Why hEDS, POTS, and MCAS Almost Always Come Together: The Mechanistic Triad and the Upstream Lesion Standard Medicine Doesn't Treat — The Pattern That Brought You Here

You are most likely a woman, between the ages of twenty and forty, with a history that follows a recognizable arc. You were flexible as a child. You bruised easily. You had stomach problems that adults dismissed as anxiety. Maybe you were the kid who could put her foot behind her head, who fainted in line at school assemblies, who threw up after eating things other kids could eat without thinking. You compensated. You probably became high achieving and high functioning. You absorbed the message that you were sensitive, dramatic, or weak, and you stopped mentioning the symptoms. Then something happened. A viral infection. A pregnancy. A surgery. A bad year of stress. A concussion. A round of antibiotics. A move to a moldy apartment. Something tipped a system that had been compensating into a system that could not compensate anymore. The fatigue did not lift. The heart rate started climbing every time you stood up. Foods you used to tolerate started causing reactions. Heat became intolerable. Your menstrual cycle became more difficult. You developed sensitivities to fragrances, alcohol, supplements, medications you had taken without issue your whole life. You eventually found your way to the diagnoses. Hypermobile Ehlers Danlos Syndrome (hEDS), or the broader hypermobility spectrum disorder. Postural Orthostatic Tachycardia Syndrome (POTS), or the broader category of orthostatic