Strep Throat Can Cause Body, Mood, Behavior & Psych Change? Hope for PANDAS & PANS!

In this episode, we explore the growing issue of antibiotic resistance in strep throat, especially in children, and its far-reaching effects on the immune system and brain health.

We discuss into the complexities of PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and PANS (Pediatric Acute-onset Neuropsychiatric Syndrome), conditions where strep triggers autoimmune responses that impact the brain. Discover why a holistic approach to health is vital, from proper hand hygiene to reducing antibiotic use, and how supporting the immune system can make all the difference. Tune in to learn about comprehensive treatment strategies to address strep's systemic impact and the importance of working with experts in the field to navigate these complex conditions.

Please note that transcripts may contain minor errors or inaccuracies. We hope you enjoy reading them and find them helpful.

Hey, you're gonna be okay. I'm your host, Elizabeth Mae, and my functional health practice helps people heal when they've exhausted traditional options. When no one can figure your health challenges out, my team helps you resolve symptoms and restores your health. You're listening to my podcast where we'll hear stories of healing chronic illness from a root cause approach. A strep throat is something most of us have experienced once or twice or at least are familiar with. But did you know that strep is becoming more antibiotic resistant? And many children, kids are often experiencing strep more than adults, often they have a harder time kicking the infection with just one round of antibiotics. Plus, antibiotics are wonderful when we need them, truly, truly, in the holistic space. That is not discussed enough, but that is my stance. But when we have multiple rounds, we're degrading the gut's healthy microbiome at the same time, and we are also killing the unhelpful strep, right? But the goal is not necessarily to decimate the immune system, though that's what happens when those multiple antibiotics are there. So strep throat may be a familiar instance to you. The use of antibiotics for strep may be familiar to you, but a strep brain isn't a familiar experience for most. Now, when strep triggers an autoimmune response on brain tissue, because streptococcal proteins look very similar to brain structural proteins, we have a condition called pandas, often paired with the condition um PANS. So PANDAS stands for pediatric acute onset neuropsychiatric disorders associated with streptococcal infection or with streptococcus. PANS is when the same change or this neuropsychiatric disorder is associated with other primary infections, not just strep. So we see this sometimes when kids have Bartonella or they have Lyme. Basically, the brain is affected by the infection and neuropsychiatric change, mental health change sets in. When pandas sets in, it's in various severity levels. Some kids really struggle. Practically, parents can lose their children to erratic behaviors, obsessions on everything from death to cleanliness, anxiety, separation anxiety from one particular person or parent, sleeplessness. Essentially, the infection can wreak havoc not only in the throat or the belly or the heart, as we're familiar with strep doing, but strep interacts with the brain intermittently as the immune system ebbs and flows. So you can even have a kid who looks like they're struggling with mental health issues, and then they look like they're fine and great. And then they dip back in, and then they're they're really doing great again. Strep can ebb and flow in its way that it's affecting the body because the immune system ebbs and flows, addressing the infection. Now, did you know that a child experiencing acute mental health changes could be experiencing them because of an infection? When it comes to strep driving mental health change, it's really as simple as the strep bacteria crossing into the brain, but also the strep bacteria can simply be present in the body and affect the brain. So, really important to know that the strep infection can cause psychiatric changes when the immune system begins to target brain tissue instead of the infection. But we're going to talk about that more. Where else do we see infections impacting the brain? Very, very commonly with UTIs in our seniors. There's no different situation really than a senior adult suffering a mood change as a first sign of a urinary tract infection. This is similar, different bacteria. Actually, sometimes strep can cause UTIs, but strep is one of the big four infections we see in my practice. Okay. So our big four are going to be Lyme, episteme, barivirus, or mono, mold, and streptococcal infections. Okay. So these four infections, which mold isn't exactly an infection, it's more of an exposure, but uh kind of group them together. Um, they're gonna create a dysregulation of the immune system in big ways, which leads the body to do funky things like attack tissue, autoimmune, attacking the self, right? So let's pause here. Dysregulating the immune system essentially means that the infection breaks or imbalances the immune system. That means that strep can break or imbalance the immune system. And that's when we see these more profound effects of a bacterial infection. Can the immune system recover? This is such an important question because I know so many of you listening know, love, care for, have raised children who are now struggling with a pandas infection and are completely different people. The immune system can recover. Absolutely. Does resolving a strep infection that's systemic or cross into the brain or at the pans or pandas level require a specific process? Yes, absolutely. But whether you're struggling to resolve strep throat in your kids or live living the extreme suffering that is pandas, watching your child kind of regress and disappear, struggle with major habits, we really have some unpacking to do. There's a lot of hope. We see regularly, and I'll continue to share regularly, stories of children who have faced pandas or pans for years, or even just a low-level, very persistent strep infection for years. Find resolution to that. So, first things