What Foods Should People with EDS Avoid for Symptom Management?

Research indicates that a significant majority of people with Ehlers-Danlos Syndrome (EDS) experience chronic gastrointestinal problems, with some studies citing rates as high as 84%. Addressing gut health and potential food triggers is a crucial part of managing the complex symptoms of EDS, including understanding what foods should people with EDS avoid.

Quick Summary

Managing EDS symptoms often involves individualized dietary adjustments, prioritizing anti-inflammatory foods while avoiding common triggers. This includes limiting processed foods, identifying histamine-rich culprits, and addressing gut sensitivities associated with comorbid conditions like MCAS and POTS for improved well-being.

Key Points

• Inflammatory Foods: Limit or avoid processed foods, added sugars, and refined carbohydrates to reduce systemic inflammation that can worsen EDS pain.

• MCAS and Histamine: If you have comorbid MCAS, avoid high-histamine foods like aged cheeses, fermented products, and alcohol, as they can trigger flares.

• POTS and Hydration: Those with POTS should limit diuretics like caffeine and alcohol while consuming smaller, more frequent meals to manage symptoms.

• Gut Health: Many with EDS benefit from reducing potential gut irritants like gluten and dairy or exploring a low-FODMAP diet under professional guidance.

• Individualized Approach: The most effective dietary plan for EDS is personalized. Keeping a detailed food and symptom diary is crucial for identifying your unique triggers.

• Prioritize Whole Foods: A foundation of fresh fruits, vegetables, lean proteins, and healthy fats can help reduce inflammation and provide essential nutrients.

The Link Between EDS and Dietary Triggers

For individuals with Ehlers-Danlos Syndrome, dietary choices can profoundly influence a wide range of symptoms. While there is no single "EDS diet," many people with EDS find relief by addressing specific dietary triggers that exacerbate their unique health challenges. This personalized approach often focuses on reducing inflammation, supporting a fragile digestive system, and managing common co-occurring conditions like Mast Cell Activation Syndrome (MCAS) and Postural Orthostatic Tachycardia Syndrome (POTS).

Common Inflammatory Foods to Limit or Avoid

Many of the foods commonly linked to inflammation in the general population can be particularly problematic for those with connective tissue disorders. Chronic, low-grade inflammation can worsen joint pain and fatigue, common symptoms in EDS.

• Processed and Fried Foods: These items often contain trans fats and other additives that can trigger systemic inflammation. Examples include fast food, prepackaged snacks, donuts, and many baked goods.
• Added Sugars and Refined Carbohydrates: Found in sodas, sweets, pastries, and white bread, these can cause spikes in blood glucose and increase inflammatory markers like cytokines. Checking nutrition labels for ingredients like high-fructose corn syrup is essential.
• Excessive Omega-6 Fatty Acids: While some omega-6 fats are necessary, an overabundance, often found in corn, soy, and sunflower oils, can promote inflammation. Opt for sources higher in anti-inflammatory omega-3s, such as olive oil and avocados.
• Red and Processed Meats: High in saturated fats and compounds like advanced glycation end products (AGEs), these can contribute to inflammation, especially when grilled or fried.

Dietary Considerations for Comorbid Conditions

EDS rarely occurs in isolation. Addressing diet is critical for managing related issues.

Mast Cell Activation Syndrome (MCAS)

MCAS is a condition where mast cells inappropriately release histamine and other chemicals, causing a variety of symptoms, including digestive issues and skin reactions. A low-histamine diet may be beneficial, though it should be undertaken with professional guidance to avoid nutritional deficiencies.

Foods high in histamines or that trigger histamine release include:

• Aged cheeses and fermented foods (sauerkraut, kombucha)
• Smoked and cured meats (sausage, hot dogs)
• Alcohol (especially wine and beer)
• Certain vegetables (spinach, tomatoes, eggplant)
• Citrus fruits and strawberries
• Leftover meats or fish

Postural Orthostatic Tachycardia Syndrome (POTS)

POTS involves an abnormal heart rate increase upon standing. Dietary strategies often focus on hydration and electrolyte balance.

• Caffeine and Alcohol: Both are diuretics and can lead to dehydration, worsening POTS symptoms. Limiting or avoiding them is often recommended.
• Large, High-Carbohydrate Meals: These can cause blood to pool in the abdomen as digestion occurs, exacerbating POTS symptoms. Smaller, more frequent meals are often better tolerated.

Gut Sensitivities and Motility Issues

Weakened connective tissue in the gut and nerve dysfunction can lead to digestive problems, including Irritable Bowel Syndrome (IBS), constipation, and gas.

