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Autoimmune & Inflammation

ANA (Antinuclear Antibodies)

A blood test that screens for antinuclear antibodies to help diagnose autoimmune conditions like lupus, rheumatoid arthritis, and Sjögren's syndrome.


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What this test measures

An ANA (antinuclear antibody) test detects antibodies that mistakenly target the nucleus of the body's own cells rather than foreign invaders like bacteria or viruses. The nucleus is the control center of each cell, housing DNA and directing essential cellular functions, so antibodies directed against it can disrupt normal tissue throughout the body. Small numbers of antinuclear antibodies are present in many healthy individuals, but elevated concentrations may signal that the immune system is mounting an autoimmune response.

The test measures both the presence and concentration of these antibodies, typically reported as a titer that indicates how many times the blood sample can be diluted while still showing detectable antibody activity. The laboratory method most widely considered the gold standard for ANA detection is indirect immunofluorescence using specialized human epithelial cells (HEp-2 cells), which allows identification of different staining patterns that can provide clues about which autoimmune condition may be involved.

Who should consider this test

You might consider this test if you are experiencing any of the following:

  • Individuals experiencing unexplained multisystem inflammatory disease, symmetric joint pain with inflammatory features, photosensitive rash, and cytopenias
  • Those with suspected autoimmune conditions, particularly when symptoms suggest lupus, Sjögren's syndrome, or scleroderma
  • People presenting with specific symptoms such as skin tightening, lupus rashes, inflammatory arthritis, oral or nasal ulcers, alopecia, or cytopenia
  • Individuals with a family history of autoimmune diseases who are experiencing suggestive symptoms
  • Those being evaluated for connective tissue disorders when other laboratory findings suggest autoimmune disease activity

What to expect

Preparation

No fasting is required for the ANA test. The test can be taken at any time of day. Certain medications may potentially affect results, but individuals should not stop prescribed medications without consulting their healthcare provider first.

Sample Type

A 7 mL blood serum sample is collected in a red top tube through a standard blood draw from a vein, typically in the arm.

Collection

The collection process is quick and straightforward. A healthcare professional will clean the injection site, insert a needle into a vein, and collect the blood sample. The entire process typically takes just a few minutes.

Turnaround

Results are typically available within 1-3 business days. Some laboratories may provide results within 24 hours, while others may take up to one week depending on testing volume and laboratory procedures.

Understanding your results

ANA results are usually reported in two parts: the titer (expressed as a ratio such as 1:40, 1:80, 1:160, 1:320, or 1:640) and the staining pattern. A higher titer means antibodies were still detectable at greater dilutions, which generally indicates a stronger autoimmune signal. A negative result means antinuclear antibodies were not found at significant levels, making an autoimmune disorder less likely. A positive result means detectable antibodies are present, but it does not confirm a specific diagnosis on its own; healthcare providers interpret the titer, pattern, symptoms, and additional laboratory tests together to determine whether an autoimmune condition is present and, if so, which one.

PopulationReference RangeNotes
Adults (All ages)Negative: ≤ 1:40; Positive: ≥ 1:80The normal ANA level is typically defined as a titer of 1:40 or lower. ANA titers of less than or equal to 1:40 are considered negative.

Reference ranges shown are general guidelines. Your lab report will include the specific reference range used by the laboratory that processed your sample, which is the authoritative range for interpreting your results.

What does a “Low” result mean?

A negative result on an ANA test means that antinuclear antibodies were not found in your blood, and you're less likely to have an autoimmune disorder. But a negative ANA test doesn't completely rule out the possibility that you could have an autoimmune disorder. Most people with lupus will have a positive ANA test result. It is very rare, but it is possible to have a negative ANA test and still have lupus. A negative result typically indicates a lower likelihood of systemic autoimmune conditions, though some autoimmune diseases may still be present with specific antibodies not detected by the ANA screen.

What does a “High” result mean?

Higher titers, especially those above 1:160, may warrant further investigation, as they can be indicative of autoimmune diseases but do not confirm a diagnosis on their own. The 2019 EULAR/ACR Classification Criteria for SLE now require ANA positivity (≥ 1:80 on HEp-2 or equivalent) as an entry criterion, reflecting its high sensitivity (~97-98%) in SLE diagnosis. Having antinuclear antibodies in your blood doesn't always mean you have a disease. Some healthy people have antinuclear antibodies in their blood, and levels tend to increase with age. Many healthy adults may have a positive ANA test result, especially women over the age of 65. Elevated ANA levels can be associated with various autoimmune conditions including lupus, rheumatoid arthritis, Sjögren's syndrome, and scleroderma, but may also occur in certain infections, cancers, or from specific medications.

Privacy & confidentiality

All test orders are authorized and results reviewed by an independent, board-certified physician who is not the patient's personal doctor. Your ANA test results are completely confidential and handled with the highest level of privacy protection. Results are <u>not sent to your personal doctor</u> unless you specifically request them to be shared, giving you complete control over your medical information. These test results are <u>not added to your medical records</u> automatically and remain separate from your standard healthcare documentation. Your insurance company will not receive these results, and the test <u>will not appear on your insurance explanation of benefits (EOB)</u> since you are paying directly for the test. This privacy-focused approach ensures that you can take charge of your health screening without concerns about unwanted disclosure to employers, insurance companies, or other third parties. The results are accessible only through your secure online portal, providing you with confidential access to your health information whenever you need it.

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Last reviewed: April 2026

CPT Code: 86235

This test may not be available in: NY, NJ, RI

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