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Hypermobile disorders, especially Hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorder (HSD), are among the most commonly overlooked root causes behind Postural Orthostatic Tachycardia Syndrome (POTS). Many people diagnosed with POTS experience years of confusing symptoms before discovering that an underlying hypermobility condition is contributing to their struggle. Understanding the link between hypermobility and POTS can bring clarity, proper management, and a sense of control to daily life.
What Is a Hypermobile Disorder?
Hypermobile disorders affect the body’s connective tissue, which acts like the “glue” that holds everything together: joints, organs, skin, blood vessels, and ligaments. When connective tissue is overly stretchy or fragile, the body becomes unstable. This leads to:
- Frequent joint pain
- Recurrent dislocations or subluxations
- Soft or velvety skin
- Fatigue
- Digestive issues
- Autonomic nervous system dysfunction
Because connective tissue exists everywhere in the body, hypermobility can create problems in multiple systems, not just the joints. And that’s where the connection with POTS becomes important.
What Is POTS?
POTS (Postural Orthostatic Tachycardia Syndrome) is a form of autonomic dysfunction. It occurs when the body is unable to properly regulate heart rate and blood circulation upon standing up. Instead of adjusting smoothly, the heart rate shoots up by 30+ beats per minute (or over 120 bpm), causing symptoms like:
- Dizziness and lightheadedness
- Rapid heartbeat
- Chest discomfort
- Fatigue
- Brain fog
- Fainting or near-fainting spells
- Exercise intolerance
POTS isn’t “just feeling dizzy.” It can affect daily tasks, work, and even standing for short periods.
How Hypermobile Disorders Lead to POTS
Many individuals with POTS discover they also have hEDS or HSD—but why?
1. Weak Connective Tissue Affects Blood Vessels
In hypermobile disorders, connective tissue is looser and less supportive. Blood vessels may stretch more than usual, making it harder for them to push blood back toward the heart. When you stand up, blood pools in the legs instead of circulating properly.
This forces the heart to beat faster to compensate, triggering POTS symptoms.
2. Joint Instability Causes Chronic Pain and Fatigue
Individuals with hypermobility often experience chronic muscle strain, pain, and fatigue. These stress factors can push the autonomic nervous system into overdrive, increasing the risk of POTS.
3. GI Problems and Nutrient Malabsorption
Hypermobile individuals frequently struggle with digestive issues such as slow stomach emptying, reflux, and IBS. Poor nutrient absorption and dehydration worsen POTS symptoms by lowering blood volume.
4. Autonomic Nervous System Involvement
HEDS and HSD affect not only joints and skin but also the autonomic nervous system itself. This can directly impact heart rate, blood flow, digestion, and temperature regulation.
Common Symptoms Shared by Hypermobile Disorders & POTS
These two conditions overlap in many ways. Patients often report:
- Chronic fatigue
- Headaches or migraines
- GI distress (bloating, nausea, constipation)
- Temperature sensitivity
- Trembling or shakiness
- “Wobbly” joints
- Anxiety-like symptoms (actually physical autonomic reactions)
- Difficulty exercising
- Brain fog
Because the symptoms blend, many people are misdiagnosed with anxiety, panic disorder, or even depression before receiving the correct diagnosis.
Why Many Patients Go Undiagnosed
Hypermobile disorders are often invisible. Patients may be dismissed with comments like:
- “You’re just flexible.”
- “It’s normal to be tired.”
- “Maybe you’re just anxious.”
Similarly, POTS symptoms often appear unrelated: heart palpitations one day, stomach issues the next, and dizziness another.
It’s no surprise that many patients spend years searching for answers.
Greater awareness among doctors and patients can lead to earlier diagnoses and better outcomes.
How to Recognize If Hypermobile POTS May Be Affecting You
You may be dealing with hypermobility-related POTS if:
- Your joints are very flexible or “double-jointed.”
- You frequently sprain or injure your joints.
- You experience dizziness when standing.
- Your heart rate spikes quickly.
- You feel unusually tired after minimal activity.
- You struggle with digestive issues.
- Symptoms worsen after illness, stress, or dehydration.
A simple self-check called the Beighton Score assesses joint hypermobility. While it isn’t the only diagnostic tool, it’s a helpful starting point.
Living With Hypermobile Disorders and POTS
While neither hypermobility nor POTS is “curable,” both conditions can be managed with the right approach. Many patients experience significant improvement through:
1. Increasing Salt and Fluid Intake
This helps expand blood volume and reduce dizziness.
2. Compression Garments
Waist-high compression stockings improve blood return to the heart.
3. Physical Therapy
Strengthening muscles around the joints stabilizes the body and reduces pain.
4. Diet Adjustments
Small, frequent meals; managing GI symptoms; addressing nutrient deficiencies.
5. Graded Exercise Therapy (NOT intense cardio)
Slow, structured strengthening programs (often starting in seated or recumbent positions) can improve symptoms over time.
6. Medications
Some patients benefit from medications that regulate blood pressure, heart rate, digestion, or blood volume—always under medical guidance.
The Emotional Impact: What People Don’t Talk About
Living with two chronic, misunderstood conditions is exhausting. Between daily symptoms, unpredictable flare-ups, and medical appointments, it’s common to feel:
- Overwhelmed
- Frustrated
- Misunderstood
- Isolated
But you are not alone. Support groups, proper medical care, and a clearer understanding of your condition can make a tremendous difference.
Hypermobile disorders and POTS often go hand in hand. Recognizing their connection is the first step toward getting proper care and improving daily life. Understanding your symptoms isn’t just validating—it’s empowering. With the right strategies and professional support, many people with hypermobile POTS live full, active, and meaningful lives.