Living with PANS/PANDAS can be a living nightmare for children and their families. The sudden OCD, anxiety, rage, aggression, sleep disturbances, and food refusal can put any family in crisis. I know plenty of parents of children with PANS/PANDAS have PTSD.
Lessening these symptoms is critical not only for improving daily life but also for putting the body in a place where it can focus on healing, not just surviving.
Herbal remedies can offer a gentle alternative to pharmaceuticals that can help stabilize and manage symptoms. Herbs like Albizia, Ashwagandha, and Brahmi have been used for centuries to calm the central nervous system and relax the body.
There are some children who will not find an herb sufficient enough for their condition. I think a lot of times this is more true for children who went undiagnosed and untreated for years (my son being one of them). Once their bodies heal more, the severity of the symptoms will reduce and then it’s more likely that herbs will be sufficient, but they can still be taken at the same time as pharmaceuticals to allow the herbs time to build in the system.
Some herbs, like Ashwagandha, are building herbs, meaning the longer you take them the more effective they are. Also, the dosage needs to be high enough to be effective. You should always start with a low dose of a new herb, but if there is no reaction at the low dose you can quickly build to a higher dose. In my opinion, most children will need the adult dosage of nervines and adaptogens. The siblings of PANS/PANDAS children suffer through the illness as well, and many could benefit from an herb in this category.
[Common dosages for adults are below. Dosages can vary greatly for each individual, especially those herbs that have a tendency to cause a problem for some children. One child may react to 5 drops of an herb and another child can take an adult dose. Do your research and discuss with your medical practitioner]
My favorites are
Albizia for its mood stabilizing + antihistamine properties.
Gotu Kola for its calming, peaceful affects.
Blue Vervain for the Type A personality types.
Ashwaganda for its adaptogenic + anti-inflammatory effects.
Pine Bark for its anti-inflammatory + cognitive performance enhancing properties.
Albizia (Albizia julibrissin)
Properties: Known for mood stabilization, anti-inflammatory, antihistamine effects, antioxidant.
Uses: Albizia acts as a calming agent, especially beneficial for managing anxiety, irritability, and sleep disturbances. It provides an uplifting calm; Albizia is known as the “happiness bark.” Its antihistamine effect can also help when histamine reactivity contributes to neuroinflammation, which often worsens behavioral symptoms. It’s a mild sedative, so it’s best used at night until you known how your body respond to the herb.
Dosage: 1ml to 5ml or 500mg, one to three times daily.
Notes: Gentle yet effective, Albizia is suitable for ongoing long-term use and works well in combination with other herbs like Gotu Kola. This herb is one you may have to use at higher doses to get the full effect.
Gotu Kola (Centella asiatica)
Properties: Nervine tonic, promotes relaxation without sedation, antioxidant.
Uses: Gotu Kola has long been revered for its ability to promote mental clarity and a calm, balanced state. Known as the “herb of enlightenment,” it gently supports cognitive function and reduces mild anxiety, providing a centered sense of focus. This makes it particularly beneficial for children with PANS/PANDAS who experience obsessive thoughts, mental agitation, or difficulty concentrating. Gotu Kola easily crosses the blood-brain barrier, working as a tonic for the brain and engaging the parasympathetic nervous system to ease the body into a relaxed state, reducing excessive worry. Additionally, it supports emotional resilience, allowing children to manage stress more effectively.
Dosage: 2ml to 5ml or 200 to 400mg, two to three times daily.
Notes: Gotu Kola is also helpful when taken before meals, as it can reduce the amount of endotoxins that reach the brain, offering an additional layer of protection and reducing inflammation. Its mild taste and versatility make it easy to incorporate into a daily routine for long-term benefits.
Blue Vervain (Verbena hastata)
Properties: Nervine, relaxing for muscular and mental tension.
Uses: Blue Vervain is particularly valued for its ability to release deeply held tension, both physical and emotional. Often recommended for individuals who tend to hold stress in their bodies, this herb is ideal for those with “Type A” personalities—children and adults alike who are prone to anxiety, self-criticism, and perfectionism. It helps ease physical manifestations of stress, such as tight muscles and tension headaches, especially those that begin in the back of the head or neck. By promoting relaxation without sedation, Blue Vervain helps the mind and body unwind, making it easier to let go of built-up tension and find calm. It is helpful for spasmodic nervous disorders, including tics. And, can be helpful for people who are prone to anger.