first, what is strep? Well, streptococcus are a family of bacteria. They make up a good part of your microbiome. Okay, so our body's made of human cells, but we're also primarily made of bacterial cells. So some Streptococcus families are actually helpful. They can even be great. Some are not helpful. Um, streptococcus thermophilus is a particular variety that we actually supplement as a probiotic to help brain and psychiatric health. So strep is a little confusing, but all of them are bacteria. And we're most commonly familiar with strep A and strep B. Strep B, we know from group B positives when you're pregnant, you are group B strep positive, then you have to deliver your baby while taking IV antibiotics in America. Strep B tends to inhabit the lower GI tract, the vaginal area. Um, it can be a root of recurrent SIBO or small intestine bacterial overgrowth. It can be part of GI issues. And research has even shown that strep infection, group B, can be the trigger for Crohn's disease. So if that's something that affects you too, Crohn's, all that is is just an autoimmune attack of intestinal tissue over and over again. Well, what provokes that immune system to be dysfunctional? Research shows us that sometimes it's strep. Now you also have the strep A family, and this is another bad group that primarily is in your airway, so ear nose throat, it's considered the root of strep throat. Um, ear infections, many ear infections, so they can be viral, are often rooted in um streptococcal bacteria. Throat struggles, sinusitis, recurrent um sinus infection, all of these things can be a trigger for the autoimmune process called pandas, which again is going to be an autoimmune process stimulated by that strep bacteria. So strep is just a bacteria. Streptococcus is the family, and there are different varieties of strep. Now, what else can strep do? Honestly, strep can be the root of a lot. In my practice, we help folks resolve chronic and complex illness of all varieties. And a lot of times I look at our client load and say, how in the world can we help all of these varied tens of people with one same group of skills? Because a lot of chronic and complex illness, though it's different body systems, go back to the same dysregulating causes. Strep, you're about to see, can really affect lots of different systems. So strep can show up as skin issues, dermatitis, eczema. We resolve rashes, often acne. Teens who struggle with acne, when we are able to address strep, acne goes away. Um, skin conditions like embatigo often has strep at the root. We're pretty, we're pretty good and accepted around the embatigo idea that it's usually rooted in strep and staph together, parting on the skin. Strep is also at the root of ear, nose, and throat issues. We just talked about that strep A that's there primarily in the throat. So we know strep throat. Recurrent ear infections, large tonsils are another piece, large adenoids even can be part of strep-rooted infections, sinus infections, chronic oral issues like gingivitis and bleeding gums, anything in that ear, nose, throat area. Tanger sores and styes are often sores that are expressed in those areas from strep bacteria at the root. Now, strep also shows up in our GI tract, right? So we see stomach issues, um, we see diarrhea, constipation, vomiting, gas and bloating. Sometimes your pediatrician may let you know that if your kid is struggled with strep, you can see it pop up as a GI issue. Your kid may vomit a couple of times, doesn't really make sense, my belly hurts. Those can be symptoms of a strep infection as well. You go to the doctor, you do the usual throat test, swab it, positive, but no throat symptoms. Strep can be in our guts, strep can create it to your sore bottoms, um, constipation, pain with wiping stools. So we do need to and get to learn to listen to our children differently because symptom really can be such a variety of things. Strep can show up as uh an acne-type rash on the bottom or in the genital area. We can also see a sore rectum or a red rash around the anus due to strep, urinary frequency, bed wetting, though bed wetting can cross over with other infections because really urinating with frequency and urgency and force can just be the body trying to clear out infection, but strep is one of those that can infect urinary attract. Hair loss, dry or brittle hair, these are some other physical symptoms that are kind of randos, but again, are kind of part of that hair skin presentation. Now let's talk about behavioral issues. For me, these tend to break down into things that we think um one can't control and things that we would think are controllable. One of the hardest parts for us emotionally supporting families through pandas and pans is how little is known about pandas and pans from your peers. So you may have a child who struggles with pandas who has all sorts of wild behavior issues, and your peers are going to look at you and think, well, gosh, can't Betty just keep her little kid together? She's got so many issues. She's not doing good in math, she's really regressing. They're not working with her very much at home. She seems so anxious. Must be something going on in their house. She's very impulsive and hyperactive. She just needs ADHD medication. That child is super aggressive. She needs to teach her son not to be so aggressive. Listen, that whole host of issues can be their own things, but they can also and very, very often, particularly in children who should be the healthiest amongst us, but unfortunately in our country, not so much. But these behavioral issues can go back to strep. Let's talk about things we'd agree one can't control. Ticks can be sign of strep. Repetitive movements or sounds is what we're talking about with the tick, all the way to someone presenting like they maybe have Tourette's. We want to think about an onset. So if someone's had and presented with Tourette's for a very long time, maybe strep exacerbates that. But we're talking about more of an acute change. Ticks, repetitive movements, sounds, um, some stimming stuff that pops up for kids that hasn't been there before, ADHD behaviors, anxiety. We would say anxiety is not controllable. Sometimes it's just situational, depression or