What Every Parent Should Know About PANDAS Syndrome

Nope, we’re not talking about cookware and cute black and white bears. PANS and PANDAS syndrome has gotten more attention in recent years. For children with PANDAS parents say it’s like a switch was flipped. All of the sudden their child becomes consumed by anxiety, OCD, tics and compulsions. 

This kind of abrupt transformation can be a sign of PANS or PANDAS. In these conditions the immune system and brain become tangled in ways that most parents (and even many doctors) don’t expect.

Though not widely recognized in conventional medicine, these conditions are increasingly being discussed by parents, functional practitioners, and researchers who see their profound effects. It’s estimated that at least every 1 in 200 children has PANDAS, but many cases are likely misdiagnosed as other disorders. 

What Are PANS and PANDAS?

PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. It describes a group of sudden-onset symptoms that appear in children after a strep infection. 

PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome, is broader. It refers to the same kind of abrupt symptoms, but triggered by other causes, such as viral or bacterial infections, environmental toxins, or disruptions in the immune system.

Both conditions involve a misdirected immune response. Instead of focusing solely on fighting the infection, the immune system mistakenly affects the brain, especially areas that regulate behavior and mood. Because children’s brains and immune systems are still developing, they are more vulnerable to this kind of misfire.

Causes and Triggers

For PANDAS, the trigger is usually a strep infection. For PANS, it might be another infection such as Lyme disease, Epstein-Barr virus, or even something environmental like mold exposure. In both cases, the root issue is an immune system under stress. The majority of PANDAS families also report a history of family autoimmune disease.

When the immune system is overwhelmed or misdirected, it can spark inflammation that affects the brain. The result is not a gradual shift in personality, but an abrupt and dramatic change. Parents often describe it as their child becoming a completely different person in a matter of days or even hours.

Recognizing the Symptoms

The hallmark of PANS and PANDAS is sudden onset. A child who was calm and focused one week may suddenly develop obsessions, compulsions, or extreme separation anxiety the next. Other symptoms can include irritability, aggression, motor tics, sleep disturbances, food restrictions, or a sharp decline in school performance.

Because these behaviors overlap with conditions like ADHD, OCD, or autism spectrum disorders, children are often misdiagnosed. Many families report years of frustration as they are told the issues are purely psychological or behavioral. In reality though, the symptoms are being driven by brain inflammation.

Understanding that these behaviors can be immune-driven can be very helpful for parents. It opens the door to different kinds of testing and treatment that address the root cause instead of just managing the outward behaviors.

Can Symptoms Be Prevented or Improved?

The good news is that children can improve, and many do. Early recognition and intervention can make a big difference, but even children who have struggled for years often see relief once the root causes are uncovered.

These conditions highlight the deep connection between the immune system and the brain. By calming inflammation, supporting the body’s healing pathways, and giving the nervous system time to reset, symptoms can improve. 

Testing for PANS and PANDAS

One of the most frustrating parts of these conditions is that there’s no single definitive test. Instead, diagnosis usually involves a combination of lab work, medical history, and symptom tracking.

Common Lab Tests for PANDAS

• Throat culture or rapid strep test: To check for a current or recent strep infection.
• ASO (antistreptolysin O) and anti-DNase B titers: These blood tests measure antibodies to strep and can indicate if the body is reacting strongly to it.
• Cunningham Panel: A specialized test that looks at antibodies associated with autoimmune neuropsychiatric disorders.
• Inflammatory markers: Tests like CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate) can show systemic inflammation.
• Other infection panels: Depending on the child’s history, a practitioner may test for Lyme, Epstein-Barr virus, mycoplasma, or mold exposure.

Functional medicine testing helps identify nutrient deficiencies, gut imbalances, or toxin exposures. Since the gut and immune system are so closely linked, uncovering food sensitivities or digestive imbalances can shed light on what’s driving inflammation.

