Surgical procedure impact on autoimmune conditions such as PANS or PANDAS

By Stella Chadwick BSc (hons) mBANT, CNHC

Has Your Child Ever Regressed After a Surgical Procedure?

Many families report that their child with autism or other autoimmune conditions such as PANS or PANDAS suffered a definite shift in behaviour and mood as well as a decline in cognitive skills following a surgical procedure.

It is thought that there may be a number of contributory factors resulting in possible developmental regressions which may include:

  • expressive and receptive language,
  • gross motor skills,
  • fine motor skills,
  • cognitive skills, and
  • overall neurological deterioration.

In this article, I explore the potential contributory factors to these developmental changes and provide clear actionable steps to help your child both before the procedure and post-operatively.

Type of Anaesthesia Used

Propofol, albeit considered an older type of drug and not used very often in the UK, is a short-acting agent and is administered intravenously; it is used for induction and also for maintenance of a general anaesthetic. It contains soybean oil and egg phospholipid, so that fact should be considered for patients with allergies or intolerances to soy or eggs. Concerns have also been raised regarding a potential for propofol to exacerbate mitochondrial disease.

There is some evidence that all general anaesthetics have a tendency to inhibit mitochondrial function, and  Dr. Jon Poling’s paper on developmental regression and mitochondrial dysfunction in autism helps to explain the overall impact anaesthetic choice might have. The mitochondria provide energy to our cells and are necessary for the Kreb’s cycle, fatty acid oxidation, metabolism of amino acids, and oxidative phosphorylation.

Groundbreaking work by Robert Naviaux and his team at the University of California, San Diego School of Medicine, on the Metabolic Features of the Cell Danger Response can help us understand the significance and importance of mitochondrial function and its role in autism. If you suspect mitochondrial dysfunction please discuss this with your medical professional and your anaesthetist before the procedure.

Administration of Nitrous Oxide

In 2003, The New England Journal of Medicine published a report by Selzer et al. on the risks of nitrous oxide in individuals with MTHFR. “On the strength of the current findings, we believe that patients with a diagnosis of severe MTHFR deficiency should not receive nitrous oxide as anaesthesia.

In the case of emergency procedures, patients whose clinical presentation fits that of severe MTHFR deficiency, even if the disorder has not been diagnosed, should also not receive nitrous oxide. In the case of elective procedures, patients whose clinical presentation fits that of severe MTHFR deficiency should be evaluated, and the diagnosis should be ruled out before anaesthesia with nitrous oxide is contemplated.”

Testing for MTHR is simple and can be done via a finger prick blood test or a buccal swab. At the Brainstorm Health® clinics, we often test children and young adults we work with for MTHFR and other gene mutations. Please contact us for more details.

Disturbed Gut Microbiome

Findings from the UK and American Gut Project show evidence of vast change in gut bugs after a surgical procedure, way beyond changes observed under any other circumstances including in cases of extreme diets. There may be a strong link between the changes in the gut microbiome and the ability for the body to function at optimum level postoperatively.

Research published in Nature in May 2018 focuses on the influence of gut microbes on two types of cells that play a major role in the central nervous system: microglia and astrocytes. Microglia are an integral part of the body’s immune system, responsible for scavenging the CNS and getting rid of plaques, damaged cells and other materials that need to be cleared. But microglia can also secrete compounds that induce neurotoxic properties on the star-shaped brain cells known as astrocytes. This damage is thought to contribute to many neurologic diseases.

If you have ruled out mitochondrial dysfunction and your child is due to have a surgical procedure then consider the following simple steps to help negate some of the potential side effects and support the health of the body and brain.

Your 3-Step Plan:


Support the gut with probiotic foods and drinks as well as supplements. Make sure you include saccharomyces boulardii a beneficial yeast that may protect against the growth of candida. The Optibac probiotics range are good quality supplements and readily available in most health shops and online.

We have secured a 10% discount on all supplements purchased from the Natural Dispensary for the readers of our blog. You can get your discount by placing SMC010 in the promo code at the checkout. To make your own probiotic drink consider making delicious coconut water kefir which is also rich in calcium, magnesium, phosphorus and B vitamins as well as a host of amino acids and enzymes.


Support detoxification with Epsom salt baths, castor oil packs, and liver cleanse juice at least 3 times a week. If you have an IonCleanse detoxification system by AMD use it as much as possible. A 4-month study completed by the Thinking Mum’s Revolution using the IonCleanse by AMD with children with an ASD diagnosis aged between 4 and 19, showed an average drop in ATEC score of 55%. This was based on using the IonCleanse by AMD footbaths for 30 minutes for 3 consecutive days with a one day break over those 4 months.  These positive changes continued to manifest with consistent use of the footbaths, on a twice weekly basis.

Also consider using supplements like glutathione with the support of your practitioner or medical doctor. We like the transdermal glutathione lotion by Neurobiologix which you can obtain from one our favourite suppliers Mandimart.


Support methylation by ensuring you eat plenty of dark, leafy greens. Aim for l cup a day of vegetables like bok choy, Swiss chard, kale, watercress, spinach, or dandelion, mustard, spring or beet greens.

Get more B vitamins in your diet – Good food sources include sunflower seeds and wheat germ (vitamin B6); fish and eggs (vitamin B6 and B12); cheese (B12); beans and walnuts (vitamin B6 and folate); leafy dark green vegetables; asparagus, almonds, and whole grains (folate); and liver (all three). Consider high quality transdermal B complex or B12 supplements. Please see our transdermal range of B vitamin supplements on our online shop

ALWAYS WORK WITH YOUR PRACTITIONER OR MEDICAL DOCTOR! This article is meant for educational purposes and should not be considered as medical advice.