PANS: Is the Immune System Keeping Your Child’s Brain on High Alert?

Many parents of children with PANS can trace the story back much further than the sudden onset of anxiety, tics, or behavioural changes.

Long before the neuropsychiatric storm arrived, there were often quieter signs that something was brewing beneath the surface. Frequent allergies. Chronic congestion. Enlarged tonsils. Mouth breathing. Snoring. This was the child who was “always a bit unwell” but never quite sick enough to raise alarm bells.

These patterns are often dismissed as common childhood issues. But in sensitive children, they can be part of the cumulative immune picture that sets the stage for PANS.

The Immune System at the Front Door

The immune system does not just live in the blood. A significant portion of it sits at the body’s "front lines," particularly in the tonsils, adenoids, sinuses, and gut.

Tonsils and adenoids are active immune organs. Their specific role is to sample what enters the body and decide how the immune system should respond. When a child is exposed to repeated infections, allergens, or ongoing inflammation, these tissues can remain chronically enlarged or reactive.

Instead of switching on to fight a threat and switching off when the job is done, the immune system stays perpetually activated. For some children, this constant immune signalling does not stay local. It begins to influence the nervous system and, ultimately, the brain.

Allergies: A Sign of Immune Load

Allergies are frequently viewed as inconvenient but harmless. We tend to treat sneezing, itchy eyes, eczema, or food reactions as separate issues from behaviour or emotional regulation.

However, in children with PANS, allergies matter because they reflect immune hypersensitivity. Histamine release, mast cell activation, and inflammatory cytokines all signal that the immune system is reacting strongly to perceived threats.

Parents frequently notice that neuropsychiatric symptoms worsen:

• During peak allergy seasons.

• With exposure to dust, mould, or environmental triggers.

• Alongside flares of eczema, asthma, or chronic congestion.

This pattern is not a coincidence; it is cumulative immune load. When immune messengers circulate at higher levels, they can breach the blood-brain barrier, affecting areas of the brain involved in mood, cognitive flexibility, sleep, and emotional regulation.

Why the Immune System Affects the Brain

In PANS, the symptoms are not caused by psychological weakness, bad behaviour, or poor coping skills. They are driven by immune-mediated inflammation affecting the brain.

When the immune system is repeatedly triggered - whether by infections, allergens, or chronic inflammation - the brain can get stuck in a defensive state. This "brain on fire" mode manifests as anxiety, rigidity, emotional outbursts, tics, OCD-like behaviours, or developmental regression.

The brain is not the problem. It is simply responding to the signals it is receiving.

Environmental Stress and the Sensitive Child

Integrative physician Dr. Jill Crista has spent years studying how chronic immune stress affects children’s brains, particularly in those who are genetically or immunologically sensitive.

She explains that for some children, the immune system fails to switch off properly after repeated exposures. These exposures may include infections, allergens, or environmental stressors such as mould, damp buildings, or chronic inflammatory triggers.

Rather than causing acute illness (like a fever), this ongoing activation quietly affects:

• Emotional regulation

• Anxiety and mood

• Cognitive flexibility

• Sensory processing

• Sleep architecture

What matters here is not just the trigger itself, but the immune response. This perspective helps explain why some children with PANS appear "healthy" on standard blood tests yet continue to struggle. Their immune system remains in a defensive state, sending inflammatory signals to the brain even when an obvious infection is no longer present.

A Story from the Clinic

I recently saw a mother who brought her seven-year-old son to see me after what she described as a complete personality shift.

He had become anxious, rigid, and emotionally reactive. Bedtime had become a battleground, and school felt overwhelming. Small changes to his routine felt unbearable. PANS had been mentioned by other practitioners, but strep tests were negative, and antibiotics had only helped briefly.

As we talked, a longer, deeper story emerged.

He had always had allergies. Chronic sniffles. Hay fever. Itchy skin. His tonsils had been enlarged for years. He snored at night and was a mouth breather. He was rarely acutely unwell, but he was never fully well either.

No one had ever connected those dots.

When we looked at his symptoms through an immune lens, the picture changed. His nervous system was not failing; it was responding to years of ongoing immune stimulation. We took a gentle, layered approach, focusing on reducing immune load, supporting histamine balance, addressing gut health, and helping his nervous system feel safe again.

Progress was gradual-not linear, but real. Months later, his mum said quietly, “I feel like I’ve got my child back.”

Is Surgery the Answer?

Parents often ask about tonsillectomies. Some children improve significantly after surgery, while others do not.

This is because removing the tonsils addresses one potential immune reservoir, but it does not automatically resolve the wider issues of allergic load, gut permeability, immune dysregulation, or nervous system stress. This doesn't mean surgery is wrong; it simply means it works best when considered as part of a broader plan that supports the whole immune system.

Supporting Regulation, Not Just Symptoms

Supporting a child with PANS means looking beyond the brain to address the systems that influence it. This often includes:

• Reducing triggers: Identifying and lowering environmental or biological immune irritants.

• Pathway support: Aiding allergic and histamine pathways.

• Gut health: Strengthening the microbiome and gut barrier.

• Nervous system: Prioritising rest, rhythm, and safety.

Care must be paced and layered. The goal is not to suppress symptoms, but to help the immune system calm down so the brain can do the same.

A Note for Parents

If your child has a history of allergies, enlarged tonsils, or chronic immune issues and later developed sudden behavioural changes, you are not imagining the connection. These patterns matter.

With the right support, many children can move out of constant immune defence and back into steadier health. Healing is rarely instant, but it is entirely possible.

A Gentle Next Step

If this story feels familiar, you do not have to navigate it alone.

You are welcome to book a Discovery Call if you would like to talk things through and see whether this approach feels right for your family. If you are ready to begin, you can book a consultation, and we can start looking at your child’s full picture together.

There is no rush. We move at your child’s pace.

With care,

Ayelet