PANS/OCD/Mast Cell Herbal Protocol

(dosing extrapolated from adult dosages for approx 50 lb child, stop any herbal that
is causing problems. All can be found on Amazon or iHerb except Angelica. Give each
herbal 2 weeks before adding next. This protocol does not ‘kill strep’)

*Angelica Sinesis (aka Dong Quai)

300-500 mg 3 X daily
approx. ¼ tsp dried herb or 1 “0” capsule, 3 X daily
Source: Elk Mountain herbs, loose leaf, grind in coffee or spice grinder
White Chestnut remedy
1 drop under tongue 3 X daily
and as needed for perserverent thoughts
Source: Bach’s White Chestnut remedy, no need to dilute in water for OCD
Horse Chestnut (Aesculus hippocastanum)
25-45 mg standardized ingredient aescin 3 X daily
This will come out to ½ capsule of the below product 3 X daily
Source: Nature’s Way Horse Chestnut, this has the added benefit of calendula
included in the capsules, also beneficial for mast cell issues
Resveretrol (standardized from Japanese knotweed)
Variable dosing, start with 100 mg 3 X daily
Source: Paradise Herbals, I capsule 3 X daily
Bacopa Moniera
50 mg, 2 X per day
Source: Pure Mountain Botanicals, approx. ½ capsule twice per day, take with food,
notice the standardized amount is what I am using
(can take 4-6 weeks to notice results)
Holy Basil (Ocinum sanctum)
Approx 125 mg twice daily
Source: Paradise Herbals, ½ capsule twice per day
Black Cumin Seed Oil (Nigella sativa)
500 mg 3 X daily
(can work up to 1 g three times daily if tolerated)
Source: Amazing Herbs, black seed gel caps, I capsule 3 times daily
Vitamin K (if it is not already in your daily supplements)
270 mcg 2 X daily
Source: Life Extensions Super K, I gel cap twice per day

Notes on Herbals
Goal of this protocol: Reduce the inflammatory excitement of mast cell activity that
occurs (for various reasons, from bacteria, viruses to allergens to diet) in PANS/OCD
by blocking histamine activity, reducing cytokines that lead to mast cell stimulation,
stabilizing mast cells directly, reducing damage caused by mast cell activity like
leaky blood vessels, regulating Ca+ influx into mast cells
Side Effects: In the case of adverse side effects, discontinue herbal immediately.
Some herbals are high in methyl donors, adding niacinimide to the protocol may
help with that. Using No Fenol may also help reduce the phenolic issue that some
kids may experience. All of these herbals also have some antimicrobial effects, have
a detox support plan handy. It is the responsibility of the parent to pay attention
and research individual effects on their child and any other supplements or
medications
Angelica Sinesis
 new study shows Angelica downregulates a unique signaling molecule for the
activation of mast cells called Fyn
 supresses excessive antibody production
 Normalizes estrogen (often high in MCAS)
 Immunoregulatory
 Inhibits platelet aggregation
Impt: Please take the time to use the dried leaves from Elk Mountain herbals, they
are a far superior quality to any of the already made Dong Quai capsules I could
source
 You can decoct (make a concentrated) ½ tsp in 4 ounces of water (simmer ½
tsp in about 4 ounces of water for 10 mins, covered, and strain and drink.
Adding chamomile, which is also anti-histamine, can help quiet the GI
inflammation before meals)
 Yes, this herbal is known as a ‘female’ usage herbal here because it modulates
estrogen, but it has been used forever in Asia for asthma and the new studies
show unique promise with allergic/mast cell issues

White Chestnut and Horse Chestnut

 White chestnut is a ‘rescue remedy’ for anxiety and OCD. The aescin in horse
chestnut seed is anti-histaminic, and importantly helps normalize the
vasculature that is made ‘leaky’ by mast cell overactivity. May be helpful with
leaky blood brain barrier and increases blood flow to brain
Resveretrol
 As Buhner fans know, Japanese knotweed inhibits many more cytokine
cascades all at once than other herbs. Those cytokines trigger mast cell
activity and resveratrol is therefore incredibly helpful for inflammatory
processes
 Modulates calcium (Ca+) channel signaling, it is the influx of Ca+ into mast
cells which cause their activation
 Specific for maintaining integrity of the blood brain barrier through
endothelial regulation and downregulating CD40 (which causes the
activation of a large number of other cytokines)
 Yes, you can use Jap knotweed instead, it may be better
 Can cause stomach upset, discontinue if this occurs. It may help to take
minerals with/prior since the oxalate issue may be causing the GI upset

Bacopa Moniera
 One study showed mast cell stabilization as effective as the drug Cromolyn
 Adaptogenic
 Normalizes stress induced neurotransmitters, often HIGH in MCAS/PANS
 Reduces beta amyloid plaques
 Increases cerebral brain flow
 Known as the ‘memory herbal’
 Takes 4-6 weeks to see full results
 May increase GABA
 Holy Basil (Ocinum sanctum)
 Reduces total IgE and therefore reduces IgE activated mast cell issues
 Inhibits mast cell degranulation
 Inhibits pathological effects of histamines
 Good for noise-induced stress
 Lowers cortisol and glucose

Black Cumin Seed Oil (Nigella sativa)

 Autoimmune encephalitis study on rats showed back cumin see oil
suppressed brain inflammation and enhanced remyelination in
cerebellum
 Reduces expression of TGF Beta1
 May be effective in treatment and prevention of progression of MS
 Other study showed decreased number of activated mast cells in
gut after cumin seed usage, and decreased gastric tissue histamine
levels
Vitamin K
 Low in leaky gut people
 Important for keeping calcium regulated, which causes more issues with
mast cell activation, and may help with the blood thinning properties many
herbals have