What is PANDAS, What causes it? What do conventional and alternative approaches look like? The causes can differ per person. Find out what those possible health causes are...

1. RETHINKING TREATMENT OF
PANDAS
By Dr. Alex Rinehart, DC, MS, CNS
https://www.DrAlexRinehart.com

2. PANDAS - Pediatric Autoimmune
Neuropsychiatric Disorders
Associated with Streptococcal
Infections
 PANDAS is when neurological symptoms
present following acute or
persistent Streptococcus infection.
 Microorganisms such as Streptococcus sp. have
the potential to cause and worsen
behavioral/neurological conditions. One variant
is PANDAS.
 Current medical diagnosis often limited to OCD
or other specific behavioral/neurological
presentations - Immune/Post-infectious
component can be overlooked.

3. • Autoimmune in nature – a process known as Molecular Mimicry.
Molecular Mimicry - antibodies targeting bacteria, toxins, & food proteins
mistake parts of healthy tissue as the enemy. Healthy tissue can “mimic” an
invader on a microscopic level.
 Immune Overactivation can happen with acute & chronic
infections (food rxn, heavy metals, etc). Become “trigger-happy”
• Functional Health: Infection affects individuals differentially
(adrenals, food allergies/sensitivities, immune balance, gut health,
coinfections, breastfeeding history, Vitamin D levels etc.)
Streptococcal infection + Molecular Mimicry + Immune
Overactivation + Health Susceptibilities higher PANDAS probability
What is the Underlying Mechanism of
PANDAS?

4. • Function can be measured on a spectrum of what’s “healthy” and
“normal” in anyone.
• Foundational health issues (stress, gut function, immune triggers,
etc.) - many overlapping symptoms improve when these foundational
factors are addressed.
• The cause(s) of immune overactivation will differ person-to-person –
no “silver bullet” approach
• Functional medicine is a bridge between alternative & conventional
medicine; it is not always a full substitute for conventional care.
How Does a Functional Approach Work?

5. Connecting an Underlying
CAUSE
 Molecular mimicry is not limited to
PANDAS
 Sydenham’s chorea (a movement disorder) is also known to
present following acute infection with Streptococcus.
 Rheumatic fever occurs when GABHS antibodies cross-react
with multiple tissues such as the heart, joints, and skin.
 Lyme disease may also present with various neurological
presentations –due to activity of the spirochete and the
numerous co-infections.
 In PANDAS, symptoms are diverse, making it hard to
diagnose.
 A functional healthcare lens is necessary to
address the array of causes
 A common theme is Immune Overactivation
affecting the nervous system

6. • Conventional treatment for PANDAS may include penicillin treatment,
immunoglobulin therapy, plasmapheresis as well as tonsillectomy.
• While conventional approaches may be limited, alternative approaches
may offer some clues to what’s missing in care.
• Gut function, bacteria and yeast influence neurological health. When you improve
digestion and gut flora, you have a functional effect on immune & nervous system
health.
• Symptoms may present in the nervous system; the functional cause
may be outside of the nervous system.
Conventional Treatment of PANDAS

7. Alternative Approach to
PANDAS
 Acute and Chronic Infections (Virus, Bacteria,
Yeast)
 Allergies/Sensitivities (Food, Chemicals,
Environmental toxins, Household products)
 Chronic Stress (Cortisol, DHEA, and others)
 Leaky gut/dysbiosis (Creates general
environment for hypersensitivity reactions)
 Exposure to heavy metals and toxins (Can
trigger autoimmune presentations)
 Poor Detoxification/Liver and Kidney
Clearance (methylation, liver function,
hormones)

8. Get nutrition tips from Dr. Alexander Rinehart
DR. ALEXANDER
RINEHART, DC, CNS
Owner, DrAlexRinehart.com
• See original article (with references):
Rethinking Treatment of PANDAS
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