Anti Nuclear Antibody / Factor (ANA / ANF) Test

An antinuclear antibody (ANA) test measures the amount of antinuclear antibodies in a blood sample. The test may also be referred to as an ANA panel, fluorescent antinuclear antibody (FANA) test, or ANA reflexive panel.

Antibodies are proteins made by the body’s immune system (defence system) to help fight harmful substances, such as viruses and bacteria. However, ANAs can mistakenly target the nucleus (control centre of a cell) of the healthy cells in your body. Higher than normal ANA levels are a sign of an autoimmune disorder, like systemic lupus erythematosus (a long-term disease in which the immune system attacks the body’s own tissues), Sjogren’s syndrome (a disease affecting the tear and salivary glands), and systemic sclerosis (a disease that causes the skin and sometimes internal organs to become thick and hard).

You may be advised to get the ANA test if you are experiencing the following symptoms of an autoimmune disorder:

• Fatigue or tiredness
• Fever
• Muscle aches
• Stomach pain
• Skin changes such as rashes, blisters, or discoloration
• Swollen glands

The following categories of people are at higher risk of developing an autoimmune disorder:

• Young women: They have a higher chance of developing autoimmune diseases, such as lupus, than men, which can lead to a positive ANA test.
• Individuals who have family members suffering from autoimmune diseases – A family history of autoimmune disease, especially among female relatives, is associated with an increased likelihood of ANA positivity.
• Individuals with one autoimmune disorder – Patients with a history of one autoimmune disorder are at higher risk of developing multiple autoimmune disorders.

The ANA blood test can help detect and diagnose autoimmune diseases, such as:

• Systemic lupus erythematosus – Lupus is a long-term disease that affects many major organs, such as the kidneys, heart, lungs, blood vessels, brain, and skin.
• Rheumatoid arthritis – This condition causes joint pain and inflammation.
• Addison’s disease – This affects your adrenal glands (located on the top of your kidneys). It causes fatigue, weight loss, and muscle weakness.
• Scleroderma – This disease affects your skin or other systems in your body.
• Autoimmune hepatitis – This disease is characterised by inflammation of the liver.
• Sjogren’s syndrome – This disease affects the glands that produce tears and saliva, leading to dry eyes and a dry mouth.
• Autoimmune thyroid disorders – This can lead to an overactive or underactive thyroid gland.

What to Expect Before the ANA Test

No fasting is required for a standalone ANA test. You can eat and drink normally. However, if it is part of a broader package that includes fasting tests, your doctor may advise fasting for 8-12 hours. Avoid strenuous exercise for 24 hours before the test, as intense physical activity can temporarily raiseANA levels and affect interpretation. Always inform your doctor about any ongoing medications.

What to Expect During the Blood Collection

A phlebotomist cleans the skin with an antiseptic, then places an elastic band around your upper arm to make the veins easier to access. A small needle is inserted into the vein; you may feel a brief pinch. Blood is collected into a labelled tube in under a minute.

What to Expect After the ANA Test

A small cotton swab and bandage are placed over the site to stop any minor bleeding. You can return to normal activities immediately. Minor bruising is normal and disappears quickly. If dizzy, sit and rest for a few minutes.

The ANA autoimmune disease test measures one primary parameter:

• The amount of antinuclear antibodies in the blood.

The ANA test normal range is indicated in the table below.

Note: The normal range may vary slightly depending on the laboratory and individual health conditions.

The table below provides a general interpretation of ANA test results based on whether the levels are low or high.

Note:

• A negative ANA test does not completely rule out the possibility of having an autoimmune disease.
• A positive ANA test does not necessarily mean that you have an autoimmune disease. It can also occur in some healthy people too, especially women and older adults.

Like any other medical test, this test also has some risks and limitations.

Risks:

• The ANA test is generally safe and involves minimal risk. You may feel slight pain when the needle is inserted or mild bruising afterwards, which usually resolves on its own.

Limitations:

• The ANA antibody test cannot diagnose a disease on its own and must be used in combination with other imaging tests to confirm a diagnosis.
• Certain medicines, age, and other factors can affect the level of ANAs in the body.

Depending on your symptoms and results, your doctor might recommend additional tests to better understand your condition:

• C-reactive protein (CRP) test
• CCP antibody test
• Antibody serology tests
• Antineutrophil cytoplasmic antibodies (ANCA) test
• Immunoglobulins blood test
• Protein electrophoresis by immunofixation blood test
• Immunoglobulin A (IgA) test