### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Yes, I am a 47 year old woman who is concerned lately about my overall health.  I have been seeing a urologist for the past 4 years regarding gross hematuria or blood in my urine.  He has run all sorts of tests to rule things out and cannot determine where the blood is coming from.  Upon a recent ultrasound of my kidneys, they found that I also have hemangiomas on my liver.  The blood in my urine was originally found by my primary care doctor during a physical.  I had been feeling overly tired and still do.  I am also hypothyroid.  During an MRI of my neck for an unrelated injury, they found I had tumor on my left thyroid gland.  It was removed and I was placed on Levoxyl.  About a 8 months later and having neck surgery for 3 ruptured discs I began having swallowing problems, a larger tumor was found on my right thyroid.  A gastroenterologist removed the gland and said everything was contained and other than trying to regulate my thyroid medicine I am doing well.  I then developed a rash on my face.  I have been tested 3 times for lupus each time the results are negative thank goodness.  My primary care doctor is in the process of checking my thyroid levels again to see if my medicine needs adjusting which seems to happen quite frequently.  I am a very active and busy lady and attribute my aches and pains to getting older however lately, I am totally exhausted even after sleeping 7- 8 hours.  I have been having chest pains that come and go...it almost feels like a charlie horse in the middle of my chest.  My hair is falling out, my bones hurt if that is possible, I am cold all the time, Ive been getting night sweats, my color is pale.  I am waiting to be seen this next week by my doctor.  I was just curious if a lupus test can show up negative and a patient actually has it or signs of it.  Any input or advice would be greatly appreciated

### output:

Your symptoms suggest that you probably have anemia, and it would be ideal if you could consult hematologist to look for the cause. Also, fatigue can also be related to hypothyroidism. A negative lupus test does not rule out lupus, about 2% have a negative lupus test. That is if you have done a ANA test and is negative do go ahead and get antihero/SSA, antiphospholipid antibody if not done earlier.