sadness, same thing. These things can all go back to strep. They don't always, but they absolutely can. And there are things that we think behaviorally are controllable person to person. Impulsivity, hyperactivity. If we just let that boy run his energy out, things will be better. Sometimes strep is at the root of that. Oppositional defiance is a big one. If you've met an oppositional personality who ebbs and flows over time, strep often is the root of that ebb and flow. Behavioral aggression is big, and we're going to talk about why that happens, but we're looking at regression of handwriting. That's a big one for kids. Behavior regression. Sometimes they're learning, losing skills, language, um, particularly math and science. Sometimes they're acting younger than they are, baby talking, shrinking, shaking, being very, very afraid in situations that don't really merit being very afraid. These are things we would think, oh, that's controllable. Oftentimes streps at the root of that. The biggest symptom that I see disabling families with recurrent strep is separation anxieties and phobias, followed by aggression. But with separation anxiety and phobias, that can be fear of big crowds, fear of vomiting, fear of sickness, fear of going outside, fear of going to bed by myself, fear of not having my person. Pandas clients typically have one person, whether they're a child or an adult, because yes, pandas and pans can can totally exist in children and adults. But they will have one person that they're very attached to. They cannot be without. That person needs to do their bedtime. That person needs to be near them. That person shouldn't go to work because they need to stay home with that. They become their very um preferred anchor, which in some ways we could say, oh, well, that kid just prefers this mom. Sometimes an extreme change like this really has to do with an infection affecting the brain, aggression, and um I would say extreme unkindness, if you will, violence, even. So a lot of times kids are in between that three preteen area. So we're talking toddler to preteen concentration of pandas, but absolutely extends all the way into adulthood. It can, but we see a lot of times a lot of aggression and hitting. And between the ages of three and 10 or 11, there can be a host of reasons that we're hitting or being aggressive. But again, the distinct change. Um, a child who's aggressive who hasn't been, we want to be thinking about strep at the root of that. These are all things that strep can do. Very, very bizarre, right? Because it's just a bacteria. But remember, back to our senior adults, bacteria can do weird things. You can have a urinary tract infection and it affects your brain and your mood. Same situation here, okay? Now, if Streph is doing all of this, I know when I first started moving into seeing clients with multi-systemic issues, I would see threads and think, how in the world can we be having mood disorder, GI disorder, skin issues, major rashes, and all these phobia? That's lots of different systems of the body, balance issues, movement issues, very clutsy, very clumsy. How can all of those things go back to one thing? Remember that strep families are very vast and there are many types, even those helpful kinds. Strep is a bacteria, so it's transmitted very readily from coughing on one another, sharing saliva, breathed on by your neighbor, including your neighbor in your classroom at school. It's very easily transmittable, right? Now, strep becomes a recurrent issue when it collides with a dysregulated immune system. Your immune system is there to keep infections out. So strep should come in, your immune system deals with it, maybe you have a short sickness, it's resolved, and we move on with life. Strep becomes a recurrent issue when it collides with a dysregulated immune system. That could be from other infections being there first. Say Lyme is there, the immune system's dysregulated. Could be from the immune system being weakened. There's mold in your child's school, their immune system is going to be regularly weakened and challenged. We can see strep come in and take a place. Maybe your child's immune system is weakened from recurrent antibiotic use for various issues. The microbiome's just slow and good bacteria to balance out and help protect when that strep does come in or gets out of whack. Maybe your child had a C-section and early IV antibiotic use. Maybe mom had to have IV antibiotic use during labor, during early days with baby while nursing. There are lots of things, right, that can that can cause our microbiome to be overwhelmed with bad bacteria in proportion to good bacteria. And then there are environmental things that can limit the immune system too. Mold exposure, toxin exposure. I cannot underestimate to you the amount of mold in our country's elementary schools, unfortunately. So I want you to be thinking, even private schools. I have a list of private schools on my desk where I put a little mark next to it every time I have a child in my community who is struggling with mold and goes to school there because it is so present. Practically, let's talk about how strep moves in the body. Strep is able to make a sight change by generally riding the nose up into the brain, really. You know how you um can make a drink come out your nose if you laugh too hard after you sucked in some liquid? Okay. Strep brain is basically based on this idea. If you take liquid in your mouth and you can make it come out your nose, all that's connected, right? Okay, cool. Your nose is designed with a weak gate to your brain. Okay, so I'm literally talking up here inside of your nose. If you look at a diagram of the face, your olfactory nerve, you can see where those sinuses go up and your olfactory nerve comes down, and there are little nasal fibers, nerve fibers, sorry, that that extend into your nasal cavity. Why is this? This is good design for you to smell. That's what we want. This is one area of the brain where there's not as strong of a blood-brain barrier because we don't really need to keep things out of the brain. Smell is actually like a physical experience. Your nerves that are coming from that olfactory nerve, you got these little nerve fibers