Ask the Doctors: The 5 Questions Every Patient Is Really Asking (And the Honest Answers You Need to Hear)
Behind closed doors at London's leading private clinic, these are the practical health concerns patients bring up most often and the expert guidance that finally provides clarity
Dr Sarah Chen has noticed a pattern during her years at The Online GP. "Patients often start with one concern, then halfway through the appointment, they'll say 'Oh, and one more thing...' That's usually when they ask what they really came for," she observes. "It's rarely the dramatic stuff you see on medical TV shows. It's the everyday health questions that keep people awake at night but seem too trivial to mention."
After reviewing hundreds of consultations at The Online GP, five practical questions emerge consistently across all age groups and backgrounds. These aren't life-or-death concerns, but the common health uncertainties that affect daily life and long-term wellbeing.
Understanding these frequent concerns and their evidence-based answers can help patients make informed decisions about their health whilst knowing when professional guidance provides the most value.
Question 1: "Should I Be Taking Vitamins and Supplements?"
This question tops the list at virtually every consultation. Patients arrive with carrier bags full of supplements, wondering if they're wasting money or missing something crucial for their health.
The Supplement Confusion
The UK supplement market is worth over £400 million annually, yet most people have no idea whether their specific collection of pills provides any benefit. Patients typically start taking supplements based on magazine articles, social media recommendations, or advice from health food shops rather than medical guidance.
Common scenarios include taking vitamin D in summer, expensive multivitamins "for insurance," or single nutrients like vitamin C in massive doses that the body simply excretes. Many patients spend £50-100 monthly on supplements whilst being unsure about their necessity.
The marketing around supplements often suggests that more is better, leading people to take multiple products with overlapping ingredients or doses that far exceed physiological needs.
What the Evidence Actually Shows
Most healthy adults following a reasonably balanced diet don't require routine supplementation. The exceptions are specific circumstances where deficiencies are common or where evidence supports supplementation for health outcomes.
Vitamin D supplementation benefits most UK residents, particularly during winter months when sunlight exposure is insufficient for adequate production. The recommended dose is typically 10 micrograms (400 IU) daily, though higher doses may be necessary for those with confirmed deficiency.
Folate supplementation is crucial for women planning pregnancy or in early pregnancy to prevent neural tube defects. This is one of the clearest examples where supplementation prevents serious health problems.
Iron supplementation is sometimes necessary for individuals with heavy menstrual periods, vegetarians, or those with confirmed iron deficiency anaemia. However, iron supplements can cause digestive upset and shouldn't be taken without medical guidance.
Vitamin B12 supplementation is essential for vegans and may benefit older adults with absorption issues. This vitamin is found almost exclusively in animal products, making supplementation necessary for those following plant-based diets.
The Personalised Approach
Blood testing can identify specific deficiencies that warrant targeted supplementation rather than generic multivitamins. Common tests include vitamin D, B12, folate, iron studies, and occasionally magnesium or zinc depending on symptoms and risk factors.
Medical history matters significantly. Certain conditions, medications, or dietary restrictions create specific supplementation needs that differ from general population recommendations.
Age influences supplement requirements, with older adults potentially benefiting from vitamin D, B12, and calcium, whilst younger adults may need nothing beyond a balanced diet.
The Money Question
Most expensive supplements provide no additional benefit over basic formulations. Fancy packaging, celebrity endorsements, and premium pricing don't indicate superior absorption or effectiveness.
Generic brands from reputable manufacturers often contain identical active ingredients to expensive alternatives at a fraction of the cost. The regulatory requirements for supplements mean that active ingredient content must match label claims regardless of brand prestige.
The Honest Answer
Most people take more supplements than they need whilst missing the ones that might actually help them. Rather than guessing, have your vitamin levels tested and get personalised recommendations based on your individual circumstances, diet, and health goals.
Stop wasting money on expensive multivitamins and focus on the specific nutrients your body actually needs.
Question 2: "How Often Should I Really Be Getting Checked?"
Patients constantly ask about screening schedules, unsure whether they're being overly cautious with frequent check-ups or negligent by avoiding routine care.
The Screening Schedule Confusion
NHS guidelines provide general recommendations, but patients wonder if these apply to their individual circumstances or if private healthcare allows for more frequent monitoring. Many people either avoid all screening or request excessive testing based on anxiety rather than medical evidence.
