Why Are You Keeping Things A Secret?

“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.

The top six things you aren’t telling your doctor about, but really should, are:

Supplements. You may think the doctor will look down her nose at certain herbs and supplements, but you need to tell them exactly what you take, since some supplements and OTC products may not mix well with prescription medicines you've been prescribed. Patients can even have specific conditions for which they shouldn't take an OTC medicine.

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.

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.

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 upcoming 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 not only get screened properly, but often enough.

Smoking, Drinking & Other Recreational Habits. 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," 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.

Emotional Health Problems. 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.

Not Doing What The Doctor Told You To Do. 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.

Sleep Problems. 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.