New Long Covid Study: What it Means for PANDAS & PANS
A recent study has given us an intriguing new lead in understanding Long COVID and its effects on the cholinergic system – the network that governs brain function, muscle movement, and immune responses. Think of the cholinergic system as a phone line between the brain and body. When SARS-CoV-2 binds to nicotinic acetylcholine receptors, it’s like that line getting disrupted – calls between the brain and the body become garbled or even drop entirely. The result? Symptoms like brain fog, fatigue, and autonomic dysfunction – similar to those we see in children with PANDAS and PANS, particularly after infections.
The researchers found that using a nicotine patch (in low doses) helped “unlock” these receptors again, leading to significant symptom improvement in many people. A brain scan in one patient even showed apparent recovery after using nicotine. This could mean that treating Long COVID by supporting these receptors might be a new and promising approach.
Obviously, using nicotine patches isn’t an option for children. However, the key takeaway here is this: the cholinergic system could be a major factor in PANDAS/PANS, offering new possibilities for helping children who’ve regressed after COVID. If we can restore balance to this system, we may improve their recovery and overall well-being.
Why This Matters for PANDAS/PANS
In PANDAS/PANS, infections can send the immune system into overdrive, causing brain inflammation and triggering symptoms like OCD, tics, and anxiety. All children with PANDAS/PANS experience flares, but for those who have worsened after COVID, cholinergic disruption could be a key factor.
This research helps us refine our approach, offering a more targeted way to support recovery in children dealing with this specific challenge. Now, let’s look at what that might involve.
What We’re Exploring: Natural Solutions
With this exciting new information, we’re now looking at a number of natural, research-backed solutions to support the cholinergic system and help reduce symptoms in children with PANDAS/PANS. These aren’t quick fixes, but they offer a promising way forward to rebuild the cholinergic system. Here are some of the top things we’re focusing on at therapeutic doses:
Choline Precursors: Alpha-GPC and CDP-Choline are essential for producing acetylcholine, the neurotransmitter that plays a critical role in brain function, mood regulation, and cognitive clarity. Supporting acetylcholine levels may help ease symptoms like brain fog, focus issues, and mood swings.
Mitochondrial Support: The brain requires energy to function properly, and PANDAS/PANS children often struggle with fatigue and brain fog – symptoms linked to mitochondrial dysfunction. Acetyl-L-Carnitine, and CoQ10 help restore energy production in brain cells, reducing fatigue and improving mental clarity.
Magnesium L-Threonate: This form of magnesium supports acetylcholine release and is key for maintaining brain health. It’s also known for its ability to cross the blood-brain barrier, helping with sleep, mood regulation, and inflammation – all areas that need attention in children with PANDAS/PANS.
Vagus Nerve Stimulation: The vagus nerve acts like a reset button for the body’s inflammation levels. Stimulating it through simple techniques like deep breathing, gargling, and cranial osteopathy can help calm the immune system, reduce neuroinflammation, and improve autonomic function – critical for children with symptoms like POTS.
What’s Next: Testing and Refining
PANDAS and PANS are complex, with multiple factors at play such as immune function, infections, metabolic imbalances, gut disorders and more. There is no one-size-fits-all approach, but that is exactly why it is so exciting when we find something truly targeted that has the potential to make a real difference.
The insights from Long COVID research have opened up promising new angles, particularly for brain fog, POTS, and fatigue, issues we frequently see. We are refining our approach, testing these strategies, and tracking their impact.
This is an evolving process, and we will continue to fine-tune our approach as new insights emerge. As we test and refine these strategies, we will share what works, what does not, and what holds the most promise. Our aim is to cut through the noise, give you practical, evidence-backed options, and help you move forward with confidence and clarity.
IMPORTANT
The information provided in this article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. It is crucial to consult with medical doctors or qualified functional medicine practitioners to address specific health concerns and obtain personalised guidance tailored to individual needs. Never add any supplements to your plan until it has been assessed and approved by your medical doctor or a suitable qualified practitioner who is familiar with your health history.
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Reference
Leitzke, M., Roach, D.T., Hesse, S., Schönknecht, P., Becker, G.-A., Rullmann, M., Sattler, B. and Sabri, O., 2025. Long COVID – a critical disruption of cholinergic neurotransmission? Bioelectronic Medicine, 11(5)
