PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) is a sudden-onset, immune-mediated condition that disrupts a child’s brain and behavior—often overnight. A once-happy, thriving child may suddenly develop severe anxiety, obsessive-compulsive behaviors, tics, emotional outbursts, or even food restriction. For parents, this transformation can feel both heartbreaking and confusing.
At its core, PANS is not a behavioral or psychiatric disorder—it is a neuroimmune condition. It occurs when infections, toxins, or environmental triggers cause the immune system to mistakenly attack neuronal tissue, leading to neuroinflammation in areas of the brain responsible for mood, movement, and behavior.
In simple terms, the brain becomes inflamed—not broken. The child’s symptoms are the visible signs of an immune system in distress.
Common triggers for PANS include:
- Infections such as strep (in PANDAS), Bartonella, Mycoplasma, Babesia, or viral reactivations.
- Mold and mycotoxin exposure, which can fuel ongoing inflammation.
- Environmental toxins or heavy metals that disrupt immune balance.
- Physical or emotional stressors that overload the nervous system.
For many families, this condition is misunderstood or misdiagnosed as purely psychiatric. But as Dr. Teresa Birkmeier-Fredal emphasizes, PANS is a medical condition with an immune foundation. It requires addressing what’s happening in the child’s body, not just what’s showing up in their behavior.
At Restorative Medicine Center in Rochester Hills, Dr. Teresa takes a natural, integrative approach—one that looks beyond surface symptoms to uncover the underlying causes of immune dysfunction. Instead of masking symptoms with medication alone, she seeks to identify and calm the immune triggers responsible for neuroinflammation.
Her process is guided by the Root Cause Triad, a framework that considers how three key systems interact to create illness:
- Microbes – Hidden infections or imbalances driving inflammation.
- Toxins – Biotoxins, mold, or environmental chemicals overwhelming the immune system.
- Stress Response – A dysregulated nervous system keeping the body in fight-or-flight mode.
By understanding how these layers work together, Dr. Teresa helps children heal from the inside out—restoring both neurological balance and emotional stability.
Why Conventional Treatment Often Falls Short
For most families, the search for answers begins in traditional medical settings. Doctors may diagnose PANS or PANDAS and prescribe antibiotics, corticosteroids, SSRIs, or antipsychotic medications. While these interventions can sometimes offer short-term improvement, many parents notice that the relief doesn’t last—or that symptoms return when the medications are stopped.
That’s because these treatments often target the symptoms, not the cause.
They attempt to suppress inflammation or manage mood changes, but they don’t answer the crucial question: Why is the immune system attacking the brain in the first place?
In many cases, underlying infections, toxins, and immune imbalances remain undetected. The body stays in a cycle of inflammation and reactivity, leading to relapse after relapse. Over time, the child’s immune system becomes more dysregulated, making each flare more difficult to calm.
Dr. Teresa’s approach is different. Rather than focusing on symptom management, she focuses on root-cause resolution—helping the immune system remember how to regulate itself.
At Restorative Medicine Center, her treatment philosophy is based on these principles:
- Identify the triggers. Determine whether infections, toxins, or environmental exposures are provoking the immune attack.
- Calm the inflammation. Use natural, evidence-based therapies to reduce neuroinflammatory activity.
- Support the immune system. Replenish nutrients, repair gut health, and restore balance so the body can stop overreacting.
- Rewire the stress response. Teach the body to shift out of fight-or-flight mode, where healing cannot occur.
By combining advanced diagnostics with functional medicine tools, Dr. Teresa helps children move beyond the “flare-recovery” cycle and toward lasting wellness.
Functional Testing and Evaluation
At Restorative Medicine Center in Rochester Hills, Dr. Teresa Birkmeier-Fredal, MD, approaches every child with PANS as an individual—recognizing that no two cases are alike. While the symptoms may appear similar, the underlying biological drivers can differ dramatically. To uncover these hidden layers, she uses comprehensive functional testing to build a full picture of each child’s immune function, inflammation patterns, and environmental exposures.
This process allows Dr. Teresa to create a data-driven, personalized plan—not based on assumptions, but on measurable biology.
Immune and Inflammatory Panels
To assess the immune system’s activity and degree of inflammation, Dr. Teresa evaluates CIRS (Chronic Inflammatory Response Syndrome) biomarkers, which help identify immune overactivation and ongoing inflammatory cycles. Key markers include:
- VEGF (Vascular Endothelial Growth Factor): Indicates blood flow and tissue repair.
- MMP-9 (Matrix Metalloproteinase-9): Reflects vascular and neuroinflammation.
- TGF-β1 (Transforming Growth Factor Beta 1): Shows immune dysregulation and autoimmunity risk.
- C4a: A marker of innate immune activation, often elevated in mold or infection-related illness.
- Vitamin D ratio: Provides insight into immune balance and inflammation control.
