Your post shows Nashville - I assume you mean Nashville, TN. If so, hello to a fellow Tennessean - I was born in Chattanooga although we moved to Alabama when I was a toddler, I went to grad school at Peabody and law school at Vandy

Have you been to the rheumatology clinic at Vanderbilt? They have some excellent rheumies there, who might be able to get a better handle on your situation.

Unfortunately, lupus is so hard to diagnose because it can look like a hundred other diseases, and many of the symptoms, like fatigue and joint pain and Reynauds, aren't specific to lupus. A positive ANA can occur in many auto-immune disorders, including RA, Sjogrens, Reynauds disease, scleroderma, etc. Plus, people with no disease at all can also have a positive ANA - in fact, many relatives of lupus patients also have positive ANA tests. If you have a strong positive ANA (1:160) or higher, doctors will generally run a complete antibody panel, looking for antibody subsets which are more specific to lupus (like ds-dna, anti-sm, etc) These antibody subsets can also help your doctor distinguish between lupus and other auto-immune diseases like RA. If you don't have any of these other antibodies, and your ANA is only borderline positive, your doctor may not think it is significant for lupus.