At Restorative Medicine Center in Rochester Hills, Michigan, Dr. Teresa Birkmeier-Fredal takes a uniquely comprehensive and compassionate approach to caring for children affected by PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). These conditions are not simply behavioral or psychological—they are immune-mediated illnesses that disrupt the delicate balance between the immune system and the brain, often leaving families searching for answers across multiple specialties.
Dr. Birkmeier’s treatment philosophy begins with understanding the whole child, not just the surface symptoms. Her care model is grounded in what she calls the Root Cause Triad—a comprehensive framework addressing the three core drivers of chronic immune dysfunction:
- Microbes – Hidden or persistent infections that trigger immune activation.
- Toxins – Environmental or biological toxins that overload the body’s detoxification systems.
- Stress Response – Chronic fight-or-flight activation that keeps the nervous and immune systems in a state of overdrive.
Rather than masking symptoms with temporary fixes, this triad-based approach seeks to restore balance and resilience within the body’s interconnected systems. Through integrative diagnostics, evidence-informed therapies, and deep partnership with families, Dr. Birkmeier helps children heal from the inside out—supporting immune balance, neurological function, and emotional well-being.
This is the essence of holistic medicine for PANDAS and PANS—seeing beyond the diagnosis to understand the unique biological and environmental triggers that keep a child’s immune system stuck in overreaction mode.
What Are PANDAS and PANS?
Although often misunderstood or overlooked in conventional medicine, PANDAS and PANS are well-documented autoimmune conditions that can cause sudden, dramatic changes in a child’s emotions, behavior, and cognitive abilities.
PANDAS: When Strep Triggers an Autoimmune Response
PANDAS occurs when the body’s immune system responds to a strep infection (like strep throat) by mistakenly attacking certain parts of the brain—particularly the basal ganglia, which helps regulate mood, movement, and behavior. This misguided immune attack can cause sudden neuropsychiatric symptoms that appear almost overnight.
PANS: A Broader Immune Reaction to Infections or Environmental Triggers
PANS encompasses a wider range of causes beyond strep. It can be triggered by other infections (such as Lyme disease, Bartonella, Mycoplasma, or viruses), environmental toxins, mold exposure, or even severe psychological or physiological stress. Regardless of the trigger, the immune system becomes misdirected, creating inflammation in the brain that disrupts normal neurological function.
When the Immune System Mistakenly Attacks the Brain
In both PANDAS and PANS, the immune system—intended to protect the body—becomes confused and targets the brain instead, leading to an abrupt and often terrifying change in a child’s personality, cognition, and behavior. Parents frequently describe it as if their child “changed overnight.”
Common symptoms may include:
- Sudden-onset OCD or anxiety — new fears, rituals, or intrusive thoughts that appear abruptly
- Tics and involuntary movements — blinking, grimacing, throat clearing, or other repetitive actions
- Emotional volatility and mood swings — rapid shifts from calm to anger, tears, or aggression
- Cognitive decline or regression — trouble concentrating, handwriting changes, or academic decline
- Sleep disturbances and food restriction — new onset insomnia, food refusal, or fear of eating
Why Conventional Approaches Often Fall Short
In traditional medicine, care for PANDAS and PANS often focuses on managing symptoms, rather than asking why those symptoms developed in the first place. Children are frequently prescribed rounds of antibiotics, anti-inflammatories, or psychiatric medications like SSRIs to help stabilize mood and behavior. While these tools can provide temporary relief, they rarely address the underlying immune imbalance that triggered the symptoms in the first place.
At Restorative Medicine Center, Dr. Teresa Birkmeier-Fredal often reminds parents that a diagnosis is not a root cause—it’s a description of what’s happening downstream. Conventional medicine tends to treat this “downstream mess,” focusing on the visible problems—tics, anxiety, mood swings—without exploring the why behind them.
Holistic and functional medicine take a different path. By identifying what’s occurring at the root level—what’s driving the immune system to misfire—Dr. Birkmeier helps restore balance to the body rather than simply trying to control the fallout.
Many children become stuck in a frustrating cycle of partial recovery because the drivers of immune dysregulation—chronic infection, environmental toxin exposure, and unresolved stress—remain unrecognized. Until these factors are addressed, inflammation continues, and symptoms return. Breaking this cycle requires a shift from surface-level symptom management to deep-rooted healing, which is precisely what Dr. Birkmeier’s Root Cause Triad framework is designed to achieve.
Functional Diagnostic Testing for PANDAS/PANS
Healing from PANDAS or PANS begins with understanding the “why” behind the symptoms—and that requires comprehensive, functional testing. At Restorative Medicine Center, Dr. Teresa Birkmeier-Fredal utilizes a combination of Functional Medicine and CIRS (Chronic Inflammatory Response Syndrome) biomarkers to identify the biological imbalances driving a child’s immune dysregulation.
