Understanding PANS/PANDAS: How Diet Can Make a Difference
October 8, 2025
When your happy, healthy child suddenly changes overnight – becoming moody, anxious, or refusing food – it can leave you feeling scared and confused.
For some families, that dramatic shift may be linked to a little-known condition called PANS or PANDAS, a neuroimmune disorder that can cause sudden changes in behavior, eating, and mood.
To shed light on this complex topic, I spoke with pediatric dietitian Shannon Leatherman, who specializes in nutrition for children diagnosed with PANS and PANDAS. Her insights, and her personal story, offer hope and direction for parents navigating this difficult journey.
What Is PANDAS Illness?
PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.
It occurs when a strep infection triggers the immune system to mistakenly attack parts of the brain, particularly the basal ganglia, which affects movement, emotions, and behavior.
PANS, or Pediatric Acute-Onset Neuropsychiatric Syndrome, is the broader term. It includes PANDAS but can be triggered by other infections (like Lyme or Epstein-Barr virus) or environmental toxins such as mold.
Both conditions can look like this: one day, your child seems fine; the next, their personality and behavior have changed completely. Parents often describe it as “a light switch flipping overnight.”
Symptoms of PANS and PANDAS
Because PANDAS affects the brain and immune system, symptoms can look neurological, behavioral, or both.
Hallmark signs include:
- Sudden onset of OCD-like behaviors
- Tics (involuntary movements or sounds)
- Severe eating restrictions or food refusal
- Anxiety, aggression, or mood swings
- Regression in handwriting, bedwetting, or motor skills
- Sleep disturbances and separation anxiety
The symptoms may come and go in what are known as “flares.” During flares, inflammation in the brain increases, intensifying symptoms.
The Role of Autoimmunity in PANS/PANDAS
At its core, PANDAS is an autoimmune illness – the body’s immune system mistakenly attacks healthy brain tissue after an infection.
This inflammation can cause a cascade of emotional, behavioral, and physical symptoms.
Family history may also play a role: up to 70% of children with PANS/PANDAS have a relative with an autoimmune or strep-related condition.
How Nutrition Supports Recovery
Nutrition doesn’t cause or cure PANDAS, but it can play a powerful supportive role. Shannon breaks her nutrition approach into three categories:
1. Preventive Nutrition
Focus on anti-inflammatory foods that calm the immune system and support the gut-brain connection.
These include:
- Colorful fruits and vegetables (rich in antioxidants)
- Omega-3 fats from fish, nuts, and seeds
- Herbs and spices like turmeric, ginger, and cinnamon
Avoiding excess sugar and ultra-processed foods may also help reduce inflammation.
2. Restorative Nutrition
Many children with PANS/PANDAS become extremely picky eaters, increasing their risk for nutrient deficiencies.
Shannon’s priority: restore nourishment before expanding the diet.
She emphasizes:
- Protein for growth and brain repair
- Iron, zinc, and magnesium for mood regulation and immune balance
- Multivitamins or shakes if intake is limited
As she says, “A nourished brain responds better to healing.”
3. Therapeutic Nutrition
Once children are stable, families may explore specific therapeutic diets that reduce symptom triggers.
Some families report improvements with:
- Gluten-free or dairy-free diets
- Reduced sugar intake
- Limiting artificial dyes or additives
While these diets don’t replace medical care, they can help lessen the “brain itch” of inflammation and behavioral outbursts.
Finding Help and Hope
Early diagnosis and appropriate medical treatment (often antibiotics, anti-inflammatories, or immune therapies) are key.
Because there’s no universal diagnostic code for PANDAS, parents may need to advocate for their child and seek out informed providers.
As Shannon says,
“If your child has PANS or PANDAS, take off the guilt hat. Put on the empowered hat. Ask: what’s the next right thing we can do?”
PANDAS and PANS can feel overwhelming, but families are not powerless.
With the right medical care, nutrition support, and early intervention, many children recover or go into remission.
If you’re noticing sudden changes in your child’s mood, eating, or behavior, especially after illness, trust your instincts. Learn more, ask questions, and seek professional guidance.
Because every child deserves the chance to grow and thrive with nourishment – body, mind, and heart.
Listen to the full conversation with Shannon Leatherman on The Nourished Child Podcast for practical insights, nutritional guidance, and encouragement to help your child heal from PANS/PANDAS and rediscover a balanced, joyful relationship with food.
Resources & Links
Jill Castle, MS, RD
I like empowering parents to help their children and teens thrive at every size with realistic advice centered on healthful habits around food, feeding, nutrition and health behaviors. As a pediatric dietitian and author, my goal is to share strategies and realistic advice to help you raise a healthy and happy child through my articles and podcast.