Question
Hello, I am a 24 year old female and am just trying to figure out what could be going on. I went to my PCP about a year ago for feelings of fatigue, having trouble concentrating and just not feeling right. She ran a few blood tests and said I had an iron deficiency and was put on a supplement. Over the past year I have been experiencing some symptoms which may or may not be related but include: fatigue, depression, joint pain in my knee, headaches, back, neck & shoulder aches (a clicking has developed in my shoulder), a "pins & needles" feeling that leads to some numbness in my arms & legs that has woken me up at night, sharp pains that shoot through the left side of my chest, when it's cold out - a couple of fingers (from the tip to the first knuckle) will turn yellow-white and become numb & cold, my weight is normally around 120 - I am now at 107lbs, and in the past 2 months I have noticed thinning hair loss. In the past year I've also developed numerous ovarian cysts on both sides that have caused some lower abdominal pain, which my OB/GYN finds strange because I have been on Ortho-tricylen which usually prevents the development of cysts. Because of all this, I went to my PCP this past November and she ran some blood tests. Of all the tests, there were two that came back abnormal - the ANA came back positive at 1:640 speckled and the Ferritin test came back low at 15ng/mL. I went to see a lupus specialist who did not run any additional tests, and simply asked me if I had ever developed a rash on my face (which I haven't). She said because I don't have the rash I don't have lupus and to ignore the ANA result, that I was just stressed. My PCP was appalled at this and has subsequently scheduled me to see someone else and scheduled me to have an echocardiogram, which I did this morning. I'm just looking for any opinion you might have as to what could be going on and if there's anything I should be knowledgeable to ask about or other tests I should have for this next appointment.

Thank you very much for any help you can offer.

Answer
I'm so glad your PCP was appalled and scheduled you with someone new! It seems she's taking the right steps to find out or rule out possible causes.  Keep working with her and the new specialist - sometimes lupus and diseases like it can take a long time to diagnose, and there are many other reasons these symptoms could be happening.  

You seem very knowledgeable about some of the possible explanations but be sure to write down all your symptoms and the questions you have for the specialist.  It's so easy to forget what you wanted to say or ask in the stress of meeting a new doctor and being examined.  Think back to the progression and symptoms you've had along the way that may not be bothering you now.  It's great that you're observing symptoms related to other factors and a pain or symptom diary where you note the symptom along with the weather and time of day, how you are feeling, what you were doing before the symptom, and what (if anything) relieves it could help find patterns.