in gut microbiota) can exacerbate neuropsychiatric symptoms. Here’s how improving gut health can help:

1. Probiotics and Prebiotics:

Probiotics are beneficial bacteria that can help restore the balance of gut flora. Strains such as Lactobacillus and Bifidobacterium are particularly effective. Prebiotics, on the other hand, are fibers that feed these good bacteria. Incorporating foods like garlic, onions, bananas, and whole grains can promote a healthy gut microbiome.

2. Dietary Changes:

An anti-inflammatory diet rich in whole foods, fruits, vegetables, lean proteins, and healthy fats can reduce gut inflammation. Eliminating potential food sensitivities, such as gluten, dairy, soy, and artificial additives, can also help. For those sensitive to histamines, a low-histamine diet avoiding aged cheeses, fermented foods, and certain fish may be beneficial.

3. Nutritional Support:

Ensuring adequate intake of essential nutrients such as vitamin D, omega-3 fatty acids, zinc, and magnesium supports both immune function and brain health. These nutrients can be obtained through a balanced diet and, if necessary, supplements.

4. Herbal Medicine:

Herbs like ashwagandha, rhodiola, and holy basil are adaptogens that help modulate the immune response and support stress resilience. Anti-inflammatory herbs such as turmeric, ginger, and green tea can further reduce inflammation.

5. Functional Testing:

Microbiome analysis can provide essential insights into gut health and guide probiotic and dietary interventions. Additionally, testing for nutritional deficiencies can help direct supplementation to individual needs.

 Immune Support

Supporting the immune system is crucial in managing PANS and PANDAS, especially in preventing and mitigating the effects of infections that can trigger or exacerbate symptoms.

1. Antibiotic herbal medicine:

In PANDAS, addressing the underlying streptococcal infection with herbal medicine is critical. In PANS identifying and then treating the infection is required.  This if the first step in reducing the severity and duration of symptoms.

2. Anti-inflammatory herbal medicine and an anti-inflammatory diet:

Anti-inflammatory herbs and an anti-inflammatory diet are essential in the treatment of PANS and PANDAS. This can include herbal medicine such as turmeric, ginger, garlic, Boswellia, Cats claw, thyme and more.   

3. Immunomodulating herbal medicine and probiotics:

Immunomodulating herbs include echinacea, Andrographis, Reishi, Cordyceps, Baical Skullcap and more, these herbs can support the immune system as required.  Testing is important to assess the current immune status and choose the correct remedy.  

 Integrative Therapies

1. Osteopathy and Craniosacral Therapy:

These therapies can help alleviate physical stress and support overall well-being by improving the function of the nervous system and promoting relaxation.

2. Acupuncture:

Acupuncture may assist in balancing the body’s energy, reducing stress, and improving symptoms by promoting natural healing processes.

3. Stress Management:

Techniques such as mindfulness, yoga, and ensuring adequate sleep are crucial for supporting the immune system and reducing neuropsychiatric symptoms. Regular physical activity also helps maintain a healthy immune system and improves mood and cognitive function.

PANS and PANDAS present significant challenges, but understanding the role of gut health and immune support offers promising avenues for treatment. By addressing gut health through probiotics, dietary changes, and nutritional support, and supporting the immune system, we can help children not only manage symptoms but resolve the PANS and PANDAS.  My treatment is always concluded with an session on how to minimise the effect of future flare ups and what to do if this happens.  

If your child has been diagnosed with PANS or PANDAS or you suspect they may have this condition I encourage you to book a chat and discuss how we can support you.