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Understanding Glucose Metabolism Disorders & Inflammation

Understanding Glucose Metabolism Disorders & Inflammation

Metabolic Psychiatry

Understanding Glucose Metabolism Disorders & Inflammation

Metabolic Psychiatry is an emerging approach that focuses on how your health and metabolism impact your brain.

(And how it matters for mental health and overall wellness)

 

What do we mean by “glucose metabolism disorders”?

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At its simplest: glucose metabolism refers to how your body handles sugar (glucose) — absorbing, using, storing, and regulating it. A “disorder” of glucose metabolism implies that one or more steps in that process is impaired, such that blood sugar levels run too high (hyperglycemia) or variably swing.

Common clinical entities include:

 

    • Insulin resistance — when cells (muscle, fat, liver) become less responsive to insulin, so more insulin is needed to keep blood sugar in check. Wikipedia+1
    • Prediabetes / impaired glucose tolerance — early dysregulation before full-blown type 2 diabetes
    • Type 2 diabetes mellitus — sustained hyperglycemia because the system (insulin secretion + insulin sensitivity) fails to compensate adequately
    • Hyperglycemia / elevated postprandial glucose — spikes of blood sugar after meals that stress the system Wikipedia+1

These metabolic disturbances are not just “lab numbers” — they interact deeply with inflammation, cell signaling, and systemic health, and may even influence cancer risk. Piątkiewicz & Czech (2011) review how altered glucose metabolism is implicated in cancer risk through pathways like oxidative stress, chronic inflammation, and dysregulation in cell proliferation. PubMed+2ResearchGate+2

 

Why is inflammation involved?

Inflammation and glucose dysregulation are tightly linked — each can exacerbate the other in a vicious cycle.

 

    • In states of insulin resistance or hyperglycemia, there is increased oxidative stress and production of reactive oxygen species, which can trigger inflammatory pathways. Wiley Online Library+2PMC+2
    • Pro-inflammatory cytokines (e.g. TNF-α, IL-6) impair insulin signaling and contribute to further insulin resistance. PMC+2AHADigital+2
    • Metabolic inflammation (sometimes called “meta-inflammation”) is a low-grade, chronic inflammatory state associated with obesity, excess fat in tissues, dysregulated adipokines, and immune cell infiltration into metabolic organs (liver, fat, muscle). AHADigital+2JA Clinical Online+2
    • In the Piątkiewicz & Czech framework, chronic dysregulation of glucose and insulin may also impair anti-cancer surveillance (for instance via effects on NK cells) and promote the microenvironment favoring tumorigenesis. Spandidos Publications+3PubMed+3ResearchGate+3

In short: when glucose metabolism is out of balance, it tends to fuel inflammation. In turn, that inflammation worsens metabolic regulation. Breaking the cycle is a key therapeutic goal.

 

Mental health, inflammation, and glucose metabolism

Because CareSync Psych is focused on psychiatric/psychological well-being, it’s worth noting:

 

    • Inflammation is implicated in mood disorders, cognitive dysregulation, and neuropsychiatric conditions.
    • Insulin resistance and hyperglycemia can influence brain energy metabolism, neuroinflammation, and neurotransmitter systems.
    • Many psychotropic medications (e.g. some antipsychotics, mood stabilizers) have metabolic side effects — weight gain, insulin resistance — which increase vulnerability to glucose dysregulation and inflammation.

Thus, supporting better glucose homeostasis can have synergy with psychiatric care, improving not just physical health but potentially mental health outcomes.

 

 

What does the science say about Metabolic Psychiatry ?

Evidence-Based Strategies to Reduce Inflammation & Support Healthy Glucose Metabolism

Below are examples of possible strategies:

 

1. Dietary / Nutritional Modulation

 

