Symptoms and signs of a serious medical condition are often unmistakable. For example, there’s no doubt that sudden crushing central chest pain, radiating to the left arm, associated with vomiting, sweating, pallor and collapse, is likely a heart attack.
You call 911. Simple.
But far more often it seems, symptoms creep up on you very slowly. They can be mild and seem innocent. So, what should you look out for? What strange things can happen to you that could be a sign of something more serious? When should you go for help?
If you find you are losing weight for no apparent reason, this should send off alarm bells. Unintentional weight loss very often has a serious health issue. A 2017 research study published in the medical journal PLOS One included patients who had unintentionally lost more than 5% of their body weight in the preceding 6 to 12 months. After investigation, 33% had a malignancy (i.e. a tumor), 37% had a non-malignant medical diagnosis and 16% had psychosocial causes (such as depression, associated drug use, and immobility).
Loss of appetite is quite common as you age. The smell, sight and taste of food contribute a large part to your appetite. With aging, these senses may all become impaired. However, it can result in poor nutrition and weight loss. If you start feeling off your food, it’s time to think why this might be. Poor dental hygiene can mean chewing and swallowing is not so easy. Depression can result in a lack of interest in food. A general loss of appetite can also be the result of other chronic illnesses or can even signify dementia.
We can all feel thirsty from time to time. This is a normal body response telling us our body needs some more fluid. However, if you feel thirsty all the time, and are drinking more than 25 cups of fluid per day, this is called polydipsia. You will probably also be constantly in and out of the toilet to have a pee.
Polydipsia is one of the most common symptoms of diabetes. Early diagnosis of diabetes is very important. When diabetes occurs as an acute illness, it can be life-threatening. This is called diabetic ketoacidosis. Don’t leave it too late—if you notice increasing thirst, get yourself tested.
Do you wake up to have a pee more than once a night? This is called nocturia, and it’s more common than you think. One in three people aged over 30 visit the bathroom to pee at least twice a night. 25% of falls in the elderly are caused because of this.
So, what might be causing it? In men, prostate problems are common as they get older. The enlarged prostate restricts the flow of urine. In women, vaginal prolapse often affects bladder function. Estrogen deficiency at and after menopause can contribute to urinary symptoms and urinary tract infections. Sometimes nocturia can be a symptom of kidney disease.
Insomnia may also be a cause—people often lie awake and think about their bladder! Insomnia causes tiredness, and daytime fatigue, and is a significant risk factor for many other diseases including diabetes, obesity, heart disease, dementia and cancer.
Feeling tired is one of the most common reasons for going to the doctor. However, a 2016 review of 26 medical studies found tiredness is a poor predictor of physical disease. Results showed 18.5% of patients were depressed. 2.8% were anemic. 0.6% had cancer. 4.3% had a serious non-malignant condition.
The authors concluded that as a stand-alone symptom, tiredness itself is rarely a manifestation of an organic disease. Investigations should be tailored to any other coexisting symptoms. The focus should be on dealing with stress and psychosocial factors.
If you are feeling tired, are you suffering from any other symptoms as well? It’s important to consider your diet and lifestyle, and your work/life balance. What can you do to make improvements? However, if you have any other symptoms, this should prompt you to see your doctor.
It’s very strange that if you take a group of people in the same room, some will complain they are too hot, and others will say quite the opposite. There is often no clear reason why—however, there are some medical conditions that can make you feel cold.
- Hypothyroidism (an underactive thyroid) is one of them. Around 1 in 10 women have some evidence of hypothyroidism. This is also associated with tiredness, sluggishness, and constipation.
- Anemia occurs when your blood is lacking in red blood cells. Because these cells carry oxygen around the body, if there are not enough of them your body is relatively depleted of vital oxygen. You may feel tired and have cold hands and feet. There are lots of causes of anemia so this needs to be investigated. It can be a sign sometimes of a serious medical condition.
- Chronic Stress means your body is living in a constant state of “fight, fright and flight.” The release of adrenaline causes your heart to beat more rapidly, and you can start to sweat. As sweat dries on your body, you may then feel chills. People who suffer from chronic anxiety and stress may feel hot and cold on and off.
- Dieting—you might feel cold because you are in a negative calorie balance. In more extreme cases, those with anorexia nervosa also often feel cold.
If you notice blood on the toilet paper, this is most often due to piles (a.k.a. hemorrhoids). Piles are varicose veins which occur around your anus. You won’t know they are there unless they bleed or start to hurt. This is very common. In fact, when I was at medical school, they used to say that 50% of the population have hemorrhoids and the other half are liars!
However, it’s always best to be sure it really is only hemorrhoids.
- Bleeding on the toilet paper can be a sign of bowel cancer, so it should be checked, and you should go and discuss with your doctor. Most people, however, will not have bowel cancer.
