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If you are unsure about whether you would benefit from taking a vitamin B12 supplement we would always recommend talking to your GP

Other more invasive treatment for the immune system that might be indicated for more severe cases of PANS/PANDAS: IVIG Intravenous Immunoglobulin is a blood product made from purified antibodies pled from thousands of donors and given through an IV (it is also sometimes given subcutaneously or under the skin as well) to calm inflammation and reset the immune system

Yu W, Li Y, Hu J, Wu J, Huang Y (2022) A study on the pathogenesis of vascular cognitive impairment and dementia: the chronic cerebral hypoperfusion hypothesis