    • Emphasize whole, minimally processed foods: lots of vegetables, legumes, whole grains, lean proteins, nuts. This helps supply fiber, phytonutrients, antioxidants. PMC+3JA Clinical Online+3JACC+3
    • Choose low-glycemic index/load carbohydrates to avoid huge post-meal glucose spikes. JACC+1
    • Include anti-oxidant and anti-inflammatory nutrients — e.g. polyphenols, flavonoids, vitamins (C, E), carotenoids. The LWW article you referenced deals with how antioxidants may help buffer oxidative stress in the context of glucose disorders. Lippincott Journals
    • Prioritize omega-3 fatty acids (from fatty fish, flax, chia) — these can help counter pro-inflammatory lipid signaling.
    • Avoid or reduce ultraprocessed foods, added sugars, refined carbs — these contribute to inflammation, insulin spikes, and lipotoxicity. JA Clinical Online+2Wiley Online Library+2
    • Consider “nutritional timing” / meal sequencing: Some research suggests that eating protein and fiber before carbs, or spreading carbs across the day, may blunt postprandial glycemic responses. JACC+1
    • Modulate the gut microbiome: Dietary fiber (prebiotics), fermented foods, and supporting microbial diversity help maintain gut barrier integrity and reduce systemic endotoxin-driven inflammation. Wikipedia+1

 

2. Physical Activity & Exercise

 

    • Exercise improves insulin sensitivity (especially in muscle) and helps glucose uptake independent of insulin.
    • It also stimulates AMP-activated protein kinase (AMPK), a cellular “energy sensor” that helps shift metabolism toward more efficient, healthier processing. JA Clinical Online+3arXiv+3Nature+3
    • Both aerobic and resistance training are beneficial; consistency is more important than intensity for most clients.
    • Even moderate daily movement (e.g. walking after meals) can moderate postprandial glucose spikes and reduce inflammation.

 

3. Weight Management & Body Composition

 

    • Excess adiposity (especially visceral fat) is strongly pro-inflammatory and contributes to insulin resistance.
    • Gradual, sustainable weight loss can reduce inflammation, improve insulin sensitivity, and relieve metabolic stress. AHADigital+2PMC+2

 

4. Sleep, Circadian Rhythm & Stress Regulation

 

    • Poor or insufficient sleep is associated with worse insulin sensitivity, dysregulated appetite hormones, and elevated inflammatory markers.
    • Aligning eating/fasting windows with circadian rhythms (for example, avoiding late-night eating) may help glycemic control.
    • Stress (psychological or physiological) raises cortisol, which antagonizes insulin and can push glucose higher — meditation, biofeedback, breathwork, psychotherapy are all relevant.

 

5. Pharmacological / Medical Adjuncts (in collaboration with providers)

 

    • Some glucose-lowering medications also have anti-inflammatory effects. For example, metformin is believed to act beyond glucose, modulating inflammation via AMPK pathways. Wikipedia+2Nature+2
    • Newer agents (e.g. semaglutide) are being studied for both metabolic and anti-inflammatory benefits. ScienceDirect
    • In diabetes, certain drugs (e.g. thiazolidinediones) may reduce inflammation more than others for the same glycemic reduction. PMC+1
    • Some studies are exploring immunometabolism (targeting metabolic pathways in immune cells) as a future anti-inflammatory strategy. Nature

 

6. Antioxidant Support & Supplementation (with caution)

 

    • Because oxidative stress is a mediator between hyperglycemia and inflammation, antioxidants (dietary or supplemental) may help buffer the damage.
    • But: indiscriminate high-dose antioxidant supplementation can have drawbacks (e.g. interfering with beneficial reactive oxygen signaling).
    • It’s safer to prioritize obtaining antioxidants via whole foods (berries, dark greens, nuts, colorful vegetables) rather than “megadoses” of supplements.
    • Book an Appointment

 

    Metabolic Psychiatry involves how you eat, sleep, move, manage stress, and control blood sugar all change how your brain functions.

    So instead of focusing only on symptoms like anxiety or depression, metabolic psychiatry also explores things like:

    • inflammation

    • insulin resistance

    • nutrient deficiencies

    • symptoms

    • chronic stress hormones

    • sleep and circadian rhythm

    The goal is to treat mental health from both sides:
    brain chemistry + whole-body biology.

    Metabolic Psychiatry in Lakeland, Florida. In-person or telehealth available for the whole state of Florida.

    References

    Azzi, A., Davies, K. J., & Kelly, F. (2004). Free radical biology—Terminology and critical thinking. FEBS Letters, 558(1–3), 3–6.

    Bastard, J. P., Maachi, M., Lagathu, C., Kim, M. J., Caron, M., Vidal, H., Capeau, J., & Feve, B. (2006). Recent advances in the relationship between obesity, inflammation, and insulin resistance. European Cytokine Network, 17(1), 4–12.

