#171 Joint Hypermobility Syndrome: How to Get Out of Pain

The information provided in this podcast is educational and not intended to diagnose or treat medical conditions. Dr. Donnie Wilson struggled for decades to solve her numerous health issues and heal her body. But with focused determination, she healed herself. And in doing so, she discovered the Dr. Donnie stress recovery Protocol. On this show, you're going to hear from doctors, nutritionists and Experts along with Dr. Donnie, who will give practical advice and wisdom to help heal your body. This is how humans heal. Hi and welcome to how humans heal. I'm Dr. Donnie Wilson, and in today's episode, we're going to be talking about joint hypermobility. This is a topic that's really important to me both clinically and personally, because I was diagnosed with joint hypermobility a number of years ago. And what I find clinically is that so many people are experiencing pain and other symptoms that we'll be describing in this episode that have not been diagnosed, and they're experiencing this, an effect on their life when actually there's a lot we can do to help with the symptoms of joint hypermobility. So let's dig into finding out more about it. So it can be called joint hypermobility syndrome. It can also be called hypermobility spectrum disorder. And this is because it shows up a little bit differently in each person. So it's important to know that it's not. You might not fit one exact picture. It's important to look at all of the potential symptoms and you start to see the pattern of joint hypermobility and related conditions. And it's considered a connective tissue disorder. Connective tissue involves our skin and our joints and our ligaments and our tendons, that our connective tissue is what connects us together. So that's why it's called the connective tissue. And these hypermobility syndromes are associated with joint instability and chronic pain. So if you or someone you know has been experiencing joint pain and or muscle pain for long periods of time, this is definitely something to learn about and consider and talk to practitioners who are experts in this to help guide you. The thing is, is that it's not very well known. There's very low awareness for hypermobility syndromes. Now I have to say the awareness has been increasing, which I'm really glad for. Each year, I'm hearing more and more people who have already been diagnosed or already starting to figure out that this might be going on for them, and more and more practitioners are becoming aware of it. So I'm really glad and I'm hoping I can just add to that momentum of awareness. Ultimately, joint hypermobility was really identified as a condition and described in 1967. That wasn't very long ago. So, of course, the awareness is low because it's relatively newly identified. Also, it's what is often considered a zebra, meaning in medicine, we're always taught to think of what's most likely. So as a practitioner, whenever I'm training students and they are thinking, oh, well, it could be this and this and this and this. Even when I'm talking to patients and they say I could have all these different possible conditions, I say to them, think first of what's most likely going on. And that's most likely the issue. However, when it comes to joint hypermobility, it's not that if you hear hooves, it's probably horses is the way we say it. If you hear hooves, it's most commonly a horse, it's less likely a zebra, right? But when it comes to joint hypermobility, and especially a specific type of joint hypermobility referred to as Ehlers Danlos syndrome, it's considered a zebra because it's considered a rare condition. And so most practitioners are not thinking about that, right? When someone comes in with joint pain, they're thinking of the most likely causes of joint pain. They're not necessarily thinking of the rare causes of joint pain. And I actually think that joint hypermobility is much more common than we realize. I would not be surprised in the next decade if we find that there's many more people with variations of joint hypermobility that we weren't identifying before. Because right now in the research, and I'll be sharing the references with the notes to this episode, it's considered that about 3% of people have joint hypermobility. Only 3%, and I think it's higher than that. So please keep listening and know that what is considered a zebra actually, I think may be more common than we realize. And the other condition that I'm referring to is called Ehlers Danlos syndrome. Now, Ehlers Danlos syndrome was identified around 1900, right? Around 1900. And it was identified as a condition that had the joint hypermobility, but also issues related to collagen in general, not just related to the joints, sometimes related to the skin, blood vessels, sometimes the digestive tract and blood vessels. And there again, now, when it comes to Ehlers Danlos syndrome, which Ehlers and Danlo were two of the original researchers, related to the condition. There are 13 different types of Ehlers Danlos syndrome. The thing that makes it distinct is that they have identified specific genetic variations related to collagen. And so the key is that to be diagnosed with Ehlers Danlos, really, like now the standard is to have your genes analyzed, even to go to a genetic specialist who can look at the collagen genes and see that you have the specific collagen variations associated with Ehlers Danlos syndrome, and then you can get this official diagnosis of Ehlers Danlos syndrome. One of the most common of the 13 types of Ehlers Danlos syndrome is called hypermobile.

