The Role of Nutrition in Dysautonomia, Hypermobility Syndromes, and Pelvic Health
A common question I get from patients is the role of nutrition in dysautonomia, hypermobility, and pelvic health. Individuals with dysautonomia and hypermobility syndromes (including Ehlers-Danlos Syndrome or EDS) often experience systemic symptoms affecting the gastrointestinal (GI), circulatory, musculoskeletal, and pelvic floor systems. Research highlights the critical role of nutrition in managing symptoms and improving quality of life for these individuals.
A recent review, “Nutritional Implications of Patients with Dysautonomia and Hypermobility Syndromes,” explores dietary strategies that may alleviate symptoms in this unique patient population. Below, we break down key insights and discuss how functional nutrition and pelvic health interventions can support those living with these complex conditions.
Understanding Dysautonomia and Hypermobility Syndromes
Dysautonomia refers to dysfunction of the autonomic nervous system (ANS), which regulates involuntary functions such as heart rate, blood pressure, digestion, and temperature control. This dysfunction can manifest as conditions such as Postural Orthostatic Tachycardia Syndrome (POTS), neurogenic syncope, and multiple system atrophy.
Meanwhile, hypermobility syndromes—including generalized hypermobility disorder and EDS – are connective tissue disorders characterized by joint instability, skin laxity, chronic pain, and multi-systemic involvement, often including dysautonomia.
Many individuals with these conditions experience overlapping symptoms, including:
- Chronic pain
- Severe gastrointestinal dysfunction (constipation, diarrhea, bloating, reflux)
- Orthostatic intolerance (dizziness, heart palpitations, fainting)
- Fatigue, musculoskeletal aches and pains related to joint instability or tissue hypermobility or hypervigilance (such as occurs with fascial restriction), and vocal, breathing, and pelvic floor dysfunction (or voice to pelvic floor issues) Â
- Co-existing conditions such as endometriosis
Reading through this list of conditions makes it easy to see how musculoskeletal health can be implicated. And where joint, bone, and muscle health matters – nutrition matters. We know systemic health is impacted by what we eat. Even a single meal can change the gut microbiome for better or worse. Due to these systemic effects, nutrition plays a vital role in symptom management.
Nutritional Strategies for Managing Dysautonomia, Hypermobility, and Pelvic Health
1. Addressing Gastrointestinal Dysfunction
GI symptoms are highly prevalent in individuals with dysautonomia and hypermobility syndromes. As a result nutrition has a huge role to play in managing dysautonomia, hypermobility, and pelvic health. Research suggests that the following dietary strategies may help:
âś… Low FODMAP Diet: Reduces bloating, diarrhea, and abdominal pain by eliminating fermentable carbohydrates that irritate the gut.
âś… Gluten-Free Diet: May help individuals with IBS-like symptoms, particularly those with gluten sensitivity.
âś… Fiber Supplements: Soluble fiber can reduce diarrhea and support gut health.
âś… Probiotics and Prebiotics: Foods like yogurt, kimchi, and miso introduce beneficial gut bacteria, promoting digestive balance and nutrient absorption.
âś… SIBO (Small Intestinal Bacterial Overgrowth) Treatment: Many patients with EDS and GI issues test positive for methane-predominant SIBO, which contributes to constipation. A targeted antibiotic or dietary protocol may help.
Avoiding artificial sweeteners, high-fructose foods, and alcohol can also prevent gut inflammation and “leaky gut,” which is commonly observed in these conditions.
Connection to Endometriosis & Pelvic Health:
Many pelvic pain disorders, including endometriosis, are linked to gut dysfunction and chronic inflammation. Supporting gut microbiome health through a balanced, fiber-rich diet may help reduce pelvic pain and support hormone regulation. Additionally, pelvic floor dysfunction (PFD) is often exacerbated by chronic GI issues, making nutritional interventions critical in managing pelvic health.
2. Managing Orthostatic Intolerance & Dysautonomia or POTS Symptoms
Dysautonomia can cause blood pooling and low blood pressure, leading to dizziness, fainting, and rapid heart rate changes when standing. To counteract these effects:
✅ Increase Salt Intake (6–10g per day): Helps retain fluid and stabilize blood pressure.
✅ Adequate Hydration (2–3L per day): Water intake is crucial for reducing orthostatic symptoms.
âś… Frequent, Small Meals: Large meals can trigger blood pooling in the gut, exacerbating symptoms. Eating smaller, more frequent meals can improve circulation and digestion.
âś… Cold vs. Warm Water Intake: Studies show that drinking cold water can temporarily raise blood pressure and improve symptoms in patients with POTS.
3. Reducing Musculoskeletal Pain, Fatigue & Supporting Connective Tissue Health
Chronic pain and fatigue are hallmarks of hypermobility syndromes. Several supplements may help with joint health, muscle strength, and energy levels:
âś… Glucosamine & Chondroitin: Supports joint stability and cartilage health.
âś… Vitamin C & MSM (Methylsulfonylmethane): Essential for collagen synthesis and connective tissue repair in EDS patients.
âś… Coenzyme Q10 (CoQ10): Supports mitochondrial function and reduces fatigue.
âś… Carnitine & Alpha-Lipoic Acid: Helps with muscle pain and post-exertional malaise.
âś… Vitamin D & Magnesium: Often deficient in EDS-HT and dysautonomia patients, these support bone strength and neuromuscular function.
4. Functional Medicine Approach: The Bigger Picture
A functional medicine approach considers the root cause of symptoms rather than simply managing them. For individuals with dysautonomia, EDS, and endometriosis, this means addressing:
- Inflammation (through diet and gut health)
- Mitochondrial dysfunction (by optimizing energy production with CoQ10, magnesium, and B vitamins)
- Hormonal balance (by reducing endocrine disruptors and supporting detox pathways)
- Chronic stress and nervous system dysregulation (through medical therapeutic yoga, mindfulness, and lifestyle medicine)
Holistic interventions, including Pelvic Floor Physical Therapy, Myofascial Release, and Medical Therapeutic Yoga, can further support pelvic function, pain reduction, and nervous system regulation.
Conclusion: Nutrition as a Cornerstone of Care in Hypermobility, Dysautonomia, and Pelvic Health
Dysautonomia, hypermobility syndromes, and pelvic health conditions like endometriosis present unique challenges, but targeted dietary interventions and nutritional support can significantly improve quality of life. While more research is needed, personalized dietary plans incorporating probiotics, fiber, hydration, and key supplements may help alleviate GI distress, reduce orthostatic symptoms, and enhance energy levels and musculoskeletal function.
A holistic, multidisciplinary approach, integrating nutrition, pelvic health therapy, functional medicine, and medical therapeutic yoga, is crucial for optimizing care and reducing the burden of these chronic conditions.
Do you experience symptoms of dysautonomia, hypermobility, pelvic pain, and/or endometriosis?
What dietary strategies have helped you the most? Let’s continue the conversation in the comments.
Need help managing EDS or hypermobility? Reach out and book your first consult free at www.garnerpelvichealth.com
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Sources
Do, T., Diamond, S., Green, C., Warren, M., 2021. Nutritional Implications of Patients with Dysautonomia and Hypermobility Syndromes. Curr Nutr Rep 10, 324–333. https://doi.org/10.1007/s13668-021-00373-1
