Recognizing early warning signs of health problems can significantly improve treatment outcomes and prevent long-term complications. Subtle, “silent,” early health warnings are ignored as we take our health for granted just because we look and feel fit. Instead, we often obsess about hair loss, facial wrinkles, dark eye circles, aging, lightheadedness, poor memory, flu symptoms, mild variations in body temperature, weight-reducing diet, protein supplements, sugar substitutes, cholesterol, high and low blood pressure. Recognizing early warning signs of health problems can significantly improve treatment outcomes and prevent long-term complications.
MISSED EARLY HEALTH WARNINGS
Young people, in particular, may ignore health warnings, believing they are too young for serious illness, or they may attribute symptoms to a high-stress, fast-paced life.
• Chronic fatigue due to anaemia, thyroid disorders, nutrient deficiencies (iron, Vitamin B12, Vitamin D, magnesium, and folate), sleep disorders (apnoea), heart or lung disease, or early signs of depression, is ascribed to work stress.
• Unintentional weight loss of more than 5% of body weight due to thyroid issues, diabetes, digestive disorders, or cancers is mistaken for a change in diet or exercise.
• Brain and nervous system problems like stroke, Parkinson’s disease, etc., progress over time if sudden weakness or numbness of face or limb, headache, slurred speech, trouble understanding, or sudden personality changes, blurred, double vision, or intense flashes of light, dizziness or loss of balance, loss of sense of smell, changes in handwriting are ignored.
• Minor cognitive changes are dismissed as forgetfulness or being overworked when they may indicate high cortisol levels, sleep apnoea (detected by sleep study), or early signs of neuroinflammation.
• Subtle signs of heart disease, like mild discomfort, pressure, squeezing, burning, or tightness in the chest, radiating to the arms, back, neck, or jaw, especially on exertion, unexplained fatigue, or breathlessness or sweating after light activity, sudden light-headedness, rapid or irregular heartbeats, are ignored as heart attacks are associated with intense, chest-clutching pain.
• Puffiness around the eyes, swelling of the face, or legs can be due to kidney, liver, or cardiac dysfunction and should not be ignored.
• Excessive thirst and frequent urination due to diabetes, kidney disease, or high blood calcium (due to hyperparathyroidism or cancer) are often thought to be weather-related.
• Increased thirst and hunger, frequent urination, blurred vision, tingling or numbness in the hands and feet, and a slow-healing wound are early signs of diabetes.
• Changes in urine frequency or burning sensation due to diabetes, urinary tract infections, or kidney problems are attributed to high fluid intake or getting older.
• Persistent digestive changes due to irritable bowel syndrome (IBS), food intolerances, gallbladder issues, inflammatory bowel diseases, or tumours are blamed on having to eat spicy, adulterated food outside.
• Blood in urine or stools is often missed as these are not observed before flushing. Vomiting or coughing up blood, discoloured skin patches (bleeding under the skin), and sudden menstrual abnormalities or post-menopausal bleeding need early medical attention.
• Yellowish skin tone and eyes are not just a mild discolouration; it indicates jaundice due to liver dysfunction or bile blockage. It may be accompanied by skin itching, dark urine, pale stools, chronic fatigue, and abdominal swelling.
• Persistent pain or aches is often treated with OTC pain relievers and ignored, though it could mean chronic inflammation, arthritis, or early signs of cancer, particularly if the pain is in the bones.
• Premature greying of hair can indicate a vitamin B12 or copper deficiency, or, in some cases, thyroid or autoimmune disorders.
• New, changing, or persistent lumps in the breast, neck, or armpit, or persistent cough or hoarseness may be due to cancer.
• Skin and nail changes are not always cosmetic or aging issues. New or changing moles can indicate skin cancer; ridges/discoloration in nails can indicate other internal health issues. Chronic, itchy, dry skin can be an early sign of diabetes or thyroid problems.
• Persistent mouth ulcers, often attributed to spicy food or stress, are often due to vitamin deficiencies (B2, B3, B9, or B12), food allergies, celiac disease, or early cancer.
• Pain, swelling, warmth, and redness in one leg or arm may be due to Deep Vein Thrombosis (DVT). Subsequent sudden, unexplained shortness of breath, chest pain, and a rapid pulse are due to Pulmonary Embolism (PE), caused by the clot travelling to the lungs, and need emergency care.
