Silent Medical Conditions

Find out now if your health is jeopardized by one of these stealth medical conditions.

By Denise Mann, MS
WebMD Feature

Reviewed By Charlotte E. Grayson, MD

Remember that old saying: "What you don't know won't hurt you?" When it comes to your health, that's wrong - and dangerous!

From high blood pressure to skin cancer, some life-threatening health conditions often arrive with few symptoms or fanfare. While you may feel fine, millions of us have one of these conditions and don't know it. Now for the good news: If we spot these conditions early, we can take simple steps to greatly reduce our risk of serious complications in the future.

Here's what you really need to know about the top seven silent health thieves. Start protecting yourself now.

Diabetes Type 2 Diabetes

"Watch out for extreme thirst, dry mouth, increased urination and blurred vision. These are often the first signs of diabetes."

- Anne Borik, DO

About 18 million people have type 2 diabetes and another 16 million are silently at risk. Could it be you?

"A lot of people have diabetes and don't know it, but the symptoms will eventually catch up with you," warns Anne Borik, DO, an internist at the Arizona Heart Hospital in Phoenix.

Type 2 diabetes is usually due to bad diet and lack of exercise. Foods such as sweets, white breads, potatoes, white rice and crackers convert quickly to sugar in the body. When there is too much blood sugar in the body, the cells gradually become unable to use insulin properly.

But "if you catch it early, Type 2 diabetes absolutely can be controlled with a low-carbohydrate and low-sugar diet," Borik says.

If you have any of the early symptoms, "get either a urine or a fasting blood sugar test to find out where you stand," she says. "Controlling blood sugar is vitally important in reducing the risk of heart attack and other complications."

Testing for diabetes should be considered every three years beginning at age 45, according to current guidelines. And even more frequently in people at increased risk for the condition.

People at highest risk for the disease are those who are overweight, women who developed diabetes during pregnancy (gestational diabetes), and people with family members who have the disease.

Heart DiseaseHeart Disease

"In women, signs of a heart attack may include bloating, gastrointestinal upset, back pain, arm pain, nausea and sweating."

- Anne Borik, DO

Heart disease is public enemy No. 1 for men and women. Often, the first sign of a heart attack is not crushing chest pain like we see in the movies, especially for women.

And chest pain is often not a sharp pain, but a "very dull, achy heaviness," says Borik, an internist at the Arizona Heart Hospital in Phoenix.

If you feel such symptoms, you may not be sure what's wrong. They may even come and go, but to be on the safe side, you should call 911 immediately to seek care.

Regular exercise, eating a healthy diet and not smoking can help lower risk of heart disease and heart attack . "A daily baby aspirin may also be advisable to lower your risk, provided you have no history of ulcers or liver problems," Borik says. Talk to your doctor before taking aspirin to lower your heart disease risk.

Genital HerpesGenital Herpes

"This is an 'everywhere' disease."

- Charles Ebel, the American Social Health Association.

"It's not only common, but recent studies demonstrate that herpes cuts across race and class very dramatically," says Charles Ebel, senior director of program development at the American Social Health Association in Research Triangle Park, North Carolina.

Yet early symptoms are so subtle that people often don't recognize them as a problem. The key, Ebel says, is knowing what to look for.

About two-thirds of people with genital herpes will eventually recognize some symptoms. "If you have recurring symptoms below the belt that are unexplained - even those that you may think are yeast, dermatosis, or even hemorrhoids - consider getting tested for herpes," Ebel suggests.

There's no need to get tested if you have no symptoms at all, says Ebel. But if you think you may have symptoms, "testing makes sense because if it's herpes, we can promote appropriate prevention steps."

For example, an infected person can take antiviral drugs daily to reduce the chance of passing the virus on to a partner. Condoms also greatly reduce the risk.

"Today," says Ebel, "there are many more options to manage symptoms and protect sexual partners."


"People don't look at their moles at all and even those that do, don't notice subtle changes."

- Jeanine Downie, MD

Melanoma accounts for 4% of all skin cancers, but causes nearly 80% of the deaths. When was the last time you checked your skin?

"Go to a board certified dermatologist at least once a year for a full body screen," says Jeanine Downie, MD, a Montclair, New Jersey dermatologist. "If you catch it early, it may just be an atypical mole and not a melanoma yet. And if it's a melanoma, it may be a thin melanoma on the top layer of the skin," which is easier to treat, she tells WebMD.


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Skin checks are particularly important for Asian-Americans, African-Americans and Latin Americans. "In these populations, melanomas may not be in sun-exposed areas. We find them in the mouth, under the finger- or toe-nails or in the genital areas," says Downie, also the author of "Beautiful Skin of Color: A Comprehensive Guide to Asian, Olive and Dark Skin."

These hard-to-spot places need to be monitored in all people, but particularly in these ethnic groups, she says. Dermatologists recommend you check yourself monthly at home to look for irregular lesions that are growing and changing.

