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Cause connective-tissue-dysautonomia
Cause #26 Moderate-High - 2017 classification; diagnosis requires specialist

Eds and Brain Fog

20 min read Updated Our evidence standards Editorial policy

Guideline: 2017 EDS International Classification; NICE referral criteria

Medically reviewed by Dr. Alexandru-Theodor Amarfei, M.D.

First published

Quick Answer

EDS can contribute to brain fog. The most useful clues are the symptom pattern, nearby overlaps, and whether the mechanism described here matches your story: Youve been told youre just flexible your whole life.

79% of hEDS patients have reduced cerebral blood flow

Your brain fog isn't 'anxiety.' It's blood not reaching your brain when you stand up. 33% of hEDS patients have POTS that nobody checked for. The triad (EDS + POTS + MCAS) explains symptoms that have baffled doctors for decades.

— Am J Med Open 2025; hEDS/POTS prevalence data

Mechanism overlap

Mechanisms this cause often overlaps with

These are explanation lenses, not diagnosis certainty. If this cause fits, these mechanisms can help explain why the pattern looks the way it does.

autonomic hypoperfusion

Autonomic Stress & Hypoperfusion

Orthostatic strain, blood pooling, or autonomic instability can reduce cognitive stamina, especially when upright, overheated, or underfueled.

What would weaken it: No positional pattern at all.

structural vestibular load

Structural or Vestibular Load

Cervical strain, vestibular dysfunction, post-concussion effects, or positional head/neck load can distort clarity, orientation, and stamina.

What would weaken it: No positional or motion sensitivity.

⏱️

When to expect improvement

Immediate (screening)

If no improvement after this timeframe, it's worth exploring other possibilities.

Is Eds Brain Fog Reversible?

EDS is a lifelong genetic condition - it does not 'go away.' However, the brain fog associated with EDS is often significantly improvable by treating the comorbidities: POTS (79% have reduced cerebral blood flow), MCAS, pain, and sleep disruption. Managing these improves cognition.

Cause Visual

Eds Pattern Map

Pattern-focused visual for Eds with mechanism, timing, action, and clinician discussion cues.

Eds Pattern Map Community-informed pattern guide with clinical framing Eds Pattern Map Community-informed pattern guide with clinical framing Mechanism Cue Mechanism path: Eds can reduce mental clarity through repeatable ph… Timing Pattern Timing strip: track whether symptoms cluster in mornings, after mea… This Week Action Beighton Score : 9-point hypermobility assessment. Clinician Discussion Cue Discuss EDS Comprehensive Workup and whether findings support Eds o… Use repeated patterns, not single episodes, to guide next steps.
Subtle motion Updated: 2026-02-25 Evidence-linked visual

Why Eds Causes Mental Fog

EDS-related fog often feels like a body-structure problem and an autonomic problem at the same time: upright intolerance, pain, fatigue, GI issues, and a brain that loses clarity when the body is struggling.

What this pattern often feels like

These community-grounded clues are here to help you recognize the shape of the pattern. They are not a diagnosis.

EDS-related fog usually appears as part of a connective-tissue cluster with autonomic, pain, GI, and positional symptoms rather than an isolated brain problem.

The fog rises when my body feels unstable, painful, or hard to hold together. Standing, heat, or upright time often worsens the cognitive part too. The pattern sits next to dizziness, palpitations, flushing, gut issues, or weird allergic-feeling reactions. Pain and physical compensation seem to drain my brain as much as my body.

Differentiator question: Does the fog track with upright strain, pain, instability, GI issues, or a broader POTS/MCAS-style cluster?

EDS may be central, but POTS, cervical issues, migraine, pain, and sleep disruption often carry much of the day-to-day cognitive burden.

Eds Brain Fog Symptoms: How It Usually Shows Up

These are pattern signals, not proof by themselves. Use them to guide what to measure, compare, and discuss next.

Common Updated 2026-02-25

Eds can present with morning-heavy fog when sleep or overnight physiology is relevant.

Common Updated 2026-02-25

Post-meal worsening can strengthen Eds when metabolic or inflammatory triggers are involved.

Common Updated 2026-02-25

Post-exertional worsening can increase confidence for Eds when recovery capacity is reduced.

Less common Updated 2026-02-25

Normal or near-normal average labs can coexist with high variability; do not conclude from one number alone.