• Gluten and Casein: Many individuals with EDS report sensitivity to these proteins, which can cause gut inflammation. While it may be due to a fructan sensitivity rather than gluten itself, an elimination diet can help identify triggers.
• High FODMAP Foods: These fermentable carbohydrates can cause gas, bloating, and diarrhea in those with sensitive guts. A low-FODMAP diet is often used to identify specific triggers, though it should be done under dietitian supervision.

Dietary Comparison: Inflammatory vs. Supportive Foods

This table outlines common food groups and how to make choices that are more supportive for an EDS-friendly, anti-inflammatory diet.

Food Category	Foods to Consider Limiting/Avoiding	Supportive Alternatives	Key Reason for the Swap
Carbohydrates	White bread, pastries, sugary cereals, high-fructose corn syrup	Quinoa, oats, brown rice, ancient whole grains	Reduces inflammation by avoiding blood sugar spikes.
Fats	Trans fats (fried foods), excessive omega-6 oils (corn, soy)	Olive oil, avocado, nuts, seeds, fatty fish rich in omega-3s	Promotes anti-inflammatory processes and overall health.
Proteins	Cured meats, processed meats, large portions of red meat	Lean poultry, fresh fish, plant-based proteins like legumes (if tolerated)	Decreases inflammation associated with saturated fats and nitrates.
Dairy	High-fat dairy (cheese, cream, whole milk), especially if lactose intolerant or sensitive to casein	Lactose-free milk, plant-based milks, fermented dairy (if tolerated for MCAS)	Reduces digestive distress and potential inflammatory response.
Beverages	Alcohol, sugary sodas, energy drinks, excessive caffeine	Water, electrolyte drinks (for POTS), herbal teas, fruit infusions	Prevents dehydration, manages POTS symptoms, and avoids inflammatory triggers.

Navigating Dietary Needs for EDS

• Personalized Approach: Given the complex and individual nature of EDS and its comorbidities, it is crucial to focus on personalized triggers. What works for one person may not work for another.
• Work with a Specialist: The guidance of an EDS-aware registered dietitian is invaluable for navigating a therapeutic diet. They can help ensure nutritional adequacy, especially when following restrictive plans like a low-histamine or low-FODMAP diet.
• Keep a Food Diary: A detailed food and symptom journal is an excellent tool for identifying personal triggers. Track what you eat and how you feel afterward to spot patterns and sensitivities.
• Prioritize Whole Foods: A diet rich in fresh, unprocessed foods—including fruits, vegetables, lean proteins, and healthy fats—forms the foundation for managing many EDS symptoms. For more information on general anti-inflammatory diets, see the advice from Harvard Health at https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation.

Conclusion: Finding the Right Fuel for Your Body

There is no one-size-fits-all diet for EDS, but adopting a mindful approach to nutrition can significantly impact symptom management. By systematically identifying and reducing inflammatory foods, processing high-histamine items, and addressing gut sensitivities, individuals can reduce pain, fatigue, and digestive discomfort. The key is a personalized strategy, often supported by a healthcare professional, that focuses on a nutrient-dense, whole-food diet that respects the unique sensitivities of a body with EDS. While dietary changes won't cure the condition, they offer a powerful tool for improving daily quality of life.

Frequently Asked Questions

Is there a specific EDS diet that everyone should follow?

No, there is no single, evidence-based diet for Ehlers-Danlos Syndrome. Dietary management is highly individualized and depends on personal triggers and co-occurring conditions like MCAS or POTS.

Why do many people with EDS have digestive issues?

EDS can cause digestive problems due to faulty collagen in the intestinal tract, affecting gut motility, nerve sensitivity, and permeability. This can lead to symptoms like bloating, constipation, and pain.

Should I go gluten-free if I have EDS?

Many people with EDS report feeling better on a gluten-free diet, but it may be due to a sensitivity to FODMAPs in wheat rather than gluten itself. An elimination diet with dietitian supervision can help determine if it is a necessary change.

What role does alcohol play in managing EDS symptoms?

Alcohol can be particularly problematic for those with EDS. It is a diuretic, which can worsen POTS symptoms, and can trigger mast cell activation, making it a common irritant for those with MCAS.

Are fermented foods good or bad for EDS gut health?

This depends on the individual. While fermented foods can support a healthy gut microbiome, they are also high in histamines. For individuals with MCAS, they may trigger flares and worsen symptoms.

How can I tell if a food is triggering my symptoms?

Keeping a detailed food and symptom journal is the most effective way to identify your triggers. Document what you eat and drink, along with any symptoms you experience, to spot patterns over time.

Why is hydration so important for people with EDS?

Proper hydration is crucial, especially for those with POTS, as it helps maintain blood volume and can reduce symptoms like dizziness and lightheadedness. Sodium intake is also often increased for POTS patients.