@johnwburns Hi, John. Have just read your note about fatigue. Good stuff, but perhaps it doesn't go far enough. I also have a lot of autoimmune effects, and we are still trying to work out the really detailed dX. Primary systemic hereditary hATTRwt or some other form of Light Chain Amyloidosis. It includes Sjogrens, SICCA, disorders of the heart, brain, thyroid, esophagus, lungs, kidneys, spleen, skin, bladders, prostate, joints, and the rest. Anyway, I am 78, and since I was about 8, I have felt tired after even very little effort. It is not to say that I cannot do anything. Perhaps we humans are just too quick to throw in the towel after some less than forceful sense of fatigue. I really just have to keep going past my fatigue level. In my childhood I missed a lot of school because I was so tired, and had a lot of nausea. Yet at 18 I could throw an 80 pound hay baled over a fully loaded truck. I played, coached and officiated football for 18 years. I ran half-marathons. I backpacked frequently, often walking for 8-10 days with a 70-90 pound pack. The point is not that I didn't get tired. I did. But I learned early on that I could keep going in spite of feeling tired. I think the sense of fatigue may be one of the ways the body protects itself from doing things that would harm the body. And I believe that many diseases may increase this sense of "enough already"; they may increase it beyond the point of being helpful to the point of being hurtful, or at least beyond a necessary level. Right now, I get very tired walking 25 feet through our small house. But I have to force myself to keep going, in spite of the fatigue.