Uploaded January 2025 | Updated September 2026, 1 day ago
In this highly educational presentation, Dr. Brayden Yellman, MD and Rheumatologist, from the Bateman Horne Center, presents his research on Integrative Clinical Management of hEDS and its Common Comorbidities: Unravelling the Complexities of EDS/HSD
Presented at the November 2024 EDS Conference: Understanding EDS/HSD+ Symptomology, Diagnoses & Treatment - A Guide for Primary Care Practitioners & Physician Specialists.
Our mission at The ILC Foundation is to help individuals overcome the challenges of living with Ehlers-Danlos Syndromes and other chronic pain diseases through knowledge, sharing resources, awareness, education, peer support, and research to find cures. Learn more at theilcfoundation.org
Here is a brief summary of Dr. Yellman's presentation:
Brayden Yellman, MD, an internal medicine and rheumatology specialist at the Bateman Horne Center, discusses integrative clinical management of hypermobile Ehlers-Danlos syndrome (EDS), hypermobile spectrum disorders, and their common comorbidities. His presentation focuses on clinical management and thought processes, not specific product recommendations.
Yellman emphasizes the significant overlap between HEDS and ME-CFS, highlighting common comorbidities such as POTS, mast cell activation syndrome, small fiber polyneuropathy, gastrointestinal dysmotility, central nervous system complications, and vascular abdominal pathology.
He delves into the characteristics of ME-CFS, emphasizing the defining feature of post-exertional malaise (PEM), its triggers, and management strategies. Yellman advocates for pacing, energy conservation, and rest, cautioning against graded exercise therapy or the Levine protocol for ME-CFS patients with PEM. He also discusses low-dose naltrexone and dextromethorphan as potential pharmacological tools to reduce PEM.
Regarding orthostatic intolerance, Yellman recommends assessing hours of upright activity per day, utilizing orthostatic intolerance questionnaires, and performing the nasoline test to diagnose postural orthostatic tachycardia syndrome (POTS). He explains the adaptive responses of the autonomic nervous system in orthostatic intolerance and highlights management strategies including fluid therapy, compression clothing, and various medications like fluoroquinolone, mitadrine, droxidopa, pyridostigmine, beta blockers, and evabridin. He emphasizes that exercise can exacerbate symptoms in ME-CFS patients with orthostatic intolerance.
Yellman then focuses on mast cell activation syndrome (MCAS), outlining its common association with HEDS, POTS, and ME-CFS, and its impact on various symptoms including joint laxity, blood vessel pooling, and orthostatic intolerance. He details the diagnostic challenges of MCAS and treatment goals, which include reducing inflammation, improving connective tissue integrity, mitigating innate immune dysregulation, managing symptoms, and reducing triggers for neuroinflammation. He discusses treatment options like a low-histamine diet, histamine-reducing enzymes, H1 and H2 blockers, mast cell stabilizers, and anti-IgE biologics.
He also addresses the exaggerated sympathetic nervous system response often seen in MCAS and its management strategies.
Yellman concludes by discussing small fiber polyneuropathy, its impact on non-visceral pain, and the importance of addressing orthostatic intolerance to reduce pain in EDS patients. He explores musculoskeletal pain in EDS, common injuries, and the importance of physical therapy. He then discusses gastrointestinal complications, neuroanatomical complications, and other abdominal symptoms associated with EDS.
The presentation concludes by highlighting the complexities of EDS and the importance of understanding its potential complications for providing comprehensive care to patients.
In this highly educational presentation, Dr. Brayden Yellman, MD and Rheumatologist, from the Bateman Horne Center, presents his research on Integrative Clinical Management of hEDS and its Common Comorbidities: Unravelling the Complexities of EDS/HSD
Presented at the November 2024 EDS Conference: Understanding EDS/HSD+ Symptomology, Diagnoses & Treatment - A Guide for Primary Care Practitioners & Physician Specialists.
Our mission at The ILC Foundation is to help individuals overcome the challenges of living with Ehlers-Danlos Syndromes and other chronic pain diseases through knowledge, sharing resources, awareness, education, peer support, and research to find cures. Learn more at theilcfoundation.org
Here is a brief summary of Dr. Yellman's presentation:
Brayden Yellman, MD, an internal medicine and rheumatology specialist at the Bateman Horne Center, discusses integrative clinical management of hypermobile Ehlers-Danlos syndrome (EDS), hypermobile spectrum disorders, and their common comorbidities. His presentation focuses on clinical management and thought processes, not specific product recommendations.
Yellman emphasizes the significant overlap between HEDS and ME-CFS, highlighting common comorbidities such as POTS, mast cell activation syndrome, small fiber polyneuropathy, gastrointestinal dysmotility, central nervous system complications, and vascular abdominal pathology.
He delves into the characteristics of ME-CFS, emphasizing the defining feature of post-exertional malaise (PEM), its triggers, and management strategies. Yellman advocates for pacing, energy conservation, and rest, cautioning against graded exercise therapy or the Levine protocol for ME-CFS patients with PEM. He also discusses low-dose naltrexone and dextromethorphan as potential pharmacological tools to reduce PEM.
Regarding orthostatic intolerance, Yellman recommends assessing hours of upright activity per day, utilizing orthostatic intolerance questionnaires, and performing the nasoline test to diagnose postural orthostatic tachycardia syndrome (POTS). He explains the adaptive responses of the autonomic nervous system in orthostatic intolerance and highlights management strategies including fluid therapy, compression clothing, and various medications like fluoroquinolone, mitadrine, droxidopa, pyridostigmine, beta blockers, and evabridin. He emphasizes that exercise can exacerbate symptoms in ME-CFS patients with orthostatic intolerance.
Yellman then focuses on mast cell activation syndrome (MCAS), outlining its common association with HEDS, POTS, and ME-CFS, and its impact on various symptoms including joint laxity, blood vessel pooling, and orthostatic intolerance. He details the diagnostic challenges of MCAS and treatment goals, which include reducing inflammation, improving connective tissue integrity, mitigating innate immune dysregulation, managing symptoms, and reducing triggers for neuroinflammation. He discusses treatment options like a low-histamine diet, histamine-reducing enzymes, H1 and H2 blockers, mast cell stabilizers, and anti-IgE biologics.
He also addresses the exaggerated sympathetic nervous system response often seen in MCAS and its management strategies.
Yellman concludes by discussing small fiber polyneuropathy, its impact on non-visceral pain, and the importance of addressing orthostatic intolerance to reduce pain in EDS patients. He explores musculoskeletal pain in EDS, common injuries, and the importance of physical therapy. He then discusses gastrointestinal complications, neuroanatomical complications, and other abdominal symptoms associated with EDS.
The presentation concludes by highlighting the complexities of EDS and the importance of understanding its potential complications for providing comprehensive care to patients.
