Should You Stop Supplements?

If your child has PANDAS or PANS, you are probably familiar with long-term or prophylactic antibiotics. They can be an essential part of managing symptoms and preventing recurring infections. But here is the problem. Antibiotics do not just target the bad bacteria. They also wreak havoc on gut health, disrupt the immune system, and deplete key nutrients.

Lately, some parents have been told to stop giving their children supplements during antibiotic treatment, with the claim that supplements interfere with antibiotics. It is a worrying message, and understandably, many parents are confused.

So, what does the science really say? Let us break it down.

Do Supplements Really Interfere with Antibiotics?

In short, no. At least, not the ones typically prescribed for children with PANDAS or PANS.

There are certain antibiotics that interact with minerals like calcium, magnesium, and iron. But – and it is a big but – I have never seen a child with PANDAS or PANS prescribed these antibiotics.

Let us clear up the confusion.

The older classes of antibiotics that do have known interactions are:

• Tetracyclines (e.g. doxycycline, minocycline) – These bind to minerals, reducing absorption.
• Fluoroquinolones (e.g. ciprofloxacin, levofloxacin) – These also interact with minerals.

But here is the thing. These antibiotics are rarely used in children because of their side effects, and they are not part of standard PANDAS or PANS treatment. Even if they were, any interaction can be easily avoided by spacing supplements two hours apart.

Now, let us talk about the antibiotics that actually are used:

• Penicillins (e.g. amoxicillin, augmentin, flucloxacillin)
• Macrolides (e.g. azithromycin, clarithromycin, erythromycin)
• Cephalosporins (e.g. cefalexin, cefuroxime, ceftriaxone)

I understand the importance of making changes carefully and assessing what works. But antibiotics put significant strain on the body by disrupting gut health, depleting key nutrients, and weakening the immune system. Without proper support, the body is left to manage these effects alone, and while the impact may not be immediate, it builds over time.

In fact, stopping supplements could make things worse by leaving your child more vulnerable to the effects of antibiotics and slowing their recovery.

What Do Antibiotics Actually Do to the Gut?

We all know that antibiotics kill bacteria. But here is the catch. They do not just target the bad bacteria. They also destroy beneficial bacteria – the ones that support digestion, immunity, and even brain function.

Research shows that antibiotics can:

• Wipe out key gut bacteria, especially Lactobacillus and Bifidobacteria, which are crucial for digestion, immune function, and neurotransmitter production.
• Increase gut inflammation, leading to leaky gut, which can trigger immune overreactions and worsen symptoms.
• Disrupt the gut-brain axis, affecting neurotransmitters like serotonin and GABA – both essential for mood, anxiety, and cognitive function.

Given these effects, supporting gut health during antibiotic use is not optional – it is essential.

Lactobacillus Depletion and Candida Overgrowth

One of the biggest casualties of antibiotics? Lactobacillus.

We know this because we have run hundreds, if not thousands, of stool tests using DNA analysis and PCR. Time and time again, we see children on antibiotics with virtually no Lactobacillus left.

Why does this matter? Because Lactobacillus plays a crucial role in controlling Candida. It literally attacks yeast, producing lactic acid that stops fungal overgrowth. When Lactobacillus is wiped out, Candida takes over – and that is where the real trouble begins.

Candida: More Than Just a Gut Issue

When Candida overgrows, it does not just sit quietly in the gut. It produces toxins that spread through the body, causing symptoms that can look a lot like PANDAS and PANS.

• Ammonia – Can cause neurological symptoms, irritability, and anxiety.
• Acetaldehyde – Disrupts brain function, contributing to brain fog, anxiety, and cognitive difficulties.
• Gliotoxins – Suppress the immune system and mimic mould toxicity symptoms.

And there is more. Candida actually steals iron and zinc, two minerals that are absolutely critical for:

• Immune function
• Oxygen transport
• Brain development

Children with PANDAS or PANS are often already low in these minerals, and Candida just makes it worse.

Glutathione: The Body’s Master Detoxifier

Glutathione is one of the most important antioxidants in the body, helping to clear out toxins and reduce inflammation. Many children with PANDAS or PANS are already low in glutathione, which makes it even harder for them to handle environmental and metabolic stressors.

Here is where yeast overgrowth makes things worse.

Candida does not just steal minerals – it also produces toxins that directly deplete glutathione. Acetaldehyde and gliotoxins force the body to burn through glutathione reserves, leaving children more vulnerable to oxidative stress, inflammation, and immune dysfunction.

It is a vicious cycle.

Probiotics: When and How to Use Them

Supporting gut health during antibiotics is not as simple as “taking a probiotic” – timing matters.

Some probiotics should be taken at least two hours apart from antibiotics to ensure they survive. Research shows that certain strains can help counteract antibiotic damage:

• Saccharomyces boulardii – A yeast-based probiotic that antibiotics cannot kill. It helps prevent antibiotic-associated diarrhoea and supports gut integrity.
• Lactobacillus rhamnosus GG and Bifidobacterium strains – Shown to reduce gut inflammation and protect against antibiotic-induced damage.

What Should Parents Do?

• Check the antibiotic type – If it is a penicillin, macrolide, or cephalosporin, supplements will not interfere.
• Support gut health – Use probiotics, gut-friendly foods, and targeted nutrients.
• Monitor symptoms – Watch for signs of gut disruption, like bloating, diarrhoea, or mood swings.
• Ask for evidence – If someone tells you to stop supplements, ask them for scientific proof.

Final Thoughts

Antibiotics can be lifesaving, but they are not without consequences. If your child is taking long-term antibiotics for PANDAS or PANS, the worst thing you can do is strip away the nutrients that help their body cope.

• The idea that supplements interfere with antibiotics? Not backed by science.
• The risk of gut damage? Very real.
• The power of strategic support? Essential.

Parents need clear, evidence-based advice – not fear-driven misinformation. Supporting your child’s gut and immune health while on antibiotics is not just a good idea.

It is good science.

 

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. 

Concerned about your child’s health? We’d love to have a chat with you. 

Click the link here to book your Free Discovery Call.

 

References

• Deth, R. C., Muratore, C., Benzecry, J., Power-Charnitsky, V. A., & Waly, M. (2008). How environmental and genetic factors combine to cause autism: A redox/methylation hypothesis. NeuroToxicology, 29(1), 190-201. https://doi.org/10.1016/j.neuro.2007.09.010 
• Diaz Heijtz, R., Wang, S., Anuar, F., Qian, Y., Björkholm, B., Samuelsson, A., Hibberd, M. L., Forssberg, H., & Pettersson, S. (2011). Normal gut microbiota modulates brain development and behavior. Proceedings of the National Academy of Sciences, 108(7), 3047-3052. https://doi.org/10.1073/pnas.1010529108 
• McFarland, L. V. (2010). Systematic review and meta-analysis of Saccharomyces boulardii in adult patients. World Journal of Gastroenterology, 16(18), 2202-2222. https://doi.org/10.3748/wjg.v16.i18.2202 
• Nylund, L., Satokari, R., Salminen, S., & de Vos, W. M. (2014). Intestinal microbiota during early life – impact on health and disease. Proceedings of the National Academy of Sciences, 108(Supplement 1), 4586-4592. https://doi.org/10.1073/pnas.1000081107