Common concerns include how often to check blood pressure, when to start cancer screening, whether annual blood tests are necessary, and if family history changes standard recommendations.
The proliferation of private health screening packages creates additional confusion, with some companies promoting comprehensive annual screenings that may include unnecessary tests for low-risk individuals.
Evidence-Based Screening Guidelines
Blood pressure should be checked every five years for adults with normal readings, more frequently if elevated or if cardiovascular risk factors are present. This simple screening can identify hypertension years before symptoms develop.
Cholesterol screening is recommended every five years starting at age 40, though earlier testing may be appropriate for those with family history of heart disease or other cardiovascular risk factors.
Cervical screening occurs every three years from ages 25-49, then every five years from 50-64 for women with normal results. This programme has dramatically reduced cervical cancer rates in the UK.
Breast screening begins at age 50 with mammograms every three years until age 70, though women with strong family history may benefit from earlier or more frequent screening.
Bowel cancer screening starts at age 60 with home testing kits every two years, followed by colonoscopy if abnormalities are detected.
Individual Risk Factors
Family history significantly influences screening recommendations, with some individuals requiring earlier or more frequent testing based on inherited risk factors for specific conditions.
Personal medical history also affects screening needs, with previous abnormal results often requiring more frequent monitoring even after treatment or resolution.
Lifestyle factors including smoking, excessive alcohol consumption, or obesity may warrant more intensive screening for related health conditions.
The Over-screening Problem
Excessive screening can lead to false positive results, unnecessary anxiety, and additional testing that provides no health benefit whilst creating significant cost and inconvenience.
Some private screening packages include tests with poor predictive value that generate abnormal results in healthy individuals, leading to cascade testing and intervention that doesn't improve health outcomes.
The psychological impact of frequent screening can create health anxiety that negatively affects quality of life whilst providing no measurable health benefits.
The Honest Answer
Follow evidence-based screening guidelines unless specific risk factors warrant modified approaches. More frequent screening isn't necessarily better and may cause more harm than benefit through false positives and unnecessary anxiety.
Work with a healthcare provider to develop a personalised screening schedule based on your individual risk factors rather than generic fear or commercial screening packages.
Question 3: "Is My Tiredness Normal or Something I Should Worry About?"
Fatigue ranks among the most common complaints in general practice, yet patients struggle to determine when tiredness represents normal life demands versus underlying health issues.
The Modern Fatigue Epidemic
Contemporary life creates numerous causes for fatigue that aren't related to medical conditions. Poor sleep quality, work stress, social media disruption of sleep patterns, and constant connectivity all contribute to feeling persistently tired.
Patients often expect to feel energetic throughout the day despite maintaining schedules that would exhaust previous generations. The comparison culture of social media creates unrealistic expectations about energy levels and productivity.
Many people consume caffeine constantly to maintain alertness, creating cycles of stimulation and crash that perpetuate fatigue patterns whilst masking underlying sleep or lifestyle issues.
Medical Causes Worth Investigating
Thyroid disorders, particularly underactive thyroid (hypothyroidism), commonly cause fatigue along with weight changes, cold sensitivity, and dry skin. Simple blood tests can identify thyroid problems that are easily treated.
Iron deficiency anaemia causes fatigue along with shortness of breath, pale skin, and cold hands and feet. This is particularly common in women with heavy menstrual periods or individuals following vegetarian diets.
Sleep disorders including sleep apnoea can cause persistent tiredness despite apparently adequate sleep duration. These conditions often go undiagnosed for years whilst significantly impacting quality of life.
Diabetes can present with fatigue, excessive thirst, and frequent urination. Early detection through blood glucose testing allows for lifestyle interventions that can prevent progression to more serious complications.
Depression and anxiety frequently manifest as persistent fatigue, particularly when accompanied by mood changes, loss of interest in activities, or sleep disturbances.
Lifestyle Factors That Cause Fatigue
Sleep quality matters more than sleep quantity, with many people spending adequate time in bed but not achieving restorative sleep due to screen time, room temperature, or timing of meals and exercise.
Dehydration contributes significantly to fatigue, yet many people consume insufficient water throughout the day whilst relying on caffeinated beverages that can worsen dehydration.
