Coping with fatigue

Most patients with APS will find they suffer with fatigue at some point. Fortunately, the fatigue does not tend to be constant and many people find they have good and bad days.

Fatigue is characterised by a lack of energy and motivation. Unlike drowsiness, which is your body’s signal that you need sleep, fatigue is often accompanied by a general feeling of ‘heaviness’ or muscle aches and pains; it can affect you mentally as well as physically and can sometimes feel overwhelming.

While almost everybody experiences tiredness throughout the day, fatigue caused by APS is more extreme, can cause complete exhaustion, does not go away with sleep or rest and can limit your usual activities.

Although there is no cure for fatigue there are several measures you can take to help combat it:

• Take 200-400g hydroxychloroquine daily. This drug has long been used to treat fatigue and joint pain in autoimmune conditions such as arthritis and lupus, and is now becoming recognised as an important medicine for APS too. This will need to be prescribed by your GP, and it is also very important to have a hydroxychloroquine retinopathy eye test once a year as long-term use (over five years) of this drug can sometimes damage the retina
• Drink plenty of water. Dehydration can cause fatigue as your body lacks one of its most essential nutrients
• Maintain a healthy balanced diet with plenty of fresh vegetables and fruit
• Take vitamin and iron supplements. Sometimes people are low in essential vitamins and iron despite having a healthy diet, so try taking a daily all-round vitamin, mineral and iron supplement to combat your fatigue
• Keep to an exercise programme. Regular gentle exercise has been shown to be very beneficial in combating fatigue. You should start by aiming to walk for about twenty minutes three times a week, and then increase this slowly if you feel strong enough
• Pace yourself. It is important that you listen to your body and create strategies so your energy levels are not depleted too much. One of the dangers is that when you feel well, you will push yourself too much only to find that you are soon suffering fatigue again

Try to incorporate these pacing techniques into your lifestyle if possible:

• Know your body
• Do activities in short periods of time
• Schedule rest time
• Try and have routines
• Prioritise on what really needs to be done
• Switch tasks if you feel you are getting nowhere