20 Health Problems That are Worth a Second Opinion
If you worry about a medical misdiagnosis, you have reason to: Unfortunately, they're pretty common. According to a study published in the journal BMJ Quality and Safety, diagnostic errors affect 12 million—or 1 out of 20—American adults every year.
The reality is this: Doctors are human. Medicine isn't a flawless science, and it's evolving quickly. The best thing you can do to ensure a correct diagnosis is to be an active advocate in your own care—note any symptoms you're having and discuss them with your doctor thoroughly. Avoid the temptation to self-diagnose, but be alert to the most misdiagnosed conditions that follow, and tell your doctor if you think you fit their profile. Here are the 20 diseases doctors frequently misdiagnose, and what you can do about it.
Characterized by widespread joint pain, fatigue and muscle aches, fibromyalgia can be difficult to pin down. It can be misdiagnosed as a rheumatic disease like lupus, chronic fatigue syndrome and rheumatoid arthritis. Because it's often accompanied by sleep and mood issues, it can be mischaracterized as depression. "There are studies that show that people with certain symptoms who show up at a rheumatologist will be diagnosed with fibromyalgia, but if the same patients show up at a gastroenterologist they'll be diagnosed as having irritable bowel syndrome," Dr. Eugene Shapiro, deputy director of the Investigative Medicine Program at Yale University, has said.
The Rx: If you suspect you might have fibromyalgia, talk to your primary care doctor, who might provide a referral to a rheumatologist. Sufferers have reported having to see many doctors before receiving the proper diagnosis, putting the "patience" in patients.
The symptoms of a heart attack can be misinterpreted as something more benign, such as indigestion or a panic attack. Heart attacks are too often misdiagnosed in women—women are more likely than men to report heart attack symptoms that aren't in the chest, such as arm pain, stomach pain, chest palpitations, nausea and dizziness. A 2018 study published in the journal Circulation found that 53 percent of female heart attack sufferers saw doctors who didn't think their symptoms were heart related, compared to 37 percent of men.
The Rx: Be aware that while a crushing sensation in your chest is the most common heart attack symptom, discomfort elsewhere in the body is common, and don't hesitate to seek medical attention.
A stroke is a "brain attack," when the flow of blood or oxygen to the brain is interrupted, causing the death of tissue there. About 10 percent of strokes are misdiagnosed in the emergency room, particularly among younger people, where symptoms might be attributed to vertigo, migraines alcohol intoxication.
The Rx: Know the common test for stroke: FAST (facial drooping, arm weakness, or speech difficulties mean it's time to call 911). But according to the journal Neuroepidemiology, nonspecific symptoms like altered mental status, dizziness and nausea or vomiting can also be a sign. Other symptoms like severe headache, numbness, vision problems or confusion need immediate medical attention.
Celiac disease, an autoimmune condition in which the body attacks the small intestine in response to the gluten in wheat products, is one of the biggest sources of medical error. It's estimated that 83 percent of people with celiac are either still undiagnosed or have been misdiagnosed with other conditions.
The Rx: "If someone suspects he or she has a gluten-related condition, the first thing we must do is rule out celiac disease with a blood test for certain antibodies," says Dr. Sophie Balzora, a gastroenterologist at NYU Langone. Adopting a gluten-free diet before testing can invalidate those tests, so it's best to see a doctor before eliminating gluten from your diet.
Caused by a bacterium spread by tick bites, Lyme disease produces symptoms that are easy to dismiss as other illnesses or minor complaints—fatigue, headache and fever. One telltale sign is a rash at the area of the tick bite.
The Rx: Your doctor can make the diagnosis with a blood test and treat the illness with antibiotics. "Laboratory tests are not recommended for patients who do not have symptoms typical of Lyme disease," says the Center for Disease Control and Prevention. "Just as it is important to correctly diagnose Lyme disease when a patient has it, it is important to avoid misdiagnosis and treatment of Lyme disease when the true cause of the illness is something else."
