Experiencing Sjögren's Symptoms Without Elevated Test Results: Is It Possible?
Hello! I’m a 24-year-old woman and have just been diagnosed with Undifferentiated Connective Tissue Disease (UCTD). Although my tests showed positive markers for Sjögren's A and B, the levels were at 8, which my rheumatologist mentioned might increase as I age. Interestingly, the eye evaluation yielded normal results. This leads me to wonder: could I still exhibit symptoms associated with Sjögren's syndrome even with those test results? Lately, I’ve been contending with a persistently dry mouth and a tendency for nosebleeds. Additionally, I often feel a thick mucus in my throat that triggers coughing several times a day, despite not being ill. There have been numerous issues I've encountered overall, but for now, I'm keen to learn whether it’s feasible to experience these symptoms even without higher test levels that would confirm a diagnosis of Sjögren's. Currently, I'm taking levothyroxine and hydroxychloroquine, though I haven't undergone a salivary gland biopsy yet due to a minor mix-up in communication.
Answers (1)
7/10/2025, 11:10:36 PM
OpenHealth AI
It's absolutely possible to experience symptoms associated with Sjögren's syndrome even if your test results aren't strongly indicative of the condition. Many patients with Sjögren's can exhibit symptoms, such as dry mouth and nasal dryness, while having low or borderline lab markers.
Explanation:
Sjögren's syndrome is an autoimmune disorder characterized by dry eyes and dry mouth due to the immune system attacking glands that produce moisture. It often coexists with conditions like Undifferentiated Connective Tissue Disease (UCTD). Your symptoms of dry mouth, nosebleeds, and thick mucus could be tied to Sjögren's, especially since these can occur even at low levels of specific antibodies.
Next Steps:
-
Hydration Practices:
- Increase your fluid intake throughout the day to help manage dry mouth and mucus. Carry a water bottle to stay hydrated.
-
Humidifier Use:
- Consider using a humidifier in your living space, especially at night. This can help mitigate nasal dryness and reduce throat irritation from thick mucus.
-
Saliva Substitutes or Mouthwash:
- Look for over-the-counter products specifically designed for dry mouth relief, which can provide temporary relief.
-
Monitor Symptoms:
- Keep a symptom diary for a few weeks to track your dry mouth, nasal symptoms, and any changes. This can help identify triggers and patterns.
-
Follow-Up on Testing:
- Try to arrange for your salivary gland biopsy, as it can provide more insight into your symptoms and confirm or rule out Sjögren's.
-
Regular Check-Ins:
- Maintain regular communication with your rheumatologist about your symptoms and any changes. Their guidance will help adjust your treatment effectively.
Your symptoms are valid, and it's essential to address them actively, even if they don't align perfectly with test results. You're not alone in managing these challenges, so continue to seek support as needed.
Related Questions
Understanding the Risk of Transmitting Asymptomatic HSV1
It’s concerning to think about the implications of potentially being an asymptomatic carrier of HSV1, especially when entering a new relationship. For someone like me, who has never experienced a cold sore or any noticeable symptoms, the fear of unknowingly transmitting the virus to a partner is quite unsettling. Although I have lived my entire life without any signs of HSV1, I often wonder how to determine if I might be a hidden carrier. Is it possible (or advisable) to get tested in the absence of visible sores? Most testing protocols seem to prioritize cases where sores are present, and I've read that blood tests may not always provide reliable results. This situation is causing me a lot of anxiety. On one hand, I’m worried about the risk of passing on HSV1 to someone I care about, yet I also grapple with the uncertainty of my own viral status given my history of being asymptomatic. How can I have clarity around this issue?
In-Depth Inquiry Regarding an 11-Month-Old with Bilateral Mandibular Condylar Fracture
Greetings, Medical Professionals, I am reaching out to discuss my 11-month-old daughter, who recently suffered from a bilateral fracture of the mandibular condyle due to a fall. Imaging results indicate that one side is significantly displaced downward from the glenoid fossa, while the other side shows either minimal displacement or is not displaced at all. Initially, we were informed that her injury was a bilateral non-displaced fracture at the condyle's base or neck. Currently, we are opting for conservative management—which includes a soft diet and careful monitoring—consistent with pediatric care recommendations. This approach seems suitable, particularly considering her young age and the possibility of natural remodeling. However, one surgeon expressed concerns that unless intervention occurs in her teenage years, her jaw growth may be stunted, potentially leading to deformities, which has left us quite anxious. Given the rarity of this type of injury in infants under one year old, I am eager to hear from any pediatricians, radiologists, or surgeons with experience with similar cases. Here are my specific inquiries: • How effective is natural remodeling in young infants with displaced condylar fractures when it comes to restoring the condylar position and ensuring proper joint functionality? • Is there any guidance available on when to consider intervention or the role of physical therapy in preventing potential ankylosis? • What warning signs should we look out for that could indicate issues with growth or temporomandibular joint (TMJ) dysfunction later on? • Would you suggest conducting regular imaging, such as CT or MRI, during the first year following the injury? I recognize that this is an uncommon situation and that existing studies mostly pertain to older children or adults. I've come across a few case reports but would greatly appreciate any personal experiences or evidence-based insights you could share. Thank you very much for your attention to this matter.
