Recently I went to the doctor for a check-up for the first time in six years. I wanted to know about my basic overall health, but mostly I’d been having serious symptoms of under active thyroid for the past two years. My symptoms include chronic fatigue, sensitivity to cold, anxiety & depression, unusual weight gain & difficulty losing it (even with clean eating and exercise,) brittle hair & dry skin, and more. My mother and aunts have underactive thyroid and I have nearly every symptom, so I was confident that my blood work would indicate the problem and validate the instinctive feelings I’d been having about my health. The problem was, my blood work came back normal. My thyroid levels were fine, my doctor said. I am perfectly healthy, she said. My stomach immediately dropped, because I don’t feel fine. I am only 28, and yet I don't have any energy and can hardly get out of bed in the morning. It simply does not make sense. I know something is wrong with me. And after reading about how thyroid testing often comes back normal despite the patient having most or even all of the symptoms, and that most primary doctors don’t do the extensive testing needed to discover the problem (such as testing for thyroid antibodies,) I decided I needed a second opinion. And maybe you do too.
Whether you suspect thyroid problems or something more serious, if you’ve had your blood work come back normal, yet still harbor a nagging feeling that something is wrong, you are not alone. Recently, a study was done at Rice University in Houston that found poor self-reported health was associated with higher levels of reactivation of latent herpesviruses (cold sores) and inflammation. According to researchers, high levels of inflammation are linked to many health issues, including heart disease, stroke, and Alzheimer’s. Kyle W. Murdock, the postdoctoral research fellow at Rice University who led the research with Christopher Fagundes, a Rice assistant professor of psychology, says that having high inflammation is similar to feeling a cold coming on – that general feeling of fatigue and a lack of energy – but without the obvious outward symptoms. “You can tell something’s going on. But in this case, it’s a little bit different. Because you don’t have a cough or a runny nose or something like that – those tell-tale signs of sickness.”
The researchers at Rice were specifically testing for herpesvirus activity and noted that it would be unlikely a primary care doctor would check for the issues involved, due to the amount of time testing and the high degree of difficulty. However, overtesting and the potential harm it can cause is a worry for doctors, so finding a balance between advantages in modern medicine and your bodies signals is the right direction to head in.
Sometimes, these signals show up best while dreaming. During a small pilot study last year, 18 women were surveyed that had dreams that they had breast cancer. When the women had their symptoms checked out, sure enough, they had the disease. Dr. Larry Burk, a consulting associate professor of radiology at Duke University School of Medicine and musculoskeletal radiologist at Duke University Hospital, notes that he was driven to focus on the dream research after three of his friends reported they’d had dreams about having breast cancer before it was diagnosed. One of those friends even had a doctor dismiss her dream & didn’t order a mammogram, only for her later to be diagnosed with metastatic breast cancer and die from the disease. Some of the women who’ve had breast cancer dreams are even able to point out specifically where the tumors in their breasts were located, even before they’d been biopsied.
The dreams have been attributed mainly to denial about something that’s wrong and having that revelation come out in a dream, to some sort of physiological signaling or intuitive process that’s not yet understood. So even though your instincts and dreams may be difficult to explain, & medical tests may not show you the whole picture, your hunch shouldn’t automatically be dismissed.
The doctor should listen intently to the patient, as the information used to diagnose patients usually comes from symptoms and health history, with tests only providing a small sliver of the picture. “When the patient says something is wrong, they tend to be right,” says Dr. Salvatore Mangione, a pulmonologist and associate professor of medicine at Thomas Jefferson University’s Sidney Kimmel Medical College in Philadelphia. He adds that making a diagnosis is harder in today’s world because of the fast pace of medicine and the over reliance on testing. Both can interrupt or shorten the all-important time doctors spend talking with patients, since most follow-ups only last ten minutes or so and only a little longer in a primary visit.
The difficult part is finding the sweet spot where the doctor takes into consideration patient concerns and isn’t easily dismissive of them (even when tests don’t bear those out,) and where patients are patient about pursuing their concerns. Sometimes, patients exhibit signs of hypochondria or a related disorder, characterized by unrealistic worries about their health. However, most of the time, doctors and their patients simply wade through the dilemma of running a lot of tests in order to find the problem.
So if you’re like me and know something is wrong despite clear test results, don’t back down. Look for a skilled diagnostician who will weigh the risks against the potential benefits for any tests done. Adds Burk: “If you get subtle warning symptoms, if it’s a nagging feeling, if it’s a dream, that is your body’s screening technology, and it’s telling you something that needs to be checked out.”
It can be incredibly frustrating to be know something is wrong and have to jump through so many hoops just to find answers. But in the end, after all is said and done, you can then yell a loud "told you so" to everyone who questioned your concerns and made jokes about overreactions. I know I will.