- Bleeding piles can cause anemia, and this may be very slow in onset.
Don’t be embarrassed! Get on and go and see the doctor. Remember—even the Queen of England sits on the toilet!
Are you one of the 25% of the population who suffers from bad breath—halitosis? This is not a joke, as it can be a sign of significant underlying medical conditions. It can also be putting your health in jeopardy. 85% of cases are due to not cleaning your teeth properly, not flossing and not visiting the dental hygienist. Periodontal disease—gingivitis—is caused by the same bacteria which give rise to the bad breath.
- The presence of periodontal disease is associated with oxidative stress—this is a harmful physiologic process in which your body is unable to eradicate molecules called free radicals. The accumulation of free radicals increases your risk of diseases such as cancer, heart disease and dementia.
- 10% of cases of halitosis originate from the ear, nose and throat, for example, tonsillitis, postnasal drip, and sinusitis.
- 5% of halitosis cases derive from the gastrointestinal tract, for example, due to reflux, and peptic ulcer disease. There is some suggestion that it may be associated with Helicobacter pylori infection.
You may either notice your vision is gradually getting a bit blurry or, you could suddenly find your vision is blurred. This needs an urgent medical assessment.
- Gradual blurring of vision—age-related changes in the eye. You will only know this by seeing an optician and having an eye test and examination. It’s very important to have regular eye tests. Other slow onset causes of blurred vision include diabetes and a range of conditions which affect the nerves and muscles supplying your eyes. These include Multiple Sclerosis and Parkinson’s Disease.
- Sudden blurring of vision—this may be due for example to a retinal detachment. This is an emergency. Therefore, you should not ignore blurred vision and should visit the optician, and/or the doctor for a thorough check. If diagnosed early, a retinal detachment can be treated and your sight can be preserved, but if you leave it, this option may be lost.
- Vision may also become blurred from a stroke. If it comes on suddenly, and especially if there are other signs such as face drop, speech difficulty, difficulty chewing or swallowing, dizziness or headache—you must see a doctor right away. Some strokes can be reversed if caught early enough, but you must not leave it, you must get to a hospital straight away.
How often do people complain they would lose their head if it wasn’t screwed on? We live in an increasingly busy and stressful society, so some degree of error with personal organization and daily living skills is probably par for the course. But how can you know when your cognitive thinking is slowing more rapidly than it should be? Could you be developing dementia?
If you go to the doctor, they will very likely assess you using the Mini-Mental State Examination (MMSE). This is a test that takes 5 to 10 minutes and involves you answering some simple questions. The maximum score is 30. A normal score is 24-30. If you score <9 this indicates a severe problem, 10-18 indicates a moderate problem and 19-23 a mild problem.
The MMSE test should not be used in isolation as a diagnosis of dementia depends on more than this one test.
The NHS recommends you seek medical help if you have had a persistent cough for three weeks which is not improving. If, however, you have other symptoms such as a fever, coughing up blood, chest pain, pain on breathing in (pleuritic pain) or enlarged glands in your neck, or for example, you have a weakened immune system, you should see a doctor sooner.
- Coughing is a common symptom of asthma. When asthma is well controlled, you should not be coughing. A sign that your asthma is flaring up is often an increase in coughing. Asthmatics need to recognize the warning signs so you can increase the use of your “preventer” asthma inhalers as you will have been recommended to do, to avert an acute attack.
- Lung cancer is strongly linked to smoking. But did you know there has been a worrying increase in lung cancer in recent years, in people who have never smoked. Experts are not sure of the reasons why. If your parents smoked during your childhood this is a risk factor. Air pollution has also been cited. Radon gas is another possible cause.
- A cough is also one of the symptoms of the coronavirus along with fever and shortness of breath. Call your doctor if you are experiencing these issues.
I’m sure you’ve all heard people complaining bitterly they feel bloated. This means an uncomfortable “full” sensation in your abdomen sometimes associated with belching and passing wind. Most of the time bloating is not serious and is a consequence of over-eating, too much alcohol or perhaps eating too much spicy food.
However, if bloating is severe and causing distress you should seek help as there are a variety of more serious medical causes. Examples include Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (Crohn’s disease), some forms of gastroenteritis (e.g. norovirus, or E.coli), food intolerances (e.g. lactose intolerance, gluten intolerance) and gastroparesis (food is moving too slowly through the gut).
Sometimes bloating may be due to gynecological causes such as endometriosis, or far less commonly, ovarian cancer.
If you are suffering from bloating, don’t ignore it, go and have a check-up.