opening up into the nose. When you smell something, there's a physical collision of the smell item that touches that nerve and transmits to the brain a notice that there is a smell. So smell is quite literally touching the nerve endings with a smell that equates to your brain recognizing, oh, I smell cinnamon. Oh, I smell Mexican food. Okay. So now you got this little nerve situation, right? When you smell something really hot or spicy, what happens? A lot of times your nose runs, your eyes run. What's going on there? Snot is trying to come and dissolve and wash things out that shouldn't touch your olfactory nerve or need moving out. This is a protective mechanism. So a lot of times my streppy kids have really, really runny noses all the time. That doesn't mean you have strep if you have a runny nose. Not entirely. Not always, but you can see the good design here, right? Smell is a physical process. You've got to have that smell, the smell sensation, be able to get up into the nose, touch the olfactory nerve, send the brain the signal, hey, I'm smelling Mexican food. Hey, I'm smelling lemons. Okay. And when I smell something really spicy, there's going to be some snot coming out. My eyes may water. My my nose is trying to protect that olfactory nerve. Okay. Now, when this fails, there can be lots of setups. Okay. A child's immune system may be weak and they don't respond typically with like that snot protective because their immune system's already been hijacked by something. Maybe their immune system is just weak because they're going to school where there's malt. Maybe there's already stuff that's affecting and harming those olfactory nerves with that mold of mycotoxins coming in. Okay. But essentially the snot mechanism that's protective of that weak brain gate, if you will. It's kind of a gate that protects the brain from the outside world without those defenses of snot and in fluid. Strep can ride the nose elevator right up into the brain stem. In the brain stem, you're going to go by the basal ganglia and the hippocampus. These two pieces of the brain are most affected by strep. Now, I want to give you a different example to kind of help you process and maybe relate, because we haven't all had strep that's affected our brain. When you're exposed to toxins like cleaning chemicals, sometimes you can feel really woozy. Your nose might run. You can even feel off balance for a minute. Like when a really strong chemical smell hits you, it can be discombobulating. Same situation is going on. These chemical smells are hitting your nose elevator. They're sending information into the basal ganglia, which has a bit to do with motor skills and hippocampus as well, balance, these sort of things. And you're getting just a tiny glimmer into what it's like to have strep affect those parts of your brain too. You smell the bleach, you get a little like woozy, your nose might run, you feel a little like off balance, like I gotta get out of here, kind of a thing. And that's a good protective way for your olfactory nerve to kind of protect your body. Now, mold, same thing. Mold is going to be upcoming in podcasts. This is the last member of our big four for us to go through. Remember, we're talking about I'm EBV, strap mold. Um, when mold spores hit the nose and they're gases or mycotoxins, mold spores basically let out farts that are called mycotoxins. And these are the chemicals that really can affect our bodies the most. Um, surely if you eat mold spores, you will have some GI sickness, but the mycotoxins that they excrete are what really affect the brain and the body the most. Um, when those mycotoxins make their way to the brain via that same nose gate, you may experience all sorts of symptoms, a poor basal ganglia or hippocampus function too. Fine motor control or handwriting regresses, balance short-term memory issues when living in mold, twitching or movement disorders, changes in sensory information. You may start to um spark or shock when you touch certain things because there's a lot of electrical stimulation going on with mold and the body's nervous system. You may have changes in sensory information. Things may smell different to you when you live in mold. They may smell more sensitive to you. They um can sometimes even smell less you learn. To live with the mold and the smell no longer is something you notice. We see changes in decision making or impulsivity when the basal ganglia is affected. These changes can ebb and flow, they can be intermittent, your prioreceptive movement is impacted. That's a very trendy thing in the pediatric community, but I want to think about why proprioceptive movement is impacted? That's the sense of the body's movement and position. Well, when the hippocampus is affected, we see a loss of some of this movement skills. Same thing with basal ganglia, okay? That's your ability to know like where you are in space and then kind of respond appropriately. When the hippocampus is affected, we see short-term memory change. We see short-term memory not making it to long-term memory. Um, emotional processing and spatial navigation can be impacted. Clutzy kids, kids who all of a sudden are having spatial issues, running into things, falling down, stuff like that. That can all be hippocampus basal ganglia, kind of like consequences, if you will. Learning is impacted too when these two parts of the brain are impacted. With your hippocampus, it's involved in anxiety, avoidance behaviors leading to that separation anxiety change we see, um, all because the nosegate was essentially down in the job, but really because the immune system was impacted. So there's lots of reasons that strep can be harder to deal with for some. That can be existing infections, an immune system that's already dysregulated or imbalanced. Listen to earlier episodes if you want to learn more about that. Can be because the microbiome is depleted. Um, lots of reasons. But how do we prevent strep from progressing? What are things that we need to consider? What are things you as a parent need to consider or understand? There's so many things. There are so many things that we can do to increase outcomes with strep. I think it's really important to have hope always, because