No pain, no warning: The health conditions that can stay silent

Dubai: Some health problems do not begin with pain, fatigue, or an obvious warning sign. They can develop gradually, sometimes for years, while a person continues to feel completely well.

High blood pressure, diabetes, high cholesterol, fatty liver disease, kidney problems, and certain nutritional deficiencies have been among the conditions doctors say can remain hidden until they are picked up through a health assessment.

For UAE residents, specialists have stressed that preventive care can help identify changes before they become more difficult to manage. But they have also emphasised that screening should be tailored to the individual rather than based on a one-size-fits-all list of tests.

Dr. Yousef Said, medical director at Metabolic, has noted that some serious health events described as “sudden” are often the result of disease processes that have been developing for many years.

“The friend or family member who ‘suddenly’ died of a heart attack, well, it was anything but sudden. The underlying disease process that led to the heart attack was likely decades in the making,” Said told Gulf News.

Conditions including heart disease, prediabetes, type 2 diabetes, high blood pressure, high cholesterol, fatty liver disease, early kidney disease, thyroid problems, and iron or vitamin B12 deficiency can develop before symptoms become obvious.

The body's ability to compensate for gradual changes can make these conditions difficult to spot. 

“Fatty liver disease can progress despite normal or near-normal liver enzymes, and iron or vitamin B12 deficiency may initially cause only subtle symptoms such as fatigue or difficulty concentrating. By the time clear symptoms appear, the underlying process may have been present for some time.”

Said believes monitoring over time is important.

“One test is a snapshot. The real value comes from repeating it and watching the trend.”

For people using smartwatches and other wearable devices, Said has bared that monitoring sleep, heart rate, and activity can help build awareness of daily habits. Wearable information should be complemented by appropriate medical testing to understand what is happening inside the body.

According to Dr. Slavica Vukovic, specialist in internal medicine at RAK Hospital, a range of conditions can progress without significant symptoms that would prompt someone to visit a doctor.

She has listed hypertension, dyslipidaemia, type 2 diabetes, fatty liver, chronic kidney disease, osteoporosis, and some autoimmune diseases, including Hashimoto thyroiditis and autoimmune gastritis.

Certain cancers may also be difficult to detect early because their initial symptoms can be vague. Bloating or feeling full, for example, can have many possible causes and may not immediately raise concerns.

For UAE residents, preventive medicine should focus on identifying changes before symptoms appear.

“The purpose of screening is to detect biological changes before the body has to produce symptoms to tell us something is wrong,” shared Vukovic.

On the other hand, Dr. Joseph Youssef, specialist in internal medicine at Medcare Royal Speciality Hospital, has pointed out that one of the challenges in detecting silent conditions is that early symptoms can be extremely general.

Tiredness, changes in concentration, and mild digestive symptoms may easily be attributed to stress, lifestyle, or being busy. His particular focus is on what happens when a test result remains abnormal without an obvious explanation.

“If an abnormality is persistent or difficult to explain, it can be useful to look for an underlying reason rather than repeatedly treating the deficiency without understanding why it is occurring,” explained Youssef.

He has mentioned that preventive care should be based on a person’s circumstances.

“Prevention should not be viewed as looking for something to be wrong. It is about understanding your own risk factors and identifying potentially modifiable issues early.”

For her part, Dr. Enna Sondhi, specialist in internal medicine at Prime Medical Centre, has underscored that feeling healthy is reassuring but cannot by itself rule out several common conditions.

High blood pressure and high cholesterol may not produce noticeable symptoms, while prediabetes and type 2 diabetes can remain undetected until blood sugar becomes significantly elevated.

Chronic kidney disease and fatty liver disease may also not be obvious without an assessment. Thyroid disease can be more subtle. An underactive thyroid may develop gradually, with symptoms such as tiredness, weight gain, or constipation that can easily be blamed on a busy lifestyle.

Preventive care has been particularly relevant in the UAE because of the presence of obesity and other cardiovascular risk factors. She has recommended starting with an understanding of basic health indicators and personal risk.

“A useful starting point is to know your blood pressure and discuss your personal risk of diabetes and high cholesterol,” stated Sondhi.

Kidney assessment and cancer screening may also be appropriate depending on age, medical history, and individual risk factors. But she has cautioned against the assumption that more testing automatically means better healthcare.

“More tests do not necessarily mean better care. The aim is to choose the right checks at the right time and follow up on abnormal results.”

The doctors’ responses have pointed that some conditions can develop without symptoms, persistent abnormalities deserve investigation, and preventive screening should be based on individual risk.

For UAE residents, that can mean keeping track of blood pressure and other key health indicators, discussing diabetes and cardiovascular risk with a doctor, and not ignoring unexplained or recurring abnormalities in blood tests.

Most importantly, preventive care does not mean assuming something is wrong. It means checking when appropriate before the body has to produce a symptom to get your attention.