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FWIW, I just read through this whole thread. I have 2 with PANDAS and the 2nd has symptoms that are quite different than those of the first. The first is very emotional and oppositional the 2nd is depressive which for years we thought was his saddness over her illness and her behavior which dominates the house, the mom craziness etc. Dr. B told us he'd not seen numbers as high as my sons on any but a couple 2-3 of the Cunningham tests he's seen and he seemed quite grave when he gave me that news. (And also FWIW believe me, I'm watching my 3rd kid like a hawk.)

Our DAN recommended it to us as did our homeopath because some strep does reside or take up residence in the mouth and nasal cavities, I believe Xylitol has anti bacterial properties. The idea was to prevent or minimize new exposures. Our Homeopathic dentist is also carrying a lot of xylitol for prevention of gingivitis (sp?) and oral cancer. Does it work? Well, we're still here. Strep is nasty. But, most of the products we have tried seem better for our family than drugstore brands so we lean that way.

When DD was younger in 1st and 2nd grade we did have some success Oregamax and Oregonol and Olive Leaf Extract. Uvi Ursi also works too, though limited. We have used caprylic for yeast but when we're on Zithromax we need to use Nystatin. It is important to rotate herbals, not give the same one all the time. I'm not the biggest expert. There is a notion that the body gets used to them. When she was younger we could knock out or greatly reduce her first or second exposures in the school year, usually November or December with the herbals. The Winter exposures were still pretty bad. That was before we could get a doc to believe in her symptoms = PANDAS and agree to treat. She's in 5th Grade now. We now treat with Zithromax and keep those herbs on board to deal with other things besides the bacteria, like yeast.

Right now we're using Therbiotic Detoxification Support from Klaire Labs, no strep strains.