published by nonprofit Johns Hopkins Press
posted in Symptoms In Lupus on May 6, 2021 by
Updated March 1, 2025
Fatigue is one of the most common and disabling symptoms affecting individuals living with systemic lupus erythematosus (SLE). Fortunately, there are ways to treat it. This article discusses how to treat lupus fatigue and includes insightful research into why SLE patients suffer from fatigue.
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NOTE: Johns Hopkins University Press, publisher of The Lupus Encyclopedia, is a nonprofit publisher. If you purchase JHUP books, like The Lupus Encyclopedia, you support projects like Project MUSE.
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Exercise and fatigue? This is actually the most successful treatment in people who have lupus, Sjogren’s, fibromyalgia, sleep disorders and related problems. Numerous studies show that when lupus patients force themselves to exercise, fatigue improves. However, the big question has always been… why? Damaged mitochondria may be one reason per 2022 NIH research.
In 2022, Dr. S. Hasni and associates at the Lupus Center at the NIH did a study in sedentary women with systemic lupus who had bad fatigue. They discovered that before the study, their mitochondria (the powerhouse, energy-producing part of cells) were abnormal. After a 12-week exercise regimen, not only did the patients feel better with more energy, but their damaged mitochondria were repaired. Finally, connecting science to what sounds crazy. (it is very hard to convince someone with bad fatigue to force themselves to exercise).
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Several studies show that taking high doses of over-the-counter NAC may help lupus disease activity, fatigue, and lupus fog. See my video below about this topic. I’ll go over the research and how much NAC doctors recommend taking:
When are medicines most likely to help? If you have a high anti-dsDNA, low C3 or C4 complement, or high EC4d, then medications such as belimumab (Benlysta) may help fatigue. Hydroxychloroquine can help many patients as well.
Should you get lab tests for fatigue? Yes, I generally check blood counts, liver enzymes, kidney function, muscle enzymes, electrolytes, thyroid function tests, iron levels, vitamin B12 and vitamin D levels, hepatitis C titers, and lupus disease activity. Many people should get a sleep study to make sure they do not have other treatable causes such as sleep apnea.
https:///www.lupusencyclopedia.com/lupus-secrets.html
SHARE with anyone who may suffer from fatigue
Read chapters 6, 38, and 39 of The Lupus Encyclopedia, edition 2
Look up your symptoms, conditions, and medications in the Index of The Lupus Encyclopedia
If you enjoy the information from The Lupus Encyclopedia, please click the “SUPPORT” button at the top of the page to learn how you can help.
If you have fatigue and energy loss from lupus, what has your experience been? What do you recommend for other patients?
Do you have any questions to ask Dr. Thomas?
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COMMENT above, please share how you deal with fatigue. Are you a spoonie?
Don Thomas, MD, author of “The Lupus Encyclopedia” and “The Lupus Secrets“
Read more in The Lupus Encyclopedia, edition 2
Look up your symptoms, conditions, and medications in the Index of The Lupus Encyclopedia
If you enjoy the information from The Lupus Encyclopedia, please click the “SUPPORT” button at the top of the page to learn how you can help.
If you have lupus, what has your experience been? What do you recommend for other patients?
Do you have any questions to ask Dr. Thomas?
Please click on “Leave a Comment” above to comment.
Click on “SUPPORT” at the top of the page to learn how you can support “The Lupus Encyclopedia“
Thank you so much for the great post! I really enjoyed watching the Fatigue in Lupus, Mitochondria, and N-acetylcysteine (NAC) lecture. It was soooo helpful and I even shared what I tried and found helpful with my rheumatologist. Since then I’ve been exercising (hiking) regularly, and it sure helped with my lupus fatigue. Thank you so much, Dr. Thomas!
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