• Patients often relate stiffness, soreness, or weakness to “old age” or “just muscle fatigue” in their knees, hips, or shoulders without realising that these problems could be the first signs of arthritis. Delayed diagnosis and treatment worsen the condition and damage the joints.
• Persistent sadness, hopelessness, intense irritability, loss of interest in, or withdrawal from, friends and activities indicate the need for mental health evaluation.
STANDARD ANNUAL HEALTH CHECKS
Routine annual health checks are preventive medical evaluations designed to assess your overall health and detect common health issues early. These are mistakenly considered to be all-inclusive by most people. Many health issues need specific additional tests tailored to the person’s family history, lifestyle factors, and other risk factors. A standard annual checkup should ideally include:
• Physical examination: blood pressure, heart rate, respiratory rate, temperature, height, weight, and Body Mass Index (BMI), waist-to-hip ratio, clinical evaluation of heart, lungs, abdomen, and other parts of the body.
• Standard Laboratory Tests: Complete Blood Count (CBC) for anaemia, infections, and various blood disorders; ESR and CRP to detect systemic or acute inflammation, Lipid Profile to detect dyslipidaemia; Blood Glucose Tests and HbA1c tests to screen for diabetes or prediabetes; Kidney (KFT/RFT) and Liver Function Tests (LFT) to assesses health of these organs; Thyroid profile (TSH, free T4) to check for thyroid hormonal imbalances affecting metabolism and energy; uric acid for gout, urinalysis for kidney issues, infections, or metabolic problems. Accurate blood glucose and cholesterol readings require fasting for 10–12 hours. Some tests may be influenced by certain medications or food.
• Imaging tests: Chest X-ray; ultrasound abdomen and pelvis for stones, tumours, cysts, certain infections, hernia, liver, biliary tract, pancreas, adrenal, kidney-urinary tract-prostate, and ovarian-fallopian tube-uterine problems. Doppler studies for vascular problems.
• Sex specific tests: Clinical breast exams (and Sonomammograms typically after age 40–50) and cervical cancer screenings, such as Pap smears or HPV tests for women; Prostate screenings (PSA test) based on age and family history for men.
• Age-specific tests: Bone density (osteoporosis), hearing loss, vision, and colorectal cancer screenings for senior citizens. Newborns undergo specialized screenings within the first 24–72 hours of life to detect genetic, metabolic, and congenital disorders.
• Annual eye exams: to check for glaucoma or vision changes, and dental checkups to prevent oral infections.
• Geographic region specific: Immunisation status of annual flu shot, tetanus boosters, or shingles vaccine is reviewed and updated.
• Mental health evaluation may include discussions regarding diet, physical activity, alcohol consumption, smoking cessation, and screening for depression.
RISK REDUCTION STRATEGIES
• Blood Pressure Control: Aim for a target of 130/80 mmHg ideally, or below 140/90 mmHg.
• Smoking Cessation: Eliminating tobacco use is crucial. Avoid alcohol and substance abuse.
• Healthy Diet: Focus on fresh fruits, nuts, seeds, leafy greens, vegetable salads garnished with edible flowers and topped with extra virgin olive oil dressing, curds, herbs, and spices, and cooked whole grains with legumes, lowering salt and sugar, and replacing saturated fats with unsaturated fats. Avoid processed convenience foods and high-calorie, deep-fried comfort foods.
• Physical Activity: Aim for 150–200 minutes of moderate-to-vigorous exercise weekly and reduce long hours of sitting or screen time.
• Weight Management: Reduce excess body fat through exercise and reducing calorie intake.
• Stress management: Exercise, meditation, recreational activities, and adequate sleep reduce stress.
• Manage comorbidities: Have regular health checkups if you have diabetes, dyslipidaemia, hypothyroidism, etc.
Always “Prevention is better than cure”. Early detection of disease and prevention of its progression is better than ignorant delay in seeking medical care.
Common habits of healthy long-living people include an active lifestyle, moderate portions of plant-based, balanced meals, early dinner, adequate sleep and relaxation, a sense of purpose in life, adaptability, and a social network.
Dr. P.S. Venkatesh Rao is a Consultant Surgeon, Former Faculty CMC Vellore, AIIMS (New Delhi), and a polymath in Bengaluru, drpsvrao.com
