The Challenges of Having a Silent Condition

How to deal with your doctor, your family and friends, and your own doubts

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Managing silent conditions such as thyroid disease, osteoporosis, or high blood pressure can be challenging. Since it's not obvious to everyone that you're coping with a condition, you'll need to balance the ​management requirements imposed by your condition with questions from your friends and family. In some cases, you may even confront doubt or resistance from your loved ones and doctors.

There will be times when you'll need to temper your own expectations about your condition and treatment, since having a "silent" condition can mean both that it's not apparent to others and that it's not particularly apparent to you.

However, knowledge is truly power: Once you learn about your condition—and how to explain it to others—you'll find that managing everyone's beliefs and expectations (including your own) gets easier, too.

What Is a Silent Condition?

Silent conditions are medical issues with no symptoms that are obvious to you, the person with the condition, and/or to others.

When you have a broken leg, it's not a silent condition. It's clear to everyone, including you and all the people around you, that your leg is broken. You're probably hobbling around on crutches with a large cast, and your friends and family know they will need to adjust their expectations accordingly—you won't be going on hikes, climbing long staircases, or even standing for extended periods of time until your leg is fully healed.

Silent conditions aren't obvious like a broken leg. For example, if you have hypothyroidism, the most common thyroid condition, you might have some vague symptoms such as constipation or fatigue, but you may not notice these symptoms or connect them with your thyroid gland until your condition is well advanced.

If you have osteoporosis, you probably won't realize it at all unless you have a bone scan; if you're not properly diagnosed, your first sign of your thinning bones could be when you break one.

Other common, potentially silent conditions include:

    Sometimes you'll experience symptoms, but those around you won't notice them. These invisible conditions or disabilities might rule your life—as in, for example, chronic fatigue syndrome or fibromyalgia—but since you look fine, your friends and family members might have trouble acknowledging the problem.

    Even if you don't notice symptoms yourself (and those around you remain in the dark, too), that doesn't mean your condition isn't damaging your health if it goes untreated. In the case of untreated hypothyroidism, for example, you could find your symptoms worsening until they become obvious, and in the case of osteoporosis, you could wind up with a hip or wrist fracture that does permanent damage.

    Sticking With Your Treatment When Your Condition Is Silent

    There's no question that sticking with your treatment can be challenging when you've been diagnosed with a silent condition, especially if you had been in generally good health before your diagnosis.

    Some silent conditions, like thyroid disease and high cholesterol, require daily medications, and you might resent having to take pills each day or twice a day. In some cases, you might experience side effects from the medications that seem worse than the disease.

    For example, high blood pressure medications can carry side effects that include frequent urination, a chronic dry cough, and loss of your sense of taste. Statins, used to treat high cholesterol, can cause muscle pain and weakness.

    However, working with your doctor to find the best medication—or combination of medications—can help you treat your condition in the most effective way possible while limiting any side effects from the medications themselves.

    It can be even more challenging if your condition is one you treat with diet. In silent celiac disease, for example, your body is reacting to foods that contain the protein gluten (found in the grains wheat, barley, and rye), even if you're not aware of it.

    The only treatment for celiac disease is to follow the gluten-free diet and avoid all gluten-containing foods, and that requires a drastic, difficult lifestyle change. If you have significant celiac symptoms you may be more likely to stick with the diet, since It can be hard to see the reasoning behind this massive change if you aren't seeing a tangible benefit but do experience disruption in your life.

    The same situation can exist in type 2 diabetes, which requires keeping an eye on your carbohydrate intake and choosing protein and fiber-rich meals. This is more difficult than just grabbing any quick snack, and you might resent the level of effort it entails.

    These feelings about your medications or diet are real and legitimate, so you should allow yourself to acknowledge them. But once you've done so you need to work through them, since your health depends on following your treatment plan, regardless of whether it causes side effects or life disruption.

    The best way to do this is to educate yourself on your condition and the reasons for treating it. With high blood pressure, for example, you risk having a stroke or developing eye or kidney disease if you don't stick with your treatment. With thyroid disease, you risk heart problems and infertility. And with celiac disease, you risk malnutrition and even a rare type of cancer. Keeping the big picture in focus can help if you waver in your resolve to do what it takes to be healthy.