Look for these ABCDs in moles:

  • Asymmetry or moles where one half is different than another
  • Border Irregularity, meaning that the edge of melanomas are usually ragged and jagged
  • Color because melanomas often have a variety of colors within the same mole
  • Diameter as melanomas continue to grow
To prevent melanoma, the American Academy of Dermatology recommends avoiding sun exposure from 10:00 a.m. through 4:00 p.m. when the sun is the strongest. You should also wear a broad-spectrum sunscreen and reapply it frequently. Wear a hat and clothing with a tight weave that will block ultraviolet light.

High Blood PressureHigh Blood Pressure

"It's important to know that high blood pressure can affect you at any age - including young people and adolescents."

- Anne Borik, DO

There's a reason high blood pressure is called the silent killer! One in four American adults has high blood pressure, according to recent estimates. But because there are no symptoms, nearly a third of these people don't know it.

The only way to tell if you have high blood pressure is to have your blood pressure checked. Your doctor should check your blood pressure at every visit. The upper number in a blood pressure reading (systolic pressure) should be less than 120 and the lower number (diastolic pressure) should be less than 80, according to the American Heart Association.

Uncontrolled high blood pressure can lead to stroke, heart attack, heart failure or kidney failure. But there's a lot you can do to keep your blood pressure low.

For one, "a low-calorie, low-salt diet is key. Salt causes the body to hold fluid in the vessels, which increases blood pressure automatically," says Anne Borik, DO, an internist at the Arizona Heart Hospital in Phoenix.

"Exercise is really, really important," she says. "During aerobic exercise, the body releases [feel-good chemicals called] endorphins that have a positive effect on widening blood vessels and decreasing blood pressure."

Stress reduction is also vital. "Stress causes constriction of blood vessels and that increases blood pressure," Borik says. "Smoking increases blood pressure and one of the first things people can do is to quit smoking and try to avoid passive smoke."

If lifestyle changes don't work, your doctor can also prescribe medicine to help lower moderate-to-high blood pressure.


"Glaucoma is a painless, gradual loss of vision."

- Nauman Imami, MD

About 2.2 million Americans age 40 and older have glaucoma . But half may be unaware that they have this potentially blinding disease because they have no symptoms, according to the American Academy of Ophthalmology.

"It generally affects peripheral vision first; constricting it so slowly that you don't know that you are missing it," says Nauman Imami, MD, the director of the glaucoma service at Henry Ford Health System in Detroit, Mich.

"You can lose a significant amount of vision before you know you have it," he says. In glaucoma, the optic nerve is damaged. It can be associated with elevated pressure inside the eye and can lead to vision loss.

There is good news: Early diagnosis and treatment can preserve your sight.

"In the majority of folks, if you catch it early and lower intraocular pressure, you can slow its progress so that the typical person won't have problems during their lifetime," says Imami. Typically, an eye doctor will prescribe eye drops to lower eye pressure. Surgery is also an option if needed.

Risk factors include family history of glaucoma, African-American descent, increasing age and elevated eye pressure. "We can treat eye pressure to lower it and reduce risk of vision loss, but most of other risk factors we can't change," Imami says.

Your best bet: If you have glaucoma, get a field of vision test once a year. "More frequently, if the condition is advanced," he says. "If you are at risk and your pressure is normal and your visual field is normal, you may not need to get tested every year but should be followed by an ophthalmologist."

High CholesterolHigh Cholesterol

About 105 million Americans have total cholesterol of 200 mg/dL or higher, the level at which the risk for heart disease begins to rise.

- American Heart Association

High cholesterol is a major risk factor for heart disease, yet it has no symptoms. Most people don't know their cholesterol is too high unless they get a blood test as part of their annual physical.

"Knowing your cholesterol - good and bad - is important," says Anne Borik, DO, an internist at the Arizona Heart Hospital in Phoenix. From there, "try to decrease the bad and increase the good."


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"Bad" or low density lipoprotein (LDL) levels should be less than 100 milligrams per deciliter of blood (mg/dL) and "good" or high density lipoprotein (HDL) levels should be 40 mg/dL or higher.

The American Heart Association recommends having your cholesterol levels measured every five years- or more often if you're a man over 45 or a woman over 55.

What's the best way to get your cholesterol numbers where you want them?

"Eat foods low in saturated fat and cholesterol, lose weight if you need to and exercise," Borik says. Lifestyle changes can lower your cholesterol and reduce your risk of heart disease and stroke. If these changes are not enough, ask your doctor about medicines to lower cholesterol.

Published Dec. 29, 2003.

SOURCES: Charles Ebel, senior director of program development at the American Social Health Association in Research Triangle Park, North Carolina. Anne Borik, DO, an internist at the Arizona Heart Hospital in Phoenix, AZ. Jeanine Downie, MD, dermatologist in Montclair, NJ. Nauman Imami, MD, director of the glaucoma service at Henry Ford Health System in Detroit.

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