Concerning Symptoms: Autoimmune Disease and Profuse Sweating
I'm a 31-year-old female, weighing 180 pounds and standing at 6 feet tall. Since 2021, I've been taking Adderall at a dosage of 30 mg twice daily and sertraline at 100 mg each day, which I began last October. My medical history includes ADHD, anxiety, thyroid nodules, and Raynaud's phenomenon. In October 2023, my physician discovered thyroid nodules during an examination. After conducting blood tests, all results came back within normal parameters, except the complete blood count (CBC) showed that my mean platelet volume (MPV) was low at 7.8. I underwent an ultrasound and a fine needle aspiration, both of which confirmed that the nodules are benign. A subsequent ultrasound last year indicated no change, maintaining the classification of "TIRADS 3," necessitating a follow-up in two years. In August 2025, I sought medical advice for excessive sweating localized to my face and scalp, which began a year before I started sertraline. This symptom has not improved and may be exacerbated by the medication. My doctor has switched me to Prozac to determine if this would alleviate the issue, with a follow-up scheduled for next month. Additionally, I've noted a worsening of my Raynaud's condition along with persistent joint discomfort that arose in early June. My feet tend to ache in the mornings, making walking difficult, and I've started experiencing a bluish discoloration in my fingers instead of the typical white, which has led me to wear gloves indoors even while reading. Over the last few months, I have also encountered significant fatigue. Given my family history of rheumatoid arthritis and the recent discovery of the thyroid nodules, my doctor has requested another round of blood tests to investigate potential autoimmune issues. The retested results maintain a consistent profile compared to two years ago, with the MPV still noted at 7.8. The rheumatoid factor fell within a normal range, measuring less than 13. However, my ANA test returned positive, which is classified as "abnormal," and the FANA analysis was speckled with a titer of 1:1280. Is a titer of 1:1280 indicative of an autoimmune disorder? If so, could it point towards lupus? Additionally, is excessive sweating a known symptom of lupus?
Answers (1)
8/9/2025, 3:11:02 AM
OpenHealth AI
Your concerns about potential autoimmune issues and symptoms such as excessive sweating, worsening Raynaud's, and joint discomfort are valid and warrant attention. Let’s break this down:
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Positive ANA and High Titer: The positive ANA (Antinuclear Antibody) test with a titer of 1:1280 can suggest the presence of an autoimmune disorder, although it is not definitive for lupus or any specific condition. Many healthy individuals can have a positive ANA without any disease. In cases of systemic lupus erythematosus (lupus), a positive ANA is common, but additional specific tests and clinical symptoms are needed for diagnosis.
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Symptoms and Lupus Connection: Excessive sweating is not a classic symptom of lupus; however, it can occur in patients with autoimmune diseases due to various processes including hormonal changes, nervous system involvement, or medication side effects. The complaints of Raynaud's phenomenon and joint discomfort, along with fatigue, could align with lupus or other autoimmune conditions.
Next Steps:
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Monitor Symptoms: Keep a detailed diary of your symptoms, including any changes in severity or occurrences. Note if the excessive sweating correlates with specific activities or changes in medication.
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Schedule Follow-Up Blood Tests: You mentioned that your doctor is planning further testing. Ensure these tests include specific autoantibodies that are more indicative of lupus or other autoimmune diseases, such as anti-dsDNA and anti-Smith antibodies.
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Medication Review: Discuss with your doctor any side effects of medications, particularly sertraline and the recent switch to Prozac. Both can affect sweating and anxiety levels.
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Lifestyle Adjustments: For managing Raynaud's and joint discomfort:
- Cold Protection: Keep your extremities warm by wearing gloves indoors and in cold environments.
- Gentle Exercise: Engage in low-impact exercises such as walking or swimming to promote circulation and reduce stiffness.
- Hydration & Nutrition: Maintain a balanced diet and ensure you are well-hydrated. Omega-3 fatty acids found in fish oil may also help with joint pain.
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Consult a Rheumatologist: If your symptoms persist or worsen, consider consulting a specialist in autoimmune diseases for further evaluation and management based on the results.
While the present symptoms and lab results could suggest an autoimmune disorder, a comprehensive approach, including clinical assessments and continued monitoring, will be essential in reaching a diagnosis and managing your health effectively. Please ensure you maintain open communication with your healthcare team throughout this process.
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