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    Hypermobile Ehlers-Danlos Syndrome (hEDS)

    Hypermobile Ehlers-Danlos Syndrome (hEDS) is a connective tissue disorder characterized by generalized joint hypermobility, skin hyperextensibility, tissue fragility, chronic headaches, and much more. It is a multi-systemic condition, affecting many areas of the body at once– one of the reasons it makes it difficult to diagnose and easy to mimic other conditions or hide behind an other diagnosis or illness. Multiple genetic disorders are often associated with it, along with diagnoses of POTs, MCAS, and dysautonomia. There are 13 recognized types of EDS, many being diagnosed by a single genetic mutation. You can read a full break down of each on the Ehlers Danlos Society website.

    Connective tissue is the 'glue' of the body, which is why many types of EDS are also associated with double-jointed or extra flexibility. However, just having one of these does not automatically mean you have a form of EDS, but it does wager looking into it further particularly if other symptoms are present with no answers.

    Since effects can lead to widespread multi-systemic issues, discovering which type of EDS you have and finding a supportive system of medical professionals from physical therapists, doctors, geneticists and EDS specialists who fully understand your type of EDS through a holistic lens, will bring the highest quality of life overall.

    hEDS until recently was thought to have no known genetic connection. However, a genetic breakthrough by researchers at Boston University found that hEDS patients have a higher burden of genetic variations (differences) spread across three key areas in the body:

    • Collagen Pathways - skin, joints, tendons, arteries, strength
    • The immune System – inflammation, immunity
    • Mitochondrial Function – energy on every level

    hEDS is now confirmed to have multiple rare genetic variants working together rather than a single "hEDS gene.” This explains why it was difficult to trace down and diagnose, due to the large array of varying symptoms from patient to patient. This new discovery is encouraging, with so much research being put into hEDS continually bringing more knowledge of how to support those suffering from it.

    It is vital to find professionals who understand the genetic components of any type of EDS, especially hEDS, supporting the nutritional elements, detox pathways, dysregulation, and inflammation where the body of someone with hEDS cannot do on its own. Understanding and supporting properly, can make the difference from bedridden to thriving.

    Finding resources and communities who can resonate with you is important. This condition can feel so isolating, hidden, and difficult to explain. Many patients look normal, and may be very athletic and good at sports. This condition isn’t a sentence. If you or a loved one is diagnosed with hEDS or any type of Eds, it is a piece of your puzzle, bringing you a giant leap closer to better health.

    Common Symptoms

    Joint hypermobility, frequent subluxations, and dislocations
    Chronic musculoskeletal and joint pain
    Skin that is soft, velvety, and mildly stretchy
    Easy bruising and poor wound healing
    Gastrointestinal dysmotility and severe fatigue
    Dysautonomia (often POTS) and Mast Cell Activation (MCAS)

    Causes & Triggers

    • Genetic inheritance (autosomal dominant), though the specific gene(s) for hEDS are currently unknown
    • Hormonal fluctuations (relaxin and progesterone can increase laxity)
    • Physical trauma, repetitive strain, or viral infections triggering systemic issues

    Diagnosis

    Diagnosis is clinical, based on the 2017 International Classification of the Ehlers-Danlos Syndromes. It requires meeting specific criteria including generalized joint hypermobility (measured by the Beighton score), evidence of syndromic features or family history, and exclusion of other connective tissue disorders. Use the interactive Beighton Score assessment below to check your hypermobility.

    Comprehensive Clinical Guidelines & Context

    Treatment Approaches

    Physical therapy focusing on core strength and joint stabilization (isometric exercises)
    Pain management strategies and neuroplasticity retraining
    Assistive devices (braces, splints, ring splints)
    Managing comorbidities (like POTS, MCAS, and GI issues)
    Pacing, energy conservation, and nervous system regulation

    Top hEDS Specialists

    View All
    Dr. Paldeep Atwal, MD

    Dr. Paldeep Atwal, MD

    Clinical Genetics

    Virtual / Atwal Clinic, FL
    Telehealth
    Dr. Svetlana Blitshteyn

    Dr. Svetlana Blitshteyn

    Neurology

    Dysautonomia Clinic, NY
    Telehealth
    Dr. David Saperstein

    Dr. David Saperstein

    Neurology

    Complex Neurology, AZ
    Telehealth
    Dr. Brent Goodman

    Dr. Brent Goodman

    Neurology

    Metrodora Institute, UT
    Telehealth
    View All hEDS Specialists

    Research & Sources

    The 2017 international classification of the Ehlers–Danlos syndromes

    American Journal of Medical Genetics Part CView Source

    Hypermobile Ehlers-Danlos syndrome: Clinical description and natural history

    American Journal of Medical Genetics Part CView Source

    Top Tips for Doctors on hEDS/HSD

    The Ehlers-Danlos Society GP ToolkitView Source

    A framework for the classification of joint hypermobility and related conditions

    American Journal of Medical Genetics Part CView Source

    Understanding hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorder

    Redcliff-House Publications (Claire Smith)View Source

    hEDS Diagnostic Criteria Checklist

    The Ehlers-Danlos SocietyView Source

    Why the Zebra?

    The Ehlers-Danlos SocietyView Source

    hEDS & Hypermobility Assessment

    Evaluate your joint mobility and systemic symptoms using the internationally recognized Beighton Score and diagnostic criteria for hypermobile Ehlers-Danlos Syndrome (hEDS).

    Comprehensive hEDS & Hypermobility Assessment

    This tool combines the Beighton Score, the JUST GAPE questionnaire, and the 2017 international criteria to help identify hypermobility spectrum disorders.

    Question 1 of 38

    Can you bend your LEFT pinky finger backward past 90 degrees?