What to Try This Week for Eds

  1. 1

    Track whether the fog improves when you lie down, use compression, hydrate more consistently, or reduce long standing periods. That pattern is high-yield for EDS/POTS overlap.

    Start with one high-yield change before adding complexity.

  2. 2

    Use one body-support intervention this week and log the result: compression, seated breaks, neck support, or pacing upright time.

    Weekly focus: Body.

  3. 3

    Pair brain-fog notes with pain and dizziness notes. In EDS, those systems often rise and fall together and should not be logged separately.

    Weekly focus: Food.

  4. 4

    Drink a glass of water now. Keep a bottle visible. Aim for pale yellow urine. Don't overthink it - just drink regularly.

    Weekly focus: Hydration.

  5. 5

    Open a window for 15 minutes. Fresh air exchange reduces indoor pollutants. If outdoors is bad (pollution, pollen), use a HEPA filter.

    Weekly focus: Environment.

  6. 6

    Reach out to one person today. Text, call, walk together. Isolation worsens every cause of brain fog. Connection is a biological need, not a luxury.

    Weekly focus: Connection.

  7. 7

    Rate your brain fog 1-10 each morning for 7 days. Note sleep quality, food, exercise, stress. Patterns emerge within a week.

    Weekly focus: Tracking.

Is Eds Brain Fog Reversible?

EDS is a lifelong genetic condition - it does not 'go away.' However, the brain fog associated with EDS is often significantly improvable by treating the comorbidities: POTS (79% have reduced cerebral blood flow), MCAS, pain, and sleep disruption. Managing these improves cognition.

Typical timeline: POTS management (salt, compression, exercise): weeks to months. MCAS treatment: days to weeks. Pain management: ongoing. The underlying EDS remains, but function can improve substantially.

Factors that affect recovery:

  • POTS identification and treatment (most EDS fog is hypoperfusion)
  • MCAS management (if present)
  • Cervical stability (CCI/AAI can contribute to fog)
  • Pain control (chronic pain consumes cognitive resources)
  • Sleep quality (often disrupted by pain and autonomic issues)

Source: Am J Med Open, 2025 (cerebrovascular study); Malfait et al., Am J Med Genet, 2017

Food Approach

Primary Option

Mediterranean / MIND Pattern

The most evidence-backed eating pattern for brain health. Not a diet - a way of eating.

Leafy greens daily, berries 3-5x/week, fatty fish 2-3x/week, olive oil as main fat, nuts/seeds daily, legumes 3-4x/week, whole grains. Minimal ultra-processed food, refined sugar, and seed oils.

Collagen synthesis requires vitamin C + protein. Good sources: citrus fruits + meat/fish/eggs. Bone broth is popular in the community but collagen supplement evidence for EDS specifically is low. Focus on overall nutrition and adequate calories - many EDS patients are malnourished due to GI complications.

Open primary diet pattern →

Alternative Options

Gentle Anti-Inflammatory (Recovery-Adapted)

For people who are too fatigued, nauseous, or overwhelmed for complex dietary changes. The minimum effective dose.

Small, frequent, simple meals. Broth/soup if appetite is poor. Add ONE portion of oily fish per week. Add berries when tolerable. Reduce (don't eliminate) ultra-processed food. Hydrate. Don't force large meals.

Open this option →

Iron-Repletion Focus

For confirmed or suspected iron deficiency. Pair iron-rich foods with vitamin C. Separate from tea/coffee/dairy.

Iron-rich foods: red meat 2-3x/week, liver 1x/week (if tolerated), lentils, spinach, fortified cereals. ALWAYS pair with vitamin C (bell pepper, orange, kiwi, strawberry). Avoid tea/coffee within 1hr of iron-rich meals. Continue prenatal vitamins if postpartum.

Open this option →

How to Talk to Your Doctor About Eds and Brain Fog

Suggested Script

"I want to evaluate whether hypermobility-related strain, dysautonomia, or pain is contributing to my brain fog and how to separate that from POTS, cervical issues, or blood sugar explanations."

Tests To Discuss

  • Beighton Score
  • NASA Lean Test
  • Cervical Evaluation

Differentiator Questions

  • Is the fog more tied to standing, joint strain, neck position, and autonomic symptoms than to meals or stress alone?
  • Does this look more like POTS, cervical instability, or connective-tissue-related overload than a primary sleep or mood issue?
  • What part of this pattern is explained by pain, and what part still needs an autonomic or structural workup?