Traditional lab panels often come back “normal,” leaving parents frustrated and children untreated. Functional testing, however, looks deeper—beyond the basic numbers—to reveal the subtle signs of immune stress, inflammation, and toxicity that underlie neuropsychiatric symptoms.
CIRS and Functional Biomarkers
Dr. Birkmeier’s evaluation may include a targeted panel of biomarkers known to reflect immune dysfunction and chronic inflammation, such as:
- VEGF (Vascular Endothelial Growth Factor): Indicates tissue oxygenation and immune activation.
- MMP-9 (Matrix Metalloproteinase-9): Measures vascular inflammation and blood-brain barrier disruption.
- C4a: Reflects complement activation and chronic inflammatory response.
- TGF-β1 (Transforming Growth Factor Beta 1): A marker of immune dysregulation and fibrosis risk.
- Vitamin D ratio: Assesses immune balance and inflammatory status.
- Cortisol patterns: Evaluate stress response and adrenal function over the course of the day.
Mapping the Child’s Unique Imbalance
Because no two cases of PANDAS or PANS are identical, Dr. Birkmeier creates an individualized diagnostic roadmap. This often includes:
- Comprehensive immune panels to assess autoantibodies and cytokine activity.
- Infection panels to detect stealth pathogens such as Lyme, Bartonella, Babesia, Mycoplasma, or viruses.
- Toxin and biotoxin testing to uncover mold exposure, heavy metals, or environmental chemical burdens.
- Nutrient and mitochondrial assessments to evaluate energy production and cellular resilience.
Tracking Progress Over Time
Families are active participants in the healing process. Dr. Birkmeier encourages parents to maintain symptom and treatment timelines to document patterns and responses over time.
These tools—simple calendars or digital logs—help answer two key questions for every intervention:
- Is it tolerated?
- Is it beneficial?
Holistic Treatment Strategies at Restorative Medicine Center
Every child’s healing journey looks different—but the principles of Dr. Birkmeier’s care remain the same: address the root causes with precision, compassion, and balance. Treatment is integrative, child-centered, and designed to support the body’s natural ability to heal.
Targeted Antimicrobial Support
When infections such as strep, Bartonella, or Lyme are identified, Dr. Birkmeier uses targeted antimicrobial therapy—which may include herbal antimicrobials, nutritional immune support, and, when appropriate, carefully selected prescription antibiotics. The goal is not to bombard the body, but to reduce microbial load gently while supporting detoxification and immune recovery.
Detoxification and Drainage Support
Clearing toxins and biotoxins is essential to calming inflammation. Dr. Birkmeier’s protocols emphasize:
- Sauna therapy (Far Infrared) to mobilize toxins safely.
- Hydration and mineral balance to enhance cellular detox pathways.
- Clean food and water to reduce ongoing toxic input.
- Air quality optimization using purifiers and mold remediation when necessary.
Immune Modulation and Mitochondrial Support
Rather than “boosting” the immune system, Dr. Birkmeier focuses on modulating it—helping it return to equilibrium. This may include the use of:
- Targeted nutrients like zinc, vitamin D, omega-3s, and antioxidants.
- Adaptogenic herbs to balance stress hormones and inflammation.
- Mitochondrial support therapies to restore cellular energy and improve resilience.
Stress and Nervous System Regulation
Since immune healing cannot occur in a state of chronic fight-or-flight, regulating the stress response is foundational. Dr. Birkmeier teaches practical, evidence-informed tools such as:
- 4-7-8 breathing and gratitude meditations to calm the nervous system.
- Prioritizing sleep and circadian rhythm balance to support hormonal and immune repair.
- Encouraging gentle movement and play to restore confidence and connection.
Parental Education and Empowerment
At Restorative Medicine Center, families are true partners in care. Dr. Birkmeier takes time to teach parents how to interpret labs, recognize healing patterns, and make informed decisions at every step. This collaborative model builds confidence, accountability, and peace of mind.
Restoring Hope for Families Facing PANDAS and PANS
If your child is suddenly struggling with anxiety, tics, emotional changes, or obsessive behaviors that don’t make sense, you are not alone—and there is a path forward. At Restorative Medicine Center in Rochester Hills, Michigan, Dr. Teresa Birkmeier-Fredal provides the clarity and comprehensive care that families have been searching for.
Through her integrative, evidence-informed Root Cause Triad approach, Dr. Birkmeier looks beyond surface symptoms to identify the immune, microbial, toxic, and stress-related imbalances that are truly driving your child’s condition. By addressing these root causes—rather than simply managing the downstream effects—she helps children regain their calm, focus, emotional balance, and resilience.
Families come to Restorative Medicine Center not just for treatment, but for understanding, partnership, and lasting healing. Whether your child has been newly diagnosed or you’ve been searching for answers for years, Dr. Birkmeier and her team are here to guide you every step of the way.
Contact Restorative Medicine Center Today
📍 705 Barclay Cir #115, Rochester Hills, MI 48307
📞 248-289-6349 | 📠 Fax: 248-289-6923 🌐 www.restorativemedcenter.com