Key takeaways:
Many different things can cause a positive antinuclear antibodies (ANA) test. About 15% of healthy people will have a positive ANA test result.
Positive ANA tests don’t automatically diagnose an autoimmune condition, and it may not be cause for concern.
In order for a positive ANA test to help diagnose a medical condition, you must have symptoms that fit.
Positive test results can be stressful — especially when you aren’t sure what they mean. But positive test results don’t always mean that something is wrong. Positive results always need to be “interpreted clinically.” In other words, your healthcare professional will look at the bigger picture — your symptoms, physical exam findings, and test results — to determine whether results are meaningful.
This is especially true for the antinuclear antibody (ANA) test. Positive ANA tests are common, even in healthy people, and they have many different causes. We’re here to shed some light on it all.
What is an ANA test?
ANA tests look for something called antinuclear antibodies in your blood. To understand ANA tests, it helps to first understand a bit about cells and antibodies.
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Cells are the tiny building blocks that make up your body. Most cells have a nucleus at their center. The nucleus serves as the control center for the cell — it stores your DNA and regulates the activities of the cell. The “N” in ANA stands for “nuclear,” which refers to the cell nucleus.
Antibodies are proteins made by your body’s immune system. They’re designed to attack foreign substances like viruses and bacteria. But sometimes, your body accidentally makes antibodies for parts of your body that aren’t foreign. These are called “autoantibodies,” because “auto” means “self.”
A positive ANA test means there are autoantibodies that target proteins in the nucleus of your cells. These autoantibodies may sometimes lead to autoimmune disease, but not always.
What do ANA test results look like?
ANA test results are reported as ratios called “titers.” Titers measure how much a blood sample can be diluted and still test positive for antibodies. A high titer number means the sample can be diluted a lot and still show detectable ANA. In other words, the higher the titer number, the more ANA is present.
The lowest possible titer is a ratio of 1:40 (or 1 part blood to 40 parts of saline). After that, the numbers double as the blood sample is further diluted: 1:80, 1:160, 1:320, and so on.
Most labs and rheumatologists only consider titers of 1:80 or higher to be potentially significant, since 1:40 results are so common (more on this below).
What could a positive ANA test mean?
A positive ANA test could mean that absolutely nothing is wrong. Most healthy people make autoantibodies of some sort. Healthy people are more likely to make ANAs as they get older. Women are also more likely to make ANAs than men. The reason for this isn’t entirely clear.
But a positive ANA test could also mean something is going on inside your body. The meaning of a positive ANA test depends on why the test was sent and what symptoms are present. Your healthcare professional can help you understand whether a positive ANA test may be a sign of an undiagnosed health condition. If they aren’t sure, your healthcare professional may refer you to an autoimmune disease specialist, like a rheumatologist.
Diseases that cause a positive ANA
Common causes of positive ANA tests include, but aren’t limited to:
Infections (like Hepatitis C, human immunodeficiency virus (HIV), or even the common cold)
Cancer
Medications (like hydralazine and many others)
Autoimmune conditions (like lupus, multiple sclerosis, rheumatoid arthritis, and many others)
Fibromyalgia
No specific reason (remember, 15% of healthy people have positive ANAs)
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Does a positive ANA test mean I have an autoimmune condition?
A positive ANA test doesn’t automatically mean that you have an autoimmune condition — or any medical condition at all. It depends on your symptoms and whether those symptoms fit with a specific diagnosis that you and your healthcare team are considering. Together, you’ll decide on next best steps, like a referral to a specialist or more testing.
If my ANA titer is very high, does that increase the chances of having autoimmune disease?
Maybe. A higher ANA titer can increase the chance of having or developing an autoimmune disease. One study found that people with ANA titers greater than 1:640 were more likely to be diagnosed with an autoimmune disorder within the next 6 months.
But even a high ANA level can’t be used on its own to diagnose an autoimmune disease. This same study found that some healthy people had high ANA levels without any autoimmune issues. So if the symptoms don’t fit, a higher titer ANA still doesn’t mean much.
Can ANA tests be used to ‘screen’ for autoimmune conditions before developing them?
No. Unfortunately, there’s no test that is able to do this just yet. Each autoimmune condition has its own set of symptoms, and symptoms are required for diagnosis — not just positive test results.
How common are positive ANA tests?
Positive ANA test results are common. About 15% of healthy folks in the U.S. have an ANA titer of 1:80 or higher. This percentage is even higher for ANA titers of 1:40, which is why they’re often considered insignificant. This means that more than 50 million people in the U.S. alone may have positive ANA test results.
