I think I have an autoimmune disease. Hands hurt for no reason at all. I tested negative for sjogren's syndrome, lupus, and rheumatoid arthritis. I am tired all the time and have no appetite. I am currently taking tablet Lexapro (Escitalopram Oxalate), tablet Adderall (Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, and Amphetamine Sulfate), and tablet Junel (Norethindrone Acetate and Ethinyl Estradiol). I underwent an antinuclear antibodies test, blood sugar test, and thyroid test. I have a titer value of 1 : 1280. What test should I take next, doctor?