Quiet next step

Get the doctor handout for this pattern

Get the printable doctor handout for this pattern and keep the next steps in one place. No funnel, just the handout and a quiet email reminder if you want it.

Open the doctor handout nowNo sign-in required.

Quick Summary: Eds Brain Fog Key Points

Informative
  1. 1

    EDS-related fog often feels like a body-structure problem and an autonomic problem at the same time: upright intolerance, pain, fatigue, GI issues, and a brain that loses clarity…

  2. 2

    Worse in the morning: Symptoms often worsen after standing, long upright periods, pain flares, poor sleep, or neck-heavy activity rather than after meals alone.

  3. 3

    After-meal worsening: Many people describe clearer thinking when lying down or after unloading the neck and body, which helps separate this from mood-only causes.

  4. 4

    Worse after exertion: The pattern is often cumulative across the day as pain, orthostatic strain, and proprioceptive fatigue build up.

  5. 5

    Story language directly matches a recurring Eds pattern rather than broad fatigue alone.

  6. 6

    Symptoms recur with a repeatable trigger/timing pattern that is physiologically plausible for Eds.

  7. 7

    Context clues (history, exposures, or coexisting conditions) support Eds as a priority hypothesis.

  8. 8

    At least two independent signals point in the same direction without strong contradiction.

  9. 9

    Response to relevant interventions tracks closer with Eds than with Pots.

  10. 10

    A competing cause (Pots) has stronger direct evidence in the story.

Metabolic Lens

Secondary overlap

This cause can overlap with metabolic-pattern brain fog. Distinguish by timing, trigger profile, and objective context before narrowing to one explanation.

  • Fog episodes that cluster in repeatable timing windows (meal, exertion, posture, or sleep-pattern linked).
  • Energy or clarity drops that feel abrupt rather than uniformly low all day.
  • Symptom overlap with sleep, autonomic, anxiety, or medication factors.

These pattern clues can raise suspicion but are not diagnostic on their own; confirmation requires clinician-guided evaluation and objective data.

15 Evidence-Based Insights About Eds and Brain Fog

You've been told you're 'just flexible' your whole life. But you also have brain fog, a racing heart when you stand up, and random allergic-like reactions. Ehlers-Danlos Syndrome affects EVERY system - including how blood reaches your brain. The triad of EDS + POTS + MCAS explains symptoms that have baffled doctors for decades.

Evidence grades: A = strong human evidence, B = moderate evidence, C = preliminary or small-study evidence. Full grading guide

1

THE BEIGHTON SCORE - DO THIS NOW: (1) Can you bend your pinky back >90°?

(1 point each hand). (2) Can you touch your thumb to your forearm? (1 each hand). (3) Do your elbows hyperextend beyond straight? (1 each). (4) Knees hyperextend? (1 each). (5) Can you put palms flat on floor with knees straight? (1 point). Score ≥5/9 = generalized hypermobility.

Malfait et al., Am J Med Genet C 2017 DOI

2

33% of people with hypermobile EDS have POTS.

Your brain fog might not be from EDS directly - it's from blood not reaching your brain when you stand up. Nobody checked. The 10-minute NASA Lean Test can show this.

Clinical triad; POTS prevalence in hEDS

3

THE STANDING HEART RATE TEST: Lie down for 5 minutes.

Check heart rate. Stand up against a wall (don't walk). Check heart rate at 2 min, 5 min, 10 min. Increase of ≥30bpm = likely POTS. This is why you're foggy upright and clearer lying down.

NASA Lean Test; Wells et al., JAHA 2020

4

Average time to EDS diagnosis: 10-20 YEARS.

Patients are told they're 'just anxious,' 'too young for these problems,' or 'just flexible.' If you have hypermobility + multi-system symptoms + brain fog: you need an EDS-literate clinician.

Diagnostic delay literature; Castori et al., 2017

5

THE SKIN ELASTICITY TEST: Pinch the skin on the back of your hand.

