You need further testing for Systemic lupus erythematosus (SLE) : anti Ds DNA, anti-SS-A (Ro), anti-SS-B (La), anti-U1 RNP, anti-Sm, and follow-up with serial anti-DS DNA.
Also, you may want to rule out deficiencies, like iron, ferritin, B12 methylocobalamin (MMA test)
Vit. D, and also thyroid function tests FT3, FT$ and RT3 _all 3 are needed for thyroid function (not the standard thyroid tests which only indicate serum levels of thyroid hormones
Hypothyroidism may have a significant role in the development of Lupus and other medical conditions.
Prolonged stress and anxiety could cause adrenal dysregulation, which may in turn cause secondary hypothyroidism (among other effects). Have a 4 x cortisol test (saliva) to rule this out.
Best wishes,
Niko