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FatigueDon Thomas, Jr., MD, FACP, FACR

Author of “The Lupus Encyclopedia: A Comprehensive Guide for Patients and Families

Arthritis and Pain Associates PG County, Greenbelt, MD

www.arthritispainpg.com : 301-345-5600

Associate Professor of Medicine

Uniformed Services University of the Health Sciences

Bethesda, MD

Exhausted

Exhausted

“Can’t do the thingsI enjoy and want to do!

Help!”

Exhausted

Stopped enjoyable things

Low concentration

Exhausted

Stopped enjoyable things

Low concentration

Can’t sleep

Exhausted

Stopped enjoyable things

Low concentration

Can’t sleep

20 pounds weight gain

Requests:

Sleeping pill

Weight loss pill

Energy vitamins

Inflammation LabsSed rate (ESR)C-reactive protein (CRP) GammaglobulinsAnti-dsDNA

Inflammation LabsSed rate (ESR)C-reactive protein (CRP) GammaglobulinsAnti-dsDNA

Low complement levels (C3, C4)

Organ Inflammation LabsLiver Function Tests (LFTs)Muscle enzymesIncreased protein in urineAnemia of inflammationLow white blood cell countLow platelet count

Other Sjogren’s organ problems

Interstitial lung diseasePrimary biliary cholangitis (previously cirrhosis)

Health News Florida

Biologics HQ

Pharmaceutical Quotes

The Today Show

Sjogrens.org

DysautonomiaAutonomic dysfunction

DysautonomiaAutonomic dysfunction

POTS

POTSPostural orthostatic tachycardia syndrome

POTS

FatigueWeakDizzyLightheadedHeart palpitations

https://blog.daveasprey.com/at-home-tests/

10 minutes: If HR increases ≥30 bpm but no decrease in BP

POTS?

POTS Treatments

Exercise

Drink lots of fluids

Avoid inactivityWinker R, et al. Endurance exercise training in orthostatic intolerance: a randomized,

controlled trial. Hypertension. 2005 Mar;45(3):391-8. Epub 2005 Feb 7.

POTS TreatmentsExerciseDrink lots of fluidsAvoid inactivity

Medicines

Winker R, et al. Endurance exercise training in orthostatic intolerance: a randomized, controlled trial. Hypertension. 2005

Mar;45(3):391-8. Epub 2005 Feb 7.

Exercise as important for Living

as Eating& Sleeping

How do you motivate yourself to exercise?

Share in the Chat Box

www.dysautonomiainternational.org

Treatable

Blood countsThyroid

Vitamin B12

Vitamin D

Celiac disease

Hepatitis C

Treatable

Blood counts

ThyroidVitamin B12

Vitamin D

Celiac disease

Hepatitis C

Treatable

Blood counts

Thyroid

Vitamin B12Vitamin D

Celiac disease

Hepatitis C

Treatable

Blood counts

Thyroid

Vitamin B12

Vitamin DCeliac disease

Hepatitis C

Treatable

Blood counts

Thyroid

Vitamin B12

Vitamin D

Celiac diseaseHepatitis C

Treatable

Blood counts

Thyroid

Vitamin B12

Vitamin D

Celiac disease

Hepatitis C

Healthy Debate healthydebate.ca

Drugs that cause fatigue

AlcoholPain medicinesAntidepressantsBlood pressure medicines (beta-blockers, diuretics)Proton pump inhibitors (such as pantoprazole)Anti-anxiety pillsSleeping pillsMuscle relaxantsAntihistaminesStatinsAntibiotics Anti-psychotics

Fatigue: most common causes

Insomnia with poor sleep hygieneObstructive Sleep ApneaDepressionAnxiety DisorderFibromyalgia

Fatigue: most common causes

Insomnia with poor sleep hygiene

Depression

Rx

ExerciseSleep hygieneHealthy DietWeight loss

Rx

ExerciseSleep hygieneHealthy DietWeight loss

Meds?: Paxil

NBC News at nbcnews.com

CRESTAFatigueClinic

CRESTA Fatigue Clinic Method

Pain managementExercisePilatesSleep hygieneEnergy managementStress reduction

CRESTA Fatigue Clinic Method

Pain management

ExercisePilatesSleep hygieneEnergy managementStress reduction

CRESTA Fatigue Clinic Method

Pain managementExercise

PilatesSleep hygieneEnergy managementStress reduction

CRESTA Fatigue Clinic Method

Pain managementExercisePilates

Sleep hygieneEnergy managementStress reduction

CRESTA Fatigue Clinic Method

Pain managementExercisePilatesSleep hygiene

Energy managementStress reduction

CRESTA Fatigue Clinic Method

Pain managementExercisePilatesSleep hygieneEnergy management

Stress reduction

Join their Facebook

CRESTA Fatigue Clinic Health Champions

150minutes/week

Moderate aerobic exercise

Exercise as important for Living

as Eating& Sleeping

NBC News at nbcnews.com