    Czech, A., & Piątkiewicz, P. (2011). Glucose metabolism disorders and the risk of cancer. Archivum Immunologiae et Therapiae Experimentalis, 59(3), 215–230.

    Dandona, P., Aljada, A., & Bandyopadhyay, A. (2004). Inflammation: The link between insulin resistance, obesity, and diabetes. Trends in Immunology, 25(1), 4–7. https://doi.org/10.1016/j.it.2003.10.013

    Evans, J. L., Goldfine, I. D., Maddux, B. A., & Grodsky, G. M. (2002). Oxidative stress and stress-activated signaling pathways: A unifying hypothesis of type 2 diabetes. Endocrine Reviews, 23(5), 599–622. https://doi.org/10.1210/er.2001-0039

    Giugliano, D., Ceriello, A., & Esposito, K. (2006). The effects of diet on inflammation: Emphasis on the metabolic syndrome. Journal of the American College of Cardiology, 48(4), 677–685. https://doi.org/10.1016/j.jacc.2006.03.052

    Grundy, S. M. (2016). Metabolic syndrome update. Trends in Cardiovascular Medicine, 26(4), 364–373. https://doi.org/10.1016/j.tcm.2015.10.004

    Hawley, J. A., & Lessard, S. J. (2008). Exercise training-induced improvements in insulin action. Acta Physiologica, 192(1), 127–135. https://doi.org/10.1111/j.1748-1716.2007.01783.x

    Hotamisligil, G. S. (2017). Inflammation, metaflammation, and immunometabolic disorders. Nature, 542(7640), 177–185. https://doi.org/10.1038/nature21363

    Piątkiewicz, P., & Czech, A. (2010). Antioxidants and glucose metabolism disorders. Current Opinion in Clinical Nutrition & Metabolic Care, 13(4), 512–518.

    Rains, J. L., & Jain, S. K. (2011). Oxidative stress, insulin signaling, and diabetes. Free Radical Biology & Medicine, 50(5), 567–575. https://doi.org/10.1016/j.freeradbiomed.2010.12.006

    Reaven, G. M. (2005). The insulin resistance syndrome: Definition and dietary approaches to treatment. Annual Review of Nutrition, 25(1), 391–406. https://doi.org/10.1146/annurev.nutr.24.012003.132155

    Vozarova, B., Weyer, C., Hanson, K., Tataranni, P. A., Bogardus, C., & Pratley, R. E. (2001). Circulating interleukin-6 in relation to adiposity, insulin action, and insulin secretion. Obesity Research, 9(7), 414–417. https://doi.org/10.1038/oby.2001.54

    Xu, H., Barnes, G. T., Yang, Q., Tan, G., Yang, D., Chou, C. J., … & Chen, H. (2003). Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. Journal of Clinical Investigation, 112(12), 1821–1830. https://doi.org/10.1172/JCI19451

    Glucose and Neuroinflammation

    Glucose and Neuroinflammation

    Glucose and Hypometabolism

    Cerebral glucose hypometabolism refers to a reduction in the brain’s ability to metabolize glucose, the primary source of neuronal energy. Because neurons have limited capacity for energy storage, consistent glucose supply is essential for proper cognitive, emotional, and behavioral function. When metabolism slows, neurons become less active, leading to impaired neurotransmission, synaptic plasticity, and overall brain performance — even before structural damage occurs.

    🔬 Pathophysiology

    Glucose metabolism in the brain occurs primarily through aerobic glycolysis, producing ATP to fuel neuronal signaling. When this process falters — whether due to mitochondrial dysfunction, neuroinflammation, insulin resistance, or oxidative stress — regions of the brain exhibit hypometabolism on FDG-PET (fluorodeoxyglucose positron emission tomography) scans.

    Mechanisms contributing to cerebral hypometabolism include:

    • Mitochondrial dysfunction: decreased ATP synthesis impairs neuronal signaling.
    • Neuroinflammation: cytokines disrupt insulin and glucose pathways.
    • Brain insulin resistance: glucose uptake is blunted despite normal peripheral insulin levels.
    • Oxidative stress: damages neuronal membranes and enzymes critical for metabolism.

