PANS/PANDAS

Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) are conditions in which a child experiences a sudden, dramatic onset of obsessive-compulsive symptoms, tics, anxiety, emotional lability, behavioral regression, and sometimes severe food restriction — often overnight. Unlike gradual-onset psychiatric conditions, PANS/PANDAS strikes like a switch flipping: a child who was typically developing one day is suddenly consumed by OCD, rage, separation anxiety, urinary frequency, handwriting deterioration, and cognitive fog the next.

The conventional psychiatric model treats these symptoms as behavioral or developmental disorders — prescribing SSRIs, antipsychotics, and cognitive behavioral therapy. But as Dr. Jaban Moore, a functional medicine practitioner who has become a leading voice in PANS/PANDAS, explains, these children are not mentally ill in the traditional sense. Their brains are on fire. The behavioral symptoms are a reflection of neuroinflammation and immune dysregulation, not a primary psychiatric disorder. Treating the symptoms with psychiatric medications without addressing the immune and infectious drivers is like mopping up water while the faucet is still running.

Dr. Moore's clinical approach, along with that of Dr. Charlie (Dr. Charles Crotteau), emphasizes that PANS/PANDAS is fundamentally an immune-mediated condition triggered by infections and environmental factors. The streptococcal antibody cross-reacting with brain tissue (basal ganglia) is the classic PANDAS mechanism — the immune system produces antibodies against strep that mistakenly attack the basal ganglia, the part of the brain that controls movement, behavior, and impulse regulation. But PANS, the broader category, can be triggered by a wide range of infections and insults: strep, mycoplasma, Lyme and co-infections, Epstein-Barr, COVID-19, mold exposure, and even vaccine reactions. The common denominator is that an immune trigger causes the blood-brain barrier to become permeable, allowing antibodies, cytokines, and inflammatory mediators to flood the brain and drive neuropsychiatric symptoms.

Diet plays a profound role. The Standard American Diet — high in refined sugars, processed seed oils, artificial dyes, preservatives, and GMO-laden ingredients — directly fuels the systemic inflammation that makes a child's immune system hyper-reactive. Food sensitivities, particularly to gluten and dairy, can drive neuroinflammation through cross-reactivity and gut-brain axis disruption. A child eating a diet full of inflammatory foods is far more susceptible to immune dysregulation when a trigger infection arrives. Dr. Moore and Dr. Charlie both emphasize cleaning up the diet as a foundational step — removing inflammatory foods, supporting the gut with nutrient-dense whole foods, and identifying and eliminating food sensitivities that keep the immune system on high alert.

The vaccine conversation is one that mainstream medicine has largely shut down, but functional practitioners working with PANS/PANDAS children see the patterns clearly. Vaccines are designed to stimulate the immune system — that is their purpose. But in a child whose immune system is already primed, whose gut is compromised, whose detoxification pathways are genetically limited, and whose blood-brain barrier is permeable, a vaccine can be the trigger that tips the immune system into autoimmunity. The aluminum adjuvants used in many childhood vaccines are neurotoxic and can cross the blood-brain barrier, particularly in children with impaired detoxification genetics (MTHFR, GST). Many parents report that their child's PANS/PANDAS symptoms began shortly after a round of vaccinations. This does not mean vaccines are the sole cause — but they are one of many potential immune triggers, and to dismiss the connection entirely is to ignore the clinical reality that practitioners on the ground see every day.

GMOs and the glyphosate sprayed on them add another layer. Glyphosate, the herbicide used on most GMO crops, has been shown to disrupt the gut microbiome, chelate essential minerals, and impair detoxification enzymes (cytochrome P450). A child whose gut microbiome is disrupted by glyphosate has a compromised gut-brain axis, impaired immune regulation, and reduced ability to clear toxins. Jeffrey Smith, a leading researcher and author on GMOs, has documented extensive evidence of how GMOs and glyphosate affect neurological and immune function — and children, with their developing nervous systems and higher exposure per body weight, are the most vulnerable. The connection between GMOs, gut disruption, immune dysregulation, and neuroinflammation is a thread that runs through PANS/PANDAS, autism, and many other neuroimmune conditions.

The functional approach to PANS/PANDAS is multi-targeted. First, identify and treat the triggering infection — whether it is strep, Lyme, mycoplasma, a reactivated virus, or a combination. Second, reduce the total inflammatory burden: clean up the diet, remove food sensitivities, address mold and environmental toxins, and support the gut. Third, modulate the immune system — using anti-inflammatory nutrients (omega-3s, curcumin, vitamin D), immune-modulating herbs, and in some cases Low Dose Naltrexone (LDN). Fourth, support the nervous system and the blood-brain barrier. Fifth, support detoxification — gently, according to the child's genetics. Antibiotics and IVIG are sometimes necessary in acute flares, but they are not the whole answer. The goal is to calm the immune system, heal the gut, remove the triggers, and allow the child's brain to recover.

PANS/PANDAS is not a psychiatric life sentence. These children can recover. The brain is remarkably plastic, especially in children, and when the immune triggers are removed and the inflammation is calmed, the neuropsychiatric symptoms often resolve. But it requires practitioners who understand the immune, infectious, and environmental drivers — not just psychiatrists who prescribe medications. You can find those practitioners here.