Diagnosed with joint hypermobility syndrome, pain in joints including ribs hips knees sometimes excruciating. constant fatigue, always cold, normal?

Possible other cause: Seek a rheumatology consultation if you have not had one. Possibly an endocrinologist as well. If those workups are negative, consider physical therapy and/or prolotherapy/prp to help tighten up the ligaments.

Must be seen & advis: This syndrome is a diagnosis of exclusion and other possible disorders should be evaluated accordingly.

Workup and PT: There is no good evidence that JHS in and of itself will cause such significant pain. With that said, many people with JHS do present with chronic pain, fibromyalgia, fatigue and even autonomic symptoms such as you're describing. Evaluation by a rheumatologist, neurologist and physiatrist could be helpful in sorting out your symptoms, ruling out other problems, and providing appropriate treatment.