What are Antinuclear Antibodies?
Antinuclear antibodies (ANAs) are antibodies (proteins that our body creates to fight infections) that are made to attack our own body, or “autoantibodies”. The prefix ‘auto-’ means ‘self’. So, autoantibodies are antibodies against the self, and an autoimmune disease occurs when someone’s immune system is attacking their body using autoantibodies. Examples of autoimmune diseases include multiple sclerosis, Hashimoto’s thyroiditis, rheumatoid arthritis, scleroderma, lupus, and many more. Antinuclear antibodies attack the nucleus of our cells, hence their name.
A positive ANA usually suggests a vascular condition, or a condition that affects blood flow. Some autoimmune vasculitis conditions include systemic lupus erythematosus (SLE), Sjogren’s syndrome, scleroderma, mixed connective tissue disease, and Wegener’s granulomatosis.
Implications
The presence of ANAs in your blood could mean that you might develop an autoimmune disease in the future, if you don’t already have one. Note that typical autoimmune disorders take 5-9 years to develop and symptoms may or may not be present.
In other words, testing for ANAs may provide a chance to stop a disease before it really starts. This is why it is included in our initial and every follow-up blood panel!
The prevalence of autoimmune disease and ANAs has been rising over the last few decades. While the western medical model deems the presence of ANAs a nonconcern without the presence of symptoms, we are now seeing that it can progress into an autoimmune condition over the course of a few years if left unchecked.
Researchers from the National Institute of Environmental Health Sciences (NIEHS) studied the prevalence of positive ANA markers over a 25 year period. Here is what they found:
- From 1988–1991, 11% (~22 million people) had a positive ANA
- From 1999–2004, 11.5% (~27 million people) had a positive ANA
- Here’s the kicker: From 2011–2012, 15.9% (~41 million people) had a positive ANA
From 22 to 41 million people in 25 years is a huge jump! Among the age subgroups, adolescents (ages 12-19) had the highest rate of change, with their prevalence nearly tripling over the time period from 5% to 13%. Another way to grasp this is that from 88’-04’ ANA Abs jumped 23% and from 04’-12 ANA Abs exploded another 52%!!!
Understanding Test Results
So, you got a positive ANA result on your blood test. There are a couple of other pieces of information next to that result that may seem a bit confusing. Let us break it down for you.
Titer
Your titer is the measure of how many antibodies were found in your blood. You may have a titer of <1:40, 1:40, 1:80, 1:160, or 1:320. The ‘1’ before the colon represents a certain volume of blood, and the number after the colon represents the amount of ANA’s found in that amount of blood.
A negative test would be a level, or ‘titer’, of less than (<) 1:40 (a.k.a. 40 antibodies per measure). A low titer is between 1:40 and 1:80 (40-80 antibodies per measure), while a high result would be 1:80 or above. It can be confusing because the number presents as a ratio, so one might think that 1:160 is smaller than 1:80, but the reality is a 1:160 titer is double that of a 1:80.
Pattern
If you have a positive ANA result on your labs, next to your titer there will be a pattern. This just describes how the ANAs look under a microscope. Here are the types of ANA patterns and their associated conditions:
- Speckled (most common in females)
- Systemic lupus erythematosus (SLE)
- Sjogren’s syndrome
- Systemic sclerosis (scleroderma)
- Polymyositis
- Rheumatoid arthritis
- Homogenous (most common in males)
- Can be seen in any autoimmune disease, higher levels associated with Lupus
- Nucleolar
- Systemic sclerosis (scleroderma)
- Cancer
- Mitochondrial
- Primary biliary cholangitis (PBC)
- Systemic sclerosis (scleroderma)
- Cytoplasmic
- Primary biliary cholangitis (PBC)
- Systemic sclerosis (scleroderma)
- Autoimmune hepatitis (AIH)
- Speckled + Cytoplasmic
- Antisynthetase syndrome
- Centromere
- Systemic sclerosis (scleroderma)
- Raynaud’s phenomenon
- Homogenous + Nucleolar
- Systemic lupus erythematosus (SLE)
- Chronic autoimmune hepatitis
- Juvenile idiopathic arthritis
What Can We Do?
All autoimmune conditions, including rheumatoid arthritis, celiac disease, lupus, and Sjogren’s syndrome, require three things to develop:
- Genetic predisposition
- Intestinal permeability (a.k.a “leaky gut”)
- An environmental trigger (can be inflammation, toxin exposure, food sensitivities, infections, or even stress)
Two of these things can be controlled. With proper nutrition and supplementation, we can heal leaky gut, reduce inflammation, and remove food triggers. Interventions can be taken to remove other triggers also, such as testing your house for mold and treating infected sinuses.
When we see a positive ANA marker, we want to get those antibody levels down to slow down or stop disease progress. One of the first things to do is remove gluten from the diet because gluten is a common food trigger that causes inflammation and worsens leaky gut.
What may be most important to realize is that this one marker is a wake up call. You need to become very serious about your health if this is positive, and your level of dedication to daily habits and lifestyles that promote inflammation need to change! That may be hard to swallow, but your body is infinitely wise and it is trying to tell you that what you are doing is not working and we need to change direction to get back into harmony! Our program has shown an 85% success rate with autoimmune disorders, but it requires your participation – the pill to fix the ill is not our approach!
If you’re interested in getting a comprehensive blood test that includes the ANA marker, and then developing a plan for reaching optimal wellness, contact us below!
Ian Hollaman, DC, MSc, IFMCP
