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Doctors have heard it all. They know you may bend the truth a little when you say you're getting lots of exercise, you never drink more than one glass of wine a day, or you hardly ever hit the drive-through. In fact, 28 percent of Americans admit they sometimes lie to their physician, according to a 2010 national survey by GE, the Cleveland Clinic and Ochsner Health System. You may keep something from your doc out of fear or embarrassment or because it just doesn't seem important. But there can be consequences to those little white lies, says Michael F. Roizen, MD, co-author of the best-selling "You" series of health books. "The doctor-patient relationship should be a no-embarrassment zone where you feel comfortable to be completely honest. If you don't tell your doctor everything, he can't help you." So fess up — your health depends on it.
Little white lie: "I only have one drink with dinner."
Consequences: Yes, there are health benefits to moderate consumption of alcohol — but the key word is "moderate." If you've been swilling rather than sipping lately, you need to tell your doctor. High alcohol consumption can increase your risk of cardiovascular disease, diabetes, breast cancer, weight gain, or having an accident, says Henry R. Kranzler, MD, associate director of the Alcohol Research Center at the University of Connecticut School of Medicine. If you combine alcohol with NSAID pain relievers (like Advil), you're at greater risk of gastric bleeding, and combining alcohol with acetaminophen (Tylenol) can cause liver damage. Limiting yourself to one four-ounce glass of red or white wine (restaurant serving sizes can be much larger), one and a half ounces of liquor, or one bottle of beer is good for your heart, may prevent dementia, and also might help keep your weight down. But you can't mess with the math, says Dr. Kranzler: It doesn't work if you save up all seven drinks for the weekend.
Little white lie: "I always take my medicine."
Consequences: People stop taking their prescription meds for a host of reasons: They don't like the side effects, they're feeling fine, the pills are too expensive, or they just forget. But it's crucial that you be honest with your doc about this so he can help you understand that stopping pills suddenly may have a dire outcome. Some, such as antidepressants, certain blood pressure medications, and corticosteroids, need to be tapered off. Stopping heart, blood pressure, or diabetes medicine can cause a dangerous return of symptoms. Antibiotics may make you feel better well before the pills are gone. "But even if you just skip one or two pills, some bacteria might be left in your body and resist future antibiotic treatment down the line — not only for you but for the general population," says Shmuel Shoham, MD, scientific director for the MedStar Clinical Research Center at Washington Hospital Center. The best course of action with any medication? Never stop taking it on your own unless you have a sudden severe reaction, like a rash, hives, shortness of breath, or facial swelling, says Dr. Shoham, and call your doctor to report any side effects. If you can't afford the pills, talk to your doctor about that, too: He may be able to prescribe something less expensive.
Little white lie: "I'm not a smoker."
Consequences: Lighting up now and then with friends doesn't make you a real smoker, right? Wrong! Just as you can't be only a little bit pregnant, you can't be a little bit of a smoker, says Nieca Goldberg, MD, clinical associate professor and director of the New York University Women's Heart Center. "Either you are or you aren't." Yet 42 percent of "social" smokers consider themselves nonsmokers. And many of them probably don't think they need to tell their doctors about it. But it's vital she know because even an occasional puff increases your risk for heart attack, stroke, and cancer. Being a smoker makes it riskier for you to take birth control pills, too, so it could be a deciding factor in whether your doctor will prescribe them. If you are truly a social smoker, it should be easier to quit than if you have a pack-a-day habit, says Dr. Goldberg. It can help to figure out what triggers your social smoking. Alcohol is a common culprit, so cutting back on drinks may be a good start toward kicking the habit for good.
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Using birth control
Little white lie: "Of course I use birth control — every time!"
Consequences: As you get closer to menopause it's easy to assume that your chances of getting pregnant are tiny, which may be why women over 40 have a tendency to skip birth control (and some 38 percent of pregnancies in women over 40 are unintended). "But later-in-life pregnancies can be dangerous," says Laura Riley, MD, a maternal fetal medicine specialist at Massachusetts General Hospital. For example, there's a greater risk of miscarriage, preeclampsia, diabetes and postpartum hemorrhage — as well as more C-sections. If you don't want an unexpected pregnancy, you need to use reliable birth control until you hit menopause — meaning you haven't had a period for a year. And if you're dating, condoms are a no-brainer: They're the only method that protects against many sexually transmitted diseases.
Little white lie: "I feel fine; I'm not depressed."
Consequences: Maybe you think your internist doesn't want to hear about your mood swings, but she does. Depression, irritability, and fatigue can be signs of disorders like thyroid disease and adrenal dysfunction or a clue that you might benefit from hormone therapy as menopause nears. It's important to find out whether your moods signal an underlying physical problem or maybe a case of clinical depression that needs your doc's immediate attention. "Some people feel ashamed to admit having symptoms of depression," says psychiatrist Jennifer Yashari, MD, an instructor at UCLA. "Yet it's a common condition and very treatable. It's crucial to tell your doctor, because leaving your depression untreated can adversely affect your work, your relationships, and your life."
Little white lie: "I get plenty of exercise!"
Consequences: Of course you're reluctant to confess that the most activity you've had lately is hitting the play button on the DVR to catch up on "Mad Men." But your health and even your longevity could suffer, says Dr. Roizen. If your doc doesn't know your real exercise habits, he can't properly assess your risk for heart disease, diabetes and other illnesses. The only way to improve the way your heart functions, Dr. Roizen says, is to do exercise that makes you sweat. It only takes three 20-minute workouts a week; just make sure that you get your heart rate up high enough to break a sweat. "It may be the most important thing you do to live a long, healthy life," he says.
Little white lie: "I take a multivitamin and that's it."
Consequences: It's vital that your doctor know all the prescription or over-the-counter meds you're taking as well as any nutritional or herbal supplements. Some supplements may contain unhealthy megadoses and others can cause interactions with medications. For instance, Saint-John's-wort, an herbal supplement used for depression, may cause bleeding when combined with prescription blood thinners or make oral contraceptives less effective. "Thousands of safety problems a year are related to herbal remedies," says Gerard E. Mullin, MD, associate professor of gastro-intestinal medicine at Johns Hopkins University. Research shows that about three-quarters of patients are reluctant to tell their doctor they use complementary medicines. But to be safe taking them, says Dr. Mullin, you have to be honest.
Eating junk food
Little white lie: "I don't eat much junk food."
Consequences: We know that you don't have time to cook from the farmers' market every night. But neglecting to tell your doctor about your processed-food habit could have a negative effect on your health. It's important to remember that the fats and excess sugar in many fave fast foods and packaged goodies can raise your bad cholesterol, lower good cholesterol, and lead to heart disease, cautions Antonio Gotto, MD, dean of Weill Cornell Medical College. You should ask your doctor to determine your cardiovascular risk. This includes discussing your health history and habits as well as having a fasting blood test for cholesterol and C-reactive protein. Ask yourself if you're making the best choices to protect your health now and in the future.
Originally published in , October 2010.