Or type 3 Ehlers Danlos syndrome. And so there, so there's. I don't want this to get confusing, but it is kind of confusing. Is that. So there's 13 types of Ehlers Danlos syndrome. One of them is hypermobile, meaning their predominant symptoms have to do with joint hypermobility. Then in 1967, they started identifying joint hypermobility syndrome, which may or may not have those collagen gene variations that are associated with, with Ehlers Danlos syndrome, but they have some of the same joint symptoms and health issues. And so there's a lot of overlap between hypermobile EDS and joint hypermobility syndrome. In fact, some researchers believe they may even really be the same thing. And ultimately they, to, to some degree, as far as we know at this point, you might as well think of them as the same thing because they have the same symptoms and as far as we know, some of the same treatments. Right? So to me, whether you, whether you, you know, wherever you are on that spectrum of hypermobility, you still want to be aware of it, and you still want to start taking steps to protect yourself and prevent it from causing further health issues. So that, to me, is the most important thing for you to take away from this is if you have, whether EDS or another joint hypermobility, it's important to start taking action. And this is what I'm going to be getting into here in a few minutes in this episode. To me, the really, really awful thing is that so many people who are finally, and it can take years to finally be diagnosed, but they're finally diagnosed. And then a practitioner might say to them, either it's a genetic condition, you can't do anything about it, there's no cure, or all you can do is manage the pain. And to me, this is unacceptable. As a naturopathic doctor, as someone with hypermobile Ehlers Danlos syndrome, I'm standing here saying that that, to me, is unacceptable because I see so many things that help me feel better, that help me prevent symptoms and health issues associated with hypermobility and there's so much you can do. I'm not saying that there's a cure, but I'm saying by understanding it and by being proactive, there's a lot you can do to get yourself out of pain and prevent health issues associated with hypermobility. And that's why I feel so strongly to be sharing this information with all of you. And if you're interested in this topic, please let me know because then I will share more. I'll. I'll bring more information about this issue to you if this is something you really want to learn more about. So let's see. I think another important thing to understand about hypermobility, so, so there's the instability of the joints. Because what's happening is, you know, our, our joints and a lot of the areas of our body are made up of collagen. Collagen is so important for joints, for bones, for ligaments, for tendons, for blood vessels, for. If you think about it, almost every tissue in our body contains collagen. So if there's variations in the way each person's body makes collagen, right? We don't all make collagen the same way. We all make collagen slightly differently. And if the way your body makes collagen makes your collagen a little more stretchy, then you're going to have, you're going to notice it eventually you're going to notice it. Now when I was younger, and this is the case for a lot of people, is when you're younger, you might have been considered to be double jointed. Sometimes people, you know, see themselves as able to really contort their body into different positions. I think of like if you watch America's Got Talent and you see people who are able to really move their joints outside of the normal range of motion. Those are people who have very flexible collagen and hypermobile joints. But remember, it's a spectrum. So not everybody with hypermobile joints can do as extreme movements with their joints. And the way, you know, one of the ways besides doing that genetic testing for collagen is you can do what's called, you can do the Biton score. The Biton score is a nine point scale of different measuring different range of motion of joints in the body. It starts with, are you able to touch the floor with your hands with your legs straight? Right. So you would be basically bending over to reach for the floor and be able to reach the floor with your leg straight without bending your knees. And so that's the first Thing you know that one gets one point. And then if you look at the elbows, see a lot of times the joints that are involved are the, the elbows, the wrists, the fingers, and the knees. So if you look at the elbow and you see that your elbow can hyperextend, I could maybe I can show you some. Sometimes I don't like to purposely hyperextend my joints because it's. Because. Just because I can doesn't mean it's a good thing for my joints. It can actually send the wrong signals to my