Ana 1:640 double stranded end negative. a.anything to worry about?

May be: One test result in isolation is not suffucient to provide a meaningful opinion. At 1:640 the ANA is in the positive territory and deserves follow-up. All lab results need to be evaluated in the clinical context and the doctor who ordered the test is usually in the best position to do that.

It depends: ANA or antinuclear antibody is a screening test for an autoimmune disease. A screening test means that many will have a positive test but only a few will have an autoimmune disease associated with it. The anti ds dna is a test that's more specific than the ANA test for lupus. Discuss your symptoms with a rheumatologist, to see if the positive ANA is meaningful.