The Role of Observation

Parents are often the best historians. Writing down when symptoms started, what infections the child had recently, and any environmental changes can help practitioners connect the dots. Keeping a simple log of sleep, diet, mood changes, and flare-ups can be invaluable in shaping a care plan.

Natural and Holistic Ways to Support PANDAS

While medical testing and professional guidance are important, there’s  a lot families can do at home. Small, steady changes can calm the immune system and help the body heal. 

Nutrition for Calming Inflammation

Food is one of the most powerful tools we parents have. An anti-inflammatory approach often makes a noticeable difference. This doesn’t have to mean a highly restrictive diet, but focusing on whole, nutrient-dense foods helps reduce the burden on the immune system.

• Prioritize healthy fats like avocados, olive oil, and wild-caught fish
• Include plenty of colorful vegetables, which provide antioxidants that calm inflammation
• Aim for protein at every meal to stabilize blood sugar and support neurotransmitters
• Skip the processed foods, added sugars, unhealthy fats, and artificial dyes, which can all increase inflammation

For some children, addressing food sensitivities, such as gluten or dairy, is key. Some children see improvements after doing an elimination diet so these can also be a helpful tool. 

Supporting the Nervous System

PANS and PANDAS flare-ups often leave children stuck in fight-or-flight mode. Simple practices that regulate the nervous system can be very helpful.

• Gentle breathing exercises, with slow, deep breaths
• Short guided meditations or calming bedtime stories
• Sensory tools such as weighted blankets, swings, or soothing music
• Time in nature for vitamin D and lower stress hormones. Even better if they play in the dirt!

Even ten minutes a day of intentional relaxation can help shift the nervous system out of constant alarm.

Sleep and Rhythm

Consistent routines matter. A predictable bedtime, avoiding blue light at night, and calming rituals like warm baths or reading can help the body reset. Sleep is when our brain clears inflammation, so prioritizing it is foundational.

Supplements to Consider

We’re all individuals so it’s best to tailor any supplements to your child’s individual needs. That said, these ones are commonly recommended for PANDAS. 

All the supplements in the world won’t fix a bad diet, so it’s important to pair them with healthy, whole foods. 

Reducing Environmental Triggers

Many children with PANS and PANDAS are sensitive to toxins in their environment. Simple steps can help reduce exposure:

• Use air filters to reduce mold, pollen, and chemical exposure indoors
• Test the home for mold or other toxins and remediate as needed
• Choose clean personal care and cleaning products
• Stay hydrated with plenty of filtered water
• Spend more time outside in fresh air and natural light

By reducing the body’s overall burden, this allows the immune system to focus on healing instead of always playing defense.

Getting to the Root Cause

Healing from PANS or PANDAS isn’t about finding a quick fix. It’s about peeling back layers to see what’s fueling the immune system’s reaction. For some families, that means addressing hidden strep infections. For others, it’s uncovering mold exposure in the home or resolving gut imbalances.

The process often looks like this:

1. Test and identify potential triggers
2. Support detox and digestive health with food and hydration
3. Calm the nervous system daily with small, consistent practices
4. Fill in nutrient gaps through food and thoughtful supplementation
5. Reduce environmental stressors at home.

It’s not about doing everything at once, but taking manageable steps that steadily build resilience. Parents who have walked this path often say the slow, steady approach not only improved symptoms but also made their child stronger overall.

Final Thoughts on PANDAS Syndrome

PANS and PANDAS may sound intimidating, but understanding them can change everything for a struggling child. Mental health and physical health are deeply connected and we can’t address one without the other. A sudden change in behavior or mood can be signs of immune dysregulation and brain inflammation.

As more people become aware of PANDAS and its effect on children, more functional practitioners are stepping up to help. And thankfully, while healing may take time, many children return to themselves once the root causes are addressed. The key is supporting their body by calming inflammation and finding the root cause behind their symptoms.

Has your child ever struggled with PANDAS? What strategies have you found to be helpful? Leave a comment and share below!