Dosage: 1 to 5 ml, three to four times daily.
Notes: Blue Vervain has a naturally bitter taste, so it’s best introduced slowly to allow for adjustment. Its bitterness is part of its therapeutic profile, supporting digestion and the nervous system, but mixing it with other herbs or sweetening agents can help make it more palatable if needed
Ashwagandha (Withania somnifera)
Properties: Adaptogen, anti-inflammatory, and calming agent.
Uses: Ashwagandha is a well-regarded “building” herb, known for its ability to provide sustained stress relief and support a balanced nervous system. As an adaptogen, it helps the body manage stress more effectively, while its anti-inflammatory properties reduce underlying inflammation that can exacerbate neuropsychiatric symptoms. This makes Ashwagandha especially beneficial during flare-ups of anxiety, aggression, or irritability, as it calms the mind and soothes the body, offering a sense of stability even in stressful times.
Dosage:
Notes: Ashwagandha works best with consistent, long-term use. For children, starting with a lower dose and gradually increasing helps to avoid any potential sedative effects and ensures a gentle buildup of its benefits over time.
Pine Bark Extract (Pinus pinaster)
Properties: Anti-inflammatory, antioxidant, supports cognitive performance.
Uses: Pine Bark Extract is valued for its rich antioxidant profile, which supports cognitive health by reducing oxidative stress and inflammation. It’s particularly beneficial for managing symptoms like brain fog, enhancing mental clarity, and improving focus. This can be especially helpful for children who experience cognitive “slowness” or struggle to concentrate following a flare. Pine Bark’s effects on cognition and focus make it a valuable addition for those needing gentle yet effective support for brain function.
Dosage: 100 mg to 200 mg, once or twice daily.
Notes: Pine Bark is generally well-tolerated in children. It’s gentle enough for long-term use, providing consistent support for mental clarity and resilience over time.
Chamomile (Matricaria chamomilla)
Properties: Anti-anxiety, digestive support, mild sedative.
Uses: Chamomile is a gentle yet effective sedative, widely used to ease anxiety and support restful sleep. Its calming properties make it especially helpful for children who struggle to wind down at night or experience restlessness. Beyond its soothing effect on the nervous system, Chamomile also supports digestive health, reducing symptoms of an upset stomach or digestive discomfort, which can often accompany stress or anxiety.
Dosage:
Notes: Chamomile is very mild and rarely causes reactions but should be monitored if there’s a known ragweed allergy.
Passionflower (Passiflora incarnata)
Properties: Sedative, antispasmodic, anxiolytic.
Uses: Passionflower is a soothing herb commonly used to relieve insomnia and intense anxiety, providing calming support for both mind and body. Its sedative and antispasmodic properties make it particularly effective during high-stress moments, especially when anxiety is accompanied by irritability, restlessness, or muscle tension. By gently calming the nervous system, Passionflower helps ease the transition to sleep, offering a natural alternative for children and adults who struggle to relax at the end of the day.
Dosage:
Notes: Caution-This is an herb that may cause children to flare. It’s best to start with a low dose and adjust gradually to find the optimal level.
Skullcap (Scutellaria lateriflora)—Not to be confused with Chinese Skullcap
Properties: Nervine, supports nervous system relaxation.
Uses: Skullcap is a calming herb known for its effectiveness in easing nervous tension and reducing excitability. It provides gentle yet reliable support for managing acute emotional outbursts and can also be used for ongoing nervous system support. By helping to regulate the body’s stress response, Skullcap reduces the frequency and intensity of emotional outbursts, making it particularly beneficial for children who experience sudden waves of agitation or restlessness.
Dosage:
Notes: Often combined with Chamomile or Valerian, Skullcap is gentle enough for daily use.
Brahmi (Bacopa monnieri)
Properties: Nervine, adaptogen, cognitive enhancer, antioxidant.
Uses: Brahmi is revered in Ayurvedic medicine for its ability to enhance cognitive function and reduce anxiety. It’s a well known “brain tonic” and cognitive aid. Its adaptogenic and neuroprotective effects make it a prime choice for managing stress and improving memory and focus. Brahmi also modulates neurotransmitters, which can help balance mood and reduce overstimulation.
Dosage: 2ml to 5ml or 350 to 650 mg, two to three times daily.
