Understanding PANDAS and Why Functional Medicine Matters
When your child’s personality or behavior changes overnight, it can feel frightening and confusing. One day they’re happy and focused; the next, they’re anxious, emotional, or struggling to concentrate. For some children, this sudden change isn’t “just a phase”—it may be a sign of PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.
PANDAS occurs when the immune system mistakenly targets parts of the brain—especially the basal ganglia—after a strep infection. Instead of resolving the infection normally, the immune system continues to produce antibodies that cross-react with brain tissue, causing inflammation that affects mood, behavior, and neurological function.
Children with PANDAS may develop sudden, intense symptoms such as:
- Obsessive-compulsive behaviors (OCD) or intrusive thoughts
- Severe anxiety or separation fears
- Motor or vocal tics
- Mood swings, irritability, or rage episodes
- Regression in learning, handwriting changes, or attention difficulties
- Sleep disruption, fatigue, or changes in appetite
These symptoms often appear abruptly, leaving families searching for answers. Conventional medicine may treat the infection with antibiotics or recommend psychiatric medications for symptom control, but this band-aid approach rarely addresses the underlying immune dysregulation driving the condition.
At the Restorative Medicine Center, Dr. Teresa Birkmeier-Fredal takes a Functional Medicine approach—one that looks at the full picture: infection, inflammation, and immune imbalance. By identifying and treating the root causes behind the brain inflammation, her goal is not just to manage symptoms, but to help children truly recover.
The Root Cause Triad in PANDAS Treatment
Dr. Teresa Birkmeier-Fredal’s Root Cause Triad is the foundation of her treatment philosophy. This model recognizes that **three interrelated categories—Microbes, Toxins, and Stress Response—**work together to fuel inflammation and immune dysfunction.
By addressing all three areas systematically, we can calm the immune system, reduce brain inflammation, and support long-term recovery.
Microbes
Infections are often the initial trigger for PANDAS and PANS. While strep bacteria are the most common culprits, other pathogens—such as Mycoplasma, Bartonella, Babesia, viruses, and mold-related microbes—can also activate the immune system in similar ways.
These stealth infections often persist quietly, evading detection by standard medical tests. Through advanced microbial testing and clinical assessment, Dr. Birkmeier-Fredal identifies which infections are still active and contributing to inflammation.
A functional treatment plan then targets these infections safely and gradually, supporting the body’s ability to clear pathogens while calming the immune response.
Toxins
Environmental toxins and biotoxins can amplify inflammation, keeping the immune system “on alert” long after an infection resolves. Common sources include:
- Mold exposure in water-damaged buildings
- Heavy metals such as mercury, lead, or aluminum
- Pesticides and chemical pollutants that strain detoxification pathways
Dr. Birkmeier-Fredal incorporates gentle, evidence-informed detoxification strategies to support toxin elimination without overwhelming the body. These include:
- Adequate hydration to promote kidney and lymphatic drainage
- Binders (activated charcoal, bentonite clay, or cholestyramine) to capture toxins in the gut
- Liver support through nutrients like milk thistle, NAC, and glutathione
- Air and water filtration to reduce ongoing exposure
- Nutrient-based detox support to replenish minerals and antioxidants
This process helps reduce the total inflammatory burden, allowing the immune system to reset and restore balance.
Stress Response
The nervous system and immune system are deeply interconnected—when one is in distress, the other follows. Chronic stress, trauma, or fear can amplify inflammation and worsen PANDAS flares.
Supporting the stress response is therefore essential to long-term healing. Dr. Birkmeier-Fredal integrates tools that help retrain the nervous system toward safety and calm, such as:
- Limbic system retraining to rewire chronic fear and fight-or-flight loops
- Breathwork and mindfulness to activate the vagus nerve and reduce inflammation
- Restorative sleep programs that align circadian rhythms and enhance brain repair
By addressing the stress response alongside microbial and toxin load, children can regain a sense of emotional stability and resilience—the foundation for lasting wellness.
Functional Medicine Approach to PANDAS Treatment
At the Restorative Medicine Center, Dr. Teresa Birkmeier-Fredal takes an integrative and evidence-informed approach to treating PANDAS and PANS—one that goes beyond symptom management to identify and correct the underlying causes of immune dysfunction.
Each child’s plan is personalized, based on their specific infections, immune markers, environmental exposures, and nervous system resilience. The goal is to calm inflammation, restore immune balance, and support the brain’s ability to heal—without overwhelming the body.
Comprehensive Testing and Diagnosis
Healing begins with understanding the “why.” Because PANDAS and PANS are rooted in immune dysregulation, Dr. Birkmeier-Fredal uses functional diagnostic testing to identify the microbial, environmental, and metabolic factors driving each child’s symptoms.
