Getting checked: seeing a doctor about body symptoms

When a body symptom will not go away, the first step is a medical check. This is true even if you suspect stress plays a part. Stress can cause real symptoms, but so can thyroid problems, heart disease, infections, medicines and many other conditions that need their own treatment.

This page covers the warning signs that need emergency or same-day care and how to get the most from a visit. It also explains what normal test results do and do not mean, and how to talk about the mind–body side without feeling brushed off.

Call 911 for these

Never assume chest pain is "just anxiety" until a doctor has checked you. If you have had panic attacks before and a new attack feels different, get checked.

Other symptoms that need care right away

These symptoms should not wait for a routine visit. The table shows what to do. If the advice is to get help right away and you cannot reach your doctor, go to urgent care or the emergency room.

Book a prompt appointment

Call your doctor's office soon, within days rather than months, for:

• Weight loss you cannot explain, such as losing more than 10 pounds, or 5% of your body weight, over 6 to 12 months without trying.⁶
• Small amounts of blood in the toilet, on toilet paper or streaked on stool.⁷
• A symptom that is new, getting worse, or changing in pattern, even if you have had something like it before.
• Symptoms that keep you from work, sleep, family life or things you enjoy.

Preparing for your visit

Your description of the symptom is often the most useful thing the doctor has. Tests and the exam add to it, but your story points the doctor in the right direction.⁸ The National Institute on Aging suggests thinking through:⁸

• What exactly the symptoms are
• When they started, and what time of day they happen
• How long they last and how often they come
• Whether they are getting better or worse
• What makes them better or worse
• How they affect your daily activities

Bring a list of every medicine you take, including over-the-counter drugs, vitamins, herbal products, eye drops and laxatives. Medicines can interact and cause side effects.⁸ Also mention big changes or stresses in your life, such as a death in the family or a move. This is not prying. It can matter medically.⁸

Worry about your symptoms is not a sign of weakness. Telling your doctor how you feel is part of good care, not complaining.⁸ If it helps, bring a family member or friend to take notes.

Keeping a symptom diary

A short diary can show patterns that are hard to see from memory. MedlinePlus suggests a diary for headaches, and the same idea works for many symptoms.⁴

1. Write down when it starts: the day and time.
2. Note how strong it is, from 0 (none) to 10 (worst).
3. Record what was going on just before: what you were doing, where you were, and how you were feeling.
4. Add sleep, food and drink from the last day, including caffeine and alcohol.
5. Note how long it lasted and what helped it ease.
6. Bring the diary to your visit and go over it with your doctor.⁴

A few weeks is usually enough. If tracking every detail starts to make you more worried, or makes you focus on the symptom all day, keep it simpler or stop and talk with your doctor.

What normal test results do and do not mean

Lab "normal ranges" are based on results from large groups of healthy people. It is common for healthy people to have a result a little outside the range. A result inside the range is also not a full guarantee of good health. Your doctor reads each result alongside your symptoms and exam.⁹

When your tests are normal, it usually means:

• Many serious causes your doctor was looking for are unlikely.
• Your symptoms may come from a problem that tests cannot see well, such as muscle tension, a sensitive nervous system, a gut–brain problem or a sleep problem. See How stress, anxiety and depression cause real body symptoms.

It does not mean:

• That nothing is wrong
• That you are imagining or exaggerating your symptoms
• That nothing can be done

Many common conditions are diagnosed mainly from your symptoms and an exam. For most headaches, for example, the diagnosis is based on the history of symptoms.⁴ Functional disorders such as irritable bowel syndrome are also recognized by their pattern. See Functional disorders.

The downside of repeated testing

It is natural to want one more test to be sure. But tests have limits.

Tests often do not bring peace of mind. A review of 14 randomized trials with 3,828 patients looked at people whose symptoms had a low chance of a serious cause. Having diagnostic tests did not reduce their worry about illness or their anxiety, and it did not make their symptoms go away. Tests may have slightly reduced later doctor visits.¹⁰

Tests find things that are not the problem. Scans often show changes that are common in people with no symptoms at all. In a review of spine scans in people without back pain, disk wear was found in 37% of 20-year-olds and 96% of 80-year-olds.¹¹ Findings like these can lead to more tests, more worry and sometimes treatments that do not help.^11,12

Unneeded tests and treatments can cause harm of their own.¹²

This does not mean you should refuse tests. It means a good question to ask is: "How likely is this test to change what we do?" Testing makes the most sense when your doctor thinks there is a real chance of finding something, or when your symptoms change.

Talking about the mind–body side without feeling dismissed

Many people fear that if they mention stress, the doctor will stop taking their symptoms seriously. A review written for family doctors says the opposite should happen. It advises doctors to listen and accept that what you feel is real. They should explain the mind–body connection and avoid saying "there is nothing wrong with you." They should also plan regular follow-up visits, so you do not need a new symptom to be seen.¹²

Phrases that can help:

• "I know these symptoms are real. Could stress, mood or sleep be making them worse, along with anything physical?"
• "What did the tests rule out, and what do you think is going on?"
• "What signs would make you want to look again?"
• "Can we set up a follow-up visit even if things are stable?"
• "I have also been feeling low or anxious. Can we talk about that too?"

If you feel dismissed, you can ask for a clear explanation, bring someone with you, or ask for a second opinion. A good doctor keeps looking at both body and mind over time, rather than choosing one.

When to go back to the doctor

Go back if a symptom changes, gets worse, or a new one appears, even after normal tests. Also go back if you develop any warning sign above. Normal results today do not rule out a new problem later.

If you notice a lot of time and worry going into your symptoms, read Health anxiety and Somatic symptom disorder. Both can be treated.

Common questions

My tests were normal but I still feel awful. What now?

Ask your doctor what the tests ruled out and what the plan is. Many people improve with a mix of steady activity, better sleep, calming skills and, when needed, therapy or medicine. See Self-help and Treatment.

Should I ask for a scan to be sure?

Ask whether the result would change your care. For many symptoms with a low chance of a serious cause, scans do not ease worry and can show harmless findings.^10,11 If your doctor sees warning signs, testing is the right choice.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.