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Estimated reading time: 7 minutes
Testing for PANDAS typically involves evaluating a child for recent strep infections, immune system activation, inflammation, and the sudden onset of neuropsychiatric symptoms such as OCD, anxiety, tics, rage, or regression. Doctors may use throat cultures, bloodwork, medical history, symptom timelines, and neurological or behavioral assessments to help determine whether PANDAS or PANS could be contributing to a child’s symptoms.
I’m Dr. Roseann Capanna-Hodge, and for more than 30 years I’ve helped families navigate the confusion and frustration that often comes with PANS and PANDAS diagnoses. I know how stressful it can feel when you’re trying to piece together symptoms while wondering if something medical is being missed. My goal is to help parents better understand the testing process so they can advocate for the right support and next steps for their child.
What You’ll Learn
- The most common blood tests doctors use when evaluating PANS/PANDAS.
- Why inflammatory markers and infection testing can provide important clues.
- What elevated lab results may reveal about immune system dysfunction.
What is PANS/PANDAS Disorder?
What are the common symptoms of PANS/PANDAS?
- Avoidant/restrictive of specific foods
- Intense separation anxiety or general anxiety
- Irregular bowel or bladder movements
- Compulsive behaviors or rituals
- Mood swings, including feelings of sadness or depression
- Aggressive or challenging communication styles
- Frequent tantrums or emotional outbursts
- Behavioral and developmental regression
If you're seeing these sudden changes in your child, you’re not overreacting. These signs are your child’s way of communicating that something deeper is going on—and there are ways to help them heal.
Why is Testing for PANDAS/PANS Important?
Studies show about 1 in every 200 kids gets diagnosed with PANDAS/PANS, and the numbers are rising. The good news? Research keeps growing, leading to better, personalized treatments, including holistic options that actually work.
- Sudden Onset of Symptoms: These symptoms don’t just creep up over time. They hit hard and fast, often out of nowhere, pointing to an underlying medical issue.
This makes early medical guidance essential—don’t wait around to get answers.
- Overlap with Other Disorders: Here’s where it gets tricky: a lot of symptoms from PANDAS/PANS look similar to other mental health conditions. (Leonardi et al., 2024) Multiple tests help rule out other issues and make sure your child gets the right diagnosis.
- Comprehensive Testing: Doctors will dig deep, looking at blood tests, medical history, and more. These tests help figure out if there’s an immune response triggered by an infection, so you can plan the best treatment.
- Early Diagnosis is Key: Early detection gives your child the best shot at recovery. Without it, PANDAS/PANS can cause long-term challenges that impact their neurocognitive, psychiatric, and behavioral growth.
How Do You Test for PANDAS/PANS?
PANS/PANDAS testing involves a mix of clinical evaluations, lab tests, and a thorough review of your child’s medical history.
1. Rapid Strep Test / Throat Culture
If your child has strep throat, Group A Streptococcus bacteria could be triggering PANDAS. A throat culture is key for diagnosis—your doctor will gently swab the back of your child’s throat and tonsils. The sample is sent to a lab to check for the bacteria.
While rapid tests give quicker results, a throat culture offers more accuracy, helping determine if a recent strep infection is behind your child’s symptoms.
2. PANS/PANDAS Blood Tests
It’s important to partner with a PANS/PANDAS/AE specialist who can help interpret blood tests and guide care.
The following blood tests are the same lab tests we recommend for Lyme Disease or any tick-borne infections, as well as viruses.
- Lyme Disease and Co-infections: Lyme Western Blot, Babesia microti, Bartonella, Ehrlichia, Anaplasma
- Strep-related Tests: Anti-Streptolysin (ASO), Anti DNase B, Streptozyme
- Viral Testing: Epstein Barr Virus, Coxsackie A & B Titers, HHV-6, COVID
- Immune and Autoimmune Markers: IgE Level, IgA, IgG, IgM, White blood cell count, CBC, ANA, Ferritin, Vitamin D, B-12, B-6, Serum Copper
- Thyroid Testing: Free T3 & T4, TSH
- Genetic and Nutritional Testing: Genetic and Nutritional Testing: Genetic mutation testing (e.g., MTHFR), Full panel nutrient testing, Food allergy testing, Mold testing
- Other Tests: Organic Acids Test, Plasma Amino Acids, Stool Testing, Cunningham Panel. Please note that a Cunningham Panel is NOT required for a PANS or PANDAS diagnosis (Hesselmark & Bejerot, 2017).