    🧩 Clinical Correlations

    Cerebral glucose hypometabolism is observed across neuropsychiatric and neurodegenerative disorders, with distinct regional patterns:

    Condition Commonly Affected Regions Clinical Correlates
    Alzheimer’s Disease Posterior cingulate, parietotemporal cortex Early memory loss and executive dysfunction
    Frontotemporal Dementia Frontal and anterior temporal lobes Behavioral disinhibition, apathy
    Major Depressive Disorder Dorsolateral prefrontal cortex, anterior cingulate Impaired concentration, emotional regulation
    Schizophrenia Frontal and temporal regions Executive dysfunction, cognitive impairment
    Bipolar Disorder Frontal, limbic circuits Mood instability, impulsivity
    Traumatic Brain Injury Site-specific Cognitive slowing, emotional dysregulation

    In psychiatry, hypometabolism often reflects neural circuit inefficiency rather than cell loss. For instance, decreased glucose utilization in the prefrontal cortex may explain poor emotional regulation in depression or executive dysfunction in schizophrenia.

    ⚕️ Integrative and Metabolic Psychiatry Perspective

    At CareSync Psych, cerebral glucose hypometabolism underscores the mind-body connection — illustrating how metabolic and psychiatric processes intertwine. Emerging research links metabolic dysfunction (e.g., insulin resistance, obesity, chronic inflammation) with neuropsychiatric symptoms, suggesting that improving systemic metabolism may also enhance brain energy and mood stability.

    Therapeutic approaches that can help restore cerebral metabolism include:

    • Lifestyle interventions: balanced nutrition, exercise, restorative sleep.
    • Nutritional psychiatry: ketogenic or low-glycemic diets supplying ketones as alternate brain fuel.
    • Pharmacologic supports: metformin, GLP-1 receptor agonists, and mitochondrial antioxidants (e.g., CoQ10).
    • Psychotherapy and mindfulness: reducing stress-driven cortisol spikes that impair glucose utilization.

    🌿 Clinical Implications and Future Directions

    • FDG-PET imaging remains the gold standard to detect regional hypometabolism.
    • Metabolic psychiatry is reframing depression, anxiety, and cognitive decline as partly bioenergetic disorders.
    • Addressing glucose dysregulation early may prevent progression of cognitive and emotional disorders.
    • Future research aims to integrate metabolic biomarkers into psychiatric diagnostics and personalized treatment plans.

    🧾 References (APA 7th Edition)

    • Butterfield, D. A., & Halliwell, B. (2019). Oxidative stress, dysfunctional glucose metabolism, and Alzheimer disease. Nature Reviews Neuroscience, 20(3), 148–160. https://doi.org/10.1038/s41583-019-0132-6
    • Cunnane, S. C., Trushina, E., Morland, C., Prigione, A., Casadesus, G., Andrews, Z. B., … & Mattson, M. P. (2020). Brain energy rescue: An emerging therapeutic concept for neurodegenerative disorders of ageing. Nature Reviews Drug Discovery, 19(9), 609–633. https://doi.org/10.1038/s41573-020-0072-x
    • Mosconi, L., Berti, V., Glodzik, L., Pupi, A., De Santi, S., & de Leon, M. J. (2010). Pre-clinical detection of Alzheimer’s disease using FDG-PET, with or without amyloid imaging. Journal of Alzheimer’s Disease, 20(3), 843–854. https://doi.org/10.3233/JAD-2010-091504
    • Rasgon, N. L., & McEwen, B. S. (2016). Insulin resistance—a missing link no more. Molecular Psychiatry, 21(12), 1648–1652. https://doi.org/10.1038/mp.2016.163
    • Tomasi, D., & Volkow, N. D. (2019). Associations between brain activation, glucose metabolism, and psychiatric symptoms in major depressive disorder. Molecular Psychiatry, 24(12), 1672–1680. https://doi.org/10.1038/s41380-018-0262-9
    • Zhang, X., Chen, W., Li, J., Zhang, Y., & Xu, Y. (2021). Brain glucose hypometabolism and psychiatric disorders: A review of mechanisms and therapeutic perspectives. Frontiers in Psychiatry, 12, 700–714. https://doi.org/10.3389/fpsyt.2021.700714

    The Impact of Diet and Metabolic Health on Mental Health: Revolutionary Treatment Approaches

    The Impact of Diet and Metabolic Health on Mental Health: Revolutionary Treatment Approaches

    For decades, psychiatry has focused heavily on neurotransmitters—serotonin, dopamine, norepinephrine—as the “big three” of mental health. But new science is showing that the mind is not separate from the body. Instead, our mental health is tightly linked with our diet, metabolism, and even the way our mitochondria produce energy. This growing field—metabolic psychiatry—is reshaping how we understand and treat conditions like depression, anxiety, and other psychiatric disorders.

