Tag: symptoms

As GPs, we spend much of our time reassuring people. Most symptoms turn out to be harmless, self-limiting, or easily explained.

Yet occasionally a symptom that seems minor can be the first clue that something more significant is going on.

One of the most common things I hear in consultations is:

“I didn’t want to bother anyone.”

Or:

“I thought it was just getting older.”

Most of the time it isn’t something serious. But sometimes the symptoms we dismiss are the very ones we should pay attention to.

The challenge is knowing the difference.

Why Do We Ignore Symptoms?

One of the interesting observations in general practice is that men are often less likely to seek medical advice than women.

There are many possible reasons for this. Some practical barriers are well recognised, including long waiting times and difficulties accessing appointments around work commitments.

Many men tell me they do not want to make a fuss. Others worry about wasting the doctor’s time or believe that GP appointments should be reserved for serious problems. Some admit they are concerned about what might be found if they seek help.

There may also be an element of embarrassment. Certain symptoms, particularly those relating to mental health, urinary problems or erectile dysfunction, can feel difficult to discuss. As the medical workforce has changed and more women have entered general practice, some men may feel less comfortable raising sensitive issues with a female doctor.

Of course, women can be guilty of exactly the same thing. Many put their own health at the bottom of an already busy list of priorities. Symptoms are often dismissed as stress, ageing, menopause, family life or simply being tired.

The reality is that doctors are not worried about patients coming in too early.

We worry when they come in too late.

Most symptoms will turn out to be nothing serious. But when something persists, changes or simply doesn’t feel right, it is always worth seeking advice.

Persistent Fatigue

Feeling tired is one of the most common reasons people seek medical advice. Modern life is busy, many of us are juggling work, family and other commitments, and sleep is often the first thing to suffer.

But fatigue that is persistent, unexplained or doesn’t improve with rest deserves further assessment.

Common causes include:

• Iron deficiency anaemia
• Vitamin B12 deficiency
• Thyroid disease
• Sleep disorders such as sleep apnoea
• Perimenopause and menopause
• Chronic stress and low mood

Fatigue is rarely a diagnosis in itself. It is often a clue that something else may be happening beneath the surface.

Increased Thirst or Frequent Urination

Needing to drink significantly more than usual or finding yourself making repeated trips to the toilet can be an early sign of type 2 diabetes.

The concern is not simply the diagnosis itself, but the complications that can develop before diabetes is recognised. Damage to the eyes, kidneys, nerves and cardiovascular system may already be occurring long before symptoms become obvious.

These symptoms can have other causes too, but they should never be ignored if they persist.

Shortness of Breath on Mild Exertion

Most of us expect to become breathless when exercising vigorously.

However, if climbing stairs, walking uphill or carrying shopping suddenly becomes more difficult than it used to be, it is worth seeking medical advice.

Possible causes include:

• Anaemia
• Asthma
• Chronic lung disease
• Heart rhythm problems
• High blood pressure-related heart changes
• Early heart disease or heart failure

Many people assume breathlessness is simply part of ageing.

It isn’t.

Whilst fitness levels naturally change over time, unexplained breathlessness always deserves assessment.

Unintentional Weight Change

Our weight naturally fluctuates throughout life.

However, losing more than 5% of your body weight over six to twelve months without trying to do so should prompt further investigation.

Possible causes include:

• Thyroid disease
• Diabetes
• Digestive disorders
• Chronic illness
• Occasionally, cancer

Weight gain can also provide important clues.

In particular, weight gain around the middle is strongly associated with insulin resistance, metabolic syndrome and increased cardiovascular risk.

The number on the scales matters less than understanding why the change has occurred.

Easy Bruising or Bleeding

Most of us occasionally discover a bruise and have no idea how it got there.

But persistent or unexplained bruising, recurrent nosebleeds, bleeding gums or bleeding that seems excessive for a minor injury should be investigated.

Possible causes include:

• Vitamin deficiencies
• Medication side effects
• Platelet abnormalities
• Clotting disorders
• Less commonly, blood disorders

While many causes are harmless, they are not symptoms that should simply be ignored.

Erectile Dysfunction: More Than a Quality of Life Issue

Many men find erectile dysfunction difficult to discuss, yet it is one of the most common conditions seen in primary care.

Whilst stress, anxiety and relationship difficulties can all contribute, erectile dysfunction can also be an early sign of underlying vascular disease.

The blood vessels supplying the penis are smaller than those supplying the heart. As a result, problems with blood flow may become apparent here several years before symptoms of cardiovascular disease develop elsewhere.

In some men, erectile dysfunction can be an early warning sign of:

• High blood pressure
• Diabetes
• High cholesterol
• Cardiovascular disease

Although many men view it as an inevitable part of ageing, it should always be considered an opportunity to assess overall health.

Changes in Bladder or Bowel Habits

Many people feel embarrassed discussing bladder or bowel symptoms, but they can provide important clues about underlying health.

For men, a weaker urinary stream, difficulty emptying the bladder completely, or frequent trips to the toilet at night may simply reflect an enlarged prostate. However, these symptoms can also be associated with infection, diabetes or other medical conditions.

Changes in bowel habit that persist for several weeks should also be assessed.

One symptom that always warrants prompt medical attention is blood in the urine or stool.

In many cases the cause is straightforward and treatable. However, blood can also be an early warning sign of more serious conditions affecting the bladder, kidneys or bowel.

Most causes will not be serious, but these are not symptoms that should be dismissed or simply attributed to ageing.

Changes in Mood, Motivation or Personality

When we think about depression, we often think about sadness.

But mental health difficulties do not always present that way, particularly in men.

Sometimes the first signs are:

• Irritability
• Anger
• Withdrawal from family and friends
• Loss of motivation
• Loss of enjoyment in activities that were once pleasurable
• Feeling flat or disconnected

Many men struggle in silence because these symptoms do not fit their idea of what depression looks like.

Physical health can also play a role. Hormonal changes, thyroid disease, sleep disorders, chronic stress and other medical conditions can all affect mood, energy and motivation.

Family members are often the first to notice that someone “just isn’t themselves.”

Mental health deserves the same attention as physical health.

The Importance of Paying Attention

One of the challenges in medicine is that serious conditions often begin with very ordinary symptoms. Fatigue. Breathlessness. Changes in weight. Increased thirst. Changes in mood.

Symptoms that are easy to explain away.

That does not mean every symptom represents something serious. Far from it.

But it does mean that persistent symptoms deserve attention.

As doctors, we are rarely concerned about a symptom that appears briefly and disappears. We become more interested when symptoms persist, progress or begin affecting day-to-day life.

Our bodies are remarkably good at signalling when something has changed.

The challenge is listening.

If something doesn’t feel right, trust your instincts. Speak to a healthcare professional and seek advice.

Most of the time you will be reassured.

Occasionally, that conversation may make all the difference.

Thank you for reading.

Prevention begins with awareness. The sooner we recognise changes in our health, the more opportunity we have to take action.

For more evidence-based health information and practical advice, explore the Practical Health section of the blog.