Health symptoms that may signal need to visit a doctor (Part 1of 2)

By October 1, 2020 Health & Nutrition

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Nobody wants to be a hypochondriac. Yet. Ignoring symptoms seems to be a bigger risk. Here’s an attempt to sensitise you to different health symptoms and what they could mean so that you are able make a judgement on when and what to visit a doctor for. These are just broad indications that the author has compiled for easy reading and you have to assess your symptoms and changes well to make the best decisions. This is part 1 of 2 and both parts together cover a wide range of symptoms. Team RetyrSmart

Health symptoms that may signal need to visit a doctor (Part 1of 2)

Unintentional Weight Loss

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 tumour), 37% had a non-malignant medical diagnosis and 16% had psychosocial causes (such as depression, associated drug use, and immobility).

Reduced Appetite

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.

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Constant Thirst

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.

Getting Up at Night to Pass Urine

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.

Tired All the Time

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 anaemic. 0.6% had cancer. 4.3% had a serious non-malignant condition.

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.

Feeling Cold

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.
  • Anaemia 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 anaemia 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.

Blood on the Toilet Paper

If you notice blood on the toilet paper, this is most often due to piles (a.k.a. haemorrhoids). 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 haemorrhoids and the other half are liars!

However, it’s always best to be sure it really is only haemorrhoids.

  • 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 anaemia, 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!

Bad Breath

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.

Blurred Vision

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.

Forgetting Things, Being Muddled

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.

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