Fatigue and Lupus: The Many Different Kinds of Exhaustion

What Causes Lupus Fatigue?

Some causes of lupus fatigue are obvious, such as having a flare – your immune system uses a lot of energy when it’s actively attacking your body. While some fatigue sources are directly related to lupus, others are more subtle and therefore harder to identify.

Here are some of the many causes of lupus fatigue:

  • Direct UV light exposure from the sun or indoor lighting.
  • Many common lupus medications list fatigue as a side effect.
  • Additional, underlying medical conditions (such as anemia, hypothyroidism, diabetes, kidney disease, acute infections, etc.).
  • Mental health issues, including anxiety, stress, grief, and depression.
  • Lupus flare-ups.
  • Immunosuppression.
  • Adrenal fatigue (which can happen with chronic steroid use).
  • Inactivity or overactivity.
  • Poor nutrition.
  • Using tobacco or illegal drugs.
  • Dehydration.
  • Pain – especially chronic or intense pain.
  • Ineffective breathing (which leads to a lack of oxygen).
  • Sleep issues.

Keeping a fatigue journal can help narrow down potential causes. Remember that it’s not always possible to find the specific reason behind fatigue and don’t be too hard on yourself if you haven’t figured it out yet.

How to Manage Lupus Fatigue

It’s important to take action if you’re suffering from lupus fatigue. Uncontrolled fatigue typically results in poorer health outcomes and can be dangerous in some situations (such as driving). Here are some ideas for managing fatigue.

1. Tackle the Causes

Start by reviewing the possible causes of lupus fatigue for any potential candidates. Carefully examining your life will help to pinpoint sources of fatigue.

Perhaps you need to go over your medications with your doctor or ask for diagnostic tests to rule out suspected causes. Make sure you are getting enough nutrition from your diet and find ways to manage stress if that is an issue. It may take some trial and error to figure out what contributes to fatigue, but it’s important to keep trying.


2. Exercise

You may be surprised how an effective, appropriate exercise can be in treating fatigue. Although it seems counterintuitive to work out when your body feels depleted, aerobic exercise is one of the best non-drug treatments for fatigue when it’s done correctly. As long as you are careful not to push yourself too hard, you’ll likely experience renewed energy after an exercise session.

For me, there are times where exercising is helpful and rejuvenating. On the other hand, sometimes I feel like I simply cannot go on and I have to end the workout. With time, practice, and perhaps direction from a physical therapist, you’ll learn how to define your limits and exercise safely.

3. Learn Pacing Techniques.

Pacing is an essential skill for any lupus warrior. Learning to pace yourself will go a long way in preventing fatigue instead of just managing it after the fact.

Try scheduling rest periods throughout the day based on a schedule (such as taking a break every two hours) instead of a fatigue schedule (i.e., taking a break when you feel tired). Make a plan for each day so that you can accomplish essential tasks while still taking time to listen to your body and give it the rest it needs.

Resting and pacing should be highly prioritized in your life. Be sure to communicate with your friends, family, or coworkers why it’s important for you to take breaks and how they help you to keep going. Having support from those around you will help you to avoid overactivity.

4. Track Your Fatigue.

Taking time to study your body for patterns of fatigue can help you to identify, treat, and prevent fatigue. It will also help you to know the difference between your normal fatigue levels and sudden, intense fatigue that may require prompt medical care.

One way to track your fatigue is to use the fatigue severity scale (FSS). The FSS is a nine-question survey that can help you quantify your fatigue levels over time. It’s a useful tool for tracking the impact of fatigue as well as your progress.

5. Learn Coping Methods.

Learning how to cope when fatigue is unavoidable, such as during a lupus flare, is crucial.

Accepting that fatigue is part of having lupus can help you to move forward and make any lifestyle changes that are necessary. It’s also important to learn not to blame yourself for fatigue that is beyond your control.

If coping with lupus fatigue seems insurmountable, you may want to talk to a therapist.

This will likely be an ongoing struggle and therapy can help – especially if one of your fatigue symptoms is a lack of motivation or feeling like giving up. Therapy will equip you to handle fatigue and your feelings concerning it in a healthy way.

Moving Forward with Lupus Fatigue

Not having control over your lupus fatigue is frustrating – but it doesn’t have to stay that way. Continue to be as open as you can about your fatigue and the way it impacts you.

Stay vigilant in monitoring the symptoms of fatigue and taking steps to manage it as best you can.

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