Asthma & Allergies & hEDS/HSD
Asthma, Allergies, and Airway Problems in Hypermobility
None of us writing this are doctors. This page collects what the published research actually says about respiratory and allergic symptoms in hypermobility syndromes, so you have something concrete to bring to a doctor.
Asthma and allergies are common enough on their own that most people would not think to connect them to joint hypermobility. A well-powered case-control study found a real, statistically significant link - and some physical findings in the airways themselves that help explain why.
How Common Are Asthma and Allergies in Hypermobility Syndromes?
A 2007 case-control study published in the Annals of the Rheumatic Diseases surveyed 509 people: 221 healthy controls, 126 with Hypermobility Syndrome (HMS, now generally called HSD), and 162 with EDS. It found a significantly increased prevalence of asthmatic symptoms in both groups compared to controls - an odds ratio of 2.4 in HMS and 3.1 in EDS, meaning EDS patients had roughly three times the odds of asthma symptoms as the control group. Atopy (the tendency toward allergic conditions generally, including hay fever and eczema) was similarly elevated, with an odds ratio of 2.7 in HMS and 2.6 in EDS.
These findings held up under closer clinical scrutiny, not just self-report: a subgroup of 157 responders underwent full clinical and blood testing, and the increased asthma and atopy rates were confirmed by that clinical assessment, not just questionnaire answers.
Why Airways Themselves May Be Part of the Problem
A subgroup of 57 subjects underwent physiological lung testing, which found increased lung volumes, impaired gas exchange, and an increased tendency for both the lower and upper airways to collapse. That last finding is mechanically distinct from typical asthma, where airways narrow due to inflammation and muscle constriction - airway collapse is closer to a structural, connective-tissue-driven floppiness of the airway itself, similar to how joints and other soft tissues behave in hypermobility.
The study's authors proposed two possible explanations: either a genetic linkage between whatever causes hypermobility and whatever causes asthma susceptibility, or a more direct effect where the same connective tissue defect that affects joints also affects the airways and lung tissue directly. The study could not fully distinguish between these explanations, and reduced exercise tolerance was also observed more often in the HMS and EDS groups, which may relate to either the respiratory findings or to hypermobility-related fatigue and deconditioning discussed elsewhere on this site.
What to do with this
If you have hEDS or HSD and also deal with asthma-like symptoms, allergies, or unexplained reduced exercise tolerance, it is worth mentioning the hypermobility diagnosis to whoever is treating the respiratory symptoms - standard asthma treatment may still be appropriate, but if airway collapse rather than classic inflammatory asthma is part of what is happening, that can change what a pulmonologist looks for on testing. This is not a reason to avoid physical activity; the research on strength training elsewhere on this site suggests graded, supervised exercise is generally tolerated well in hEDS/HSD.