Nearly always a major factor in the lupus life, and very difficult for the specialist to treat. The fatigue may be severe, fleeting or persistent and can form a vicious circle, as the tired patient is unlikely to exercise and without exercise can become lethargic.

Rest however is essential – it is important to ensure a balance between exercise and rest – exercise and rest intermittently as the body allows. Listen to your body, it will tell you when it is time to rest. Increasing stamina allows you to gain more strength and muscle tone. Remember that rest is also needed to restore energy.

Lupus patients will want to work towards a healthy tiredness where subsequent rest or sleep recharges the batteries, and more recovery obtained in this way should help to minimise lupus tiredness.

Activities that help improve stamina yet do not cause stress to the joints and muscles are suggested, such as swimming, walking and cycling. Jogging is not suitable as it may prove too strenuous and it is always advisable to ask the advice of the family doctor, a physiotherapist or occupational therapist regarding a new or changed exercise regime.

“I was taken ill during the summer holidays leading up to my GCSE year. Prior to being ill, I was very sporty and athletics was my talent. It seemed overnight I had gone from being a very “healthy” young girl, to a 90 year old, crippled with pain and fatigue. The psychological impact of this is indescribable.”