Functional Lab Work and Infection Panels
Specialized testing is used to detect both acute and chronic infections, including:
- Strep and other bacterial infections
- Lyme disease and co-infections such as Bartonella and Babesia
- Mycoplasma pneumoniae and viral reactivations
- Mold and fungal species contributing to ongoing inflammation
Immune Biomarkers
Inflammatory markers help assess how the immune system is functioning and whether it’s in an overactive or exhausted state. Key tests include:
- C4a, TGFB1, MMP-9, VEGF, and autoantibodies that reflect inflammation and blood-brain barrier integrity.
- These biomarkers provide insight into the degree of immune activation and guide treatment pacing.
Gut and Nutrient Testing
Since 70% of immune activity originates in the gut, Dr. Birkmeier-Fredal assesses:
- Microbiome balance, identifying overgrowth or depletion of beneficial bacteria.
- Nutrient status (zinc, magnesium, vitamin D, B vitamins) essential for detox and immune regulation.
- Markers of inflammation and leaky gut, which can perpetuate systemic immune activation.
Environmental Assessments
Because toxins and mold exposure often fuel inflammation, testing may include:
- Mold and mycotoxin panels to identify biotoxin load.
- Heavy metal testing for mercury, lead, or arsenic.
- Chemical sensitivity and VOC exposure evaluations to identify ongoing environmental triggers.
This thorough diagnostic process ensures that no hidden contributor to inflammation is overlooked—allowing for a plan that is both comprehensive and sustainable.
Personalized Treatment Strategy
Once the underlying triggers are identified, treatment is designed to restore balance across the immune, detoxification, and nervous systems. Dr. Birkmeier-Fredal’s functional protocols are layered carefully to meet each child where they are—focusing on stabilization before deeper detox or antimicrobial phases.
Antimicrobial Support
Depending on lab results, the plan may include:
- Antibiotics or herbal antimicrobials for infections such as strep, Bartonella, or Mycoplasma.
- Probiotics and gut repair to prevent dysbiosis during antimicrobial therapy.
Anti-inflammatory and Immune Modulation
To calm neuroinflammation and help the immune system reset, Dr. Birkmeier-Fredal often incorporates:
- Omega-3 fatty acids for brain and immune regulation.
- Curcumin and glutathione to lower oxidative stress and support detoxification.
- Vitamin D balancing and targeted botanicals (such as quercetin or resveratrol) to reduce inflammation safely.
Detoxification and Mitochondrial Support
Clearing toxins and restoring cellular energy are essential steps in recovery.
- Binders (activated charcoal, bentonite clay, or cholestyramine) to capture biotoxins.
- Hydration and mineral support to enhance elimination pathways.
- Far infrared sauna and red light therapy to promote circulation, lymphatic flow, and cellular repair.
- Nutrient repletion to replenish antioxidants and mitochondrial cofactors needed for energy production.
Hormone and Adrenal Balancing
Chronic inflammation often disrupts hormone communication, leading to poor stress tolerance, sleep issues, and emotional instability.
- Dr. Birkmeier-Fredal focuses on rebalancing cortisol rhythms, optimizing thyroid function, and stabilizing adrenal output to support calm focus and resilience.
Nervous System Healing
PANDAS treatment isn’t complete without addressing the nervous system’s role in inflammation.
- Neural retraining and vagus nerve stimulation to re-establish parasympathetic balance.
- Mindfulness and breathwork to reduce fight-or-flight activation.
- Parental guidance to help families create a calm, predictable home environment that supports recovery.
Together, these layers form a whole-person treatment plan designed to rebuild health from the inside out—treating causes, not just symptoms.
Parental Support and Education
At the Restorative Medicine Center, Dr. Birkmeier-Fredal believes that informed parents are powerful advocates for their child’s healing. Education and guidance are integral to every visit.
- Families are taught how to recognize immune triggers, such as infections, stress, or toxin exposure.
- Parents use symptom and treatment timelines to track flares and identify patterns over time.
- Practical, at-home strategies are shared to help reduce triggers and support calm—such as nutrition tips, sleep routines, and environmental modifications.
This partnership empowers families to feel confident, informed, and supported throughout the recovery process.
Bring Calm Back to Your Child’s Brain
If your child’s personality, focus, or emotions have changed overnight, don’t accept “it’s just anxiety” or “a phase” as the answer. Sudden behavioral or neurological shifts often have a medical root cause—and with the right approach, healing is possible.
At the Restorative Medicine Center, Dr. Teresa Birkmeier-Fredal specializes in Functional Medicine treatment for PANDAS and PANS, helping families uncover the infections, toxins, and immune triggers driving these sudden neurological changes. By identifying and treating the true source of inflammation, we help the brain and body return to balance.
Together, we’ll address the why—so your child can return to feeling calm, connected, and themselves again.
Contact Us
📍 Restorative Medicine Center
705 Barclay Cir #115
Rochester Hills, MI 48307
📞 Phone: 248.289.6349
📠 Fax: 248-289-6923
🌐 Website: www.restorativemedcenter.com