09/05/2026
EDS Awareness Month 2026 — Blog 2 of What We Don’t Know is live.
This week: an honest audit of the medications most commonly prescribed for hEDS, POTS and MCAS.
What the evidence actually shows:
→ Cromolyn sodium — less than 1% absorbed systemically. Mechanism unresolved after 50 years. Evidence base built in a different disease entirely.
→ Antihistamines — 5 trials, 71 patients, 1983–1993. All in mastocytosis. All before MCAS existed as a diagnosis. And we use a positive response to antihistamines to confirm MCAS — which means the evidence and the diagnostic criteria are circularly dependent on each other.
→ Beta blockers — the strongest evidence in this blog. Still small trials. Still significant caveats.
→ Fludrocortisone and midodrine — extrapolated from orthostatic hypotension. Not validated in POTS-specific trials.
→ Ketotifen and quercetin — biologically plausible. Largely unevidenced in MCAS.
This is not an argument against treatment. It is an argument for honesty about what we know — and urgency about the research that still needs to happen.
Link in bio.