Most headaches are related to stress, tension and anxiety. Sufferers will generally know that they get these headaches on and off and regard this as an unfortunate consequence of the pressures of modern life. However, dealing with stress is very important, as it has a marked influence as we age, on our overall health, and increases the risk of many different medical conditions.
There are many other causes of headache, some of which are serious or can be life-threatening. It’s important to take action if you have a headache which is different from your usual headaches. Beware of headaches that come on suddenly and are associated with other symptoms. For example:
One common cause of a sudden, severe headache is a stroke. Look out for the FAST signs:
- Face – your face is drooping on one side
- Arms – inability to lift arms over your head
- Speech – slurred speech
- Time – get help immediately as in the early stages some strokes can be reversed.
If you are concerned about headaches, go and discuss this with your doctor. They will check your blood pressure and may recommend for example an eye test. Also review your medication, as a headache can be a side effect of some medicines. Don’t leave it, prevention is always better than cure.
The incidence of skin cancer—melanoma—has increased by 135% since the 1990s! For the best prognosis, it’s very important to diagnose the melanoma early and before it has spread.
Risk factors for melanoma include being Caucasian, having pale skin, fair hair, and a history of intense sun exposure. Be aware of your moles and check to see if there any changes. Look for one or more of the following:
- A – is the mole asymmetrical?
- B – does it have an irregular border?
- C – does your mole have different colors?
- D – is it bigger than 6 mm (the size of a pencil eraser)?
- E – is it evolving, that is, changing over time?
Dizziness means different things to different people. You might say you feel dizzy if you feel lightheaded, or faint. Or you might feel dizzy because you feel you are spinning— more correctly called vertigo.
These attacks can last minutes or hours at a time. They may be accompanied by other symptoms such as tinnitus, hearing loss or pressure in the ear. 15% of patients complaining of dizziness have a serious underlying disease.
Examples of causes include: anxiety, panic attacks, heart arrhythmias, Meniere’s Disease and benign positional vertigo.
You will know by now what your normal bowel habit is like. Some people only have their bowels open two or three times a week, whereas others do this every day.
If your bowel habit changes, for example, you poo more often, have softer stools or diarrhea, abdominal pain, and especially if there is blood mixed in with the stool, this can be a sign of bowel cancer, and you must see the doctor without delay.
Always take any lumps and bumps you notice on your body seriously. These may or may not have a serious cause. They may take a while for you to notice them, and then fail to disappear or start to enlarge.
It can be hard for the doctor to find out the cause of the lump. This will depend on where it is, how long it’s been there, the size and feel, and any associated symptoms.
Common lumps include:
- Lipomas – simple fatty lumps
- Sebaceous cysts – benign cysts containing sebum
- Other cysts – e.g. hernias, epididymal cysts and hydroceles
- Enlarged lymph nodes – may be due to infections e.g. glandular fever, or to lymphoma/leukemia, or other cancers
- Skin infections – e,g. abscesses
- Benign breast conditions e.g. fibroadenoma
- More rarely: cancers e.g. breast cancer, thyroid cancer
This is called dysgeusia and has many possible causes. The taste of food affects your appetite and if you can’t enjoy eating, this can lead to anorexia and weight loss.
Short-term causes include upper respiratory tract infections and mouth infections. In the longer term, viral hepatitis is a recognized cause. It can also be associated with autoimmune disorders such as Sjogren’s Syndrome and SLE. Loss of taste can, however, be a feature of serious diseases including HIV and advanced cancer.
Are you sweating at night? In middle-aged women, the menopause may well be the culprit. However, there are many other causes for a night-time fever. Don’t assume this is normal—see your doctor, especially since fever is one of the coronavirus symptoms.
Common causes included hyperthyroidism, low blood sugars (diabetes not controlled properly), sleep apnea, and as a side effect of some drugs (e.g. antihypertensives).
Causes are split broadly into four categories – infections (e.g. subacute bacterial endocarditis, osteomyelitis), inflammatory conditions (e.g. Rheumatoid arthritis, sarcoidosis), cancers(e.g. kidney, pancreas) and miscellaneous (e.g. Inflammatory Bowel Disease, and thyroiditis).
After reading all this, what’s the conclusion?
Get to know your body and don’t be shy about reporting any changes that are worrying you.
It’s hard not to become a hypochondriac! It’s also true that self-help is important in the early stages of any illness, so you shouldn’t rush to the doctor too quickly. However, if things are persistent, and just not right, don’t feel intimidated to ask for help.
You can phone your doctor’s surgery and speak to a member of the team. Alternatively, you could phone a help-line for advice. The emphasis these days is firmly on preventative medicine and catching things early to get the best prognosis.
Focus on a healthy lifestyle and adapt good health behaviors to give yourself the best lifetime outcome.
Dr. Deborah Lee is a medical writer at Dr Fox Online Pharmacy.