According to the Journal of Clinical Oncology, doctors misdiagnose certain types of cancer up to 44 percent of the time. Diagnostic tools aren't perfect, and symptoms can be ambiguous, indicating other ailments (like a lung infection, instead of lung cancer) even after tests. Even pathologists can be tricked by your body.
The Rx: Get a second opinion—especially if your doctor isn't a cancer specialist, or isn't able to identify what kind of cancer you might have. Keep copies of all the records associated with your case, and ask all the doctors involved in your case to communicate about your care.
The classic symptom of appendicitis—pain in the lower right quadrant of the abdomen—isn't always that straightforward. "Some people have an appendix that points backward instead of forward in the body, so the symptoms present in a different location," Dr. Shapiro told CNN. "And sometimes people do have pain, but then the appendix ruptures and the pain is relieved so they think they're fine."
The Rx: A ruptured appendix can be a life-threatening condition, so head to the emergency room if you have abdominal pain that won't let up.
While depression is a common condition, marked by chronic feelings of sadness, irritability, hopelessness, or a lack of enjoyment in previous activities, doctors don't necessarily ask patients about their mood during a normal physical exam. Physical symptoms associated with depression, such as headaches and fatigue, can go unaddressed or attributed to other causes.
The Rx: Be open and thorough with your doctor about any symptoms of depression or anxiety you might be experiencing. Whatever stigma there once was is gone, and as Dwayne "The Rock" Johnson said: "Depression never discriminates."
Ovarian cancer is known as a silent killer because early detection is difficult. As you age, it's important to be vigilant about possible symptoms. According to the American Cancer Society, most ovarian cancers develop after menopause, and more than half of cases are in women over age 63.
The Rx: If you experience bloating, pelvic or abdominal pain, or feel full quickly when eating, consult your doctor. If you have a family history of ovarian cancer, tell your doctor about it. He or she might decide that more extensive or periodic testing is necessary.
The symptoms of this chronic inflammatory disease include fatigue and joint pain; some patients might develop a telltale butterfly-shaped rash across their cheeks, along with damage to the heart, kidneys or lungs. But the condition ranges in severity and symptoms are often nonspecific.
The Rx: Talk to your doctor about your symptoms. He might order tests like a chest X-ray, ANA and lupus erythematosus cell tests, or the most specific test for lupus: an anti-double-stranded DNA test (anti-dsDNA).
About 30 percent of cases of this chronic and progressive condition are initially misdiagnosed. Symptoms—which often include trembling, stiffness and unsteadiness—can mimic other neuro-degenerative conditions, including essential tremor. And remember: even a proper diagnosis isn't a death sentence. "I was only supposed to work for another 10 years. I was supposed to be pretty much disabled by now," Michael J. Fox told the Today Show. "I'm far from it. This is as bad as I get, and I can still go to the store and go marketing."
The Rx: Getting a second opinion from a neurologist at a research hospital can help prevent an expensive and time-consuming misdiagnosis.
A study in BMC Research Notes found that this serious heart condition—when the wall of the aorta tears and blood rushes through—was misdiagnosed in a third of patients, usually as a simple heart attack. It's particularly urgent and requires quick diagnosis and treatment.
The Rx: "Key in the management of acute aortic dissection is to maintain a high level of suspicion for this diagnosis," says BMC Research Notes. It can be diagnosed via tests like an X-ray, CT scan and transthoracic echocardiography.
A May 2019 study published in the journal Multiple Sclerosis and Related Disorders found that almost 1 in 5 multiple sclerosis patients are misdiagnosed with the autoimmune disease and spent an average of four years in treatment before learning they had another condition. The most common correct diagnoses were migraine, radiologically isolated syndrome, nerve damage, and spondylopathy, a disorder of the vertebrae.
The Rx: "The diagnosis of MS is tricky. Both the symptoms and MRI testing results can look like other conditions, such as stroke, migraines and vitamin B12 deficiency," said study leader Dr. Marwa Kaisey, from Cedars-Sinai Medical Center in Los Angeles. If you've received an MS diagnosis, don't be afraid to get a second opinion, describe your symptoms thoroughly and be candid with your doctors about your concerns.