we're still living in this world with all these things, right? And to know that there are things within your control. There are ways that you can impact your child's health. It's not an entirely helpless thing. So strep is a bacteria. Step one, wash your hands. Have your kids wash their hands. Um, washing with water and soap is more effective against bacteria being removed than trying to kill it with hand sanitizer. So anytime you're able to wash with water and soap, we do it. We overemphasize hand washing processes, right? These things matter. We want to keep our fingers out of our nose. That's an easy one. If I touch Johnny on his hand, Johnny just licked on his finger, and then I go pick in my nose. Well, guess what happens? I maybe just move Johnny's strep infection right up into my nose, ready to roll right up and affect my brain. It's not always that simple, but picking the nose is very important to um NYX as far as the behavior because you're pushing bacteria up into the nose. Now, strep doesn't need to be in the brain to affect it. So before you're like kids are washing their hands always, no one will pick their nose anymore. We're not leaving the house. That's that's not gonna work. So remember, strep doesn't have to be in the brain to affect it. We all have strep in our body. There's different families, right? Okay. So strep can be in the gut in predominance or the bloodstream, and we can see symptom load in the brain. So some things we want to do are support healthy immune status. We're gonna avoid antibiotics overall. Sometimes we need them, right? They can be life-saving, they can be wonderful. I really love an antibiotic when we need it, but when we don't, or when we don't need it yet, learn to seek other routes of care. If possible, seek other modalities. Learn about them for common conditions. Say you're somebody that struggles with UTIs. Okay, you can avoid UTI antibiotics if you learn why are UTIs happening for you. It can be as simple as a thing most ladies know. If you're gonna urinate after intercourse, that's gonna change your proclivity towards UTIs, right? Without that information, you're gonna be set up for more. You can take preventative herbs like UVA ursi. If you learn about your common conditions or your child's common struggles, we do sick day coaching calls and you don't have to be sick to have them. Sometimes parents hop on and are like, I just want to learn what the heck a fever's for. Why are we not treating the fever? What is the fever doing? Be equipped. Um, for something like an ear infection, that's a common antibiotic route, right? If you learn how to care for your kids' ears with mully and garlic oil at the first hint of ear or throat pain, you can prevent an antibiotic very often. Every time, no, but very often. So we want to equip ourselves to understand how to support bodies healthily to avoid antibiotics and know when when do we really need to do it? When do we need to cut off all the holistic options? Because sometimes I meet families too who are doing way too much holistic business. And antibiotic really could help clear out some stuff in a body. So learning those things. And if you don't know those things, reach out to providers who can who can teach you. Um seek to be educated and also yield to good education. Stay home if you're sick. This is a big one. We are taught to stay home if you've had a fever within 24 hours. I think after COVID, I'm not sure that we really honor that. I would also say that after COVID, um we kind of use that as a really short rule. And our pediatricians unfortunately set us up for that. Once you're on the antibiotic for whatever for 24 hours, you're considered not contagious for most things and you're allowed to go back to school. I would argue that we need to keep ourselves and our kids home until they are no longer sick, until they are no longer symptomatic for 24 hours. Not just until they're no longer showing a fever. Remember, something like Epstein Baravirus, you can transmit that through your saliva for 360 days. That means there are actually more 180 days. You can, it's more likely that you're gonna transmit via saliva. Earlier on, the likelihood that you're gonna transmit via saliva is really even higher. So the longer, sometimes with particular different viruses or illnesses, we keep ourselves away from others, we limit contact, the more we'll be able to help um control the spread of various things. So stay home if you're sick. Rest, hydrate, eat real food, sugar, process carbohydrates, things that your body has to go, huh? What is this? Not, oh, this is an apple. Oh, this is tomato. Oh, this is lettuce. Like these are whole foods. Your body has to figure out what it is. The processing is a little harder. I put stress on the body. Eat real food, hydrate with water, remove sugar. All these things are really helpful, right? These are basics. Um, our immune kit is a really helpful support for basic immune supports, learning how to use supplements. It's another really good place too to learn about basic immune nutrients. It is like a good one-on-one on how to support an immune system just day to day, and then how to really like buckle down and support it when we see some sickness coming in. You can also strategically support your microbiome. If I can make one test mandatory in the whole entire country, it would be a GI map stool test. You know why? Because you can build and balance your microbiome based on data. That is one of the best gifts you can give an immune system. So if your kids had many antibiotics, if your kid had to have IV antibiotics early on, if they didn't have a C-section, if they were born via C-section, not knocking a C-section, but the reality is the inoculation of that good bacteria via the vaginal canal is just not there the same way. One of the best things we can do in those situations where we suspect low good bacteria is to look. Let's look at a GI map stool test, fortify that microbiome, strengthen the immune system. Now, one of the other groups of things that we can do is just really understand what strep looks like. Some things to look for. Learn to listen to, study, be informed by, yield to our kids. Okay. When we see folks with pans and pandas, particularly