<s>[INST] Hi doctor, One laboratory report says that I am positive for Lyme disease and another lab report says it is negative. Both used serum and western blot. I was in tick borne Lyme areas overseas but do not recall a bite specifically. I have positive ANA test (speckled pattern 1:80), anti ds-DNA 8 iU/ml. I am negative on all the autoimmune disease antibody tests (Sjorgens, lupus, etc). I have low vitamin D, low B12, low calcium and low albumin. I have mild neutropenia. CRP a bit high at 6.7. Alpha 2 globulin mildly elevated. I am wondering if the ANA tear has any significance? I am quite unwell with extreme fatigue, numbness and heavy leg one side, peripheral neuropathy (numb, tingling, spasms), ankle edema and I have put on 10 kg. I am usually quite thin (59 kg and 178 cm), now I am 71 kg and it is all in my stomach (fluid?). I have had skin nodules and my scalp feels swollen and I have some hair loss/thinning. Finger nails have vertical ridges and no moons. I have tried antibiotics, anti fungal oral and topical. I was a frequent traveller for work and thought maybe got something there. I am so confused as to if I should commence treatment for a Lyme disease as I do not know if I have it or not.I am currently taking Vitamin B12, vitamin D supplements, and Nystatin. Illness has been chronic for past three years. Symptoms already discussed except I forgot to say periods suddenly stopped about 18 months ago. It might be pre menopause but strange thing is they did not slow down or become irregular, just bang stopped. [/INST] Hi. Your ANA (antinuclear antibody) report is not much significant. Lyme disease test IgG positivity reflects its chronic presence. Many of your neurological symptoms could be attributed to it. However, few symptoms need further evaluation by a rheumatologist, because the physical examination is necessary. Your nail ridges and a few skin changes could be due to Psoriasis or Reiter's disease which may also cause fatigue and joint pains. I would suggest you take treatment for Lyme disease because it is not much longer. Also, you should get yourself evaluated by a rheumatologist, for the presence of inflammatory arthritis. I hope this helps. </s>