joints. But if you can stretch your arm out and you. Instead of having your arm be straight and have an end point where the. The joint comes to an end point, but now you notice that your, your arm can bend, almost looks backwards. That's an hypermobility of the elbow. Um, so if you, if you see what my elbow can do, you see how it. Most elbows might just go to straight. My elbow can go to where it's overstretched backwards. And I'm not even going fully because I don't. Again, I like to. I'm teaching my joints. Part of addressing joint hypermobility is to teach your body how to hold your joints in the right position and not overdo it. And so you get a point for each elbow, by the way, if you can. If that happens with both elbows, same thing with your knees. So when you stand, if your knees bow backwards with they're all the way straight, that's hypermobility of the knees. My knees can do that too. Both of them. So that's two points on each knee. Then there's also where you can look at the fingers. A classic is to measure if your thumb can reach all the way to your forearm when you bend down. And another is if your little finger can point back more than 90 degrees from your hand. Right. And there's others too. If you start to notice other joints that can move more than other people's joints. And if you notice. What I find when I'm talking to patients is I'll say to them, have you ever dislocated a joint? So if your shoulder dislocates or if, if your neck vertebrae move out of position easily, if your ribs keep moving out of position. So if you have joints that easily dislocate and go, maybe go back into position and back out again. That's also a symptom I find of joint hypermobility. There's also.

Let'S see, there's so many other symptoms I want to go through because, yes, it starts by Looking at the joints. But we, what we started to figure out, and the researchers are showing is that it goes way beyond just symptoms in the joints. It can go into fatigue. So another very common symptom with joint hypermobility is more tiredness. Also anxiety. Anxiety is highly correlated with hypermobility. And you think, well, what is joint, the joints have to do with the mind, the mind and the mood? Right. But they show that 70% of people with hypermobility have anxiety. And people with anxiety are more likely to have joint hypermobility as well. And, and that's also correlated with depression and what's called neurodivergence. Neurodivergence is relatively newer terminology that's associated with differences in social preferences, ways of learning, ways of communicating, ways of perceiving our environment. It's often associated with autism, adhd, even Tourette's syndrome and anxiety. And I'm finding that more and more that neurodivergence is also associated with sometimes what we consider like maybe someone who's empathic or highly sensitive to their environment emotionally and chemically and physically. So it's like the nervous system is more sensitive and perceptive and, and that can relate to these symptoms. Of course, being in chronic pain also makes some of these things worse. So someone who's in pain, physical pain, and likely not getting the help that they need because the diagnosis is not, it's not, it's hard to get this diagnosis. So people are being told it's all in their head, when actually it's not all in their head. It's.

They may have symptoms, mood related symptoms, fatigue related symptoms, and pain related symptoms all in the same person. And that's sometimes why it's challenging in a standard medical setting to get a diagnosis. Because sometimes then people are kind of dismissed for having all these different symptoms. Well, what I'm here to say, because I've lived it, is it's possible to have all those different symptoms and have them be related. I constantly, as a, as a doctor, showing up with my patients, I'm constantly reminding them that if something's showing up in your body, it's related to the other things showing up in your body. You are living in one body, one system, mind, body, spirit. If something's coming up, it's very likely related to the other things that are going on. And, and so, and it's not that you're just making it up, it's that you're experiencing it. And to the extent that medicine or medical practitioners are dismissing you, to me that just means Maybe they're not aware of some of the other conditions to consider, like hypermobility syndrome and some of the others that I'm going to mention here. And so I think because I've lived this experience, I've lived being a hypersensitive person. I've lived with being in pain. And, and now looking back at my life, I'm like, oh my gosh, it makes so much sense because I really didn't diagnose myself with hypermobility until just in the past decade. But my whole life I was experiencing pain from menstrual cramps, pain, migraines, neck pain, you name