pandas, we see a pretty regular group of symptoms. Diagnosis in a traditional setting is from testing and symptom load, okay? These are both things. They both have to clinically correlate to create a diagnosis. That does mean you can have symptoms and not have labs that show a major strep infection and you may have strep at root issues, right? So we have to work with someone who can think and understand strep. You want to work with a provider who's familiar with pants and pandas for figuring out is strep a root of what's going on. Some odd things to look for, equipping you as parents. If your child avoids certain people in their lives, sometimes these people are strep carriers, and there's an innate knowing in someone who struggles with strep that they want to stay away from someone who carries strep. Now, strep carriers, interesting theory. I do think it holds up seeing kids who avoid particular parents, they avoid particular caregivers. So that's just a little flag. Not a perfect flag, but a little one. If your kid gets really whiny sick when they're sick, not they get a fever, they really get knocked out and then they bounce right back up. No. If they're kind of this like chronic, whiny little person, their immune deficiency is constant, low grade, there's not enough immune strength there to really mount a response. We want to be thinking about that. If your child is exposed to increased glyphosate levels, that's going to be Roundup weed killer exposure. Now, why? Weed killer degrades bacteria, degrades your good bacteria. So if you live on a golf course, if you spray your yard regularly, if your family farms with a high chemical load and kids are exposed, if you live in flyover spraying states where we're flying over and spraying crop with Roundup, there's a lot, quite a bit of glyphosate and weed killer exposure. Um, but there are ways to definitely mitigate that. But if that is something that's present for your child, we want to think about how that's impacting their microbiome. High EMF exposure can be something. The nerves are affected by the electrical currents. We won't get into that today, but if you've got a new 5G tower, if you live in the city, if you have a smart meter by your child's bed, looking at EMFs can be something and just reducing those overall can be really helpful. Mold exposure is huge. Removing mold exposure, mitigating mold exposure, um, nasal rinsing if you have to have a child exposed to mold for any length of time. All these things are really important because they can lay the foundation for immune deficiency that allows strep to take over. We want to avoid silver fillings and mercury in the mouth. Um, we want to support their stress response. They need strong adrenals to handle infections. You do and you inherit your adrenal strength from your mother and her stress capacity. I laugh because that can really stink sometimes. But also, the strong adrenals are gonna handle infections, they're gonna handle inflammation. So there are things we can do for our kids. We can help support their stress response. We can equip them with tools, we can keep them in routines, we can have them rest when they need to, make sure they get adequate sleep, have them have some calm down or nap time if they've been overstimulated or exhausted. But look, if a kid is stressed, we do need to listen and yield and kind of help equip and make space for them, even if it's inconvenient. Picky eaters often have a strep issue. Um, we want to watch for sleep alterations, insomnia, night terrors, inability to sleep alone is a big one, especially if sometimes your child can do the sleep alone, and then other seasons they're like a stage five clinger. We want to think about that. Um, disordered eating, again, with the picky eating, it doesn't have to just be picky. It can be very disordered, it can be very preferential in large pupils. Anything that shows us the body is hyper-vigilant. So maybe there's a major startle response. The pupil situation is part of how the body um allows us to appear more hyper-alert. So a lot of times there are other symptoms for kids. Strep can be playing a factor there. Sensory change, if we see a child become very hypersensitive or insensitive to things that their peers are affected by, something like misophonia, being very sensitive to auditory things, um, other people chewing. And I'm gonna tell you right now, that's annoying. But if it is disabling your child to where they can't function normally because various sensory things are more for them, then that can be like a kid who's obsessed with wearing sunglasses can't go anywhere without their very dark sunglasses. It doesn't just have to be auditory, but sensory changes. Worries are a big one. Worrying over getting sick, fear of throwing up, fear of harming others, um, obsessions with death and dying, obsessions with symmetry or order, control, a sense of impending doom. And remember, this is where I kind of enter too that strep infections can be not just crossing the blood-brain barrier for children, but they can also for adults. So if these are changes you've noticed in yourself, we want to consider infections as a possible route. Intrusive thoughts, unwanted images, experiences. There's an OCD, like legitimate obsession, compulsive, impulsive, um, impulsivity that we can see come along with strep. So a lot of times there will be intrusive thoughts or repetitive images or concerns or worries or distress, or even a child that creates or causes worry and distress, looping thoughts, big streppy symptom. A child who needs reassurance constantly. We are talking reassurance about normal everyday things. We want to be thinking about strep and coinfections, routines that must be done the same way. Bedtime routines are a big one. If bedtime is insane and it hasn't always been, that's a big flag for me. The usual maybe things we think of when we think of OCD, counting things, needing to do rituals, um, but when it's crossing over to doing a ritual to keep something from happening, when there's kind of this superstition component, if you will, we want to think about strep. And really, if a person's behavior or or another person relieves anxiety, that can become something that they