Why hEDS, POTS, and MCAS Almost Always Come Together: The Mechanistic Triad and the Upstream Lesion Standard Medicine Doesn't Treat — How to Read Your Own Triad Through This Lens

If the framework above describes your situation, the practical question is how to apply it to your specific case. The triad is not uniform. Different patients have different relative weighting of the three subsystems, and the relative weighting determines what to address first and how. Several common configurations are worth distinguishing. The Connective Tissue Dominant Pattern In this configuration, the structural features of hEDS dominate. Frequent joint instability, dislocations, subluxations, severe chronic pain, slow tissue healing, easy bruising, skin features, dysmotility from gut wall laxity. The autonomic and mast cell features are present but secondary. The patient's daily function is most limited by the musculoskeletal and tissue maintenance failures. In this configuration, the intervention sequence prioritizes the bioenergetic support of the connective tissue compartment (fibroblast metabolism, collagen synthesis cofactors including vitamin C, copper, lysine, glycine), the matrix preservation work (manageable physical therapy, joint protection), and the suppression of the inflammatory state that is accelerating connective tissue breakdown. The autonomic and mast cell features will respond when the underlying capacity improves but will require some direct support along the way. The Autonomic Dominant Pattern In this configuration, the POTS features dominate. Severe