Does it tent and slowly return, or snap back immediately? Pinch your forearm skin. Does it stretch more than normal? Velvety, soft skin that stretches easily + hypermobility = investigate EDS.

hEDS diagnostic criteria

View all 15 citations ▼
  1. Malfait et al., Am J Med Genet C 2017 doi:10.1002/ajmg.c.31552
  2. Clinical triad; POTS prevalence in hEDS
  3. NASA Lean Test; Wells et al., JAHA 2020
  4. Diagnostic delay literature; Castori et al., 2017
  5. hEDS diagnostic criteria
  6. Am J Med Open 2025 - hEDS cerebrovascular study
  7. Clinical triad; MCAS literature
  8. Clinical safety; case reports
  9. hEDS criteria; clinical presentation
  10. Recent hEDS research
  11. hEDS inheritance pattern
  12. Hakim et al., Am J Med Genet C 2017
  13. POTS management; clinical intervention
  14. Clinical advocacy
  15. EDS management guidelines

Common Questions About Eds Brain Fog

Based on clinical evidence and community insights. Use these as discussion prompts with your doctor, not self-diagnosis.

1. Can eds cause brain fog?

EDS can contribute to brain fog. The most useful clues are the symptom pattern, nearby overlaps, and whether the mechanism described here matches your story: Youve been told youre just flexible your whole life.

2. What does eds brain fog usually feel like?

Ehlers-Danlos Syndrome (especially hypermobile type) causes brain fog through multiple pathways: craniocervical instability affecting blood flow, POTS/dysautonomia, mast cell activation, poor sleep from pain, and potential Chiari malformation.

3. What should I try first if I think eds is involved?

Track whether the fog improves when you lie down, use compression, hydrate more consistently, or reduce long standing periods. That pattern is high-yield for EDS/POTS overlap. Start with one high-yield change before adding complexity.

4. What tests should I discuss for eds brain fog?

The most useful next tests depend on the pattern, but common discussion points include Beighton Score, NASA Lean Test, Cervical Evaluation. Use the timing of your fog and the closest competing causes to narrow the first step.

5. When should I bring eds brain fog to a clinician?

STOP - Seek urgent medical evaluation if: sudden onset of cognitive symptoms (hours/days), new focal neurological symptoms (weakness, numbness, vision or speech changes), seizures, fever with confusion, or rapidly progressive decline. These may indicate a medical emergency requiring immediate care, not lifestyle modification.

6. How is eds brain fog different from pots?

Does this look more like POTS, cervical instability, or connective-tissue-related overload than a primary sleep or mood issue?

7. Could this be Pots instead of Eds?

What part of this pattern is explained by pain, and what part still needs an autonomic or structural workup?

8. How quickly can I tell whether this path is helping?

Improvement timing depends on the root driver. Track the pattern for 1 to 2 weeks before deciding whether this path is helping, unless the story includes urgent escalation features.

9. When should I take this to a clinician instead of self-tracking?

Escalate when fog stays stable or worse after a focused 1-2 week trial, function keeps dropping, or your story includes red-flag features. Bring your trigger/timing log, medication list, and prior test results to save appointment time.

10. What do people usually try first when they suspect Eds?

A common first step from related community patterns is: Beighton Score (free, 2 minutes): 9-point hypermobility assessment. Score ≥5/9 = generalized hypermobility. Combined with chronic pain, POTS symptoms, and brain fog = investigate hEDS. ALSO: do the NASA Lean Test (#25) - 33% of hEDS patients have POTS that nobody has diagnosed yet.

Source: Community pattern analysis (50 analyzed stories)

📖 Glossary of Terms (6 terms)

EDS

EDS can contribute to brain fog.

NASA Lean Test

A simple orthostatic screening test: stand leaning against a wall (heels 6 inches from wall) for 10 minutes.

dysautonomia

Dysfunction of the autonomic nervous system — the automatic controller of heart rate, blood pressure, digestion, and temperature.

mast cell

Immune cells that release histamine and other chemicals during allergic and inflammatory reactions.

MCAS

Mast cell activation syndrome — mast cells release excessive histamine and other mediators, causing brain fog, flushing, hives, GI symptoms, and reactions to foods/chemicals.

POTS

Postural orthostatic tachycardia syndrome — heart rate rises excessively (≥30 bpm) when standing.