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    The Metabolic–Mental Health Connection

    Research has uncovered a bidirectional relationship between depression and metabolic syndrome, a condition marked by obesity, high blood pressure, high cholesterol, and insulin resistance. In a groundbreaking Mendelian randomization study, Zhang et al. (2021) demonstrated that not only does metabolic syndrome increase the risk of depression, but depression itself may worsen metabolic health—creating a vicious cycle that traps patients in both poor physical and mental health.

    This finding highlights an important truth: when we treat the body, we treat the brain, and when we treat the brain, we treat the body.

    The Role of Mitochondria and Tryptophan Pathways

    Our mental state depends on how well our brain cells produce and use energy. Mitochondrial impairment—the reduced ability of cells’ “powerhouses” to generate energy—has emerged as a common factor in psychiatric disorders. Tanaka et al. (2022) emphasize the link between dysfunctional mitochondria and disturbances in the tryptophan–kynurenine pathway, which regulates serotonin and neuroprotective metabolites. When this pathway is imbalanced, patients may experience both mood disorders and cognitive changes.

    This suggests that psychiatric symptoms are not just “chemical imbalances” but may also reflect underlying metabolic and cellular dysfunction.

    Diet as a Foundation for Mental Health

    Dietary patterns directly influence brain health. Diets high in refined sugars and processed foods can promote inflammation, insulin resistance, and mitochondrial stress—all of which worsen depression and anxiety. Conversely, nutrient-dense diets rich in omega-3 fatty acids, antioxidants, fiber, and amino acids like tryptophan can support healthier brain signaling and energy metabolism.

    Examples include:

    • Mediterranean-style diets, associated with reduced depression risk.

    • Ketogenic or low-carbohydrate approaches, which stabilize insulin and may improve treatment-resistant mood disorders.

    • Anti-inflammatory foods (leafy greens, fatty fish, berries), which reduce oxidative stress on the brain.

    Revolutionary Treatment Approaches in Metabolic Psychiatry

    What makes this field revolutionary is that it goes beyond traditional antidepressants by addressing root causes in metabolism. Innovative strategies include:

    1. Metabolic Medications with Psychiatric Impact

      • Drugs like metformin (used for diabetes) are being studied for depression in insulin-resistant patients.

      • GLP-1 receptor agonists (like semaglutide) may also reduce both metabolic burden and depressive symptoms.

    2. Targeting Mitochondria

      • Nutritional supplements such as CoQ10, NAD+ precursors, and certain amino acids may support mitochondrial resilience.

      • Therapies that restore mitochondrial function could improve both mood and cognition.

    3. Diet-Based Interventions

      • Structured programs integrating dietary counseling into psychiatric care are being tested to break the depression–metabolic syndrome cycle.

    4. Integrated Care Models

      • Combining psychiatric and metabolic treatments into holistic, whole-person care may offer the most promise. Patients with depression, obesity, and metabolic syndrome benefit most when both aspects are treated together rather than separately.

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    A New Horizon: Treating the Whole Person

    The future of psychiatry lies in seeing mental health through the lens of metabolic health. Instead of separating “brain” and “body,” metabolic psychiatry brings them together, creating space for innovative therapies that restore balance at the cellular and systemic level.

    By focusing on diet, metabolism, and mitochondrial health, we move toward revolutionary treatment approaches that sync the mind and body, ultimately offering hope for patients who haven’t found relief through traditional psychiatric care.

    Ehlers-Danlos Syndrome: The Overlooked Impact on Mind and Body

    Ehlers-Danlos Syndrome: The Overlooked Impact on Mind and Body

    Living with Ehlers-Danlos Syndrome (EDS) often means more than just joint hypermobility or fragile skin—it means navigating a long, complex journey through the healthcare system while managing pain that others can’t always see. Recent research highlights just how misunderstood EDS remains, and why supporting both body and mind is essential in care.

