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Hello, My DS8 whom has been treated for PANS/Pandas and suspected Lyme for 2 1/2 years with Azithro daily with occassional 2nd antibiotic added and also the last 4 months with flagyl and diflucan recently went from 90% to about 80% so we decided to pull away everything (including most supplements, only left a few dosing daily) slowly and get a new baseline. The waters were getting muddy and he also had an elevated liver panel for the first time ever so it was necessary. Well taking him off everything he looks better than he has in a long time. Eyes look good, skin, sleep good, for a whole 9 days. But on day 10 he had some intrusive thoughts usually either early morning or late evening but is stable the rest of the day. We pushed through the scary thoughts with talk therapy and strategies of talking back to the ocd. He is still holding strong today but I fear the signs of intrusive thoughts creeping back in are indicative of something bigger coming. I am treating him for allergies as I know pollen is high here where we live. That helps some. He has Gut issues since birth, chronic constipation and tends to get his intrusive thoughts right before he is going to get a bowel movement. He is getting scoped in a couple of weeks but I don't anticipate a breakthrough. Mainstream doc that wants me to give him miralax daily for the rest of his life. yada yada I am going to try diet changes because I was thinking maybe leaky gut triggers his PANS. He used to have chronic impetigo but that finally stopped. It seems his immune system is trying to wake up and act normal. He responded normally to a stomach virus this past fall and actually threw up. That was a first he usually suffers with just behavior but won't mount fevers or respond normally to illness. I really think the main issue triggering PANS is now yeast. I think his gut was a mess before treatment and now is a bigger mess. Here is my question? Should I go back to giving Azithro every 3 days prophallaixis dose or continue to push through. I feel like if I do I counteract the efforts I am making trying to clean up the gut, which is likely the trigger. Or is the zithro needed to modulate immune system and prevent a breakdown.? He is never well for more than a couple weeks since the first huge episode two and half years ago while on antibiotics and now while off its the same pattern. I am so confused. Sorry for babbling I just need some support and maybe it will help me find clarity. Thank you for reading.