Moms - Sounds like me, too. ANA went from 1:320 to 1:1280 in 6 mos. Other labs all remain within normal range, so I still don't have a firm diagnosis. I've had white casts in my urine, and week long fever flares that make my CRP go sky high along with a low white cell count, and elevated liver enzymes. After about a month - those things return to relatively normal ranges. My primary care doc treated me during that last one and didn't test any of the AI labs during that time, so I've always wondered if he'd known to do so, would they have been positive during the flare? Next time I'll drag myself to the rheumie (an hour away) no matter how rotton I feel.
I also get a bad reaction to sun/flourescents- much more so than ever before - but don't have a continuous malar rash, and I get sores in my mouth. I've had many things over the past few years that I now think are related to Lupus (2 disc shaped raised patches that took months to go away, inflamed eyelids, and a ringworm type annular rash) but seemed random at the time and if I went to the doc, just got some cortisone cream. The eyelid rash was attributed to chlorine in the pool I was taking water therapy in (NOT putting my face in the water). None were seen by a rheumie, since I hadn't been to one yet. So, as everyone here advises, be sure to take pictures and include all symptoms/oddities - even if you don't think they are related. It's a big puzzle and there are many pieces.
Find a good rheumie (don't stick with one who isn't listening) and shoot for treatment, even if you can't get a firm diagnosis. I'm taking Plaquenil now and do feel it's made a good bit of difference in the fatigue department. Not so much with pain - but perhaps that will improve more over time. I've been 2 years on the (not so) merry go round. I just try to be grateful that even as frustrating as it is - I know it could be a lot worse.
Good luck and let us know how you make out - I'd never heard about the thyroid microsomial antibodies.
Lucy