Managing Hypermobile Ehlers-Danlos Syndrome: A Naturopathic Approach to Whole-Body Wellness

Hypermobile Ehlers-Danlos Syndrome (hEDS) is a connective tissue disorder primarily characterized by joint hypermobility, chronic pain, and a range of other systemic symptoms. Though often underdiagnosed, hEDS can have a significant impact on a patient's quality of life. Naturopathic medicine offers a holistic approach to managing hEDS, focusing on treating the whole person and addressing underlying issues.

What is hEDS?

Ehlers-Danlos Syndromes (EDS) are a group of heritable connective tissue disorders affecting collagen, a key protein that provides structure and strength to various tissues in the body. Hypermobile Ehlers-Danlos Syndrome (hEDS) is the most common subtype, marked by joint hypermobility, musculoskeletal pain, and frequent dislocations or subluxations. In addition to joint-related symptoms, patients with hEDS may experience:

• Gastrointestinal issues (e.g. irritable bowel syndrome – IBS)

• Dysautonomia (e.g. postural orthostatic tachycardia syndrome – POTS)

• Fatigue and sleep disturbances

• Easy bruising and poor wound healing

• Anxiety and mood disorders

The condition can vary widely in its severity, from mild joint hypermobility to disabling chronic pain and multi-systemic issues. Diagnosis of hEDS is primarily clinical, relying on a combination of patient history, physical examination, and established criteria.

Conventional Management of hEDS

Conventional treatment of hEDS often involves a multidisciplinary approach, including physical therapy, pain management, and medications to control symptoms. While these interventions can help manage some aspects of the condition, many patients seek additional support to address the chronic and systemic nature of hEDS. This is where naturopathic medicine can offer valuable adjunctive care.

Naturopathic Approach to hEDS

Naturopathic doctors (NDs) focus on treating the underlying causes of disease while emphasizing lifestyle changes, natural therapies, and patient education. For hEDS patients, a naturopathic approach includes:

1. Nutritional Support

   An anti-inflammatory diet incorporating omega-3 fatty acids to help reduce systemic inflammation can be helpful in managing chronic pain associated with hEDS. Other essential nutrients to include are vitamin C (a key co-factor in collagen synthesis) and zinc (important for tissue repair and immune function).

2. Digestive Health

   Irritable bowel syndrome (IBS) is a common symptom in patients with hEDS, utilizing probiotics to maintain a balanced gut microbiome, recommending a high fiber diet to support gut motility and identify and eliminating food sensitives can also be beneficial for patients with hEDS to reduce inflammation within the body and alleviate symptoms of IBS.

3. Movement

   Exercise programs that focus on low-impact activities and emphasize gentle, controlled movements to support muscle recovery and alleviate pain would be ideal for patients with hEDS.

4. Nervous System Support

   Using mind-body practices such as meditation, yoga and/or breathing exercises can support the autonomic regulation and reduce anxiety and pain perception in patients with hEDS. Adaptogenic herbs has also been shown to help modulate the body’s stress response.

5. Pain Management

   Anti-inflammatory herbs such as ginger, turmeric or Boswellia can help reduce inflammation and pain. Acupuncture has also been beneficial for some patients who experience chronic pain from hEDS.

6. Sleep Optimization

   Sleep disturbances can be common in patients with hEDS. Utilizing herbal supports and nutraceuticals such as passionflower and magnesium can help promote relaxation and improve quality of sleep in hEDS patients.

Hypermobile Ehlers-Danlos Syndrome is a complex condition that affects multiple body systems. While conventional management is crucial for stabilizing joints and managing acute symptoms, naturopathic medicine offers a comprehensive approach that addresses the underlying causes, supports overall health, and empowers patients with hEDS to take an active role in their care. Through nutritional support, digestive health optimization, nervous system regulation, pain management and sleep optimization, NDs can help patients with hEDS improve their quality of life and manage symptoms more effectively.