Notes: Brahmi is a “building” herb, meaning it’s most effective when used consistently over time. It’s generally safe for long-term use. It’s helpful for children who may be restricting food, as it offers brain-protective effects during periods of low blood sugar.
Reishi Mushroom (Ganoderma lucidum)
Properties: Immunomodulator, adaptogen, anti-inflammatory.
Uses: Revered as the “mushroom of immortality” in traditional Chinese medicine, Reishi is celebrated for its potent immune-balancing effects. This adaptogenic mushroom is particularly beneficial for children with PANS/PANDAS, as it helps regulate immune function, calming the overactive inflammatory responses that often exacerbate symptoms. Additionally, Reishi has a soothing effect on the nervous system, which can ease anxiety and reduce stress, supporting emotional stability and resilience during challenging times.
Notes: Reishi is gentle, generally well-tolerated, and suitable for long-term use, making it a dependable option for ongoing immune and nervous system support.Nutraceuticals
Nutraceuticals
Inositol
Properties: Mood stabilizer, supports neurotransmitter function.
Uses: Inositol is a type of B-vitamin-like compound that plays a key role in cellular signaling and neurotransmitter support, especially for serotonin. It’s highly beneficial for managing obsessive-compulsive symptoms, anxiety, and mood swings in children with PANS/PANDAS. Research indicates that it can help reduce symptoms associated with obsessive-compulsive disorder (OCD), making it a valuable option for children struggling with intrusive thoughts or repetitive behaviors.
Notes: Inositol is water-soluble and has a pleasant taste, making it easy to mix into drinks or applesauce. Dosage can be gradually increased to an effective level, though it’s generally safe with minimal side effects.
Lithium Orotate (1 mg)
Properties: Mood stabilizer, neuroprotective.
Uses: At low doses, lithium orotate is a safe form of lithium that can help stabilize mood and reduce irritability and aggression. This natural mineral has been found to support emotional balance, making it particularly useful in managing emotional outbursts, rage episodes, and mood swings in PANS/PANDAS. Beyond its calming effects, lithium orotate is known for its neuroprotective benefits, helping to shield brain cells from stress and inflammation.
Notes: Lithium orotate is best used in low doses (like 1 mg), especially for children. Hydration is important while using lithium, as it helps the body process minerals effectively.
NAC (N-Acetylcysteine)
Properties: Antioxidant, mucolytic, supports glutathione production.
Uses: NAC (N-Acetylcysteine) is a powerful antioxidant precursor to glutathione, one of the body’s most essential compounds for detoxification and cellular protection. By boosting glutathione levels, NAC helps reduce oxidative stress throughout the body, with notable effects on brain health and mental clarity. This makes NAC particularly beneficial for children with PANS/PANDAS, as it can alleviate symptoms related to obsessive-compulsive behaviors, anxiety, and mood dysregulation. Its neuroprotective effects support brain function and emotional stability, making it easier for children to manage challenging symptoms.
Beyond its neurological benefits, NAC is also a valuable support for detoxification, aiding in the clearance of environmental toxins and supporting liver and lung health. For families managing mold exposure or other environmental sensitivities, NAC is particularly beneficial. By increasing glutathione levels, NAC helps the body gently encourage toxins out of tissues and supports their safe elimination. Its detoxifying effects reach deep into cellular layers, helping to pull out stored toxins, whether from environmental sources or metabolic waste, without overwhelming the body.
Notes: NAC is generally well-tolerated but should be introduced gradually to avoid digestive upset.
Glycine
Properties: Calming, supports sleep, and acts as a neurotransmitter modulator.
Uses: Glycine is an amino acid with calming properties that play a key role in the central nervous system. It acts as an inhibitory neurotransmitter, helping to regulate nerve impulses and reduce overstimulation, which can be especially beneficial for children experiencing anxiety, restlessness, or difficulty sleeping. Glycine is known to support deeper, more restful sleep, making it a helpful option for children with PANS/PANDAS who struggle with sleep disturbances. Additionally, it has a mild mood-stabilizing effect, which can help manage emotional fluctuations and improve overall mood.
Notes: Glycine has a naturally sweet taste, making it easy to incorporate into drinks or mix with applesauce or other foods. It’s generally safe with minimal side effects, even at higher doses, but starting with a low dose and gradually increasing is recommended to gauge individual tolerance. Glycine can be taken in powder or capsule form and works best when used consistently, allowing its calming effects to build over time