want to repeat. And once we're seeing that repeat of a behavior or a person or activity relieving anxiety, we want to be thinking about strep too. Now, why does strep create such a problem in the brain? This sounds a little wild that so many behaviors can come from a bacteria that's that's present in the body anyway, right? That was kind of my thinking. We were seeing clients who are struggling with all sorts of random psych and behavioral issues, in addition to their GI issues that rooted from strep. Quantity matters when it comes to bacteria, quantity matters. So if we don't have enough good bacteria, we know bad bacteria can take over and create distress in our gut. Same situation in your whole body. If we don't have enough good bacteria to balance out the bad strep bacteria that have grown, then the immune system is gonna have a hard time keeping it at bay. Your immune system handles infections. If your immune system is not sufficient, if it is not active, it's if it's imbalance, it's gonna have a hard time keeping strep at bay. And then we're gonna see the infection proliferating, infecting many body systems. What body systems are affected? The adrenals with a strep infection are gonna tank for managing stress and inflammation. We can see food sensitivities pop up. We see those severe food preferences, if you will, pop up. We see an inability to manage stress. Melatonin can be greatly depleted. Melatonin is an antioxidant for the brain. It can become so depleted that sleep is difficult, that sleep is evasive, that sleep is impossible. The gut lining can become compromised in picky eating, lack of appetite, nausea before meals, digestion, bloating. Um, some kids, when their microbiome is imbalanced, they refuse to stool in public. There's an internal abundance of caution where they're trying to keep one of the inroads to the body, the bottom, protected from dirty toilets, if you will. There's a much higher likelihood that there's going to be more strep in general fecal matter on public toilets than the toilet at your home. So a person struggling with a strep infection can, in their little inherent wisdom, want to avoid public stooling. Sometimes kids don't want to flush their stool. They don't want it to go away. There's some very bizarre things that our GI tract can do to our body, whether strep is the root cause or not. And we're going to see those showing up when there is a strep infection. Brain inflammation is the big thing. I could talk about this Tom Blue in the face, but I'm going to kind of leave it at a base of introduction. When brain inflammation is present, we see all these side changes, okay? When brain inflammation is present, usually the immune system is trying to pull strep from that area. Remember, strep proteins and brain tissue proteins look very similar. So the immune system can get confused. Similar example would be thyroid tissue. So thyroid tissue looks very similar to gluten or proteins. If the immune system has decided that it does not like gluten, it can then cross-react and attack thyroid tissue, and you can have Hashimoto thyroiditis. Same situation going on here. The brain is essentially attacked by the immune system. And the immune system is really just trying to clean out the strep, but strep and the brain tissue look similar and there's some cross-confusion. So brain inflammation is really the big thing. Dr. Kenneth Bach prefers to chuck the labels pandas and pans. And truly, if we work together, you'll know that that's kind of what I do with it too. Because infection-triggered autoimmune brain inflammation fits so much better. So he refers to that shortly as ITABI, ITA B I. Infection-triggered autoimmune brain inflammation. We can see this with Lyme. We can see this with Bartonella. Other pathogens cross into the brain. Toxoplasmosis, uh parasite can cross into the brain. When the immune system is working on cleaning that out, or the immune system responds with inflammation to the areas where those pathogens are going, we see infection-triggered brain, autoimmune brain inflammation. It's so important. The inflammation and ineffective immune processes that happen with your well-meaning immune system tend to breach that brain safety area. Um, you're having pathogens crossing the brain, you're having an overactive immune system there, creating inflammation, then we're going to see symptoms, okay? The big thing when it comes to strep is that strep proteins look similar to brain proteins, and you're going to have a confused immune system. And then we're going to see this cascade of all sorts of symptoms that are weird, right? Like balance issues don't really equate as like the same root as OCD, but they are. Um, extreme clutziness does not equate to me as coming from the same system as picky eating, but they do. Extreme sensory preferences do not equate to me as the same as like a person who has enlarged pupils. All that's coming from the brain. Your brain is in charge. So when strep crosses into the brain, when strep affects the brain, we see lots of different symptoms. Strep can be the root of all these things. Now, what do we do about it? Because that feels kind of overwhelming, right? There's so many systems involved when strep is crossing into the brain or affecting the brain, or even just we address strep immune dysregulation with folks who have purely GI and skin issues. It's one of the ways that we root out ongoing eczema, acne, um, Crohn's, major GI issues is by addressing the immune system's poor regulation of strep. So I want you to know that there are things we can do if it's addressing or it's affecting the gut, if it's affecting the brain, if strep is affecting behavior, regressions, all those things. A base thing you can do is to ask your doctor to run an anti-streptolase and o-titer. Um, we run that usually alongside anti-DNAs B antibodies to get information. This will give you data on the potential cause. But we also use a more extensive panel, often when we're checking for infections, because strep is one infection that can dysregulate the immune system. Once the immune system is dysregulated, other infections can kind of come forth. So again, earlier episode, I'm going to talk about why immune chronic infections