 In health,

Dr. Sami Leung, ND

References:

1. Castori, M., Morlino, S., Pascolini, G., Blundo, C., & Grammatico, P. (2015). Gastrointestinal and nutritional issues in joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type. American journal of medical genetics. Part C, Seminars in medical genetics, 169C(1), 54–75. https://doi.org/10.1002/ajmg.c.31431

2. Chopra, P., Tinkle, B., Hamonet, C., Brock, I., Gompel, A., Bulbena, A., & Francomano, C. (2017). Pain management in the Ehlers-Danlos syndromes. American journal of medical genetics. Part C, Seminars in medical genetics, 175(1), 212–219. https://doi.org/10.1002/ajmg.c.31554

3. Demes, J. S., McNair, B., & Taylor, M. R. G. (2020). Use of complementary therapies for chronic pain management in patients with reported Ehlers-Danlos syndrome or hypermobility spectrum disorders. American journal of medical genetics. Part A, 182(11), 2611–2623. https://doi.org/10.1002/ajmg.a.61837

4. Do, T., Diamond, S., Green, C., & Warren, M. (2021). Nutritional Implications of Patients with Dysautonomia and Hypermobility Syndromes. Current nutrition reports, 10(4), 324–333. https://doi.org/10.1007/s13668-021-00373-1

5. Doyle, T. A., & Halverson, C. M. E. (2022). Use of complementary and alternative medicine by patients with hypermobile Ehlers-Danlos Syndrome: A qualitative study. Frontiers in medicine, 9, 1056438. https://doi.org/10.3389/fmed.2022.1056438

6. Guedry, S. E., Langley, B. O., Schaefer, K., & Hanes, D. A. (2024). Integrative medicine for hypermobility spectrum disorders (HSD) and Ehlers-Danlos syndromes (EDS): a feasibility study. Disability and rehabilitation, 1–14. Advance online publication. https://doi.org/10.1080/09638288.2024.2314713

7. Hakim, A. (2004). Hypermobile Ehlers-Danlos Syndrome. In M. P. Adam (Eds.) et. al., GeneReviews®. University of Washington, Seattle.

8. Heds Body System. The Ehlers Danlos Society. (2024, September 12). https://www.ehlers-danlos.com/heds/

9. Langevin, H. M., Churchill, D. L., Wu, J., Badger, G. J., Yandow, J. A., Fox, J. R., & Krag, M. H. (2002). Evidence of connective tissue involvement in acupuncture. FASEB journal : official publication of the Federation of American Societies for Experimental Biology, 16(8), 872–874. https://doi.org/10.1096/fj.01-0925fje

10. Mantle, D., Wilkins, R. M., & Preedy, V. (2005). A novel therapeutic strategy for Ehlers-Danlos syndrome based on nutritional supplements. Medical hypotheses, 64(2), 279–283. https://doi.org/10.1016/j.mehy.2004.07.023

11. Pullar, J. M., Carr, A. C., & Vissers, M. C. M. (2017). The Roles of Vitamin C in Skin Health. Nutrients, 9(8), 866. https://doi.org/10.3390/nu9080866

12. Topan, R., Pandya, S., Williams, S., Ruffle, J. K., Zarate-Lopez, N., Aziz, Q., & Fikree, A. (2024). Comprehensive Assessment of Nutrition and Dietary Influences in Hypermobile Ehlers-Danlos Syndrome-A Cross-Sectional Study. The American journal of gastroenterology, 119(4), 727–738. https://doi.org/10.14309/ajg.0000000000002586

13. Song, B., Yeh, P., Nguyen, D., Ikpeama, U., Epstein, M., & Harrell, J. (2020). Ehlers-Danlos Syndrome: An Analysis of the Current Treatment Options. Pain physician, 23(4), 429–438.

Make Every Day Self-Care Day!

Our busy, modern lives can sometimes make it hard for us to tune into our body’s needs. Here are some of our favorite tips on how to keep balanced while keeping busy!

