Abnormal Parasympathetic Responses to Stress Exacerbate Hypermobility and Ehlers-Danlos Syndrome Symptoms

Introduction. Ehlers-Danlos Syndrome/Hypermobility (EDSh) patients demonstrate abnormal parasympathetic responses to stressful stimuli. This has been labeled “Parasympathetic Excess” (PE). PE may be caused by the need in EDSh patients’ immune systems to be over-active due to the porous connective tissue. Methods. From a suburban cariology and autonomic clinic (Sicklerville, NJ, USA) drawing patients from around the world, a cohort of 243 patients (223 female, 91.8%; average age 34.0 yrs, range 13 to 65 y/o; average BMI 27.3#/in2) previously diagnosed by Rheumatology with EDSh were followed from between November 2018 through May 2020. Baseline and at least two follow-up autonomic tests, with questionnaires, were administered. At follow-up testing autonomic therapy for PE, including low-and-slow exercise and very low dose anti-cholinergics. Results. From the questionnaires, PE is found to cause symptoms associated with a deconditioned heart, including: lightheadedness, fatigue, brain-fog, memory and cognitive difficulties, headache or migraine, sleep difficulties, and depression-like and anxiety-like symptoms. Conclusion. PE in EDSh patients exacerbates the debilitating nature of the disease and simply treating the symptoms often exacerbates the case. Therapy durations are among the shorter of the treatments for Dysautonomia, often lasting at least 6 to 9 months depending on the duration and severity of the disorder.