Hi there. Thank you for your question. I will be helping you out with your queries
What are your symptoms?
What are your liver enzymes like?
Please let me know.
The anti-nuclear antibody is strongly positive and the anti SMA antibody is also positive. Have you been to a rheumatologist as yet
i would like that an autoimmune disorder like lupus (systemic lupus erythematosus) should be ruled out in your case.
If you have not had your thyroid function tests I would like to have your thyroid hormones checked as well.
You mentioned that you have been tired for many months, another thing that I would like to rule out is low cortisol (Addison's disease).
Lastly, your age of makes you near menopause or you have had your menopause already. In either case your ovarian function would be very low at the moment and even that can cause all the symptoms that you have mentioned.
So after ruling out a rheumatological issue, I personally think that your issue is more related to hormones more than anything else.
Are you with me?
So I would like to rule out all the hormonal causes that I mentioned above if you have not had those ruled out already.
Fibromyalgia can cause one to have fatigue like what you are having as well.
You need a doctor who is willing to spend time and rule out/rule in all these options.
I would also like that you should have a vitamin D level done as well because quite often aches and pains in the body are due to low vitamin D
Are you there?
Let me know if you have more questions.
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