Infection and Co-Infection Panels
Because infections often play a central role in triggering PANS, Dr. Teresa uses advanced laboratory testing to identify bacterial, viral, and vector-borne pathogens that standard tests may miss. These include:
- Streptococcus (for PANDAS)
- Bartonella, Babesia, Mycoplasma, and Lyme disease organisms
- Viral reactivations such as Epstein-Barr, Coxsackie, or HHV-6
Toxin and Mycotoxin Testing
Environmental exposures can profoundly influence immune balance. Mold, mycotoxins, and chemical pollutants can suppress immune function, increase oxidative stress, and sustain inflammation in the brain. Dr. Teresa uses urine-based mycotoxin assays and environmental toxin panels to measure the body’s toxin burden and guide gentle, phase-based detoxification.
Hormone and Adrenal Analysis
Chronic illness and immune dysregulation often place enormous strain on the adrenal glands and hormone systems. To evaluate this connection, Dr. Teresa assesses:
- Cortisol patterns throughout the day
- Thyroid and sex hormones for metabolic and regulatory balance
- Melatonin and sleep hormones that affect recovery and emotional regulation
Symptom and Behavior Tracking
Healing from PANS requires both data and observation. Dr. Teresa empowers parents to participate actively in their child’s care through symptom tracking tools, including behavior journals, treatment timelines, and progress calendars. This allows families to identify cause-and-effect patterns—helping refine treatment and prevent setbacks.
By integrating objective biomarkers with daily symptom tracking, Dr. Teresa creates a complete map of each child’s immune and neurological health. This map becomes the foundation for precise, individualized treatment—ensuring that every intervention is safe, strategic, and effective.
Natural and Integrative Therapies for PANS
At Restorative Medicine Center, Dr. Birkmeier combines advanced functional medicine with natural, evidence-informed therapies to address the root causes of PANS. Her multidimensional care model is designed to calm inflammation, strengthen immune regulation, and rebuild neurological stability—while always honoring the child’s pace and tolerance.
Every treatment plan is individualized, evolving as the child’s body heals and rebalances.
Targeted Antimicrobial Support
Once infections are identified, Dr. Teresa uses targeted antimicrobial therapies—both natural and prescription-based—to address microbial triggers safely.
- Herbal antimicrobials such as berberine, Japanese knotweed, or olive leaf may be used to reduce bacterial or viral load.
- Prescription options are carefully selected when necessary to complement natural protocols.
- Biofilm disruptors may be included to expose hidden pathogens.
Detoxification and Drainage
Clearing toxins gently and consistently is crucial for healing. Dr. Teresa supports the body’s detox pathways using:
- Far-infrared sauna therapy to enhance sweating and circulation.
- Proper hydration and mineral balance to aid liver and kidney function.
- Binders (such as activated charcoal or chlorella) to capture and remove toxins.
- Liver and lymphatic support nutrients to optimize natural detoxification.
Immune Modulation
PANS is an immune misfire, not just an infection. To restore balance, Dr. Teresa focuses on immune retraining, not suppression.
- Key nutrients like vitamin D, zinc, omega-3 fatty acids, and antioxidants help recalibrate immune signaling.
- Adaptogenic herbs (ashwagandha, rhodiola, reishi) support adrenal resilience and immune balance.
- Mitochondrial support improves energy production and reduces fatigue linked to chronic inflammation.
Nervous System Support
Because PANS impacts the brain directly, nervous system regulation is essential for lasting recovery. Dr. Teresa teaches both children and parents how to bring the body out of fight-or-flight mode, using:
- Breathing techniques such as 4-7-8 or box breathing to calm the stress response.
- Mindfulness and gratitude practices to build emotional resilience.
- Sleep optimization protocols to restore circadian rhythm and neurological repair.
- Gentle movement and outdoor time to regulate the vagus nerve and enhance grounding.
Parental Education and Empowerment
Healing from PANS is a journey that involves the entire family. Dr. Teresa provides parents with the tools to:
- Track progress and identify symptom patterns.
- Implement nutrition and detox support at home.
- Understand the emotional and behavioral manifestations of immune dysfunction.
Find Hope and Healing for Your Child
If your child is suddenly struggling with anxiety, tics, obsessive thoughts, or emotional changes that seem to appear out of nowhere, you are not alone—and there is hope. What may look like a behavioral or psychological issue is often a biological response to immune dysregulation and brain inflammation.
At Restorative Medicine Center in Rochester Hills, Michigan, Dr. Teresa Birkmeier-Fredal, MD, helps families uncover the why behind these changes. Through her Root Cause Triad approach—addressing microbes, toxins, and the stress response—she identifies the underlying immune triggers that keep the brain inflamed and helps the body return to balance naturally.
Her approach is scientifically grounded yet deeply compassionate, providing clarity where confusion once existed. By combining advanced testing, natural therapies, and individualized care, Dr. Teresa helps children heal from within—restoring calm, focus, and connection to themselves and their families.
Contact Restorative Medicine Center Today
📍 705 Barclay Cir #115, Rochester Hills, MI 48307
📞 248-289-6349 | 📠 Fax: 248-289-6923 🌐 www.restorativemedcenter.com