It’s also a common misconception that a positive ANA test diagnoses lupus, an autoimmune disease. But of the more than 50 million people in the U.S. with a positive ANA test, only about 1.5 million have lupus.
When might a healthcare professional order an ANA test?
Positive ANA test results are a lot more meaningful if you also have symptoms of an autoimmune condition. Symptoms like these could raise concern for an autoimmune condition and might warrant ANA testing:
Painful, swollen joints
Rashes
Sores inside your mouth or nose
Hair loss, especially near your temples
White or purple color changes in your fingers when exposed to cold (Raynaud’s)
Muscle weakness that makes it hard to walk upstairs or hold your arms over your head
Low blood counts
Fluid or inflammation around your heart or lungs
Severe dry eye that requires eye drops multiple times a day, or feeling a constant sandy or gritty feeling in your eyes
Severe dry mouth, such as not being able to eat a salty cracker without drinking water
Abnormal urine tests (urinalysis)
Fatigue alone isn’t a great reason to order an ANA test. That’s because fatigue is common and has many different potential causes. But if fatigue is accompanied by any of the symptoms listed above, an ANA test might be helpful.
Frequently asked questions
Some cancers have been associated with a positive antinuclear antibodies (ANA) test, such as:
Blood cancers, like lymphoma and leukemia
Breast cancer
Lung cancer
Researchers are still trying to understand the nature of this connection. It’s important to remember that a positive ANA doesn’t mean you have cancer.
Leukemia can cause a positive ANA. But when someone has leukemia, there are likely to be other positive test results that are more telling. For example, leukemia often causes significant abnormalities of blood counts, measured by a CBC (complete blood count) test.
Lupus is usually associated with an ANA level of 1:80 or higher. But keep in mind that this level of ANA isn’t specific to lupus. In other words, plenty of people without lupus have an ANA level of 1:80 or higher. And about 5% of people with lupus have normal ANA levels. As explained above, a positive ANA needs to be interpreted in the context of symptoms and physical exam findings.
Some cancers have been associated with a positive antinuclear antibodies (ANA) test, such as:
Blood cancers, like lymphoma and leukemia
Breast cancer
Lung cancer
Researchers are still trying to understand the nature of this connection. It’s important to remember that a positive ANA doesn’t mean you have cancer.
Leukemia can cause a positive ANA. But when someone has leukemia, there are likely to be other positive test results that are more telling. For example, leukemia often causes significant abnormalities of blood counts, measured by a CBC (complete blood count) test.
Lupus is usually associated with an ANA level of 1:80 or higher. But keep in mind that this level of ANA isn’t specific to lupus. In other words, plenty of people without lupus have an ANA level of 1:80 or higher. And about 5% of people with lupus have normal ANA levels. As explained above, a positive ANA needs to be interpreted in the context of symptoms and physical exam findings.
The bottom line
Positive antinuclear antibodies (ANA) tests are common and have many different causes. They can be found in about 15% of healthy people and may not be a cause for concern. They need to be interpreted in the context of your symptoms, physical exam findings, and other test results. If you’re alarmed after seeing a positive test, rest assured that this is just one piece of the puzzle. Talk to your healthcare professional about what it means for you and what next steps are recommended.
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References
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Dinse, G. E., et al. (2021). Increasing prevalence of antinuclear antibodies in the United States. Arthritis and Rheumatology.
Guaderon, A., et al. (2020). Antinuclear antibodies with a homogeneous and speckled immunofluorescence pattern are associated with lack of cancer while those with a nucleolar pattern with the presence of cancer. Frontiers in Medicine.
Littlejohn, E. A., et al. (2024). Longitudinal antinuclear antibody titers in systemic lupus erythematosus and other rheumatic diseases. Frontiers in Medicine.
Lupus Foundation of America. (2025). Lupus facts and statistics.
Meier, H. C. S., et al. (2020). Sex differences in the association between antinuclear antibody positivity with diabetes and multimorbidity in older adults: Results from the Baltimore Longitudinal Study of Aging. Experimental Gerontology.
Nisihara, R., et al. (2013). Antinuclear antibodies and rheumatoid factor positivity in healthy elderly adults: A cross-sectional study in 336 individuals. Journal of the American Geriatrics Society.
Shome, M., et al. (2022). Serum autoantibodyome reveals that healthy individuals share common autoantibodies. Cell Reports.
Wang, K. Y., et al. (2011). The initial manifestations and final diagnosis of patients with high and low titers of antinuclear antibodies after 6 months of follow-up. Journal of Microbiology, Immunology and Infection.
Yang, H., et al. (2025). Antinuclear antibodies (ANA). American College of Rheumatology.
