Increase Energy with Lupus ([February 2025 Update]

posted in Lupus Encyclopedia: The Book on December 21, 2023 by

Gavin Abson

Updated February 16, 2025

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Did you know that energy loss is the most common disabling problem in people living with systemic lupus erythematosus (SLE)? However, some interventions can help improve energy. This article delves into strategies to increase energy with lupus, drawing insights from “The Lupus Encyclopedia.“

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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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This blog on “Increase Energy with Lupus” was edited and contributed to by Donald Thomas, MD; author of “The Lupus Encyclopedia.” Parts of this blog post come from “The Lupus Encyclopedia: A Comprehensive Guide for Patients and Health Care Providers, edition 2“

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Some of the information in this blog post comes specifically from Chapter 6 of “The Lupus Encyclopedia,” titled “Constitutional Symptoms.” The book notes on page 119:

It is essential to realize that fatigue is often due to multiple ­factors and rarely has a simple cure. Vitamins, for example, rarely help unless the person has a significant vitamin deficiency. Still, there are things you can do to improve your energy level. If you have considerable fatigue, review table 6.1 <found inside the book> to find pos­si­ble causes and learn to better manage the fatigue.

The Lupus Encyclopedia (2nd ed.), p. 119

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Factors Contributing to Lupus Fatigue

There are many potential causes of fatigue in people who have SLE. Recognizing the underlying causes of fatigue is crucial for effective treatment and improving energy levels in individuals with lupus.

Low energy with lupus due to systemic inflammation

If the fatigue is due to inflammation from SLE, medications that calm down the immune system can help. Examples of medicines that can help lupus-induced fatigue include:

• Antimalarial drugs: hydroxychloroquine (Plaquenil) and quinacrine
• Biologic drugs: belimumab (Benlysta) and anifrolumab (Saphnelo)
• Immunosuppressants: like methotrexate, mycophenolate mofetil, and azathioprine

How do you know if your fatigue is due to lupus inflammation? If it occurs while you are having a lupus flare (such as an arthritis flare, increased skin lupus inflammation, or pleurisy, for example), and if the fatigue improves significantly outside of a flare, this is a reliable indicator. Also, if you have persistently active lupus symptoms and this is accompanied by a high anti-dsDNA level, low C3 or C4 complement, or a high anti-C1q or EC4d level, then it could very well be due to your lupus, and these medications could help.

Low energy with lupus that is not due to active inflammation

Studies show that most lupus patients experience fatigue and low energy due to non-inflammatory causes. Recognizing and addressing these problems is vital to effectively boosting lupus patients’ energy levels. Recognizing that a holistic approach is often necessary for effective management is critical.

• If the person is not getting at least 7 to 8 hours of good quality sleep daily, addressing the underlying causes of sleep deprivation is essential. Download Dr. Thomas’ sleep hygiene handout to learn how to improve sleep. Sleep experts also recommend cognitive behavioral therapy for insomnia (CBT-i). Many apps are available for CBT-i.
• Drugs and other ingested substances can cause fatigue, and stopping the culprit or decreasing its dose may be best. Examples include alcohol, opioids (like tramadol), some anti-depressants, steroids, and diuretics (fluid pills). 
• Unfortunately, disorders like depression, stress, anxiety, and fibromyalgia are some of the most common causes of loss of energy with lupus, and these problems need specific treatments to help.  You can do some simple tests at home to see if you may have one of these disorders found at the bottom of our website’s “Lupus Secrets” page. Though we cannot eliminate stress from our lives, we can learn to reduce the negative effects of stress on our bodies. 
• Dry mouth from Sjogren’s disease can interrupt sleep and needs to be addressed.
• Patients with lupus are more likely to have sleep disorders like obstructive sleep apnea. Your doctor may recommend a sleep study to help identify these problems. 

Practical Strategies to Increase Energy with Lupus

Optimize Sleep Quality

Quality sleep is fundamental for managing fatigue. Establishing a consistent sleep routine, creating a comfortable sleep environment, addressing dry mouth, and avoiding stimulants close to bedtime can improve sleep quality.

Balanced Nutrition

A well-balanced diet can help improve energy levels with lupus. Ensure you’re getting essential nutrients through a varied and nutritious diet. Eating an anti-inflammatory diet is better for energy than eating the Standard American Diet (SAD diet), which is full of sugar, fried food, fats, and red meats. See Dr. Thomas’ recommendations for an anti-inflammatory diet (based upon medical research). Consulting with a nutritionist can provide personalized dietary recommendations.

Regular Exercise

Although fatigue can be a barrier to physical activity, regular exercise has proven beneficial for enhancing energy levels in those with lupus. Almost every study examining exercise and fatigue in lupus shows that exercise improves energy. A 2022 NIH-published study demonstrated improved mitochondrial function and energy levels in lupus patients with significant fatigue who exercised. This appears to be at least one possible mechanism for the positive benefits of exercise. The mitochondria are tiny organelles in cells. Scientists often call mitochondria the “powerhouse of the cell.” People with systemic lupus tend to have abnormally functioning mitochondria, and exercise appears to improve this problem. Consult a healthcare professional to develop a tailored exercise plan for your capabilities. A physical therapist can design a safe and effective exercise regimen tailored to your specific medical condition. 

Stress Management

Stress is a known contributor to lupus symptoms, including fatigue. Incorporate stress-reducing activities, such as mindfulness, meditation, or gentle yoga, into your routine.

Prioritize Rest to Increase Energy with Lupus

Balancing activity with sufficient rest is crucial. Learn to listen to your body’s signals and permit yourself to rest when needed. A popular approach by people suffering from chronic disease is “The Spoon Theory.” 

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For more in-depth information on increasing energy when you have lupus:

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

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