    If you're having trouble following your treatment plan, talk to your doctor about switching your medications or getting a referral to a dietitian, who can help you master your new diet.

    Explaining Your Silent Condition to Others

    It can be tricky enough to persuade yourself that you need treatment when you don't see any symptoms of your silent condition. When it comes to your friends and family, you may sometimes feel less than supported.

    Most people with diabetes or celiac disease have experienced the "surely a little bit won't hurt!" phenomenon of having a certain food pushed on them. And someone with chronic fatigue syndrome might get annoyed if a friend constantly pushes for more activity than is possible.

    Of course, you don't have to say anything about your condition and treatment—you can go about your daily life without explaining it to those around you (it's a silent condition, after all). But if you choose to let people know your diagnosis, you should expect questions, some of which might even seem a little clueless. Your best defense is knowledge: if you understand your condition inside and out, you'll be more successful in explaining it to others.

    Don't be afraid to push back if a friend or family member is persistent in trying to convince you to break your diet or do something you shouldn't. Remember that your present and future health is at stake, and tell the person that.

    When it comes to your job, you have no obligation to disclose your condition to your employer. However, you'll only be protected by laws that prohibit discrimination against workers with medical conditions if you have disclosed that condition. You also have the right to ask your employer for "reasonable accommodations" to take care of issues arising from your condition. For example, those with diabetes can ask for time during a shift to test their blood sugar, and someone with chronic fatigue syndrome can ask for a stool to sit, rather than standing.

    Dealing With Your Doctor

    Your doctor should work with you to manage your silent condition and should listen to any concerns you have about how treatment might be affecting your life. But we all know that doctors are overworked these days, and you may find that yours is "treating to the test" (in other words, looking solely at your test results) instead of treating you as a whole person with legitimate concerns about side effects to prescribed treatment.

    If you feel like your doctor isn't listening to you, you'll need to try harder to break through. Bring research you have done that backs up your concerns to your next appointment, and be prepared to summarize and explain it. Some doctors do fall back on a "cookie cutter" approach for treating certain common conditions, like high blood pressure or type 2 diabetes, but if those often-used treatments aren't working for you, you'll need to speak up.

    If your doctor still dismisses your concerns, then it may be time to find another doctor. If you need to do that, make sure to get copies of your medical records as you leave your former doctor's practice, and ask around for recommendations—keeping in mind your diagnosis—before choosing a new doctor.

    A Word From Verywell

    Managing a medical condition can be difficult, especially if you (or those around you) don't see any overt signs that you actually have a medical condition you need to manage. It can be discouraging to start treatment for a silent medical condition and realize the treatment itself is causing side effects or life disruptions you hadn't experienced prior to your diagnosis.

    Again, if you're taking medication for your condition and you're experiencing uncomfortable side effects, you should talk with your doctor about changing your treatment regimen—different drugs affect people in different ways, and changing formulations or brands may help. If you're struggling with diet, ask to be referred to a dietitian who specializes in your condition. You shouldn't suffer in silence, even if your condition is silent.

    If, on the other hand, you're struggling with gaining understanding and acceptance from those around you, try talking to them and educating them... but keep in mind that it's your good health at stake, so persuading them of the need to follow your treatment plan is secondary to the ultimate goal of improving your own health.

    As time goes on and you take care of your health and your condition, you may find that you feel better, even if you felt pretty good before—this effect isn't unusual for people whose treatment involves a healthier diet. And ultimately, learning about your silent condition will help you understand—and accept—the need to treat it.

    Sources:

    Centers for Disease Control & Prevention. High Blood Pressure fact sheet.

    Green PH. The Many Faces of Celiac Disease: Clinical Presentation of Celiac Disease in the Adult PopulationGastroenterology. 2005 Apr;128(4 Suppl 1):S74-8.

    National Institutes of Health. Osteoporosis fact sheet.

    U.S. National Library of Medicine/Medline Plus. Silent Thyroiditis fact sheet.

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