Some diseases get missed more often than others.
For a general overview see
Failure to Diagnose
and also various statistics
at How Common is Failure to Diagnose?.
Under-diagnosis is common for conditions
that have either no symptoms or only vague or mild symptoms.
Another reason for misdiagnosis is a lack of proper
understanding about a condition, either in the public
or by medical professionals.
Under-diagnosis can also occur for conditions that are rarer
than other conditions and thus simply don't
get considered by patients and their doctors.
Under-diagnosed due to mild or absent symptoms:
Numerous conditions remain under-diagnosed
because they either have no symptoms
or perhaps only vague symptoms.
- Type 2 diabetes and Impaired glucose tolerance:
Although the classic insulin-requiring
Type 1 diabetes is rarely overlooked, Type 2 diabetes
or "adult-onset diabetes" is more common.
It often has a gradual onset of mild symptoms over years,
often starting out as the milder impaired glucose tolerance,
and many patients are simply unaware anything is wrong
and never seek medical attention.
Generally, because diabetes is well-known,
most doctors know that when they treat certain
apparently mild problems,
such as poorly healing skin rashes, they should test for diabetes.
However, sometimes even doctors miss diabetes.
- High cholesterol:
This risk factor for artery and heart disease
also often has no symptoms.
Most conditions are only discovered via blood tests
as part of a medical checkup.
High blood pressure has no early symptoms
and is often missed
until the patient has a medical checkup.
Many women and also a lot of men suffer from thin bones
Unfortunately, many are not diagnosed
until they actually suffer a fracture.
- Sexually transmitted diseases:
Several types of STDs have no symptoms in many patients,
even after some time.
A large proportion of people with chlamydia, HPV, trichomoniasis,
or gonorrhea will have no major symptoms, if any.
Surprisingly, genital herpes can also have no symptoms
in some people.
Even HIV has a long latent phase, typically many years,
before the early symptoms of AIDS begin.
This genetic disease, affecting around 1-in-200 to 300,
causes iron overload
that gradually damages various body organs.
Because it has no early symptoms, it is often undiagnosed
until serious organ damage causes other conditions or symptoms.
This is unfortunate because hemochromatosis is easily treated.
- Chronic kidney disease:
Although kidney disease is serious and potentially
it can have an insidious onset
without noticable symptoms.
Hence, many people start to get kidney disease
without being aware of it.
- Hypothyroidism including Hashimoto's thyroiditis:
The early symptoms of hypothyroidism
or other thyroid disorders are often mild and vague
such as fatigue and weakness.
Hypothyroidism is often under-diagnosed and overlooked,
particularly in women.
The gradual buildup of pressure in the eye
that causes glaucoma does not cause early symptoms.
Hence, glaucoma is often undiagnosed
in its early stages.
Under-diagnosed due to lack of awareness:
Several conditions remain under-diagnosed
because of difficulties recognizing the conditions.
Although very common, depression is surprisingly still an
Certain groups such as the elderly often have overlooked depression.
One reason is that many people with depression are not aware
that they have a serious problem,
and might only visit their general practitioner
about some physical symptoms such as fatigue, aches, and pains.
Lack of awareness of their mental symptoms
means that people with depression are less likely
to seek treatment from psychologists or psychiatrists
but more likely to see the family doctor.
- Infectious diarrhea:
When people have a sudden attack of severe digestive
symptoms (e.g. diarrhea, nausea, vomiting),
they often assume it is food poisoning.
Although this can be true, it is also quite common for the condition
to be a contagious viral or parasitic infection of the digestive tract.
Few people are aware of viral digestive infections,
and the condition goes unreported and under-diagnosed.
- Fecal incontinence:
Many people with this condition are unaware
that it is a treatable condition.
Embarrassment and ignorance often leads to people
avoiding or delaying medical advice about this condition.
- Lactose intolerance:
Although lactose intolerance usually causes clear digestive symptoms,
many people are unaware of the condition,
and blame the symptoms on other digestive problems
such as indigestion.
Lactose intolerance is particularly common in Americans
of African, Hispanic or Asian descent,
and less common in Caucasians.
- Polycystic ovary syndrome (PCOS):
This condition causes various hormonal and menstrual symptoms,
and can lead to infertility.
Although it is surprisingly common in women,
it is not well known, and many women with the condition
are unaware that they actually have a serious condition.
- Flat feet:
Many people have foot abnormalities
that have some level of "flatness" of the arch.
However, few people actually seek treatment for this condition.
- Attention deficit hyperactivity disorder and hyperactivity:
Although ADHD is over-diagnosed in children and adolescents,
it is under-diagnosed in adults.
People who are not diagnosed in childhood often remain
undiagnosed through adulthood.
- Sleep disorders such as sleep apnea:
Many people get sleep apnea
and indeed other sleep disorders,
but they remain under-diagnosed.
Whereas insomnia is at least noticable to the non-sleeper,
sleep apnea occurs while the person is asleep,
and the affected
person may not even be aware they have interrupted sleep patterns.
Another misunderstood sleep disorder is narcolepsy.
Although the exact situation with regard to asthma
prevalence and diagnosis is unclear,
there are certainly some populations
in which asthma is under-diagnosed.
Some sources claim asthma is under-diagnosed in children,
with episodes of wheezing not considered possible cases of asthma,
and thus not seeking diagnosis and treatment.
However, other sources state that asthma is over-diagnosed in children.
Asthma is also probably under-diagnosed in the elderly.
Rarer conditions under-diagnosed:
There are numerous less common disorders
that are often missed or misdiagnosed as another disorder
at least in part because of their rarity.
- Bipolar disorder:
This condition, also known as manic-depressive disorder,
is less common than simple unipolar depression,
many people with bipolar disorder are misdiagnosed.
Part of the problem is that few patients are
self-aware of their manic or euphoric episodes
and only seek treatment during depressive times.
- Celiac disease:
The chronic digestive disorder celiac disease
is not well known and often overlooked.
Instead, it is often misdiagnosed as irritable bowel syndrome
or another chronic digestive disease.
In cases where the main symptoms are non-digestive symptoms
such as anemia and fatigue,
the condition might be misdiagnosed as chronic fatigue syndrome,
depression, or other fatigue-causing disorders.
- Whooping cough (or pertussis):
Although uncommon in children due to vaccination programs (e.g. DTP or DTPa),
protection wears off after about 10 years.
Because of this, whooping cough is making a worldwide comeback
and is a surprisingly common cause of persistent cough
in teens, adults and the elderly.
However, few adults seek treatment for the nagging cough,
believing it only to
be an annoying cough from a common cold,
and hence whooping cough often remains undiagnosed.
Sadly this means that it can be spread by adults to infants in whom it can be
dangerous and even fatal.
» Next page: Delayed Diagnosis
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