Plan B for PANS

The Plan B Field Guide

Every treatment, deconstructed.

The hardest part of PANS is the moment you stall — when the standard path stops working and no one tells you what’s left. This is what’s left. Every treatment, laid out honestly, so that when you hit a wall you know the search isn’t over — there’s a Plan B. Each guide answers the same things: what it is, the research, the real risks, how to actually get it, and how to vet a practitioner.

A note from Rachel — before you scroll

This map took me two years to understand. You don’t have to. Plan B already knows it — better than any human ever will.

So if this page tightens your chest or makes you want to close the laptop — do it. That’s allowed. Let Minta do the work; that’s exactly what she’s for.

I’m a control freak — I need to see the gears turning behind the curtain. So I’m pulling it back and showing you the basics. Fair warning: even the basics are honestly a lot. Take what helps, skip the rest, and let the system carry what you can’t.

— Rachel

★ Read this first — the whole picture

The Map

ProtocolDriversDeeperBetter

The whole journey for PANS — at a glance. Tap any branch to open its treatments. Every guide below is one limb of this map.

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1 · Start here

Understand it, then begin.

Start here: understand this first (plain English)

The simplest possible explanation for a scared parent with zero biology background. Four plain ideas — genes are the blueprint, methylation is the maintenance crew, mitochondria are the batteries, the infection is what lit the fire — and the one thing that matters most: the order to do things in (understand & find → support the engine → THEN the deep kill), so your child gets better instead of crashing.

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Where to Start — The Testing Map

Where do I even begin with testing? A tiered, scaffolded map: cast a wide net ONCE (Tier 1), then follow only the branches your results flag. Elevates the two tests almost every family misses — a comprehensive methylation panel and an organic-acids (mitochondrial) test — even two years in.

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How to actually use a genetic test

A genetic test like 23andMe is a blueprint — it shows what your kid might struggle with, but on its own it's just a spreadsheet of letters. The whole value is the read: a practitioner like Yasko interprets it — and Minta does it free, then overlays the bloodwork that shows what's really happening now. Plus the 3 simple steps to order both.

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The Protocol

Where everyone starts — anti-inflammatory + a targeted antibiotic, the doses, how long, and what to do if your child slips.

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2 · Check the engine first

Before you try anything else. If your child is undermethylating, detox is clogged, or the mitochondria are drained, treatments can BACKFIRE — this is the engine no specialist owns, and the bottleneck Plan B was built around.

Methylation, Detox & Energy

The body’s cleanup-and-power engine — methylation (the maintenance crew), detox/glutathione (the drains), and the mitochondria (the batteries), all one connected system. Why genes only say the crew might be short-staffed and blood tells you if it actually is, Naviaux’s Cell Danger Response, and why pushing a kill before the engine is running can make a sensitive kid worse.

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Read your raw SNPs — free

Drop your 23andMe file and get your methylation genetics read through three frameworks (Yasko · Lynch · Kara Fitzgerald) — tendencies, not prescriptions. Free.

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3 · Support & regulate — the daily foundation

The layer that runs alongside everything — nourishing the body and steadying the nervous system so the medical work is tolerable. Alongside it, never instead of it.

Diet & Nutrition

Food as a real PANS lever — the anti-inflammatory foundation, which specialty diet fits your kid’s pattern, and how to find triggers without over-restricting.

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Nervous-System Regulation

Calming a fight-or-flight brain — vagus-nerve work, HRV, limbic retraining — the layer that makes everything else tolerable.

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Brain Retraining for Kids

DNRS (Annie Hopper) as the lead, plus the kid-native tools (tapping, SSP, co-regulation) that make detox survivable.

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Screens, Dopamine & the Point System

A real family's carrot-and-stick reset for a screen-obsessed, dopamine-driven kid — points to grow good behavior, strikes (a written reflection) to deter the bad — that calmed their whole home.

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4 · Find the root drivers

If the protocol isn’t enough, this is where the answers hide.

Start here

Infections

PANS, PANDAS & Strep

How strep triggers sudden OCD, tics, and behavior changes — the molecular-mimicry mechanism, what to test, and why a negative throat swab doesn't rule it out.

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PANS and Lyme

The tick-borne connection — how Lyme and co-infections drive sudden OCD and rage, why standard tests miss them, and what to test and do next.

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Lyme & Co-infections

Antibiotics vs herbals (research-backed), the kill-menu, per-bug dosing, and how to find a Lyme doctor.

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Parasites & Behavior

The overlooked driver — pinworms, protozoa, and helminths that drive night-waking, teeth-grinding, rage, and OCD-like behavior, the full-moon pattern, and how to treat them.

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Testing for Parasites

Why a single stool test misses most parasites, the tape test and serial-sample protocols that actually catch them, and which labs to ask for.

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High anecdotal success, low research — run in the background

Biomagnetism

Low-risk, low-cost magnet therapy (the Joan Randall Protocol). Formal evidence is thin, but the risk is near-zero and families credit it with real turnarounds. Once you know what you're targeting, run it in the background — in parallel with the real work.

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Homeopathy

Safe, gentle, contested in the studies — but with real recovery stories, including OCD and intrusive thoughts resolving. One PANS therapist's daughter, who had failed O'Hara / IVIG / antibiotics, came back 100% on homeopathy. Once you know your targets, weave it in and let it run in the background. Start classical.

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Muscle Testing (self-testing)

How parents "ask the body" yes/no — the sway test, the O-ring, the arm test, step by step. Honest about the thin evidence (it's subjective), but low-risk and free. Use it only AFTER a thorough functional-medicine workup — then, once you know your targets, to help choose and sequence in the background. Never a substitute for labs.

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Environmental

Gut & mast cell

5 · Immune treatment

Calming, steadying, or supplying an over-reactive immune system.

IVIG & Immune Treatment

Who qualifies, the infusion day demystified, the studies (what it clears vs not), and the insurance fight.

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Serum Immunoglobulins (SBI Protect)

Powdered, oral IgG (serum-bovine immunoglobulin) that binds toxins and calms gut immunity — not IVIG. The gut-barrier and endotoxin-binding research, who it helps, how to dose, and the honest evidence.

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Intranasal Immunoglobulins

Immunoglobulins delivered to the nose — a far gentler, lower-cost cousin of IVIG aimed at the olfactory route into the brain. What it is, why it’s not IVIG, the early evidence, and how families access it.

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LDN — Low-Dose Naltrexone

Jill Crista’s lead “regulate immunity” tool: a tiny dose of an old drug that rebalances an over-reactive immune system and quiets neuroinflammation. How it works, pediatric dosing, the honest evidence — plus colostrum and the rest of the immune toolkit.

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6 · The deep menu

Most families never need past here. When the standard path is exhausted, this is what hasn’t been tried — grouped by what it targets. Caution is reserved for the few that carry genuine risk.

Oxygen & energy

Gut reset

Brain & nervous system

Targeted kill

⚠ Real risks — expert supervision only