Rooted Health
Dr. Matt Altman
Your child was fine. Then suddenly—overnight or within days—they're not.
Maybe they developed severe OCD (hand-washing, checking locks obsessively, contamination fears). Or debilitating anxiety. Tics. Rage episodes. Refusal to eat. Separation anxiety. Handwriting that suddenly looks like a kindergartener's. Sleep disruption. Bedwetting that came out of nowhere.
Pediatricians say "it's behavioral" or "it's anxiety—try therapy." Psychiatrists prescribe SSRIs. Nothing helps. You feel like you're losing your child.
Here's what most doctors miss: PANS/PANDAS is not a psychiatric disorder. It's an autoimmune/neuroimmune condition triggered by infection.
At Rooted Health Clinic, we specialize in PANS/PANDAS using functional medicine and integrative approaches. We start anti-inflammatory and immune-modulating treatment immediately while testing for the triggering infection.
This is complex medicine. But we've seen kids recover—from completely non-functional to back at school, thriving. It takes time, but recovery is possible.
WHAT IS PANS/PANDAS?
PANDAS = Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. Triggered specifically by strep throat (Group A Strep).
PANS = Pediatric Acute-onset Neuropsychiatric Syndrome. Same symptoms, but triggered by infections other than strep (mycoplasma, Lyme, Epstein-Barr, influenza, mold, etc.) or by non-infectious immune triggers.
What happens: An infection triggers an immune response. Antibodies mistakenly attack the basal ganglia (the part of the brain that controls movement, behavior, and emotions). Result: sudden, severe neuropsychiatric symptoms.
Key characteristics:
• Sudden onset — symptoms appear overnight or within 24-72 hours
• Dramatic change — your child is not themselves
• Multiple symptoms at once — usually a cluster
• Often triggered by illness — recent strep, ear infection, cold, flu, or stealth infection
SYMPTOMS
Primary symptom (always present):
• Sudden, severe OCD — intrusive thoughts, compulsions (hand-washing, checking, counting, contamination fears)
Plus at least two of:
• Severe anxiety (separation anxiety, generalized anxiety, panic attacks)
• Rage episodes, aggression, irritability
• Emotional instability (laughing then crying within minutes)
• Regression (baby talk, clinginess)
• Brain fog, difficulty concentrating, memory problems
• Decline in school performance, handwriting deterioration
• Tics (motor or vocal), jerky movements
• Sensory issues (sounds, textures, lights suddenly intolerable)
• Sleep disturbances, nightmares, night terrors
• Urinary frequency, bedwetting (if previously toilet-trained)
• Food restriction, fear of eating, sudden pickiness
• Dilated pupils, dark circles under eyes
OUR APPROACH: TREAT INFLAMMATION & INFECTION TOGETHER
Step 1: Start Anti-Inflammatory & Immune-Modulating Treatment Immediately
Reduce Brain Inflammation:
• Omega-3 fatty acids (high-dose fish oil, 2-4g/day)
• Curcumin (potent anti-inflammatory)
• Vitamin D (immune modulation, often deficient)
• Probiotics (gut-brain-immune connection)
Low-Dose Naltrexone (LDN): Modulates the immune system, reduces neuroinflammation. Starting dose 0.5-1mg, increase gradually. Well-tolerated, safe for children.
Gut Healing — Critical for Immune Function:
70% of the immune system lives in the gut. We start immediately with:
• Elimination diet (remove gluten, dairy, sugar)
• Probiotics + prebiotics
• Gut-healing nutrients (L-glutamine, zinc, collagen)
• Anti-inflammatory foods
Many parents see behavioral improvement within 1-2 weeks just from removing inflammatory foods.
Steroids (If Severe): Short course of oral steroids for severe, acute flares.
IVIG: Reserved for severe cases. Expensive, insurance rarely covers it, but can be life-changing.
Antimicrobials: Antimicrobial supplements and potentially starting antibiotics if recent strep or ongoing infection suspected.
Step 2: Test for Triggering Infections (Concurrent with Treatment)
Streptococcus: ASO titer, anti-DNase B, throat culture
Mycoplasma pneumoniae: IgG/IgM antibodies
Lyme & Co-infections: Western blot, Bartonella, Babesia
Viral: EBV, HHV-6, CMV, Coxsackie
Mold: Urine mycotoxin panel
Inflammatory markers: CRP, ESR, ANA
Immune function: Immunoglobulins, Vitamin D, zinc, magnesium
We don't wait for results to start anti-inflammatory protocols.
Step 3: Long-Term Management & Prevention
• In severe cases, prophylactic antibiotics (azithromycin or amoxicillin) to prevent flares
• Gut maintenance: probiotics, anti-inflammatory diet
• Immune support: daily vitamin D, zinc, omega-3s
• Monitor for flares — teach parents to recognize early signs
• CBT/ERP therapy for OCD, family therapy for support
FAQ
How quickly will my child improve? Some 1-2 weeks, others 2-3 months. Severe cases 6-12 months. Every child is different.
Does my child need IVIG? Not always. Many respond to antibiotics, LDN, and anti-inflammatory protocols. IVIG for severe/non-responsive cases.
Will my child need antibiotics forever? Some need 6-12+ months prophylactic. Others can stop once infections clear. Personalized based on response.
Can PANS/PANDAS be cured? Some kids fully recover. Others have periodic flares but recover quickly with treatment. Long-term gut/immune support reduces risk.
What if testing comes back negative? Doesn't rule it out. Infections can be stealth. We treat based on clinical presentation, not just labs.
Can you treat my child remotely? Yes — telemedicine for Texas residents.