Blood sugar fluctuations from irregular meal timing or high-sugar diets create energy crashes that feel like persistent fatigue. Stable blood sugar through regular, balanced meals often resolves these symptoms.
Sedentary lifestyles paradoxically increase fatigue, as regular physical activity actually boosts energy levels through improved cardiovascular fitness and better sleep quality.
The Investigation Approach
Basic blood tests including full blood count, thyroid function, glucose, and inflammatory markers can identify common medical causes of fatigue efficiently and cost-effectively.
Sleep assessment may involve keeping a sleep diary or, in some cases, formal sleep studies to identify disrupted sleep patterns or sleep disorders.
Mental health screening helps identify depression or anxiety that may present primarily as fatigue rather than obvious mood symptoms.
The Honest Answer
Your tiredness is probably related to lifestyle factors rather than serious medical conditions, but simple blood tests can rule out common treatable causes whilst providing reassurance.
Focus on sleep hygiene, regular meal timing, adequate hydration, and moderate exercise before assuming medical causes. However, persistent fatigue that doesn't improve with lifestyle changes warrants medical evaluation.
Question 4: "Should I Be Worried About This Mole/Lump/Skin Change?"
Skin concerns generate enormous anxiety, with patients photographing every new mark whilst struggling to distinguish between normal skin changes and those requiring medical attention.
The Skin Anxiety Phenomenon
Social media and health awareness campaigns about skin cancer, whilst important for prevention, have created heightened anxiety about every skin change. Patients arrive with detailed photographs documenting the evolution of normal moles or age spots.
The "ABCDE" rule for melanoma (Asymmetry, Border, Colour, Diameter, Evolution) gets misapplied to normal skin variations, leading people to worry about freckles, age spots, or benign moles that have remained stable for years.
Many people lack understanding of normal skin ageing processes, becoming concerned about changes that represent predictable responses to sun exposure and time rather than pathological processes.
Normal Skin Changes With Age
Age spots (solar lentigines) are flat, brown spots that develop on sun-exposed areas and are completely benign despite their sometimes irregular appearance. These increase in number and size with age and sun exposure.
Seborrhoeic keratoses are raised, waxy growths that can appear alarming but are entirely benign. They often have a "stuck-on" appearance and can be various shades of brown or black.
Skin tags are small, soft growths that commonly develop in areas of friction such as the neck, armpits, or groin. These are harmless but can be removed for cosmetic reasons if desired.
Cherry angiomas are small, bright red spots that increase in number with age. These represent dilated blood vessels and are completely harmless despite their vivid colour.
Changes That Warrant Assessment
New moles appearing after age 30, particularly if they differ significantly from existing moles, should be evaluated by a healthcare provider or dermatologist.
Changes in existing moles including size increase, colour variation, irregular borders, or bleeding require prompt medical assessment to rule out malignant transformation.
Persistent non-healing spots, particularly on sun-exposed areas, may represent skin cancers that require evaluation and treatment.
Any skin change that seems concerning or different from your normal pattern warrants professional assessment rather than anxious monitoring at home.
The Photography Problem
Whilst photographing skin lesions can help track changes over time, excessive documentation often increases anxiety without improving health outcomes. Most skin changes that worry people are benign variations.
Professional skin examination provides much more information than photographs, including assessment of texture, depth, and other characteristics that cannot be captured in images.
Annual skin checks by healthcare providers or dermatologists provide structured monitoring for individuals at higher risk whilst offering reassurance for those with normal skin changes.
The Sun Damage Reality
Most skin changes that concern patients result from cumulative sun exposure over decades rather than recent sun damage. This means that new spots or changes don't necessarily indicate recent sun damage or failure to protect skin adequately.
Prevention remains important, but existing sun damage cannot be reversed through skincare products or lifestyle changes. Accepting these changes as normal consequences of living reduces anxiety whilst maintaining focus on prevention of future damage.
The Honest Answer
Most skin changes that worry people are normal consequences of ageing and sun exposure rather than skin cancer. However, any change that seems different or concerning warrants professional evaluation rather than anxious self-monitoring.
Annual skin checks provide structured assessment whilst addressing specific concerns efficiently. Don't let skin anxiety consume mental energy, but don't ignore changes that feel genuinely different.