it, joint pain. I was also a gymnast and a dancer, and I'm still a dancer, and I love to dance. And what I find is this dance and Pilates really help me because they help me to increase my proprioce, what's called proprioception of my joint position in space. So this is the, one of the symptoms of hypermobility is we become less able to. And it's not necessarily that we become, it's more like we just are less able to identify where our body parts should be in space because the joint, the, the range of motion is bigger. And so it's harder, I think, for our nervous system to know, well, this is where my joint is supposed to be in a healthiest state. And so we, and also the nerves have different, different perception. And so it's much harder to know, oh, this is where my body and my posture is. If it's in this position, I'm going to be in less pain. But we have to actually learn that and practice that in order to really help our bodies to achieve that because we have less of an internal guidance system. And, and, and you know, for someone who has collagen that's not so stretchy, they don't have a choice because their joint isn't allowing anything else. Their joint is saying, no, this is the end point. But someone who has hypermobility doesn't have their joint telling them where to stop. And so we have to actually train ourselves to know where our body is healthiest to be in space in order to decrease our pain experience and other symptoms. So the other thing is that with joint hypermobility, as well as with Ehlers Danlos syndrome, and as I mentioned, it can affect the blood vessels. Now, again, there's a spectrum of variants. For some people it just might mean easier bruising or easier bleeding, which I've definitely had all of my life. And also for some people it could mean more Likelihood, especially with Ehlers Danlo, you can have more likelihood for mitral valve prolapse, which is prolapse of the valves. And the heart could be also symptoms and issues related to the blood vessels. So if you're concerned about that, I really encourage you to meet with cardiologists and a specialist in Ehlers Danlos syndrome, because it's important to know about and prevent issues. But again, not everybody has severe form, so it's important to know your body. Also, there can be issues with the digestive tract. Sometimes it's constipation, sometimes it's diarrhea. It can be considered IBS, or irritable bowel syndrome. It could be even diagnosed as ibd, which is inflammatory bowel disease, such as Crohn's disease and other forms of colitis, including celiac disease and gluten issues. Isn't that interesting that over 20 years ago, that's where I. One of the first things I figured out about myself is that I have gluten sensitivity, including genes associated with celiac disease, and lo and behold, that's associated with hypermobility syndrome. So it's important to know if you're having digestive issues and you have pain, like joint pain, they could be related also something called POTS, P O T, S, which is known also as dysautonomia. This autonomia has to do with imbalance in the autonomic nervous system. What's the autonomic nervous system? Oh, my gosh. This is what I love talking about all the time, because it has to do with our body's response to stress. What does our body do even with the most minute stresses on the system? How does our body respond in terms of our blood pressure and our heart rate and. And all the other things that our body can do to help us respond to stress, even from a change in posture. So what happens with pots, which stands for postural postural orthostatic tachycardia syndrome. What happens is when a person goes from laying down.

Yeah. So if you're laying down and you stand up, first of all, if you were laying down and you stand up and you feel extra lightheaded or dizzy, that's already a symptom of dysautonomia and hypermobility. But what can happen in the extremes is a person can actually have their heart rate increase because the body's trying to. What's happening is it's when you change your posture, right? You go from being horizontal to being vertical. And now gravity has to move your Blood to make sure the blood's still getting to your brain. But when you have this flexible collagen, it's harder for your body to. And your blood vessels to get the blood to your brain. And so you feel dizzy for a few seconds until your body can catch up and it increases your heart rate. And it can be at first, if it's, if it's happening, you can, you can be like, what is going on with me? Because you might feel more tired, you might feel dizzy, you might even faint. I've fainted many times in my life. We didn't know then that I had a hypermobility syndrome. But I, I'm looking back on it, I'm like, oh my gosh. Yeah, it makes sense, right? So if you can think back and go, oh, yeah, I've felt dizzy when I stand up. And it