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Ehlers-Danlos Syndrome, Mast Cell Activation Diseases and Dysautonomia –  Oh! That’s Why I‘m So Tired!! 

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Twisted!

And maybe that’s why you’re tired too! Join me on a journey of discovery about one of the most poorly recognized and unbelievably tangled health webs you can find involving not just one, but several intertwined systemic conditions I personally unofficially call the “Chronic Constellation” for lack of a better name.

Each syndrome alone is enough to take a person down at the knees, but combined as we so often find these, they can be downright show stopping, if not even lethal sometimes, sadly. Oh, That’s Why I’m so Tired!

Yet barely 10% or so who have this “trifecta” of a form of Hypermobility Spectrum Disorder or Ehlers-Danlos Syndrome, MCAD and Dysautonomia (usually POTS) plus many variations and additional issues including autism and weak immune systems get properly diagnosed, and it takes 10 years on average to get diagnosed with a form of Ehlers-Danlos Syndrome. (It took me over 25!)

Most are currently getting diagnosed with Fibromyalgia or ME/CFS, if anything at all. This site is my attempt to help remedy that for everyone – both patients AND doctors!

Hypermobility Spectrum Disorders aren’t rare, they’re rarely diagnosed!


News and Events


February is Rare Disease and Marfan Syndrome Awareness Month

I struggle with calling my condition rare. That is, because as far as we know, I have the most common form of Ehlers-Danlos syndrome: hypermobile type EDS or hEDS. (We ruled out 2 of the more rare types by genetic testing in 2012.) And some sources cite that along with the new category of Hypermobility Spectrum Disorders, together they may run in as high as 3.4% of the population. (Tinkle, Castori, Berglund et al 2017.) Far from rare!

However, 12 of the currently 13 officially classified types of EDS as of 2017 are truly rare, some extremely so. As in, running in only a couple of families in the world, so in less than 100 people known to date. (There may be more, but they haven’t been found and counted yet.)

So while the collection of forms of EDS as a whole may not be rare, some forms truly are. So I’m happy to once again promote Rare Disease Awareness Month to help raise awareness.

That said, the very similar looking Marfan Syndrome is still considered rare at about 1 in 5000 worldwide, and is highlighted this month also. Many with EDS have marfanoid features and “habitus” or body style/shape, but… they may still test negative for Marfan syndrome, which involves a defect in fibrillin, rather than collagen production as in EDS.

The more telltale signs that can help distinguish Marfan syndrome from EDS involve ectopia lentis, or displacement of the eye lens from its normal central position, aortic enlargement (even in children), high arched palate and crowded teeth, long limbs and digits (fingers and toes), and sunken chest (pectus excavatum). No single sign alone is sufficient to diagnose Marfan syndrome (forms of EDS also shares most but not all of the above), but if several are present, along with a positive family history, it might be well worth looking into.

And check out this new (to me in Feb 2020) EDS news and research collating site. (I will add it to my resources of course!) You can subscribe to receive weekly updates or just check back periodically:

Ehlers-Danlos Treatment Report

OLD NEWS: 10/8/19 My kingdom for a comma! Yes singer Sia has Ehlers-Danlos Syndrome! No, it is NOT a neurological disease as the media mistook her first October 4th tweet to read! (Look closely, there’s an Oxford comma there!) See her next tweet of October 6th clarifying this, but not before not only The Daily Mail and CNN but even WebMD *mistweeted* that EDS was “a neurological condition”, eek!

DO YOUR DUE DILIGENCE PEOPLE! Take just 30 seconds to Google or otherwise research something before spreading misinformation!! And you wonder why we’re so tired! 😉 Onward…

Ongoing news

Good news, Project EDS ECHO for doctors was rolled out in May 2019, and is officially underway. This should really help to “infect” more doctors with the latest information and insight into the forms of Ehlers-Danlos syndrome and Hypermobility Spectrum Disorders, so patients don’t have to do all the heavy lifting anymore! It’s found here: http://ehlers-danlos.com/echo .

So far 150 doctors have signed on and earned CME’s for participating, thank you! The Ehlers-Danlos Society hopes to reach 1000 practitioners by 2020. (New “sessions” roll out periodically.) Help us reach that goal by sharing it with all your doctors! (Along with the EDS Toolkit for doctors freely available here too.)

