Positive ANA: What to Know + Next Steps

If your doctor has ordered an ANA test and your results come back positive, what does this mean? What comes next? I’m here to give you a holistic, big picture view of what a positive ANA test result may indicate about your health, and what you can do about it – and to dispel some of the conventional medicine myths about autoimmunity.

ANA Testing: A Quick Overview

An antinuclear antibody (ANA) test is a blood test that’s used as a screening tool for autoimmune disease. The test looks for the presence and ratio of a particular group of autoantibodies.

Antibodies are proteins that the immune system makes in order to combat foreign substances like viruses and pathogenic bacteria. Autoantibodies are antibodies to the self – proteins that attack the body’s own cells or tissues.

Autoantibodies in general are signs of autoimmunity – the immune system attacking the self.

ANA testing isn’t used to diagnose a specific autoimmune condition, but is rather one tool that is used to ascertain whether autoimmunity may be present.

What A Positive ANA Result Means

Very simply, a positive ANA test means that you have antinuclear antibodies in your blood.

Conventional medicine is quick to say that just because you have a positive ANA result, it doesn’t necessarily mean that you have an autoimmune disease. This is true, but in a lot of cases it’s also problematic.

Doctors don’t typically order ANA tests for no reason. If you’ve had this blood test done, it’s probably because you’re experiencing chronic, unexplained symptoms like fatigue, brain fog, joint pain, muscle weakness, hair loss, or skin rashes, which may be indicative of an autoimmune condition.

As a next step, your practitioner will likely send you for more testing and/or to see a specialist, depending on the type of autoimmune disease they think you may have (based on your symptoms, health history, or other test results).

But if you don’t end up meeting the criteria for an established autoimmune disease, your doctor might tell you that there’s “nothing wrong”, or maybe to come back in 6 months or a year.

It’s in situations like this where so many patients unfortunately fall through the cracks. If you’re experiencing ongoing symptoms of autoimmunity and inflammation, and you test positive for antinuclear antibodies, your body is experiencing autoimmunity – even if you don’t fit into the box of a specific diagnosable condition.

In fact, usually by the time people are diagnosed with an autoimmune disease, they’ve already been inflamed and experiencing symptoms for several years. And positive ANA tests have been shown to be predictive, often long preceding diagnosis. (1, 2)

The good news is that you have the power to act at any time to start healing your immune system, reducing inflammation, and feeling better. You don’t have to wait until you have a disease with a label.

The Autoimmune-Inflammation Spectrum

Autoimmune conditions don’t just show up overnight. They’re at the far end of a spectrum of inflammation and autoimmunity that often starts with no symptoms at all, and progresses over time.

The three main stages of the autoimmune-inflammation spectrum are:

Silent autoimmunity: Lab tests (maybe including, but not limited to, ANA tests) that indicate autoimmunity, but no symptoms

Autoimmune reactivity: Lab tests that indicate autoimmunity and symptoms of autoimmunity and inflammation, but no specific diagnosable disease

Autoimmune disease: Diagnosis of one or more specific autoimmune condition(s)

In my functional medicine practice, I work with patients every day who are somewhere within the middle of the spectrum. They’ve often seen many doctors who either can’t figure out what’s “wrong” with them, or worse, have told them they’re fine even though they’re clearly not feeling well.

We also see many patients who have been diagnosed with an autoimmune disease (or more than one). Regardless of where someone falls on the spectrum and/or of what specific condition they’ve been diagnosed with, the overall goal is the same: we want to improve the autoimmunity and inflammation that is at the root of the problem. And we want to be as proactive as possible.

Learn more about how to combat inflammation and autoimmunity through food in my book, The Inflammation Spectrum. 

False Positives and Getting More Information

Can healthy people get “false positives” on an ANA test? This might be a cautious yes. For example, it’s possible to have elevated antinuclear antibodies because of something like a bacterial or viral infection – the immune system could theoretically become overly fired up while fighting your infection, temporarily produce autoantibodies, and return to normal afterwards.

