Antinuclear antibody

But first thing is we need to know, we need to really understand, like we need to know and we need to understand how much effort are we going to be putting into helping this person fix their thyroid So, you know, any woman who comes to me, she could be coming to me for gut issues, but full thyroid panel is going to be a non-negotiable.

Another marker is ANA, which is anti-nuclear antibody, which is a marker for autoimmune activity.

It can be positive and it can mean that there is no autoimmune, but it's a really good first step to understand, is there any autoimmune activity present? And again, another non-negotiable, I really just want every person, men and women, to get attested.

Autoimmune is way more common in women than it is in men, but we're seeing it creep up in men as well.

There are certain markers that you can get tested by your doctor.

There's one called ANA, anti-nucleotide antibody, and that gives you an indication of whether you have more of a systemic type of autoimmune condition that is targeting your cells rather than something like alopecia.

And you can also talk to your doctor about your symptoms because with my diagnosis of post-viral chronic fatigue syndrome that I got in my early 30s, they couldn't actually really do much for me from a medical perspective and it took a long time to get diagnosed with that condition but if you are living with fatigue on a daily basis and I mean the type of fatigue where you just get up feel depleted you're tired all day you're crashing and you're going to you're falling asleep straight after work or very early in the evening you're not able to maintain a good quality life because of the amount of sleep you feel you need and how fatigued you're feeling I mean that's why I ended up going to the doctor I didn't I got to the point with the hair loss and psoriasis that I just, they just went in cycles and I just lived with it.

But with the fatigue, I just thought I can't cope with this any longer.

Right.

Her, her ANA, which is the autoimmunity marker for, um, connected to her thyroid, her thyroid antibodies were high, but also this ANA number is at 1 to 320.

Mm-hmm.

A year later, we had gone through her gut protocol, we had gone through her mold protocol.

We had been able to walk through everything that she needed 'cause we found a bacterial pathogen in her gut.

We found that there is a lot of mold in her body.

One year later, we just retested recently, and her ANA marker is now at 1 to 160.

That's-

Laboratory evaluation should involve a connective tissue disease eval and primary small-medium vessel vasculitity eval.

So think about getting an ANA, double-stranded DNA, complement, ENA panel, antiphospholipid antibodies, rheumatoid factor, ANCA with anti-PR3 and anti-MPO, serum cryoglobulins, SPAP immunofixation, hepatitis B and C, HIV, and Lyme serologies, plus ESR-CRP.

EMG nerve conduction study serves two roles.

It confirms the characteristic asymmetric multifocal axonal process, and it identifies an affected nerve and adjacent muscle to guide biopsy and raise yield.

Yeah.

If your ANA is positive, but you feel okay, you still have lupus.

False.

So positive ANA is, firstly, ANA is an amazing test.

It does exactly what it's supposed to do, which is it's a screening test, which means it's supposed to cast a huge net and catch all these people, a huge pool of people.

20% of the population can have an ANA that does not have any clinical significance.

And then it's my job to really narrow down who of this big net of people actually has autoimmune disease.

But you can have a positive ANA and not have lupus.

And then there's all of the autoimmune labs.

So the ANA, which is something that I think most people have heard of, maybe with social media, which is actually a cool thing that people know about it now, but it stands for antinuclear antibody.

And that's just a screening test for like any auto antibodies against yourself.

Antibody being like your body's little army that fights off infection.

And you should have those that fight infection, but we want to check, do you have those against yourself? So it's just a screening test.

And then there's all these other things we check when the ANA is positive.

So specific markers for things like lupus and Sjogren's and something called your complement levels, which can go down with you know, active autoimmune disease like in lupus.

And we check the urine too.

I had a Orthodox Jewish father who came in who's 40 years old.

He's been suffering since he was 10 years old with chronic joint pain and gut issues, and he's, he's had positive ANA markers for 20, 30 years.

And the rheumatologist tell him like, "Sorry, like, your RF is negative, your CCP is negative, so, like, you're fine." And they'll run X-rays that your joints aren't getting eroded, your hands aren't getting mangled, and so, like, we don't know what to do with you.

And it's wild.

Like they tried steroids and antibiotics in the past for various conditions that ruined his gut flora.

He's got some family history of autoimmune, like most autoimmune folks do, and he's starting to get better, which is great.

But I just see people going five, ten, sometimes in this case thirty years without a diagnosis or just getting told their ANA is normal or that it's normal for iron to be low, or it's normal to have chronic digestive distress, and it's quite unfortunate.

But luckily, there are more practitioners like you and me who are out there starting to say, "We need tests," and patients are getting better at advocating for their own tests.

We have positive ANAs.

We have these, all these serology markers in lupus recognizing the ANA, recognize complements decreasing because of immune complexes.

So, you know, B cells seem to be the, the answer here, B cells turning into plasma secreting antibodies.

And if you say, okay, well, now if you, like, target these B cells, then that should really make a big difference.

For the story, I was kind of looking at the history of B cells and antibodies in lupus, and I started going down the rabbit hole of why B cells were targeted in the first place.

And that really kept focusing on the antibody story in lupus, and that led to the anti-nuclear antibody, one of the most famous lab tests in all of medicine.

And that I started learning a lot when I was doing this, and I sort of just kind of kept going down this rabbit hole of learning about ANA and then the extractable nuclear antigens and anti-double stranded DNA and anti-SSA.

And they're really, really interesting stories.