See full glossary →

Related Articles

When to Seek Urgent Help

STOP - Seek urgent medical evaluation if: sudden onset of cognitive symptoms (hours/days), new focal neurological symptoms (weakness, numbness, vision or speech changes), seizures, fever with confusion, or rapidly progressive decline. These may indicate a medical emergency requiring immediate care, not lifestyle modification.

Deep Dive

Clinical Fit + Advanced Detail

How This Cause Is Evaluated

The analyzer ranks all 66 causes, but this page shows the exact clues that strengthen or weaken Eds so your next steps stay logical.

Direct Evidence Needed

  • Story language directly matches a recurring Eds pattern rather than broad fatigue alone.
  • Symptoms recur with a repeatable trigger/timing pattern that is physiologically plausible for Eds.

Supporting Clues

  • + Context clues (history, exposures, or coexisting conditions) support Eds as a priority hypothesis. (weight 7/10)
  • + At least two independent signals point in the same direction without strong contradiction. (weight 6/10)
  • + Response to relevant interventions tracks closer with Eds than with Pots. (weight 5/10)

What Lowers Confidence

  • A competing cause (Pots) has stronger direct evidence in the story.
  • Core expected signals for Eds are missing across history, timing, and triggers.

Timing Patterns That Strengthen This Fit

Worse in the morning

Symptoms often worsen after standing, long upright periods, pain flares, poor sleep, or neck-heavy activity rather than after meals alone.

After-meal worsening

Many people describe clearer thinking when lying down or after unloading the neck and body, which helps separate this from mood-only causes.

Worse after exertion

The pattern is often cumulative across the day as pain, orthostatic strain, and proprioceptive fatigue build up.

Differentiate From Similar Causes

Question to ask

Does your pattern fit Eds more consistently than Pots when timing, triggers, and recovery are compared side-by-side?

If yes: Pattern consistency is stronger for Eds.

If no: Pattern consistency is stronger for Pots.

Compare with Pots →

Question to ask

Does your pattern fit Eds more consistently than Pain when timing, triggers, and recovery are compared side-by-side?

If yes: Pattern consistency is stronger for Eds.

If no: Pattern consistency is stronger for Pain.

Compare with Pain →

Question to ask

Does your pattern fit Eds more consistently than Cervical when timing, triggers, and recovery are compared side-by-side?

If yes: Pattern consistency is stronger for Eds.

If no: Pattern consistency is stronger for Cervical.

Compare with Cervical →

How People Describe This Pattern

hypermobile joints easy bruising stretchy skin joint dislocations
  • My most prominent issues are hypermobile joints and easy bruising.
  • I also struggle significantly with stretchy skin.
  • These symptoms feel like a repeatable pattern that affects my cognition.

Often Confused With

Pots

Open

Eds and Pots can both present as fatigue + concentration problems when story detail is sparse.

Key question: When timing and trigger details are compared directly, which pattern fits better: Eds or Pots?

Pain

Open

Eds and Pain can both present as fatigue + concentration problems when story detail is sparse.

Key question: When timing and trigger details are compared directly, which pattern fits better: Eds or Pain?

Cervical

Open

Eds and Cervical can both present as fatigue + concentration problems when story detail is sparse.

Key question: When timing and trigger details are compared directly, which pattern fits better: Eds or Cervical?

Use This Page With the Story Analyzer

Use this starter to run a focused check while still comparing all 66 causes:

"I want to check whether Eds could explain my brain fog. My most relevant symptoms are hypermobile joints, easy bruising, and it gets worse with overextension, repetitive motion."

Map My Pattern for Eds

Biomarkers and Tests

EDS Comprehensive Workup

View full test guide →

Doctor Conversation Script

Bring concise evidence, request specific tests, and agree on rule-out criteria.

Initial Visit

"I want to systematically evaluate whether Eds is contributing to my brain fog and compare it against close alternatives."

Key points to emphasize

  • Please document what findings would confirm this cause versus lower confidence.
  • I want an evidence-first workup with clear follow-up criteria.
  • Please note which competing causes should be checked in parallel if results are inconclusive.
  • Please separate metabolic, sleep, autonomic, and medication overlap before narrowing to one cause.

Tests to discuss

EDS Comprehensive Workup

Used to rule in or rule out Eds.

