Anti-cardiolipin igm was checked as part of tests for mctd. it was 133 nov / 82 in jan & in feb it was 9.38. gp says there no needs to refer or treat?

Treat and refer: I would personally put you on 81 mg of asa daily as the anticardiolipin levels can go up and down. I would also refer to a rheumatologist because your other symptoms could suggest the presence of an underlying connective tissue disorder.

? Referral: To have anti-phospholipid antibody syndrome you need to have 2 positive tests at least 3 months apart. Transient elevations are common and not risky. It's unusual that the first test was so high and it did not persist. If you still have other mctd symptoms you should see a rheumatologist.