When Symptoms Start to Feel Connected
If you live with EDS, you may notice symptoms that don’t seem purely “joint-related.” Dizziness when standing. Racing heartbeats. Strange reactions to foods, soaps, or even stress. Many people spend years treating these symptoms separately, not realizing they often belong to the same bigger picture of EDS, POTS, and MCAS. You’re not imagining a pattern — it’s real.
Why This Trio Comes Up So Often
EDS, POTS, and MCAS are frequently discussed together because they commonly overlap. Many patients have one, two, or all three conditions to varying degrees. In this post, we’ll briefly explain each condition, why they co-occur, and how simple screening questions can help uncover missing pieces of the puzzle.
EDS: The Connective Tissue Foundation
Ehlers-Danlos Syndrome affects connective tissue, which provides structure and support throughout the body. When connective tissue is more elastic than it should be, joints become unstable — but blood vessels, organs, and nerves are also affected. This underlying tissue fragility sets the stage for many downstream symptoms. EDS and hypermobility are often the foundation that everything else builds upon.
POTS: When the Nervous System Struggles to Adapt
Postural Orthostatic Tachycardia Syndrome (POTS) affects the autonomic nervous system. It commonly causes dizziness, lightheadedness, palpitations, fatigue, and brain fog especially when standing. Those that happen to be hypermobile also have laxity in the blood vessel walls and tend to have dysfunctional nerves as well. This combination makes it much harder to regulate blood pressure leading to the symptoms present in so many suffering from POTS.
MCAS: An Overreactive Immune Response
Mast Cell Activation Syndrome (MCAS) occurs when mast cells release inflammatory chemicals too easily or too often. This can lead to rashes, flushing, itching, GI symptoms, headaches, and sensitivities to foods, medications, or products like soaps and detergents, and SO MUCH MORE. While research is still very much in its infancy there are connections between connective tissue disease and the “sensitivity” of mast cells to release their chemical mediators. On the flip side there are some that believe the issues with mast cells can actually “cause” joint hypermobility and other connective tissue problems. It’s a classic chicken or the egg problem and at this point we just don’t know.
Why So Many Patients Have All Three
These conditions share common pathways involving connective tissue, blood vessels, and the nervous system. When one system is under strain, others often follow. Many patients don’t have textbook versions of each condition — symptoms exist on a spectrum. That’s why awareness matters more than labels.
Simple Questions That Can Reveal a Lot
When I see patients with EDS, I always ask about dizziness, lightheadedness, heart palpitations, rashes, and product sensitivities. These questions help quickly screen for possible POTS or MCAS. While this is not an exhaustive list of questions and there are more comprehensive screenings for both POTS and MCAS I have found this easy to fit into my visits with patients and have been surprised how often people say yes. Early recognition allows for better symptom management and fewer years of confusion. Listening closely changes outcomes.
You’re Not “Too Complicated”
Having multiple diagnoses doesn’t mean your body is broken beyond understanding. It means your systems are connected. When symptoms are viewed together instead of in isolation, care becomes more compassionate and effective. Improving 1 aspect of the Trifecta can decrease symptoms in the others so you just need to start somewhere and start to chip away slowly. You deserve providers who look at the whole picture.
Share Your Story
Do you live with one, two, or all three of these conditions? What symptoms helped you connect the dots? Your experience may help someone else feel seen and understood.
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Warm regards,
The Hypermobile Solutions Team
References
Home. The Ehlers Danlos Society. https://www.ehlers-danlos.com/
What is HSD?. The Ehlers Danlos Society. https://www.ehlers-danlos.com/what-is-hsd/
What is eds?. The Ehlers Danlos Society. https://www.ehlers-danlos.com/what-is-eds/
Jovin, D., Atwal, P., Herman, K., Block, N., Maxwell, A. J., Mitakides, J., Maitland, A. M., Saperstein, D., Hamilton, M., Schofield, J., Koby, M., Klinge, P., McElroy, A., Bluestein, L., Chopra, P., Tishler, J., Pocinki, A. G., Varga, J., Dempsey, T., … Lane, K. (2020). Disjointed: Navigating the diagnosis and management of Hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorders. Hidden Stripes Publications, Inc.
Smith, C., & Wicks, D. (2017). Understanding Hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorder: (previously known as Ehlers-Danlos Syndrome Hypermobility Type & Joint Hypermobility Syndrome, respectively). Redcliff-House Publications.
Cox, C. (2022). Holding it all together when you’re Hypermobile. Journey2Joy
Afrin, L. B. (2016). Never bet against Occam: Mast cell activation disease and the modern epidemics of chronic illness and medical complexity. Sisters Media, LLC.
Freeman, K., Goldstein, D. S., & Thompson, C. R. (2025). The dysautonomia project: Understanding autonomic nervous system disorders (2nd ed.). Bardolf.
Disclaimer
This blog is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no provider/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user’s own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.