doesn't necessarily happen every time, but it might be if you stand up quickly or if you're more dehydrated, if you haven't had enough water and electrolytes, it's more likely, so. Or if you've been under a lot of stress, right? Because the more we're under stress or trauma, then what happens is our body has a harder time to manage things, these other things like changing posture. So as soon as you, maybe you go through a loss or stress at work or stress in your relationship or trauma of some sort, then your autonomic nervous system, which is managing like your, your vagus nerve. Your vagus nerve is communicating between your gut and your brain and all of your other organs in your body. The autonomic nervous system is balancing sympathetic with parasympathetic. Sympathetic is the fight or flight response and adrenaline. Parasympathetic is mostly the vagus nerve communicating calm, rest and digest. And you want to have. We need a balance of the two, right? We need our bodies to be able to do a stress response and protect us from danger. But we also need our bodies to be able to go back into calm and do our digesting and all the other functions in our body. But when we're under stress, our bodies have a harder time flexing between parasympathetic and sympathetic and parasympathetic. And that's when the autonomic nervous system starts having a harder time, especially for those of us with hypermobility. And so we're much more likely to feel tired, feel pain, feel all these symptoms that I'm talking about when we're under stress. It makes sense why I've been researching stress all these years. Right. So because I was trying to figure out why I felt so much worse when I was stressed. Rest. I'm really excited to open enrollment in my new 14 day detox program. It's based on my experience spending 16 days in the Amazon. And I realized I really want to be able to support all of you to safely and effectively detox from home. The 14 day detox includes a kit with protein powder, including antioxidants to support liver detoxification as well as an anti inflammatory diet plan, daily videos and tips from me, as well as my self care notebook and lots of encouragement to spend time in nature to reset your circadian rhythm. I want you to be able to detox your mind, body and spirit so you can get back to balance and move forward in your life with resilience. I can't wait for you to join me in this transformational process so you don't have to have this.

Postural hypotension or orthostat, what's called orthostatic intolerance, meaning you're changing body positions and then, and when you're under stress, then you end up feeling, you might even feel sweaty, you might feel hot, you might feel, you might, even if you're exercising, you might have exercise intolerance like all of those intelligence, you don't have to have those things, but if you do that is could be related to this hypermobility syndrome. You might also get like heart palpitations or heart racing at various times. Okay, so the other common connection that is not well known, the research is actually just even in the past year or two is connecting mass cell activation with hypermobility. So they actually showed that 66 participants who had that POTS, you know, dysautonomia and Ehlers Danlo syndrome also had mast cell syndrome or mast cell symptoms. What are mast cells? Mast cells release histamine and so think about it as mast cells are especially related to symptoms of allergies. So if you have symptoms of classic allergies or sinus inflammation, sinusitis, asthma, urticaria, where you get hives or rashes on your skin related to allergies. But also mast cell symptoms are related to headaches like migraines as well as neuropathy. So other types of tingling, numbness and pain in the peripheral nerves as well as symptoms of vulvodynia. So vaginal vulvovaginal pain, vaginitis.

And other types of vaginal and uterine pain as well as other types of autoimmunity like rheumatoid arthritis, psoriasis, ankylosing spondylitis, and another inflammatory spondylitis, which is another one that I've been diagnosed with, which is called Sappho. So I want to mention that here in case any of you are experiencing the symptoms of Sappho, another rare and relatively unknown condition. Sappho or S A P H O is a chronic inflammatory arthritis, specifically of the joints in the sternum. Right. So mostly we've been talking about like shoulders and hips and knees, but with Sappho it's the sternoclavicular joint, so where the clavicle meets the sternum. And it also has symptoms on the skin.

And it's also related to Ehlers Danlos syndrome. So having joint hypermobility can be associated with other inflammatory conditions or autoimmune conditions. And it's important to know that because again, you might have been dealing with another autoimmune condition and you didn't realize that it's related. Also.

