The Top 8 Secrets You Keep from Your Doctor

Are you telling your doctor everything he needs to know to take care of you?

From the WebMD Archives

At your annual doctor's checkup, you hop up on the exam table and bare your deepest secrets.

You 'fess up about how much alcohol you consume, how many times you smoked last week, the herbal supplements you pop, or the fact that you're battling depression or are anxious about job layoffs at the office. Maybe you tell her you're worried about your 401K rebounding in time for retirement, or your recent new sexual partners.

No? Isn't everyone sharing this level of information with their doctor?

Apparently not. And that hush-hush attitude may be risky.

Why You're Not Telling

“People often don't share with their doctors aspects of dysfunction in their lives because it's embarrassing and creates a great level of discomfort," says Bernard Kaminetsky, MD, FACP, the medical director of MDVIP, a group of boutique medicine doctors headquartered in Boca Raton, Fla. “You're not going to share unless you have a very trusting relationship with your doctor."

Patients withhold information from their doctors for a variety of reasons. Often they just don't think their marital problems, anxiety, or worries are fodder for their cholesterol checkup. Or they're embarrassed to bring up touchy topics like sex or bathroom problems like incontinence or constipation.

Others may skip information that they don't think is important. And there's not much time during a checkup to tell all.

But not telling could spell trouble -- even if you'd rather not admit to an inconvenient truth or two.

Everything from your stress to your sexual history to your use of supplements can affect your health and should be disclosed to your doctor.

Here are the top eight secrets you keep from your doctor and why you should spill them.

1. Use of Over-the-Counter (OTC) Medicines, Herbal Supplements, and Vitamins

You may think the doctor will look down her nose at certain herbs and supplements, but you need to tell her exactly what you take.

Some supplements and OTC products may not mix well with prescription medicines you've been prescribed and could cause a reaction. Patients can even have specific conditions for which they shouldn't take an OTC medicine.

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For instance, Kaminetsky says people with liver disease should use acetaminophen sparingly if at all. Likewise, certain weight loss supplements could have cardiac implications for someone with heart disease.

And "natural" does not always mean "safe," according to the web site for the National Center for Complementary and Alternative Medicine (NCCAM). "For example, the herbs comfrey and kava can cause serious harm to the liver," states NCCAM's web site.

Vitamins and minerals are also something your doctor needs to know about. High doses can be risky; for instance, too much selenium can cause gastrointestinal upset, hair loss, fatigue, irritability, and mild nerve damage, according to the National Institutes of Health's Office of Dietary Supplements.

2. Your Sexual History

"It's really important for us to know how many sexual partners someone has had, so if you've had 40, I may approach things differently than if you've had four," says Lissa Rankin, MD, author of the forthcoming What's up Down There? Questions You'd Only Ask your Gynecologist if She was your Best Friend.

It matters to a gynecologist because your lifetime chance of getting sexually transmitted diseases rises with how many partners you've had. “The new Pap guidelines say if you're low risk, you can go three years between Pap smears, but if someone's had 100 sexual partners, then I would say that rule doesn't apply to you," Rankin says.

Men need to come clean, too. Their risk for HIV, hepatitis, and other STDs increase with the number of sexual partners and their sexual preference. Doctors need to make sure men get screened properly and often enough.

3. How Much You Smoke, Drink, or use Illegal Substances

It may be difficult sharing these secrets because you think your doctor will give you yet another smoking lecture or judge you. But doctors aren't there to do that.

Plus, doctor-patient confidentiality laws ensure your information remains private. In most states, doctors can only break confidence if someone is an imminent danger to themselves or others.

What's more, your doctor needs to know what you're taking to protect your health, run the right tests, and diagnose correctly.

For instance, "we may need to check your liver function or you may be at risk of ulcers," Rankin says. There are a host of other medical issues if you've got an addiction or take too much of any drug -- legal or not.

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4. Whether You're Stressed, Depressed, or Abused

If you're often stressed or sad -- or if you're in an abusive relationship -- speak up.

"Doctors may not be licensed therapists, but every primary care physician who has been practicing for a number of years is a bit of a therapist because we've heard it all," Kaminetsky says.

Your doctor can help in offering advice, referring you to the right specialist, or suggesting a counselor to deal with stress. He can also evaluate if medication or therapy might help with depression.

5. Defying Doctor's Orders

When your doctor asks if you're taking your cholesterol-lowering statins daily, don't lie and nod your head if you forget three days a week. Admit that you have trouble remembering.

The same goes for birth control pills. “If I give you the pill and you're not good at taking a pill every day, that would change my approach to birth control with somebody," Rankin says.

If you're bad about taking or finishing the drugs your doctor prescribed -- no matter what it is -- tell your doctor. Your doctor won't punish you. But if, for instance, you've had a stubborn infection that won't clear up, it helps your doctor to know that you didn't finish the antibiotic he or she prescribed.

6. You Can't Sleep

You may think a sleep issue is inconsequential, that it will pass, or that it's a simple factor of aging so you needn't bother the doctor about it. But sleep problems can quickly become chronic and often can be easily remedied.

There are so many factors to consider for people who are sleeping poorly, including stress, depression, menopausal changes, anxiety, or even serious medical conditions like sleep apnea, a chronic condition in which you repeatedly stop breathing throughout the night, leading to daytime sleepiness.

Tell your doctor you're having trouble sleeping, and whether it's falling asleep or staying asleep that's difficult. He may evaluate the problem and offer advice -- like not exercising too close to bedtime, not drinking alcohol too late, or not watching stimulating television before bed; or send you for a sleep study to get at the root cause.

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7. You're Often Low on Energy

Fatigue is a factor in many illnesses, though people just think it's a byproduct of getting older. “But usually there is a reason that accounts for a change in their stamina or energy level, and if you don't tell the doctor, you won't get relief and may miss something important," Kaminetsky says.

Low energy levels could stem from illnesses, including stress, a poor diet, anemia, depression, and thyroid function. So mention it to your doctor so she can check if something medical is going on.

8. Your Hobbies

You may not think sharing your hobbies with your doctor is of any importance, especially since many hobbies are an excellent way to reduce stress and contribute to good health. But it could be your hobby that's responsible for some medical symptoms.

Perhaps the way you sit at your desk writing your novel causes back or neck pain. Maybe piano playing contributes to your Carpal Tunnel Syndrome, or building model airplanes in a non-ventilated area is leading to chronic headaches on weekends.

So mention any hobbies to your doctor on the off chance an activity you take up may be related to your medical condition.

WebMD Feature Reviewed by Laura J. Martin, MD on May 05, 2010

Sources

SOURCES:

Bernard Kaminetsky, MD, FACP, medical director, MDVIP, Boca Raton, Fla.

Lissa Rankin, MD, ob-gyn and author of What's Up Down There? Questions You'd Only Ask Your Gynecologist If She Was Your Best Friend.

The American Congress of Obstetricians and Gynecologists, Pap Smear and Cancer Screening Guidelines.

National Center on Complementary and Alternative Medicine: "Using Dietary Supplements Wisely."

Office of Dietary Supplements, National Institutes of Health: "Dietary Supplement Fact Sheet: Selenium." 

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