I was referred to internist due to hair loss, joint pain, fatigue.

Patient

Q: I was referred to internist due to hair loss, joint pain, fatigue, nausea
I have hypothyroid
Celiac
The only test results that were abnormal are Ana and asma
I'm looking for possibilities as to what this means

Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,

A positive ANA test means autoantibodies are present. By itself, a positive ANA test does not indicate the presence of an autoimmune disease or the need for therapy. Some medications cause a positive ANA. A negative ANA reading means no autoantibodies are present in the body. However, a positive ANA reading alone does not indicate an autoimmune disease.

The prevalence of ANAs in healthy individuals is about 3-15 percent. The production of these autoantibodies is strongly age-dependent, and increases to 10-37 percent in healthy persons over the age of 65. Even healthy people with viral infections can have a positive ANA, albeit for a short time.Some medications can cause a positive ANA.Other conditions, such as cancer, can cause a positive ANA.
The positive ANA reading simply tells your doctor to keep looking. In fact, you may have a “false positive” ANA, which means that the evidence is not there to make a diagnosis of lupus or any other autoimmune disease.

Now, an anti-smooth muscle antibody (ASMA) test detects antibodies that attack smooth muscle. This test is performed on a blood sample. ASMA testing looks for one type of autoantibody—the type that attacks smooth muscle. Autoimmune diseases that attack smooth muscle include the liver diseases cirrhosis and hepatitis. An ASMA test is often performed in patients who have chronic liver disease. It can confirm a diagnosis of chronic, active autoimmune hepatitis. The ASMA test can also distinguish between autoimmune hepatitis and systemic lupus erythematosus (SLE) . ASMAs are present in patients with autoimmune hepatitis. They are not found in patients with lupus. A test that comes back positive for anti-smooth muscle antibodies may be due to:
1.cirrhosis
2.chronic active autoimmune hepatitis
3. infectious mononucleosis

I hope i have addressed your query in detail,
Wishing you good health,
Regards

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