Supporting Children with PANS or PANDAS: Nutrition, Testing & Lifestyle Tips

It can be alarming for parents when their child’s behaviour changes overnight. One day your child is thriving; the next, they’re overwhelmed with anxiety, showing obsessive behaviours, experiencing tics, or refusing food. For many families, these sudden shifts are not behavioural but biological—triggered by an immune response to infection. Conditions like PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and PANS (Paediatric Acute-onset Neuropsychiatric Syndrome) are now recognised as underlying causes in many such cases.

These conditions are complex, often misunderstood, and frequently misdiagnosed. But with the right support—including targeted nutrition and functional testing—many children can improve significantly.

WhatAre PANS AND PANDAS?

PANDAS occurs when the immune system reacts to a streptococcal infection (like strep throat) and mistakenly attacks healthy brain tissue, particularly in areas linked to mood, movement, and behaviour. PANS is similar but can be triggered by other infections (such as viruses, Lyme disease, or even mould exposure) or environmental factors.

Symptoms often develop suddenly and may include:

* Severe anxiety or panic

* OCD-like thoughts or rituals

* Vocal or motor tics

* Food refusal or restriction

* Irritability or aggression

* Bedwetting or frequent urination

* Sleep disruption

* Regression in academic or developmental milestones

These changes can be dramatic, leaving families feeling frightened and helpless—especially when conventional medical tests come back normal.

What Is a Flare?

Children with PANDAS or PANS often improve with treatment, but many experience relapses known as "flares." These are sudden reappearances or intensifications of symptoms, often triggered by a new infection—especially in school or nursery settings where viruses and bacteria circulate freely.

Even after initial improvement, the child’s immune system may still be in a heightened inflammatory state. This means they remain vulnerable to future exposures unless the underlying immune issues are addressed.

Inflammation

Chronic inflammation is a key player in PANS and PANDAS, and it doesn’t just come from infections. Factors like poor diet, nutrient deficiencies, environmental toxins, gut issues, and even stress can exacerbate issues.

Understanding these contributors is essential to calming the immune system and reducing the risk of future flares.

Nutrients That Help Regulate Inflammation and Immunity

Supporting your child’s nutritional status can go a long way in modulating the immune system and protecting the brain. Minerals including magnesium and zinc are often key, as is sufficient stomach acid.

Lifestyle Strategies to Support Recovery

In addition to nutrition, there are lifestyle changes that can help stabilise your child’s immune system:

• Prioritise sleep: Rest is essential for immune repair and brain detoxification.

• Stay hydrated: Even mild dehydration can exacerbate inflammation.

• Encourage outdoor time:Fresh air and natural light help regulate circadian rhythms and boost vitamin D.

• Reduce screen time: Excessive screens can overstimulate a sensitive nervous system.

• Minimise processed foods: Many additives, preservatives, and sugars can fuel inflammation.

Going Beyond Blood Tests

At Pebble our approach is always 'testing, not guessing' and we always recommend functional testing to uncover hidden imbalances. Two of the most valuable tools are Hair Tissue Mineral Analysis (HTMA) and Organic Acid Testing (OAT).

Hair Tissue Mineral Analysis (HTMA)

HTMA is a non-invasive test that analyses mineral levels and heavy metals in the body over a period of several months. It provides insight into long-term patterns of nutritional status and stress.

Benefits of HTMA include:

• Identifying key nutrient deficiencies (like zinc, magnesium, calcium, potassium)

• Highlighting mineral imbalances that affect mood, focus, and energy

• Detecting heavy metal toxicity (such as mercury or lead), which may impair brain function

• Assessing adrenal and thyroid stress patterns that could contribute to behavioural issues

HTMA helps tailor supplement and dietary strategies for your child’s unique needs, making interventions more effective.

Organic Acid Testing (OAT)

OAT provides a detailed snapshot of your child’s metabolic health. By analysing compounds excreted in urine, it can identify nutritional deficiencies, oxidative stress, yeast or bacterial overgrowth, and problems with detoxification and neurotransmitter metabolism.

Benefits of OAT include:

• Detecting imbalances in gut flora (which may trigger or worsen symptoms)

• Assessing levels of neurotransmitter precursors linked to mood and focus

• Revealing B-vitamin deficiencies that impact nervous system health

• Highlighting mitochondrial function and energy production issues

A Personalised, Child-Centred Approach

Every child with PANS or PANDAS presents differently, and there is no one-size-fits-all solution. That’s why we test first and take a gentle, individualised approach that considers your child’s symptoms, history, environment, and emotional well-being—not just their diagnosis.

In Summary

By supporting the body’s natural defences, calming inflammation, and using functional testing to personalise care, it is possible to reduce symptom severity, prevent frequent flares, and help your child thrive.

If you'd like to learn more about how we support children with PANS and PANDAS email charlotte@pebblenutition.co.uk or visit www.pebblenutrition.co.uk

A little about me: I'm Charlotte, a registered nutritionist with a background in secondary education, an MA in Learning and Teaching, and a distinction in Nutritional Therapy. I'm a certified HTMA Practitioner and have undertaken further CPD training in Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Autism Awareness.