I just think all of this is so interesting. Recent study 2023 is associating hypermobility with MTHFR gene variations. And as some of you know, that's another area that I've researched because I also have MTHFR gene variations. Mthfr, the brief version of this, because I have other episodes on this I can link to. MTHFR is the gene that converts folic acid into folate and folate is the active form of vitamin B9. And of course we all need B9 along with all the other B vitamins to help us for so many reasons in our bodies, including for healthy connective tissue, is what they're finding. So if we don't have enough folate and if we don't have healthy methylation. Methylation is the use of folate and the other B vitamins for producing something called SAM S adenosyl methionine that is going to affect the way our body creates collagen and the, what's called the, the ecm. It's the, it's the, the matrix of our connective tissue, the extracellular matrix, it's called is it throws it off and so there's more fibrosis and there's. The tissue becomes more hypermobile and that's been associated with having MTHFR gene variations. So now there's connection with MTHFR and hypermobility. Not only that though, and this is what I always do whenever I'm looking at this research and these connections, I'm always asking myself then, does that tell us something? We can do to help with hypermobility. Right? So if we know that mthfr, the gene variation is associated with hypermobility and we know that not having enough folate and not effective methylation affects your connective tissue, then we can do something about that. We can make sure you have adequate folate, we can make sure you have effective methylation processes in order to help protect your connective tissue. You see where I'm going with that? So I def. If that's you, I encourage you to go listen to my, my podcast as well as my free classes on MTHFR and what you can do to optimize your methylation. At the same time, I would do the same with the other things I just mentioned. So when I mention mast cells and histamine, we need to be thinking about what can we do to help your body to metabolize histamine that can also be genetically related. We can look at your histamine related genes and understand where you, your body needs more help metabolizing histamine. I used to have the worst allergies. I was constantly with sinusitis, I was constantly sneezing and it took me years to solve my allergies, but I didn't. Allergies really are not an issue for me now. And so I feel so strongly that even something like allergies that people think you can't do anything about and I never did any kind of allergy shots, I'm saying that it's possible to help your body to, to rebalance and to correct where, where it needs help. It's, it's not about a, it's. You know, I don't use the word cure to me. It's understanding your biochemistry, understanding your body's tendencies and giving your body what it needs, which usually comes in the form of dietary changes, nutrients, herbs and substances that are. And, and then activities in your daily life that help your body reset. And I can talk you through. I have other episodes as well on how I help to reduce my allergic symptoms. But I want you to know that because I don't want. There's so many people who feel like they have mast cell symptoms and again they just feel stuck. And a lot of times they might feel like they're stuck with only medications as an option. In fact, if you say to me, well, what can you do about hypermobility? When you look in the research and online you'll often find a list that's things like pain management, right? Because remember, one of the main symptoms is joint and muscle pain. So One of the first things we think of when it comes to pain. Well, we think of things like non steroidal anti inflammatory drugs which have a lot of side effects and they're, you can't really take them long term. Plus they're not really solving anything. In fact they might be making things worse. So that's not really a solution. Neither are you can take steroids for long periods of time. Those have definitely negative effects on our bodies and you and pain medications of other types. They have again dependency and withdrawal symptoms. So to me it's not enough for us to tell people with joint hypermobility that your only option is pain management because there's so much else there we can do. It might still be pain management, but it doesn't have to be medications. Now some of you may have to be on a medication right now some of you might have to be on a medication for neuropathy. For example. Sometimes patients who are diagnosed with hypermobility are taking SSRIs or anti anxiolytic medications. Right? So you might have already been prescribed certain medications. But what I'm saying is that I, what I would do is I would start helping you alongside of those medications to help you to reduce your symptoms so that with the intention of hopefully being able to reduce the need for medications. Because we really only want to use medications to the extent that we really need to, otherwise we're at risk of experiencing side effects and dependency and withdrawal symptoms. And I'm going to be having another episode about that specifically. And so I'm not saying, you know, I'm not, I don't, I'm not saying stop what you're taking and I'm not saying don't take medications. But I'm just trying to say there's so many more options besides reliance on medications that you might not be reading about or hearing about now. You will often see, and I agree with this, things like physical therapy and acupuncture and other