can dysregulate immune systems earlier back in the podcast. But strep remodels the immune system for its own benefit. So the immune system can be tricked by strep so that strep can live, proliferate more, have a nice, happy home in your body, and not be policed by your immune system. Because remember, all an immune system does is figure out what is you and what is not you. And it's going to try to kill what's not you, right? Because we shouldn't have things that are not us inside our body. We shouldn't have strep bacteria in our body from Johnny's strep throat. We shouldn't have mold in our body. Our bodies don't need mold. So our immune system is going to go break that down, clean it up, and get it out. But when the immune system is dysregulated by something like strep or other infections, we have to modulate the immune system to really address and fully resolve pandas, pans, IT ABI, whatever you want to call it, we have to address the immune system. So we use an extensive panel to look for infections. We use your health history, we use symptom load. It's really important to work with a practitioner who understands these things. The thing that I say over and over again about pandas is working with someone who is equipped to work with pandas is extremely important. And I say this as a mom of two boys because pandas is something that can harm brain tissue, right? An autoimmune attack on brain tissue is harming brain tissue. What does your brain do for your body? Oh my goodness, it runs everything. So we want to be Very wise and very careful and very quickly stop that brain attack and re revert the immune system back to healthy function. If a practitioner comes to us and wants to consult around their pandas cases, my first question is: have you had success resolving pandas? If the answer is no, we won't do it. I don't feel like it's prudent. It may seem harsh, but your child's brain is at stake. We want to work with someone who's had success in resolving pandas, who has worked at it in a comprehensive manner, who's going to work at it in a comprehensive manner because it affects so many different systems. You have to care for all systems. We have to modulate the immune system. We have to support brain tissue and repair. We have to support your family, even to various therapies that can help to rejuvenate the body, um, to help rejuvenate the brain. And it's important that you have practitioners who can remind you of the light at the end of the tunnel that has happened for them. Um, and it's the most important that we're stopping that brain harm, right? The immune system with pandas and pans is in some form or fashion attacking the brain tissue, which equates to these symptoms. We want to cut that off as quickly as possible, especially in a developing brain. There are other things that can come behaviorally rage, aggression. If you've ever lived with a 10-year-old boy, they can be particularly strong. And so if we have aggression going on, it's really important that we're able to resolve those sort of symptoms as we're addressing the root. So a lot of times we see kids come in with major psych issues, and we want to resolve and stabilize that brain inflammation very quickly to help their day-to-day be better while we retrain the immune system to address the strep. So the big things I want you to remember is strep throat can become mental health challenges. Strep bacteria can be the root of very many different system issues in the body from dermatitis, eczema, acne, rashes to earnose throat issues to GI issues to many behavioral and psych issues. If your child's had strep and that was a changing point for them, if you're an adult in a house with children who have had strep and you got to have strep, which is awfully uncomfortable as an adult, we want to be thinking, is strep there? Did the immune system fully put it into dormancy or any of these symptoms we talked through today still present for you? Because strep can dysregulate the immune system for its own benefit, meaning it will change how your immune system works to allow it to live there. And that's when we see things like antibiotics not being affected. And as that antibiotic use happens more and more, we see kids struggle more and more because the microbiome is affect it. It's kind of like a cascade effect, right? So the base of this is I want you to understand what strep can impact. What does it look like? When do you need to reach out for help? And what kind of help to look for? I hope this has been helpful. I do want to point you to episodes around pandas and pans. Episode before this, I mean it is a great crash course. And what does it look like? There will be episodes for weeks to come to remind you that it is possible to get your kiddo back. It is possible to get your adult friend back from pans and pandas. It is possible to modulate the immune system, which resolves the root of when a child or an adult's health, mental status, infection loan changed. If you need help doing that or here for you, grab a clarity call. I would love to talk. I would love to help you discern whether or not strep is at the root of your issues. Know that there's support for you. And a clarity call is absolutely the first place to start. It doesn't commit you to anything, but know that we work with this all the time. It can be a lonely place. It's often not understood by traditional practitioners. It might not even be recognized as a thing by your pediatrician. It will one day, but it hasn't quite spread enough that all are recognizing. But we're absolutely here to help, here to chat through a symptom limb with you, plans for resolving it on a clarity call. Mostly want to remind you that there's hope, it can resolve, and you absolutely can get your kit back. I hope you're leaving encouraged, curious, and hopeful. If you learned something, I'd love for you to share this episode with a friend. Hey, we're all healing together. You can learn more about my practice, our team, and what it's like to work with us at heyheymae.com. I teach lots on Instagram and answer questions each Monday. My Instagram handle is at Hey Hey Elizabeth Mae. And my cookbook, Hey Hey Everyday, is available on heyheymae.com and Amazon. Happy healing.