Healthcare System Navigation

Healthcare Guidance

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🇺🇸US

2017 International EDS Classification

  • hEDS diagnosis requires meeting 3 criteria: generalized hypermobility, systemic features, family history considerations
  • Genetic testing available for most subtypes EXCEPT hEDS (gene not yet identified)
  • Multidisciplinary management essential (PT, cardiology, genetics, autonomic specialist)
View official guidelines →

How the United States Healthcare Works for This

Step-by-step pathway for getting diagnosed and treated

EDS diagnosis in the US typically requires a geneticist for confirmation. Finding EDS-literate providers can be challenging.

Insurance rules vary by provider. Confirm coverage with your insurer before procedures.

If Your Insurance Denies Coverage

Tools to appeal denials (US-specific)

⚠️This condition/test typically requires prior authorization. Get approval before scheduling.

Appeal Script Template

I meet 2017 International Classification criteria for hypermobile Ehlers-Danlos Syndrome and have documented multi-system involvement. Per EDS management guidelines, multidisciplinary care including [PT/autonomic testing/genetics] is indicated. I request coverage.

💡Fill in the blanks with your specific scores and symptoms. Customize as needed.

Compliance Requirements

No specific compliance rules.

Disclaimer: This is informational guidance, not legal or medical advice. Insurance rules change frequently. Always verify current policies with your insurer. Consider consulting a patient advocate if appeals are denied.

Safety Considerations

🚗

Driving

POTS symptoms (dizziness, presyncope) may affect driving safety. Consider symptoms before driving. UK: Notify DVLA if condition affects driving.

💼

Work & Occupational Safety

EDS may qualify for disability accommodations. Flexible seating, ergonomic equipment, rest breaks, reduced standing may be needed.

🤰

Pregnancy

Higher-risk pregnancy in EDS. Specialist obstetric care recommended. Vascular EDS requires high-risk management. Discuss family planning with geneticist.

Medical Treatment Options

Discuss these options with your prescribing physician. This information is educational, not medical advice.

Multidisciplinary Management

EDS requires a team: geneticist (diagnosis), PT (stability), autonomic specialist (POTS), allergist/immunologist (MCAS), pain management. No single doctor covers it all.

Supplements — What the Evidence Says

Supplements are adjuncts, not replacements for lifestyle changes. Discuss with your healthcare provider.

Vitamin C (collagen support)

Dose: 500-1000mg daily

Vitamin C is essential for collagen synthesis. EDS is a collagen disorder. Theoretical basis strong; clinical evidence for EDS-specific benefit limited. Low-cost, low-risk adjunct.

See the full Supplements Guide →

Psychological Support and Therapy

Pain psychology. PT is primary. Occupational therapy for joint protection. If psychological impact of chronic condition → ACT or counseling.

Quick Reference

Quick Win

Beighton Score (free, 2 minutes): 9-point hypermobility assessment. Score ≥5/9 = generalized hypermobility. Combined with chronic pain, POTS symptoms, and brain fog = investigate hEDS. ALSO: do the NASA Lean Test (#25) - 33% of hEDS patients have POTS that nobody has checked for.

Cost: Free Time to effect: Immediate (screening)

Malfait et al., Am J Med Genet, 2017 - hEDS diagnostic criteria; Am J Med Open, 2025 - cerebrovascular study

Not sure this is your cause?

Brain fog can have many causes. The story analyzer can help narrow down what pattern fits best for you.

About This Page

Written by

Dr. Alexandru-Theodor Amarfei, M.D.

Medical reviewer and clinical content lead for the What Is Brain Fog cause library

Research methodology

Evidence-based approach using peer-reviewed sources

View our evidence grading standards

Last updated: . We review our content regularly and update when new research emerges.

Important: This content is for educational purposes only and does not replace professional medical advice. Consult a qualified healthcare provider for diagnosis and treatment.

Claim-Level Evidence

  • [C] Pattern-focused visual summary for Eds intended to support structured, non-diagnostic investigation planning. low/validated
  • [B] eds: Castori et al., Am J Med Genet C, 2017 - Natural history of hEDS. medium/validated

Key Citations

  • Malfait et al., Am J Med Genet C, 2017 - EDS international classification [DOI]
  • Castori et al., Am J Med Genet C, 2017 - Natural history of hEDS [DOI]
  • Hakim et al., Am J Med Genet C, 2017 - Management of hEDS [DOI]