types of exercise. But the thing is with hypermobility is the treatment is so different. So if you go to a physical therapist, it's really important that you tell them that you have hypermobility because the exercises that they're going to give you or they should give you are different when you have hypermobility. I can't tell you how many times I've been to massage therapists, physical therapists, so many different practitioners who did not know were not familiar with joint hypermobility and were giving me suggestions that were not going to help or potentially make things Worse. So I really encourage you when you go in, and it definitely can be helpful, but you have to make sure you're working with a practitioner who understands joint hypermobility and can give you correct suggestions and for you also to have the awareness. I've worked with personal trainers who I. I taught them. This is what joint hypermobility is. I need to. I need to strengthen my muscles because the muscles can help keep your joints in place. But you have to be careful because with hypermobility, you're much more at risk of an injury. And I could tell you, even after explaining to personal trainers that I need to be careful, I still ended up with injuries. And so it's so important for you to be careful about that and to really yourself start to learn what is the right. Because it's not about not exercising at all, because when we're in pain, it makes you. And when you're tired, you feel like not exercising at all. But actually what helps is to learn the right type of exercise, the right amount of exercise for your body and for you to heal. And it took me a long time to figure that out. I still have to. I've learned, I have to underdo it. And one of my favorites is Pilates. I do have another episode about Pilates. So if you want to learn about Pilates, I encourage you to listen to that. Pilates really has helped me to learn joint position and posture and also to help my body to. To gain strength without causing injury. So I love Pilates. I also love dance. I mentioned. But all along the way, I always have to be communicating with the people who are helping me. And by the way, myofascial release, which I also have an episode on, that has been hugely helpful. So if you're. Sometimes it's not just about regular massage, but myofascial release, because myofascial release can release the restrictions in the. In the connective tissue and really make a difference for hypermobility symptoms. So can acupuncture, and especially acupuncture that's using electrical stim. So they're electrically stimulating the acupuncture needles to help address the trigger points and motor points in the muscles. And so I definitely encourage you to consider and find acupuncturist who again understands hypermobility and understands how to address trigger points using electrical stimulation of the acupuncture needles. So these are already some different options for you to consider. And one thing that was kind of a hard lesson for me, and I encourage you to just realize this, is that for Someone with hypermobility, you're going to need to pay attention to your body and your posture and your strength every day, every week. This is not something where you can just, oh, maybe I'll get a massage once a year, or maybe I'll go to a physical therapist only if I get injured. No, if you have hypermobility, you need to have a weekly plan of. For me, I weekly have acupuncture and Pilates and dance and myofascial release, and these things have to happen. And including daily exercises for posture and strength, because if I don't keep up with that routine of managing my body and my joints, that's when I find myself in pain. And I also have to really learn my limits, which is not easy. But because a lot of times we're. We think we can do more. I mean, believe me, me too. I'm like, I know this needs to get done. I know I can do it. I would like to do it, but I know that if I do it, I'm going to end up injuring my joint. And so I need to ask for help. So hypermobility has really taught me to ask for help, to be able to ask others to help me or to hire people to help me, because otherwise I'm putting myself in danger by doing more than my body and my joints can handle. There's so much more we can do. In fact, maybe if you all are interested, I can do a whole nother episode on what I've been developing as my protocol for myself and for my patients with hypermobility. It includes, excuse me, dietary changes, avoiding gluten, but also testing for food sensitivities, healing leaky gut, addressing the gut biome. Because if the, if there's leaky gut and imbalanced gut biome, now you have a source of inflammation from within your gut that's causing inflammation through your whole body, and that's going to increase your rate of pain, your likelihood of pain. So I had to had two years ago, had to figure out food sensitivities and how to heal leaky gut, recover from gluten sensitivity. Not that I now eat gluten. I still avoid gluten, but I had to help my body recover from the effects of gluten and to restore a healthy biome. Because, as in other episodes I've mentioned, our biome is so important. It's not just about having a bunch of bacteria. It's about how these bacteria communicate with our immune system, our nervous system, everything. Also, I definitely believe it's essential for Anyone that with hypermobility to be measuring your cortisol levels, adrenaline levels and neurotransmitter levels because again, hypermobility makes it more likely that you are we mentioned the autonomic nervous system, but it makes it more likely that your body and