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May 2017 historic EDS update

Ehlers Danlos Syndrome Awareness Month

May is Ehlers-Danlos Syndromes Awareness month and boy did we have some updating to do in 2017! Thanks to the brand new 2017 EDS  nosology and diagnostic criteria published March 15th, 2017 there were 7 new rare types to know about (making a total of 13, up from 6 before), and they tightened the criteria for the most common form, hypermobile EDS making it (technically) rare again.

UPDATE 4/10/18: There’s a new 14th type out now too.

ALL 18 PAPERS covering all aspects of the NEW Ehlers-Danlos Syndrome revised nosology and diagnostic criteria are here now. For those unaware, this is the FIRST update since the Villefranche nosology was presented in 1997 (over 20 years before!), and this also supplants and replaces the Brighton Diagnostic Criteria for Joint Hypermobility Syndrome which some also used to diagnose hypermobile type EDS also. So there will at least be no more confusion between Brighton and Beighton going forward, even if many of us no longer count as bendy!

Update March 2018 – The non-specialist LAY versions of those 18 crunchy papers above are HERE now too for the win! Big thanks to The Ehlers-Danlos Society for writing these up for the rest of us who don’t speak medicalese, or whose brains are just too tired to parse it. I think even some doctors will appreciate them too! And…

Update May 2018 The Royal College of General Practitioners in London, England just successfully rolled out a brand new, brilliant “EDS Toolkit online for their GPs (and other allied healthcare professionals) to learn and study from! And I got to help draft it at the invitation of the primary author, Dr. Emma Reinhold, a GP with hEDS and MCAS herself I met on Twitter along with some other much esteemed company.

I’m very pleased to have played even a small part in “midwifing” this project along. Please share it far and wide with any and all doctors you can! It is freely available to anyone and everyone on the web, not just the NHS.

The International 2017 EDS Classification via The Ehlers-Danlos Society

EDS Pamphlet

You might wish to refer to this FAQ document previously shared by The Ehlers-Danlos Society for clarification on the new criteria and terminology update as well. We will now be referring to EDS in the plural as the “Ehlers-Danlos syndromes” with an “s” on the end. (Or trying.)

As well as diagnosing an entirely new category of several Hypermobility Spectrum Disorders for those who look a lot like they have EDS, suffer much the same, but don’t meet the criteria for any more specific diagnoses involving hypermobility of varying degrees yet.

I.e, they are subclinical for hEDS as I was for my first 44 years, and may now be technically again since I stiffened so much with age and arthritis. Kind of like how Pluto was re-classified to a dwarf planet 10 years ago right? It never changed a spot. We just changed our minds about it.

These forms of HSD also all supplant and replace the former diagnoses of Hypermobility Syndrome, Joint Hypermobility Syndrome, and Benign Joint Hypermobility Syndrome to my understanding. I like to think of the HSDs as the less visible bulk of patients “below the water line” as shown here:

graphic of an iceberg with labels of EDS above the water line, and HSD below
See the rest of the iceberg! Copyright Jan Groh 2018

The criteria for what has been called hypermobile EDS or hEDS were just tightened in 2017, so I will no longer refer to this form as common anymore accordingly. I actually no longer meet the new criteria since it requires a much higher Beighton 9 pt score than before. I now fit one of the forms of the new catch-all bin of the Hypermobility Spectrum Disorders better even though I was extremely bendy as a child, but…

NB you do NOT need to “lose” your diagnosis of hEDS until/unless someone requires you to, such as to meet the criteria for a research study. Further, you will still have a diagnosis that represents a hypermobile disorder, but just with a different name. It is hoped this will lead to speedier presumptive care and management rather than just leaving patients suffering because they did not meet the new higher bar of hEDS diagnosis.

I, Jan, unscientifically personally now feel very strongly that the newly recognized Hypermobility Spectrum Disorders as such are NOT rare at all, but also just rarely diagnosed – and not just because they are newly introduced. But because they’ve always been dismissed as “normal” or early aging, or “just depression”, fibromyalgia,  chronic fatigue or hypochondria under any name/classification scheme when they should not be!

It is my deepest wish that one day, this disease cluster will be as well known as multiple sclerosis, and much more quickly recognized. Everyone knows someone with a hypermobility spectrum disorder, if not even EDS. I will continue to post and tweet to that end, while I finish writing my book. Join me.

I can use your financial support at any level to help keep this blog online here thank you!