3. Medical History
Understanding your child’s medical history is essential, especially if they've had infections like strep. If you notice sudden shifts in behavior or neuropsychiatric symptoms, make note of when these changes happened.
Early diagnosis and testing give your child the best chance at getting the right support they need.
With the right testing, support, and timely care, your child can get back on track and continue to thrive. Let’s work together and take action quickly for the best possible outcome.
Need extra support? Apply for our one-on-one for personalized care designed specifically for your child's needs. Together, we'll get to the bottom of their challenges, once and for all.
Parent Action Steps
☐ Keep track of any symptoms or changes in behavior
☐ Review test results with your healthcare provider
☐ Talk to your healthcare provider about treatment options
☐ Get in touch with medical providers in other organizations such as Aspire.care, Epidemic Answers, and The International Lyme ☐ ☐ Disease and Associated Disease Society (ILADS)
☐ Download the PANS/PANDAS Checklist for Practitioners
☐ Discover natural and science-backed strategies through our Natural PANS/PANDAS Calm Brain Kit to help your child heal at the root cause—without relying on medication
FAQs
Do all kids with PANS or PANDAS need a Cunningham Panel?
Nope. While it can offer insights, it’s not essential for diagnosis or treatment planning.
What’s the best time to get testing done?
As soon as you notice sudden or severe neuropsychiatric changes—early testing helps guide faster, more effective care.
What blood tests are commonly used for PANS and PANDAS?
Blood tests commonly used for PANS and PANDAS may include inflammatory markers, immune testing, infection panels, vitamin levels, and thyroid testing.
Why are blood tests important for PANS and PANDAS?
Blood tests are important for PANS and PANDAS because they can help identify infections, inflammation, immune dysfunction, and underlying health issues.
Can blood tests confirm a PANS or PANDAS diagnosis?
No, blood tests cannot fully confirm a PANS or PANDAS diagnosis, but blood tests can provide important clues about triggers and immune activity.
What inflammatory markers are checked in PANS and PANDAS blood work?
Inflammatory markers checked in PANS and PANDAS blood work may include CRP, ESR, cytokines, and other markers linked to immune activation.
What infection testing is done for PANDAS?
Infection testing for PANDAS often includes strep-related blood tests such as ASO titers and Anti-DNase B antibodies.
Can vitamin deficiencies affect PANS or PANDAS symptoms?
Yes, vitamin deficiencies can affect PANS or PANDAS symptoms because low nutrient levels may worsen mood, focus, anxiety, and nervous system function.
How often should children with PANS or PANDAS get blood tests?
Children with PANS or PANDAS may need blood tests during flares, treatment changes, or ongoing monitoring based on provider recommendations.
Who should order blood tests for PANS and PANDAS?
An experienced pediatrician, functional medicine provider, immunologist, or PANS/PANDAS specialist should order blood tests for PANS and PANDAS.
Citations
Leonardi, L., Perna, C., Bernabei, I., Fiore, M., Ma, M., Frankovich, J., Tarani, L., & Spalice, A. (2024). Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS): Immunological Features Underpinning Controversial Entities. Children (Basel, Switzerland), 11(9), 1043. https://doi.org/10.3390/children11091043
Hesselmark, E., & Bejerot, S. (2017). Biomarkers for diagnosis of Pediatric Acute Neuropsychiatric Syndrome (PANS) – Sensitivity and specificity of the Cunningham Panel. Journal of Neuroimmunology, 312, 31–37. https://doi.org/10.1016/j.jneuroim.2017.08.002
*Disclaimer: This article is for informational purposes only and is not intended to give health advice and it is recommended to consult with a physician before beginning any new health regime. *The effectiveness of diagnosis andtreatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.
Always remember… “Calm Brain, Happy Family™”
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