Your thyroid, the butterfly-shaped gland on your neck, is a relatively discreet organ but is absolutely crucial—it dispenses hormones that are critical to hundreds of bodily functions. When it's underactive (hypothyroidism), you might experience nonspecific symptoms like fatigue, sensitivity to temperature or unexplained weight gain; if it's overactive (hyperthyroidism), you might have weight loss, irritability or rapid heartbeat.
The Rx: If you're experiencing any of those symptoms associated with a thyroid disorder, ask your doctor for a blood test that will check your TSH hormone levels. Imbalances can be treated with medication.
This painful gynecological condition—in which the lining of the uterus grows throughout the abdomen—can be overlooked and attributed to unusually heavy periods or severe cramping.
The Rx: If you have symptoms of endometriosis, ask your doctor for an ultrasound or laparoscopy tests to confirm it.
Polycystic Ovary Syndrome
This gynecological condition, in which benign cysts grow in one or both ovaries, is the leading cause of infertility—it's estimated up to 18 percent of women are affected. And they're often misdiagnosed. According to a March 2019 study published in the Journal of Clinical Endocrinology & Metabolism, nearly half of women with PCOS visited three or more doctors before getting a diagnosis, and that process took a third of the women more than two years. Two of these three conditions must be present: small ovarian cysts, elevated levels of testosterone, and irregular or missed menstrual periods.
The Rx: PCOS is difficult to pinpoint, because there's not a single blood test or diagnostic exam for it. If you're having trouble getting or staying pregnant, or experiencing symptoms like excess hair growth, headaches, weight gain or mood changes, talk to your doctor about testing for PCOS.
Headaches are notoriously difficult to diagnose, as they can be attributable to a number of factors—anything from stress and eye strain to depression, sinusitis and allergies. Migraines—recurring headaches that throb or pulse, are often isolated to one side of the head, and may be accompanied by sensitivity to light of sound—are frequently misdiagnosed as many of those conditions, a frustrating process that can take years before migraine sufferers are prescribed medications that effectively treat the condition.
The Rx: According to the Mayo Clinic, a neurologist can diagnose migraines by giving a full neurological exam, which may include an MRI or CT scan. Several prescription drugs can treat and prevent migraine pain.
Just as migraines are often misdiagnosed, cluster headaches are often misdiagnosed as migraines. According to the U.S. National Institute of Neurological Disorders and Stroke, cluster headaches are short but extremely painful headaches that occur in clusters, usually at the same time of the day and night for several weeks. They often occur behind or around one eye, and the pain can last for up to three hours. Other symptoms include tears, runny nose, congestion or sweating.
The Rx: If you suspect you have cluster headaches, visit a headache specialist. "In most cases, this kind of headache is very treatable once it is correctly diagnosed," says Dr. Juline Bryson, an assistant professor of neurology at Wake Forest Baptist Medical Center. "During an episode, we can inject a drug used to treat migraines, which can provide relief within minutes. And there are several drugs available that are quite effective in preventing these headaches."
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) consists of two autoimmune conditions: Crohn's disease and ulcerative colitis. Both cause inflammation of the intestines, which can result in stomach pain, diarrhea, fatigue, nausea and vomiting. Those symptoms overlap with irritable bowel syndrome (IBS) and celiac disease, which each have their own treatments.
The Rx: Discuss any bothersome digestive symptoms completely with your doctor, who may provide a referral to a gastroenterologist. Being completely candid can help a specialist pinpoint subtleties in symptoms that can lead to effective treatment faster.
A pulmonary embolism occurs when a blood clot lodges in the lung, blocking blood flow or oxygen. It's usually caused by a deep vein thrombosis (DVT) breaking free from a blood clot in the leg. It can cause chest pain, shortness of breath, dizziness and other symptoms that could be confused for a heart condition.
The Rx: If you experience symptoms of PE, tell your doctor about your risk factors for DVT, such as leg pain or swelling, recent long periods of sitting (including on plane travel), or a previous DVT diagnosis. And to get through life at your healthiest, don't miss: This Supplement Can Raise Your Cancer Risk, Experts Say.
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