your nervous system is disrupted by stress. It's more likely you're going to have neurotransmitter imbalances. It's more likely that you're going to have either too high or too low cortisol and adrenaline. And to me, it's different for each person. So each person with hypermobility doesn't have not everybody has high cortisol and not everybody has low cortisol. Not everybody has high adrenaline. Not everybody has low adrenaline. We have to find out for your body. So everybody with hypermobility still has different variations in cortisol and adrenaline or what I call the stress types because there's the five most common disruptions of cortisol and adrenaline or the five stress types. And that's what I wrote about in the master your stress reset your health book. And so you can read the book, you could do the quiz online and you can order the test kit through my office where we measure your cortisol at different times a day. Your adrenaline in the urine and your neurotransmitters, which is your serotonin, dopamine, GABA and so on, can be measured in urine even if you're on medications? To me, absolutely. If you're experiencing anxiety, depression, and if you have been on medications, we need to know your neurotransmitter levels. Let's not guess anymore. Let's get the information we need because once we see hey, do you have low serotonin? SSRIs don't increase serotonin. They only prevent the breakdown of serotonin. If we want to increase a low serotonin, we need to give the precursor nutrient to so your body can make more. And I have episodes on that as well and I talk about it in the book. So if you're wondering about how to solve for anxiety, depression, sleep issues, to me it has to start with measuring your neurotransmitters, your adrenaline and your cortisol so that we can re optimize your HPA axis, your autonomic nervous system, get it all back on track again. We which is absolutely possible on proof of that. And so these are some of the first things I would do. We also need to do specific blood work so we can understand exactly how hypermobility is looking for you, do you have nutrient deficiencies, including a folate, which I mentioned? Do you have celiac disease? Do you have issues with digesting fructose or fodmaps, which are fructose, which I also have? If you don't have the ability to digest fructose, you're more likely to experience not only ibs, what might be diagnosed as IBS and sibo and bacterial overgrowth, because you're not digesting fructose, we have to change your diet and heal your digestion so that you can better digest fructose again and avoid those digestive symptoms. Plus, there's all of the urinary. There can be urinary symptoms, frequent urinary infections, or interstitial cystitis, as well as vaginitis, vaginal infections, vaginal pain I mentioned, as well as even HPV likelihood could be increased from having hypermobility because it becomes this snowball effect, right? Once you have the hypermobility and then you have the inflammation and the nutrient deficiencies, and then it just snowballs into various health issues. And. And because I have experienced it and lived it myself and had to solve it for my own health and I see it in my patients, this is why for me, I'm much more able to see this big picture, see the interconnections, and then guide you through the steps to solve it. Because I know it can feel overwhelming. Um, I'm hoping that this episode is helping you to, you know, start to see the pieces and has you thinking. And I encourage you to take notes from this and say, oh, yeah, this is me, and I've noticed this, and I've noticed this, and I want to research this more and I want to learn more. Just start writing about it. Start, let your mind just let you think about it, see that there's these interconnections and then see that there's more information we can discover about your body that likely you're not going to find in the conventional doctor's office. Conventional doctor's offices tend again, not to identify hypermobility. And even if they do, they don't know what to do about it. Because the best treatments for hypermobility are actually from what I would consider naturopathic approach, or sometimes it's considered functional medicine. But actually naturopathic medicine has been around much, much longer than functional medicine. And naturopathic medicine has to do with giving your body what it needs in order to heal, in terms of food, in terms of nutrients, in terms of plants, herbs and other natural approaches that just support the body to heal itself by taking away what's the problem and giving what your body needs. And that's always my strategy and approach. Also always individualizing it for you, helping you to understand your body and what it needs so that you can go forward in your life. Integrating this information and still doing what you love. This should not prevent you from doing what you love and living out of pain. I could tell you that physical and emotional pain can go away by learning about this and addressing it in this way. So again, if you want to learn more, definitely get my book, the Master Stress Reset your health book. I talk about all of these things in there as well and join me for the next episode of How Humans Heal. You can either subscribe wherever you're watching and listening, and you can also subscribe to my newsletter, where you'll receive a newsletter from me every Thursday or with the latest episode and additional resources and tools for your success with achieving optimal health. Thanks so much for joining me. I'll see you next time.

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