However, this is likely not what’s happening for most people who get a positive result. Again, you’re probably not just running ANA testing on yourself regularly for fun. If your symptoms are chronic and they come alongside markers of autoimmunity, chances are your symptoms are related to chronic autoimmunity and not a passing virus.

ANA test results also aren’t as simple as just positive or negative. ANA analysis looks at patterns of how the antibodies are distributed, and ratios called titers to assess the severity of the problem.

It’s also important to understand that one positive ANA test alone doesn’t give us much information. Again, a conventional practitioner will likely send you for additional testing to help determine whether you have a specific disease. This testing is important and valuable.

In functional medicine, we also want to gather more detailed information about what’s going on in your body overall.

Some of the laboratory tests we run most commonly for our patients with signs of inflammation and autoimmunity include:

• Markers of inflammation like C-reactive protein (CRP)
• Gut microbiome testing
• Other autoimmune reactivity labs
• Homocysteine testing
• Intestinal permeability (leaky gut) testing
• Toxin panels
• Methylation testing

LISTEN: Autoimmune-Inflammation: Top Causes, Functional Medicine Labs, Diet + Lifestyle Factors, The Nervous System Component & Exactly How To Heal 

Conditions That Can Cause a Positive ANA

There are more than 100 established autoimmune conditions, all of which are characterized by the immune system attacking the body’s own tissues and cells. Where they essentially differ is in the parts of the body and/or types of tissues and cells being attacked.

A positive ANA test doesn’t point to any specific condition, but some of the autoimmune disorders that it may indicate include:

• Connective tissue diseases including rheumatoid arthritis, systemic lupus erythematosus (SLE), and Sjögren’s syndrome
• Digestive conditions including inflammatory bowel disease (IBD) and Celiac disease
• Thyroid diseases including Hashimoto’s and Grave’s disease
• Skin conditions including scleroderma
• Central nervous system conditions like multiple sclerosis (MS)

Again, remember that a positive antinuclear antibody test can also indicate that you are experiencing autoimmune reactivity, even if you don’t have a diagnosable condition (or don’t have one yet).

It often takes several years after symptoms start for patients to receive a specific autoimmune diagnosis. That’s why it’s so important for clinicians to ask: what can we do now to improve someone’s health, instead of just waiting for it to get worse?

Learn how to reverse autoimmune symptoms, dampen inflammation, and balance your immune system with my course, Mastering Autoimmune Conditions & Inflammation with Functional Medicine.

Moving Forward Towards Healing

While healing from autoimmunity can feel elusive, we have a significant amount of power and control here. About 77% of immune system reactivity is thought to be determined by environmental factors – in other words, things that we have the ability to change at least to some extent. (3) These include things like diet, exposure to toxins or pollutants, stress, and lifestyle habits.

There are many things you can do to naturally help calm inflammation, restore immune system function, and feel better. These include:

• Following an anti-inflammatory diet (starting with an elimination diet in order to determine your individual food triggers)
• Introducing anti-inflammatory supplements like curcumin, resveratrol, fish oil, and vitamin C
• Implementing a regular fitness routine
• Practicing mindfulness techniques like meditation, breathwork, and yoga
• Supporting the gut microbiome with probiotics
• Incorporating intermittent fasting into your routine
• Testing for and removing build-up of toxins
• Supporting vagal tone through practices like humming and singing
• Contrast therapy with heat and cold
• Prioritizing more restorative sleep

READ NEXT: It’s Not Just One Thing Making You Sick: Here’s Why That’s A Good Thing 

Seeking Help From A Functional Medicine Expert

We use tests to help us find answers. But without thorough interpretation from a practitioner, tests might sometimes leave you with more questions.

At our functional medicine telehealth clinic, we work with patients from around the world and all across the autoimmune-inflammation spectrum to get to the root cause of symptoms and disease, and start the healing process now.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe.