12/13/2025
My women’s health practice sees this a lot. I am often the one to help women recognize it’s not in their head. You deserved great care!
Gut problems? Pelvic floor and abdominal issues? I can definitely help!
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Autonomic Dysfunction in hEDS: What the New Research Actually Shows
If you live with hypermobile Ehlers-Danlos Syndrome, you already know the autonomic system feels chaotic. Your heart jumps when you stand, digestion slows down for no reason, and fatigue hits like a shutdown. For years, this was written off as “anxiety” or “stress sensitivity.” The 2020–2025 research says something completely different.
Screening data from national registries, proteomic studies, and autonomic neurology show that hEDS is not just a “joint problem.” It’s a condition with measurable neurological and immune-matrix dysregulation that directly affects the autonomic nervous system.
What the evidence points to
1. It starts in the connective tissue and the immune system
Recent proteomic work (ImmunoHorizons 2025) found that hEDS patients have reduced levels of core complement proteins like C1QA, C3, C8A, and C9. These proteins help regulate inflammation and mast cells. With complement depletion, mast cells become overactive, which disrupts blood vessel tone and autonomic balance. This provides the first biological mechanism linking hEDS, POTS, and MCAS as one cluster rather than unrelated comorbidities.
2. Vascular laxity affects heart rate and blood pressure regulation
Connective tissue governs the elasticity of blood vessels. In hEDS, the vessels stretch more than they should. When you stand, blood pools instead of returning quickly to the heart. The result is classic POTS physiology: rapid heart rate, dizziness, chest pressure, and cognitive fog.
3. Neuropathy plays a major role
Skin biopsy studies show reduced small fiber nerve density in many hEDS patients. These small fibers control heart rate, sweating, temperature regulation, and gut motility. Damage or loss of these fibers leads to heart rate spikes, heat intolerance, irregular sweating, and dysmotility.
4. It is not caused by psychological anxiety
Multiple cohort studies confirm that over 90 percent of hEDS patients are misdiagnosed with anxiety before they receive their correct diagnosis. The new data explains why: the body produces adrenaline because the autonomic system is malfunctioning, not because the mind is distressed. It’s a physiological adrenaline storm, not a psychological one.
5. The GI system is heavily affected
The American Gastroenterological Association’s 2024 guidance notes that gastroparesis, reflux, constipation, re**al prolapse, and functional GI disorders are common in hEDS due to autonomic imbalance combined with connective tissue laxity. They recommend targeted motility testing, not standard IBS routines.
What this means for people with hEDS
Your autonomic symptoms are real and measurable.
They have identifiable biological pathways.
And they consistently show up across cardiovascular, neurological, and gastrointestinal systems.
This is not “just hypermobility.” It is a multisystem connective tissue and neuro-immune condition with a predictable autonomic signature.
If these symptoms describe your daily life, you are not imagining them. You are experiencing a documented pattern that science is only now catching up with.
If you live with hypermobile Ehlers-Danlos Syndrome, you already know the autonomic system feels chaotic. Your heart jumps when you stand, your digestion slows down for no reason, and fatigue hits like a shutdown. For years, this was written off as “anxiety” or “stress sensitivity.” The 2020–2025 research says something completely different.
