Eds and Brain Fog
Guideline: 2017 EDS International Classification; NICE referral criteria
What Is Eds-Related Brain Fog?
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. The triad of EDS + POTS + MCAS is increasingly recognized. Often missed for decades because 'you're just flexible.'
What to Do This Week
Seven actionable steps you can start today — free, evidence-based, and designed for when you're foggy.
Body
20-minute walk outside today. Evidence supports this for virtually every cause of brain fog. Start with 10 if that's all you can do.
Food
Eat a proper meal with protein, vegetables, and good fat (olive oil, nuts, avocado). Skip the ultra-processed snack. One meal upgrade today.
Water
Drink a glass of water now. Keep a bottle visible. Aim for pale yellow urine. Don't overthink it — just drink regularly.
Environment
Open a window for 15 minutes. Fresh air exchange reduces indoor pollutants. If outdoors is bad (pollution, pollen), use a HEPA filter.
Connection
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.
Tracking
Rate your brain fog 1-10 each morning for 7 days. Note sleep quality, food, exercise, stress. Patterns emerge within a week.
Avoid
Don't change everything at once. One new habit per week. Don't compare your progress to others. Don't spend money on supplements before nailing sleep, food, and movement.
What to Eat: The Mediterranean / MIND Pattern Approach
The most evidence-backed eating pattern for brain health. Not a diet — a way of eating.
Sample Day
- breakfast: 2 eggs scrambled in olive oil + handful spinach + slice sourdough + blueberries
- lunch: Big salad (mixed greens, chickpeas, cucumber, tomato, feta, olive oil + lemon) + water
- snack: Apple + handful walnuts or almonds
- dinner: Salmon or chicken thigh + roasted vegetables (broccoli, sweet potato, red onion) + olive oil
- evening: Herbal tea (chamomile or peppermint)
For Eds: 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.
This is a PATTERN, not a prescription. Adapt to your budget, culture, preferences, and what's available. The principles matter more than perfection: more plants, good fats, less processed food.
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.
Tests and Investigations
EDS Comprehensive Workup
- Beighton Score
- hEDS checklist (2017 criteria)
- NASA Lean Test / Tilt Table (POTS screening)
- Skin punch biopsy (small fiber neuropathy — 82% of hEDS in 2025 study)
- Tryptase + N-methylhistamine (MCAS screening)
- Upright MRI if cervical symptoms (CCI screening)
- Echocardiogram (aortic root measurement — vEDS screening)
Evidence-Based Lifestyle Changes
EDS-Informed Physical Therapy (NOT general PT)
Find a PT who understands EDS. Focus: stability strengthening (NOT stretching — EDS patients are already too flexible). Isometric exercises, proprioceptive training, core stability. AVOID aggressive stretching, high-impact activities, chiropractic adjustments.
Evidence: Moderate — Engelbert et al., 2017; Castori et al., 2017
Manage POTS Component
See POTS (#25). Salt loading, compression, recumbent exercise. This addresses the brain fog mechanism in most hEDS patients — reduced cerebral blood flow on standing.
Energy Management (Pacing)
Activity-rest cycles. Track energy expenditure. Stop BEFORE crashing, not after. 'Boom-bust' pattern (overdoing on good days → crashing for days) is the #1 pattern to break.
Joint Protection Strategies
Ergonomic workspace, supportive footwear, avoid end-range joint positions, splints for unstable fingers during writing/typing. Reduce subluxation events that trigger pain → inflammation → brain fog.
Holistic Support
Morning sunlight
Strong — resets circadian clock, improves mood, supports vitamin D.
10-15 min outside within 1 hour of waking. No sunglasses needed.
Cyclic sighing breathwork
Strong — Balban Cell Rep Med 2023.
5 min daily. Double inhale nose, long exhale mouth.
Nature exposure
Moderate — cortisol reduction, attention restoration.
20 min in green space weekly minimum.
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.
Psychological Support and Therapy
Pain psychology. PT is primary. Occupational therapy for joint protection. If psychological impact of chronic condition → ACT or counseling.
What People With Eds Brain Fog Say
What Helped
- • Getting the DIAGNOSIS — average 10-20 years. Just having a name changed everything.
- • Salt and fluid loading (treating underlying POTS) — brain fog wasn't from EDS directly, it was from undiagnosed POTS
- • PT who understands EDS — regular PT made things worse. EDS-informed stability-focused PT was the turning point
- • Compression garments — medical-grade compression improved standing tolerance and associated fog
What Didn't Help
- • Stretching (standard PT advice) — already too flexible. Being told to stretch was the opposite of needed.
- • Chiropractic adjustments — hypermobile joints. Manipulating them made instability worse.
- • Being dismissed because 'you're too young for these problems'
- • Standard anxiety treatment for what was actually dysautonomia
Common Mistakes
- • Accepting 'you're just flexible' as a diagnosis
- • Not checking for POTS (33% of hEDS patients have it — it's a 10-minute test)
- • High-impact exercise that destabilizes joints
- • Ignoring the MCAS component because symptoms seem random
Surprises
- • The triad is real: EDS + POTS + MCAS — once diagnosed with one, the other two fell into place
- • Small fiber neuropathy in 82% of hEDS patients — explains burning, tingling nobody could explain
- • Cervical instability (CCI) as fog driver — fog was positional, worse upright, better lying down. That's CCI, not psychological.
"EDS is not just being bendy. It's a connective tissue disorder that affects every system — including brain blood supply. Hypermobile AND foggy AND heart races standing up: you need an EDS-literate clinician, not another anxiety diagnosis."
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.
Malfait et al., Am J Med Genet, 2017 — hEDS diagnostic criteria; Am J Med Open, 2025 — cerebrovascular study