At home…

Get Outside

Being in nature has numerous mental and physical benefits. Nature therapy has gained popularity as a means to reduce stress and promote healing. Research has come to the same conclusion as nature therapy practices have been shown to reduce heart rate, blood pressure, and the stress hormone, cortisol, when compared to measurements in other environments. (1)

Connect With Loved Ones

It likely does not come as a surprise that social isolation is associated with increased risk for mental health problems–in particular, depression, anxiety, stress-related disorders, and anger. Try to make an active effort to spend time with people you love whether you are able to do so in person or via a virtual connection. (2)

Screen Time Breaks

While technology has improved our lives in an abundance of ways, there can be too much of a good thing. Studies show that increased screen time is associated with negative outcomes such as lowered self-esteem, increased incidence and severity of mental health issues and addictions, slowed learning and acquisition, and an increased risk of premature cognitive decline. Use your screen time wisely–in moderation and with intention. Consider setting time limits on your devices and cleaning up your follow lists on social media to make your social feeds more of a positive space to engage with. (3)

Balanced Nutrition

Enjoying a balanced variety of nutrient-rich, whole foods to fuel your body optimally helps to reduce inflammation and keep your blood sugar (and moods) stable. In general, you should aim for half of your plate to be vegetables, 1/4 complex carbs (whole grains, starchy vegetables), and 1/4 protein. Healthy fats should be incorporated into each meal (avocado, nuts, olive oil, etc), and fruit makes for excellent snacks or dessert. Water intake is imperative for the maintenance of good health and most healthy adults should aim for 2-3L of water daily.

Sleep

It’s not just for beauty! As neuroscientist Matthew Walker says, “There does not seem to be one major organ within the body, or process within the brain, that isn’t optimally enhanced by sleep (and detrimentally impaired when we don’t get enough).” Adequate, quality sleep (7-9 hours per night) is vital for tissue regeneration, and slacking on your sleep can increase your propensity for weight gain, chronic disease, and even cancer. If you are struggling to get a good night’s sleep, our naturopathic doctors would love to help!

At Saskatoon Naturopathic Medicine…

Acupuncture

An effective traditional therapy for many conditions including stress, anxiety, sleep, pain, digestion, and hormonal concerns.

Massage

Our knowledgeable massage therapists offer relaxing and therapeutic massage as well as myofascial release and patient self-care education such as stretching, strengthening and postural awareness.

Somatic Experiencing™

Somatic Experiencing™ is a body-based approach to treating the effects of trauma. Specifically, the symptoms that arise when trauma is held in the body, including chronic or severe pain that does not respond well to medication, headaches, digestive issues, fear, difficulty sleeping, anxiety and depression. Somatic Experiencing™ works with the nervous system and the body’s innate ability to heal and recover from the symptoms of physiological stress. Treatment is gentle, supportive and enhances the effectiveness of the traditional exercise-based physiotherapy and counselling approaches.

Nutritional IV Therapy

IV nutrient therapy is a method of administering water-soluble nutrients (vitamins, minerals, antioxidants, and amino acids) directly into the blood stream. When you infuse nutrients intravenously, you bypass the digestive system, and this achieves a higher blood concentration beyond what is orally possible, especially if digestive function is compromised. Great for many conditions as well as health optimization and energy support. (See our website or call the clinic for more details).

Targeted Therapeutics

If you are looking for a comprehensive approach to your self-care, book a consultation with one of our naturopathic doctors who will conduct a thorough assessment of your health and come up with a customized plan just for you! With a variety of treatment modalities and testing options available, a targeted treatment plan can eliminate some of the guess-work and help you reach your self-care goals more quickly.

Written by Jacalyn Sieben ND

Sources:

1. Hansen, M. M., Jones, R., & Tocchini, K. (2017). Shinrin-Yoku (Forest Bathing) and Nature Therapy: A State-of-the-Art Review. International Journal of Environmental Research and Public Health, 14(8), 851. https://doi.org/10.3390/ijerph14080851

2. Henssler, J., Stock, F., van Bohemen, J. et al. (2021). Mental health effects of infection containment strategies: quarantine and isolation—a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 271, 223–234. https://doi.org/10.1007/s00406-020-01196-x

3. Neophytou, E., Manwell, L.A. & Eikelboom, R. (2021). Effects of Excessive Screen Time on Neurodevelopment, Learning, Memory, Mental Health, and Neurodegeneration: a Scoping Review. Int J Ment Health Addiction 19, 724–744. DOI: 10.1007/s11469-019-00182-2