Time to retire 'worried well'

A term I think we need to retire is the ‘worried well’. If you go to Wikipedia you will see these people described as “ persons who are in relatively good health but believe themselves to be ill or likely to get an illness based on a current circumstance.”

This term has been used a couple of times at a conference I recently attended and what this does is completely dismiss the group of people you may fall into… those that aren’t diagnosed with a condition, or don’t have a disease, and want to prevent this from occurring. Or those that don’t have anything ‘diagnosable’ but aren’t quite right.

Many times I have clients who go to their doctor with the aim of reviewing their overall health status to ensure they are doing what they can to either stay healthy, or prevent the slide into ill health. And many times these people get eye rolls, get refused bloods (I had a client who’s doctor said that it was impossible to order a vitamin D test), and get pushed out the door because there is ‘nothing wrong with them’. Yet, when I look at blood test results I see TSH (as a marker of thyroid) is indicating sub optimal function, or HbA1c is 37 or 38 (marker of long term blood sugar control) or B12 is low normal, or ferritin is below 30 or above 150 (ferritin being an acute inflammatory marker, it will rise indicating inflammation – the hallmark and undercurrent of all chronic disease).

 Of course, it isn’t just the blood markers that are off-piste. It is the symptoms the clients are experiencing. Low energy, anxiety, sluggishness, weight gain, skin and hair problems, sleep-related issues. Do these sound like symptoms of people who are ‘well’ to you?

The most recent research would has shown that 93% of people who live in the US are metabolically unhealthy. This severely limits the people going into their doctors as being actually well (there’s no recent NZ data I can pull from for comparison).

Worried well is also a term that is thrown about based on body size. Someone ‘appears’ healthy because they aren’t over weight. Yet ‘weight’ tells us nothing about health. What kind of ‘weight’? What muscle mass are they carrying? What is their liver function like? Where is the fat that they do have distributed? What is their lifestyle like that ensures they are in fact lean, carrying muscle and have great biomarkers? A person who is carrying a little extra body fat yet is very active, sleeps well, does resistance training and manages stress is a very different person to someone who may be carrying a few extra kilograms (but not considered overweight), is very stressed, doesn’t exercise, relies on alcohol and currently their lifestyle hasn’t quite caught up with their blood biomarkers.

 For what it’s worth, anyone who isn’t exercising (as in, making time to exercise, doing a physical job) isn’t ‘healthy’. In the UK, while life expectancy is increasing, health expectancy (the amount of time spent in good health) has dropped. This means that both men and women are spending MORE time in poor health. Women spend approximately 20 years in poor health in their later life, and men spend over 16 years in poor health. Who wants to live like that?

 The term ‘worried well’ needs to be thrown out like last week’s compost. It serves no one and is almost like kicking that health can down the road for you when something does pop up that the doctor is concerned about.