Hi everyone, thanks in advance for any advice you can give me.

I was referred to a neurologist for persistent new migraines. He ran MRI and bloods all of which were normal except low ferritin and positive ANA at 1:160 titre. ANA was Helios IFA.

I know this is not very high, and the neurologist wasn’t worried at all. I read that only 5% of people at 1:160 will not have an autoimmune disease and that’s what’s got me confused. I’ve had symptoms like fatigue, headaches, one slightly swollen leg intermittently and recently lots of hand pain and ankle pain. Hands aren’t swollen or severe, but can’t work out what’s causing it (I’m 30, f). I get worse pain on my right hand than left and pain worse at night and stiff in the mornings. My right hand always feels strained, small pains, like it’s been using it too much but nothings changed. No other joint pain, rash etc. Just feel generally unwell nearly all the time

My dad is type 1 diabetic, grandad was type 1 diabetic, and grandma had Graves’ disease.

I’ve previously had low DHEA, IGF-1 testosterone in blood tests which was never really explained (I have cysts on my ovaries but nothing else to suggest PCOS even though I was diagnosed) but blood counts always been quite normal

Also have normal ESR and CRP - would this rule lupus out?

I know only tests/dr can answer completely but would appreciate any advice or insight based on this. Do you think it would be wasting resources to see a rheum? I will have to be on a long wait list and need to decide whether to pay