Understanding the Link Between PANS/PANDAS and the Microbiome in Integrative Medicine

In the realm of integrative medicine, understanding complex health conditions often involves looking at the body as an interconnected system. One such area of growing research is the relationship between Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). These conditions, which mainly affect children, are characterized by sudden and severe onset of neurological symptoms like compulsions, outbursts, or a sudden, drastic change in behavior.

Parallel to this, the human microbiome—comprising trillions of microorganisms residing primarily in the gut—has gained recognition for its profound impact on overall health. Recent studies are beginning to unravel the intricate connections between the microbiome and various health conditions, including PANS/PANDAS.

Learn more about our approach to PANS & PANDAS.

Understanding PANS/PANDAS

PANS and PANDAS are both autoimmune conditions that manifest with abrupt and intense neuropsychiatric symptoms. These can include obsessive-compulsive behaviors, severe anxiety, tics, and mood swings. The hallmark of PANDAS is its association with streptococcal infections, whereas PANS can be triggered by other infections, environmental factors, or metabolic disturbances.

Symptoms and Diagnosis

Diagnosing PANS/PANDAS can be challenging due to the sudden onset and wide range of symptoms. Common indicators include:

  • Sudden onset of obsessive-compulsive symptoms or eating restrictions.
  • Severe separation anxiety or generalized anxiety.
  • Emotional lability and mood changes.
  • Motor or vocal tics.
  • Behavioral regression, including temper tantrums and irritability.
  • Sensory or motor abnormalities.

The impact of these disorders on children and their families can be profound, often leading to significant disruptions in daily life and emotional well-being.

Related: Signs & Symptoms of Anxiety in Children

The Microbiome: A Key Player in Integrative Medicine

The human microbiome consists of diverse microbial communities that play crucial roles in digestion, immunity, and even mental health (1,2). It is increasingly clear that a balanced microbiome is foundational to overall health, influencing everything from inflammation to brain function.

The Microbiome & PANS/PANDAS

Emerging research suggests that the gut-brain axis—a bidirectional communication pathway between the gut and the brain—may be a key player in PANS/PANDAS (3).

Dysbiosis, or an imbalance in the gut microbiome, has been linked to increased permeability of the gut lining ("leaky gut"), which can trigger autoimmune responses and inflammation (4). This, in turn, may exacerbate or even initiate the neuropsychiatric symptoms seen in PANS/PANDAS.

Streptococcal infections have also been found to change the amount and type of gut bacteria associated with gut inflammation and immune response activation (5). This change in gut bacteria also impacts key neural pathways involving short-chain fatty acids and dopamine, a key mood regulator.

Read: PANS & PANDAS Cases Rising—Here’s Why & How to Recognize the Signs

Learn about becoming a new patient

Could A Child’s Microbiome Make Them More Susceptible to PANS?

For parents and caregivers of children with PANS/PANDAS, a common question is why some children develop these conditions while others do not. While the exact cause is still unknown, research suggests that certain genetic factors may increase susceptibility to autoimmune reactions triggered by infections or other stressors.

Additionally, environmental factors such as diet, exposure to toxins, and the use of antibiotics can play a role in disrupting the delicate balance of the microbiome and potentially contribute to the development of PANS/PANDAS. (6)

Integrative Treatments for PANS/PANDAS

Traditional treatments for PANS/PANDAS often include antibiotics, anti-inflammatory medications, and immunomodulatory therapies. However, integrative medicine offers additional tools by addressing the root causes and supporting the body’s natural healing processes.

Addressing Microbiome Imbalances in PANS/PANDAS Treatment

Integrative medicine approaches to treating PANS/PANDAS often focus on addressing the root cause of the conditions, including any underlying microbiome imbalances. This may involve interventions such as:

  • Probiotics and Prebiotics: Supplementing with beneficial bacteria and prebiotic fibers to restore microbial balance.
  • Dietary Interventions: Implementing anti-inflammatory diets rich in whole foods, low in processed sugars and refined carbohydrates, which can help nourish a healthy microbiome.
  • Anti-Inflammatory Supplements: Nutritional supplements like omega-3 fatty acids and vitamin D have been shown to have anti-inflammatory effects and may help in managing symptoms (7).
  • Fermented Foods: Incorporating naturally fermented foods like yogurt, kefir, sauerkraut, and kimchi to enhance microbial diversity.
  • Herbal Supplements: Using herbs like garlic, oregano, and ginger known for their antimicrobial and anti-inflammatory properties.
  • Targeted antimicrobial therapy: For infections or dysbiosis contributing to PANS/PANDAS, targeted antimicrobial therapy may be prescribed to help restore balance in the microbiome.

Related: 9 Popular Integrative Therapies for Children

Nurturing a Healthy Microbiome

Maintaining a healthy microbiome is not just key for managing PANS/PANDAS but is beneficial for overall well-being. Here are some additional strategies:

  • Regular Exercise: Physical activity supports gut health by promoting microbial diversity.
  • Stress Management: Chronic stress negatively impacts gut health. For kids, ensuring adequate down-time, freedom to play & express themselves, and promoting a stable home environment can help keep stress to a minimum. 
  • Adequate Sleep: Quality sleep is vital for maintaining a balanced microbiome and overall health.
  • Limit Antibiotic Use: Speak with a provider about how to avoid unnecessary disruption to the microbiome.

Read: The Crisis of Declining Mental Health in Teens & Young Adults

The Future of PANS/PANDAS Research and Treatment

The field of PANS/PANDAS and microbiome research is still growing, but holds great promise for more support and relief for parents and our young patients. Future directions include:

  • Microbiome Profiling: Developing more advanced techniques to understand individual microbiome compositions and tailored interventions.
  • Personalized Medicine: Integrating genetic, microbiome, and environmental data to create bespoke treatment plans.
  • Holistic Approaches: Emphasizing the importance of treating the whole person, considering physical, emotional, and environmental factors.

Schedule a 15-minute consultation now with a patient care coordinator>>

Key Takeaways

The link between PANS/PANDAS and the microbiome underscores the importance of integrative approaches in medicine. These conditions highlight how interconnected our bodily systems are, and how addressing one aspect—like gut health—can profoundly influence others, such as brain function and immunity.

For parents, understanding these connections opens up new avenues for treatment and management, offering hope and strategies for better health outcomes. As research continues to evolve, the integration of microbiome science into the treatment of PANS/PANDAS promises to enhance our ability to support those affected by these challenging conditions.

Engage in the conversation by sharing your thoughts or experiences with PANS/PANDAS and microbiome health over on our Facebook or Instagram page.


Holistic Medicine, PANDAS, PANS, pediatrics

Ready to Get Started?

Shop The Blog

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any diseases.
Why Choose to Autoship?
  • Automatically re-order your favorite products on your schedule.
  • Easily change the products or shipping date for your upcoming Scheduled Orders.
  • Pause or cancel any time.