Hypermobility-Associated Symptoms and Micronutrient Considerations

The following outlines potential existing symptoms and associated conditions commonly seen in individuals with hypermobility, including those with overlapping dysautonomia/POTS and MCAS. These symptoms can span multiple body systems and often overlap, contributing to complex clinical presentations.

Understanding these patterns can help guide appropriate screening, interdisciplinary care, and individualized management strategies.

POTENTIAL EXISTING SYMPTOMS DUE TO HYPERMOBILITY (+DYSAUTONOMIA+MCAS)

GI-related diagnosis:

• Gastroparesis

• Chronic constipation

• Functional nausea

• GERD

• Food sensitivity

• Hiatal hernia

• IBS

• Deficiencies (anemia, magnesium…)

• Celiac disease

• Crohn’s disease

DYSAUTONOMIA/POTS-related:

• Palpitations

• Lightheadedness

• Fatigue

• Blurred vision

• Generalized weakness

• GI symptoms (nausea, abdominal pain, vomiting, diarrhea, bloating, severe constipation, early satiety)

MCAS-related:

• Allergic reactions (flushing, hives, puffiness, swelling, tingling tongue or throat)

• Fatigue

• Conjunctivitis

• Headaches

• Palpitations

• GI symptoms (nausea, vomiting, dysphagia, abdominal pain, atypical chest pain, bowel dysfunction)

  
  

Other overlapping conditions:

• Migraines

• Chronic neck and muscle pain

• Suboptimal sleep quality

• Poor wound healing/skin laxity

• Poor muscle engagement

• Restless leg syndrome

• Fibromyalgia

• Raynauld’s disease

• Arnold's-Chair 1 malformation

The section below provides general micronutrient considerations often discussed in hypermobility-related care. These are not universal recommendations and should always be interpreted within an individualized clinical context.

MICRONUTRIENT RECCOMENDATION

Many individuals with hEDS/HSD or hypermobility in general have higher rates of nutrient deficiencies due to malabsorption, GI dysmotility and increased connective tissue turnover.

Each person with hypermobility is different and the supplement recommendations which would provide better outcomes and symptom relief is individualized and based on the existing symptoms and their severity. Similar, because the evidence in the literature differs in strength between the following micronutrients, so our recommendation is case specific and based on clinical judgment and expertise.

• Vitamin C

• Vitamin D

• B vitamins (B2, B12, folate)

• Electrolytes (Na, K, Mg)

• Magnesium (glycinate, citrate, malate)

• Iron

• Omega-3 fatty acids

• NADH+

• Collagen

• Probiotics and synbiotics

• CoQ10

• L-carnitine

There certain amino acids including tryptophan that have been proven to show beneficial effects on improving muscle repair, immune function, gut barrier support, hormone signaling, appetite and energy intake. However, they have not been studies in patients with hypermobility or dysautonomia populations. The scientific evidence in these fields is still emerging and we’re hoping more studies targeting this population in the future.

Always keep in mind to follow up with health professionals for monitoring of vitamins and electrolytes and making sure that your current micronutrient intake is optimized according to your health and nutritional needs. This is because some supplements like certain probiotic and magnesium types for example might worsen GI symptoms or other symptoms.

Post written by Registered Dietitian Hiba Agha