PANDAS and botanical treatment of strep

[Margaret Webb]

Hello,
I have a 15 y.o (with Asperger’s) diagnosed with PANDAS. The symptoms appeared abruptly in Feb of this year. Her Anti-DNAse B was a 1030 on her CBC (normal was 0-310) and her ASO was in normal range.The CBC was conducted 3 weeks ago. I am an acupuncturist and typically treat with botanicals. Her physician is willing to work with us to see if we can get the antibodies down through botanical means instead of a round of antibiotics–hoping to preserve her gut microbiome. I am wondering, in terms of treatment, does it make sense to treat the strep as an active pathogen (when the antibodies are elevated like this) even if it is months out from the exposure? Also, do you have a suggestion for any good research being done on the effectiveness of treating PANDAS with antibiotic therapy? Her main lingering symptoms are twitching, eye flutters, OCD behaviors and extreme irritability.
Thank you,
Margaret Webb

[Todd Roach]

https://www.pandasppn.org/treatment-of-panspandas-with-antibiotics/
This site has some good research.
Biocidin and many doses of good probiotics would be a step I would take. Any info on your daughter’s genetics? I always focus on Th1 and Th2 imbalance with this presentation as far as immune function. Also, dopamine and serotonin may be a turnover issue, again information from genetics would help there as well as an OATS. Any EEG information? Slow wave dominance in the frontal lobe at F3? Coherence between F3 and F4? Just my thoughts initially but Dr. Woeller may have better ideas.

[Margaret Webb]

Thanks for your response. We are considering doing some QEEG with her but have not gone that route yet.

Her Physician is doing supplementation for FLOR2 +/+, MTHFR 1298C and 677T (compound hetero), and TCN2 +/-. as well as well as UQCRC2 +/-, COX5 +/-, COX6 +/-, and ATP5C1+/- mitochondrial SNPs. Basically she has her on a good dose of Methyl B’s and some PPQ supplementation. As well as Fish Oil, Mag, Calcium. And, we just started working with some CBD oil which seems to be helping. I am planning on doing an OAT on her as well.

In terms of the infection we are using Chinese Herbal Formulas that are geared towards “Gu” syndrome –or latent bacterial or parasitic infections. These formulas can be great, as they target a whole host of bugs, but typically they are only used for infections. I am totally new to these area of treating PANDAS and am curious if the presence of elevated antibodies means there is an active strep infections that the body is still trying to get a handle on–or if is a lingering autoimmune reaction that needs to be managed? Or both?

Thanks all,
Margaret Webb

[Todd Roach]

I would put my allowance on both! Looking at the MTHFR and FOLR2 snps really thinking decreased T cell activity unable to control B cell activity so inflammation and immunoglobulins running wild. Any SNP’s on COMT or MAO’s at all? Does she have gut symptoms? I ask because I have had problems with patients having gut issues and not absorbing b’s by mouth, so I hit sublinguals and transdermals until the gut is improved. Certainly interested to see OATS results with B values as well as Candida and Clostridia numbers, but really that quinolinic acid/serotonin balance may be affecting the frontal lobes leading to some of the behavioral (OCD and irritabilty) issues.

[DrWoeller]

Margaret,
Tough situation. I agree with Dr. Roach in likely both things are occurring.

Here’s a few things about Anti-DNAse B:

-DNase B is an enzyme produced by almost all strains of beta hemolytic Group A and a few strains of Group C and G streptococci.
-The anti-DNase B test is an enzyme neutralization test, measuring the ability of specific antibodies to inhibit the depolymerization of DNA.
-Both the Anti-DNAse B and ASO Titers can be used to help diagnose various strep related disease – glomerulonephritis, acute rheumatic fever, and Sydenham’s chorea.

One test you might want to consider running is the Cunningham Panel from http://www.molecular.com. This looks at various autoimmune strep related reactions to things like dopamine receptors.

I don’t have a heavy PANDAS population so relying on sites like Dr. Roach listed above and http://www.pandasnetwork.org are what I use.

Also, it would be worthwhile considering low dose naltrexone as a autoimmune therapy that may be helpful – http://www.lowdosenaltrexone.org.

Dr. Woeller

[Margaret Webb]

Dr. Roach,
She is COMT H62H +/+ as well as COMT V158M +/+/ . I am still getting up to speed on how to look at the gene tests so I may be missing more relevant info. She is positive for high levels of yeast in her stool (neg on serum test) as well as high Clostridia. We are planning to do a more specific Clostridia test next.

She does have some gut issues (occasional gas and loose grainy stools) but she is also on a pretty clean diet. Family history of autoimmune issues as well….

Thanks for your input.

Margaret

[Margaret Webb]

Thanks for the suggestions Dr Woeller. I will look into the Cunningham Panel for her. And, the LDN.

Best,
Margaret

[Todd Roach]

What does the FUT2 and DAO info look like?
Dr Woeller may not agree, but I have concern if so much of the supplementation for MTHFR, etc. are by mouth. If there is this much chaos along the digestive lining as far as overgrowth, she may not be absorbing a lot of what she needs.
I would also be interested in NOS2 and NAT2. See how well she is cleaning house.

[DrWoeller]

The DAO will certainly increase the potential for histamine reactions. I usually prefer subcutaneous methyl or hydroxy-B12 if at all possible. Creams may work okay.

Dr. Woeller

[DrWoeller]

The Organic Acids Test from Great Plains will be important to evaluate for to see if the clostridia markers are elevated?

Dr. Woeller

[Margaret Webb]

Hello,

The FUT2 is +/- , the DAO is -/-. and the NOS2 are -/-.

The MTHFR support she is taking is a sublingual “Methyl Complete” by Neurobiologix. She seems to be tolerating it,but,I am not sure I would be able to differentiate a histamine reaction from her other symptoms. What might that look like?

I would say, overall, she has been showing slow but steady improvement. And, I am looking forward to checking in as we make out way through the course. I am sure some helpful stuff will show up on her OAT–

Thanks! Margaret

[Todd Roach]

Histamine reaction from food would be similar to allergies after eating high histamine foods. DAO helps break that down. Is the PQQ by mouth? I am assuming Mitocell PQQ? Need to get that OATs done and clean the gut (my opinion).

[Margaret Webb]

Yes. It is the Mitchell PPQ. And, we are working on the OATs 🙂

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