Question 5: "Do I Need to Worry About My Weight, and What Actually Works for Losing It?"
Weight concerns surface in most consultations, whether directly stated or underlying other health discussions. Patients struggle with conflicting diet advice whilst wondering if their weight affects their health risks.
The Weight Reality Check
BMI calculations often confuse patients who don't understand whether their measurements indicate health risks or simply aesthetic concerns. Many people with normal BMI worry unnecessarily, whilst others with genuine health risks dismiss weight as unimportant.
The relationship between weight and health isn't straightforward, with factors like muscle mass, fat distribution, and metabolic health often mattering more than simple weight measurements.
Social media and diet culture create unrealistic expectations about weight loss speed and maintenance, leading many people to cycle between restrictive dieting and weight regain patterns that may be worse for health than stable higher weight.
Health Risks vs Aesthetic Concerns
Excess weight around the midsection (visceral fat) poses greater health risks than overall weight or fat in other areas. This explains why some people with normal BMI but central weight gain may have higher disease risks than those with higher BMI but healthier fat distribution.
Type 2 diabetes, high blood pressure, and sleep apnoea are more strongly associated with excess weight than many other conditions, making weight management particularly important for people with these risk factors.
However, modest weight loss of 5-10% can provide significant health benefits even without reaching "ideal" weight ranges, making small changes more valuable than dramatic weight loss attempts.
What Actually Works
Sustainable weight loss occurs through modest calorie deficits maintained consistently over time rather than dramatic dietary changes that can't be sustained long-term.
Protein intake becomes crucial during weight loss to preserve muscle mass whilst promoting satiety that makes calorie reduction more manageable.
Regular physical activity, particularly strength training, helps maintain muscle mass during weight loss whilst improving metabolic health independently of weight changes.
Sleep quality and stress management significantly affect weight regulation through hormones that control hunger and metabolism, making these factors as important as diet and exercise.
The Diet Industry Reality
Most commercial weight loss programmes create short-term results through unsustainable approaches that lead to weight regain within months or years.
Extreme calorie restriction often reduces metabolic rate and muscle mass, making long-term weight maintenance more difficult whilst potentially causing nutritional deficiencies.
The focus on rapid weight loss ignores the reality that sustainable changes happen gradually through lifestyle modifications that can be maintained indefinitely.
Medical Evaluation of Weight
Healthcare providers assess weight in the context of overall health rather than appearance, considering factors like blood pressure, blood sugar, cholesterol levels, and family history.
Some people carry excess weight without metabolic consequences, whilst others develop health problems at relatively normal weights. Individual assessment provides more useful information than generic weight categories.
Weight loss medications or surgical interventions may be appropriate for some individuals with significant health risks, but these approaches require careful medical supervision and aren't suitable for cosmetic weight loss.
The Psychological Component
Many people use food for emotional regulation, stress relief, or social connection in ways that affect weight management efforts. Addressing these underlying patterns often proves more effective than focusing solely on diet and exercise.
The shame and frustration surrounding weight can create stress that actually impairs weight loss efforts whilst negatively affecting mental health and quality of life.
Body image concerns often persist even after successful weight loss, suggesting that psychological factors require attention alongside physical approaches to weight management.
The Honest Answer
Most people who worry about their weight don't have significant health risks from their current size, but many could benefit from improved eating patterns and increased physical activity for reasons beyond weight loss.
Focus on sustainable lifestyle changes that improve energy, sleep, and overall wellbeing rather than pursuing rapid weight loss through restrictive approaches that usually fail long-term. If weight is genuinely affecting your health, professional guidance can help develop realistic, sustainable approaches tailored to your circumstances.
Getting Real Answers to Real Questions
These everyday health concerns deserve thoughtful, personalised responses based on individual circumstances rather than generic advice or internet searches that often increase rather than resolve uncertainty.
The Online GP specialises in providing comprehensive discussions about these common health questions whilst offering evidence-based guidance tailored to individual lifestyles and concerns.
Our extended consultation times allow for honest conversations about supplements, screening needs, fatigue, skin concerns, and lifestyle factors including alcohol consumption in an environment free from time pressure or judgement. WhatsApp our clinic today to book a consultation where your practical health questions receive expert attention and personalised recommendations based on your individual circumstances and health goals.