Clarification Needed on Lyme Disease Testing Results and Next Steps
A 31-year-old male, weighing 180 pounds, is experiencing a range of health issues including asthma, depression, and panic disorder. His current medications include .25 mg of Xanax and 25 mg of Metoprolol. After undergoing Lyme disease testing, the PCR test returned a negative result. However, the total antibody CIA indicated a positive outcome, while both IgG and IgM antibody tests came back negative. Following a recommendation, a re-evaluation was conducted two weeks later, and the findings were identical, showing no change from the initial tests. Despite the lack of a tick bite or rash, the patient exhibits various symptoms typically associated with Lyme disease, which have persisted for over a year. He cannot recall any instances of encountering ticks. Could there be another condition producing similar antibody results that might mimic Lyme disease? I appreciate your understanding of my lack of expertise in this matter.
Hypocomplementemia with Negative ANA Results?
Greetings to all! I’m a 26-year-old graduate student based in the USA, grappling with an escalation of chronic pain that has persisted since my early teenage years. Recently, I consulted a new rheumatologist who ran several tests because of my family’s autoimmune history—my mother has psoriatic arthritis, and my sister struggles with ankylosing spondylitis. During my last evaluation in 2022, my tests showed negative outcomes except for low levels of C3 (79 mg/dL) and C4 (15 mg/dL). My recent assessments mirrored these results: negativity for anti-dsDNA, anti-Sm, and ANA, alongside a normal CRP count, yet again with low C3 (now 85) and C4 (17). No additional tests were conducted, although x-rays of my pelvis and hands appeared normal. To provide more context, here are some ongoing symptoms I’ve experienced intermittently: - Hair shedding - Regular pink rashes on my cheeks, often accompanied by headaches behind my eyes (accompanied by mild fever) and a sore throat—sometimes the rash also appears on my nose - Dry skin, dry eyes, and dry mouth, occasionally resulting in mouth ulcers - Itchy, red, and swollen hands that feel warm, frequently disrupting my sleep—sometimes this inflammation extends to my feet and seems triggered by stress, heat, consumption of alcoholic beverages like champagne or wine (whereas others have no reaction), sun exposure, and fluorescent lights—I avoid using overhead lights at work as they are particularly bothersome. - Severe fatigue and mental fog—my level of disorientation warranted a drug test during a sleep study, despite never having consumed non-prescription substances - Muscle soreness and joint stiffness, particularly after prolonged walking or upon waking - Difficulty with writing and gripping objects; I have previously participated in occupational therapy and now utilize pencil grips similar to those intended for young learners! My once hypermobile hands are now prone to locking up. These symptoms intensify periodically, erratically worsening every few months for about a week, making it extremely difficult to rise each day and attend work. I am eager to discern whether my concerns have a psychological basis or if my physical ailments can be accounted for by existing conditions. I find it challenging to locate a healthcare professional willing to help me assemble the entire picture, especially since I have various other diagnoses that are relatively well-controlled. Currently, my diagnoses include: - Raynaud’s phenomenon - Moderate dry eyes - Chronic migraine without aura, intractable - Gastroparesis with slow intestinal motility (post-GPOEM surgery, which was quite effective!) - Mild intermittent asthma - Oral allergy syndrome - Severe seasonal allergies - Increased mast cells identified in intestinal biopsy - Neuropathic pain - Hypermobile Ehlers-Danlos Syndrome diagnosed in 2021 - Childhood eczema - Recurrent sinus and ear infections (though it’s been a while since I last experienced any illness) - Frequent urinary tract infections, often presenting blood clots or protein in the urine My medications are as follows: - Gabapentin, 1200mg each day - Meloxicam - Montelukast - Zyrtec (4 tablets daily) - Omeprazole - Famotidine - Hydroxyzine - Aspirin drops - Dulera inhaler - Monthly Emgality injection - Botox for migraines Thank you for any insights or guidance you can provide—I truly value your expertise! As a pharmacology PhD student entering my final year, the stress is amplifying my situation, and I hope to uncover some answers before graduating and embarking on my career.
Concern Regarding My Son's Urological Health
I have some concerns regarding my one-year-old son’s urological health. He currently weighs 20 pounds and stands at 72 cm tall, and he does not take any medications. As a non-smoker, he has no known health issues. I haven't included any images, but I'm willing to provide them if necessary. What we have observed is that the seam on the underside of his penis appears jagged, resembling a lightning bolt rather than being smooth. Additionally, the base seems unusually tight, giving the impression that a band of skin may be constricting it, similar to a hair tourniquet, although that isn't exactly the case. While it’s somewhat difficult to ascertain, I suspect that during erections, his penis may curve down slightly. I am anxious about possible conditions such as chordee or hypospadias. The foreskin also appears somewhat irregular, as if there is extra skin present, yet it isn’t fully fused to the glans. I don’t believe his urethra is misplaced, but I must admit I don't have extensive experience with infant anatomy. Although his pediatrician hasn’t expressed any concern, I often feel dismissed by her. She hasn't been our preferred choice and has overlooked issues in the past. Living in Canada limits our options for healthcare providers, and it’s challenging to secure in-person appointments. Based on these observations, I am contemplating whether it would be prudent to seek a consultation with a pediatric urologist. Additionally, I wonder if this situation is related to the inconclusive result for Sex Chromosome Aneuploidies in his NIPT test. Should I be investigating the possibility of a genetic condition?