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    The Diagnostic Odyssey

    For many with hypermobile EDS (hEDS), the road to diagnosis is long and winding. Halverson et al. (2023) found that patients often endure years of misdiagnoses and comorbidities before receiving an accurate EDS diagnosis. Many are initially told they have fibromyalgia, chronic fatigue syndrome, or even psychosomatic conditions. This “diagnostic odyssey” delays effective treatment and increases emotional distress.

    The consequences of misdiagnosis include:

    • Unnecessary treatments or procedures.

    • Dismissal of symptoms as “in the patient’s head.”

    • Psychological harm, including mistrust of healthcare providers.

    • Worsening of both physical and mental health symptoms.

    Pain in EDS: More Than Meets the Eye

    Pain is one of the most disabling symptoms of EDS, and it’s not just mechanical. Research by Malfait et al. (2021) highlights that EDS pain is multifactorial, involving:

    • Musculoskeletal pain from joint instability, sprains, and micro-injuries.

    • Neuropathic pain due to nerve compression or damage.

    • Central sensitization, where the nervous system becomes hypersensitive to pain signals, amplifying even mild discomfort.

    This complexity makes pain in EDS hard to treat with standard approaches, often leaving patients in a cycle of trial-and-error medications, physical therapy, and alternative treatments.

    The Mental Health Impact

    Both misdiagnosis and chronic pain shape the mental health of people with EDS:

    • Anxiety & Depression – Rates are significantly higher among those with chronic, uncontrolled pain.

    • Medical Trauma – Being repeatedly dismissed or misdiagnosed can create PTSD-like responses to healthcare visits.

    • Cognitive Strain – Chronic pain and fatigue contribute to “brain fog,” memory lapses, and difficulty concentrating.

    • Isolation – Limited mobility, stigma, and disbelief from others can lead to social withdrawal.

    EDS shows us how physical and psychological health are inseparable. Treating only the joints or only the anxiety misses the full picture.

    Toward a Whole-Person Approach

    To improve care for patients with EDS, treatment must be multidimensional:

    • Medical – Accurate diagnosis, management of comorbidities (like POTS or mast cell activation), and targeted therapies for connective tissue.

    • Pain Management – Using multimodal approaches, including medication, physical therapy, nerve blocks, and mindfulness-based strategies.

    • Mental Health Care – Psychotherapy to address medical trauma, coping skills for chronic pain, and support for mood disorders.

    • Lifestyle & Integrative Care – Nutrition support, pacing strategies, gentle strengthening exercises, and sleep optimization.

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    Conclusion

    Ehlers-Danlos Syndrome is far more than a “bendy joint” condition—it is a whole-body, whole-mind disorder that demands compassionate, integrated care. By acknowledging the diagnostic challenges and the complex pain mechanisms, providers can better support patients not just in surviving with EDS, but in finding ways to thrive.

    • Halverson, C. M., Cao, S., Perkins, S. M., & Francomano, C. A. (2023). Comorbidity, misdiagnoses, and the diagnostic odyssey in patients with hypermobile Ehlers-Danlos syndrome. Genetics in Medicine Open, 1(1), 100812. https://doi.org/10.1016/j.gimo.2023.100812
    • Malfait, F., Colman, M., Vroman, R., De Wandele, I., Rombaut, L., Miller, R. E., … & Syx, D. (2021). Pain in the Ehlers–Danlos syndromes: Mechanisms, models, and challenges. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 187(4), 429-445. https://doi.org/10.1002/ajmg.c.31967
    •  

    References

    Halverson, C. M., Cao, S., Perkins, S. M., & Francomano, C. A. (2023). Comorbidity, misdiagnoses, and the diagnostic odyssey in patients with hypermobile Ehlers-Danlos syndrome. Genetics in Medicine Open, 1(1), 100812. https://doi.org/10.1002/ajmg.c.31935

    Malfait, F., Colman, M., Vroman, R., De Wandele, I., Rombaut, L., Miller, R. E., … & Syx, D. (2021). Pain in the Ehlers–Danlos syndromes: Mechanisms, models, and challenges. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 187(4), 429-445. https://doi.org/10.1002/ajmg.c.31950