PANS and PANDAS: Symptoms, Causes, and Holistic Treatment

PANS/PANDAS, affecting 1 in 200 (or 1-2%) of US children, is broadly characterized by sudden and often dramatic behavioral changes following an infection such as influenza, Lyme disease, or strep throat. Despite the prevalence, the knowledge of these conditions and their impact on children, their families, and the broader community remains misunderstood and undertreated.

As a naturopathic doctor, I often witness the limitations of the conventional medical system in addressing and healing the root causes of PANS and PANDAS. Helping kiddos and their families heal and thrive with these complex conditions requires a holistic, personalized, and comprehensive approach. 

What is PANS/PANDAS?

PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome, is commonly characterized by a sudden and dramatic onset of neuropsychiatric symptoms following an infection or event where the immune system gets triggered. Following the infection or immune system trigger, patients fairly quickly develop obsessive-compulsive disorder and/or severe eating restrictions. Other symptoms, such as anxiety, mood swings, behavioral regression, urinary disturbances, sleep issues, joint pain, and headaches, amongst many others, may develop. 

Although all of the causes of PANS are unknown, some infections implicated in the development of PANS include Lyme disease and associated co-infections, influenza, Epstein-Barr (EBV), Mycoplasma pneumoniae, and chicken pox. 

PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a subtype of PANS in which the trigger is a streptococcal infection, often strep throat. Despite the name, PANS can occur in people of all ages, while PANDAS usually begins before age 12.

Symptoms of PANS

PANS symptoms can vary widely from child to child but typically include:

• Core Symptoms:

• Obsessive-compulsive disorder (OCD)

• Severe eating restrictions

• Additional Neuropsychiatric Symptoms:

• Mood-related concerns like anxiety, irritability, aggression, depression

• Behavioral or developmental regression, such as tantrums, whining, and deterioration of motor skills

• Sensory sensitivities to light, noise, and touch

• Motor tics

• Urinary-related concerns like increased frequency, urgency, and bedwetting 

• Other concerns such as joint pain, sleep disturbances, headache, and fatigue

In most cases, symptoms appear suddenly and intensify quickly however, a small subset of people have symptoms that come on over time.  

The Impact of PANS/PANDAS

Undoubtedly, the development of PANS/PANDAS impacts a child’s life. It often touches every aspect of their life, from their daily routines and school performance to relationships with friends, family, and peers.

However, the often not talked about aspect is how PANS/PANDAS impacts the family unit and community as a whole. Families can feel a wide range of emotions, from stress and frustration to isolation and shame. Advocating or getting a diagnosis for your child or family member can often feel like a full-time job. 

When working with patients with PANS/PANDAS, I often find working with the whole family beneficial to allow every member to function optimally. 

The Pathway to Thriving with PANS/PANDAS

Every patient has unique challenges, strengths, and body systems that may need additional support. 

In general, the pathway to healing and thriving with PANS/PANDAS includes a combination of:

• Understanding the root causes and contributors to PANS/PANDAS symptoms

• Eliminating or reducing the infectious load

• Reducing neuro and generalized inflammation in the body

• Reorienting the immune system 

• Optimizing GI function 

• Restoring joy, fun, and optimal function of daily life

Many patients see the greatest benefit when working in combination with a licensed mental health professional who uses modalities like exposure response prevention (ERP) and acceptance commitment therapy (ACT).

How Naturopathic Medicine Can Help PANS/PANDAS

Naturopathic doctors like myself are uniquely qualified to help patients with PANS/PANDAS as we:

• Treat the whole person and not just the symptoms

• Understand the connection between mental health and physical health 

• Trained in conventional medicine and holistic modalities, including mental health counseling

• Addresses the root causes of PANS/PANDAS and not just masking symptoms 

• Extended visits. My new patient visits are 90-120 minutes, and follow-ups are 45- 60 minutes. Appointments are available outside of typical working hours as needed. Portal messaging 24/7

• Have many tools in our toolbox, including: 

• Botanical medicine

• Homeopathy

• Natural supplementation 

• Pharmaceuticals 

• Diet and lifestyle modifications

• Orthopedic manipulation

• Acupuncture & acupressure

• Gemstone therapy

• Good working relationships with other specialists and therapists 

Are you a parent, caregiver, or someone who is wondering whether you or your child has PANS/PANDAS? I’d love to work with you. 

Schedule a free 15-minute consultation here!

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This post is for informational purposes only and is not medical advice. Please speak to your physician before implementing any changes related to your health.