Preventing PANDAS Relapse

Spring is here, and cold and flu season is coming to an end. Because of reduced exposure to viruses and Strep throat during the Spring and Summer, this is the time of year that my patients who are ready will wean off antibiotics or start a prophylactic antibiotic plan.


I have been speaking with several patients over the last week on how to prevent a PANDAS relapse:


  1. Minimize exposure risk (to Strep especially): This means having all family members swabbed for oropharyngeal Strep. Any Strep carriers should be treated with an antibiotic and probiotics and re-tested to confirm the Strep is gone. If your child is in school or extracurricular activities, make sure their teacher informs you of any Strep going around the class. Your child should stay home from school if there is an active case.


  1. Support the immune system: Your child will constantly be coming in contact with bacteria and viruses that the immune system has to fight off. There is no way around this, but supporting immune function can make the difference between staying healthy and getting every cold that goes around! Some options I commonly use include:
    • Vitamin D drops
    • Vita-Kids Immune Liquid (Douglas Labs)
    • Probiotics: GutPro, Probiotic 50B (Pure Encapsulations), Ultimate Flora Critical Care 50 billion
    • ImmuHerbs or M/R/S Formula (Pure Encapsulations) for those who can swallow capsules


  1. Regulate immune function: PANDAS has been compared to auto-immune conditions in that the immune system produces antibodies that attack a part of the body (in the case of PANDAS, the basal ganglia of the brain is affected). This type of response is not a normal immune reaction, and can be attributed to “Th2 skewing” of the immune system.  More on this here.


With Th2 skewing in PANDAS, the immune system produces an over-abundance of antibodies that adhere to the basal ganglia, resulting in brain inflammation. Th2 skewing also results in less effective Th1 functions of the immune system, which means the body is less capable in fighting off infections from viruses and bacteria making the child more prone to illness. To prevent a PANDAS relapse, modulating antibody production and supporting the child’s immunity towards viral and bacterial infections is of utmost importance. Here are some supplements I use to correct Th2 dominance:

  • Moducare plant sterols and sterolins (Thorne)
  • Wobenzym N
  • Larch Arabinogalactan powder or ImmuHerbs (Pure Encapsulations) which contains larch arabinogalactan


Please remember that every child is special and the unique combination of supplements to be used for their case should be decided on by their physician.

Dr Ayla Wilson
About the Author
Dr Ayla Wilson
Dr Ayla Wilson is a doctor of Naturopathic Medicine and the founder of High Five Family Health – which she opened in the fall of 2017 in Gastown (Vancouver, BC) after seven years in private practice in Edgemont Village (North Vancouver, BC).

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