Clinician handoff
Autoimmune
Designed for a 60-second scan in primary care. Use this to explain why this theory fits, what would weaken it, and which tests are most worth discussing.
Why this still fits
I have symptoms that make me want to rule out autoimmune disease - brain fog alongside fatigue that comes in flares, joint involvement, or a prior positive ANA. I want to check the most relevant markers and understand what would strengthen or weaken the case for further evaluation.
What would weaken it
- -No flare-remit pattern and no joint, skin, mouth, fever, or immune symptoms traveling with the fog.
- -Negative inflammatory and autoimmune workup when the clinical story is also weak.
- -Sleep, thyroid, EBV, anemia, or depression explains the pattern more cleanly than systemic inflammation does.
Key points to communicate
- •I want to know whether the fog tracks with immune activity or whether autoimmunity is only a loose possibility.
- •Please tell me which markers or symptoms would make autoimmune disease stronger versus weaker here.
- •If autoimmune disease stays plausible, I want to know what should be ruled out before this is dismissed as stress.
Bring this to the visit
- •A timeline of cognitive symptoms relative to disease flares, medication changes, and lab results.
- •Recent inflammatory markers: CRP, ESR, complement levels, disease-specific antibodies.
- •Current immunosuppressant and steroid doses with any recent changes.
- •A list of all co-occurring symptoms: joint pain, fatigue, skin changes, fevers.
Useful screening structure
- -CRP and ESR as markers of systemic inflammation that could drive cognitive symptoms.
- -Disease-specific activity scores if available (SLEDAI for lupus, DAS28 for RA, etc.).
- -PHQ-9 for depression screening - autoimmune conditions carry high depression rates.
Tests and measurements to discuss
ANA with titer and pattern (not just positive/negative)
Anti-TPO + Anti-TG (thyroid antibodies)
What this helps clarify: Elevated in Hashimoto's thyroiditis - autoimmune thyroid attack
Range context
<35 IU/mL
How to use the result
Save the result with date and symptoms from the same week.
ESR + hs-CRP (inflammation markers)
What this helps clarify: High-sensitivity inflammatory marker relevant to systemic and neuroinflammatory burden.
Range context
<1.0 mg/L
How to use the result
Save the result with date and symptoms from the same week.
CBC + CMP
What this helps clarify: Baseline panel combining complete blood count and metabolic chemistry for broad screening context.
Range context
Lab reference interval
How to use the result
Save the result with date and symptoms from the same week.
Vitamin D (25-OH)
What this helps clarify: Patient-facing vitamin D explainer route matching the common 25-OH wording used in lab and search language.
Range context
Lab context
How to use the result
Save the result with date and symptoms from the same week.
tTG-IgA (celiac screening)
What this helps clarify: Patient-facing celiac serology explainer route focused on the test wording users actually bring from clinician visits.
Range context
Serology context
How to use the result
Save the result with date and symptoms from the same week.
Ferritin + iron saturation (TIBC)
What this helps clarify: Iron storage marker that can affect energy, focus, and cognition.
Range context
40-100 ng/mL
How to use the result
Save the result with date and symptoms from the same week.
Questions to ask directly
- •Is the fog from active disease inflammation, medication side effects, or something co-occurring?
- •Should we adjust immunosuppression if the fog tracks with disease activity?
- •Are there overlapping causes worth screening for: thyroid, anemia, vitamin D, sleep?
- •Would a neurology referral help if the cognitive symptoms are out of proportion to disease activity?
Functional impact snapshot
- -Rate fog severity against disease flare intensity - do they rise and fall together?
- -Track whether medication changes (especially steroids) shift the fog pattern.
- -Note which cognitive domains are worst: memory, processing speed, word-finding, executive function.
Escalate instead of self-managing if
- •Rapidly worsening confusion, seizures, or new focal neurological deficits.
- •High fever with cognitive changes suggesting CNS infection on immunosuppression.
- •Sudden vision changes, severe headache, or signs of vasculitis affecting the brain.
Peer-reviewed references