Early Warning Signs

Topics …

• 7.1 What’s normal and what’s not 
• 7.2 Early warning signs and symptoms
• 7.3 Symptom clusters or patterns
• 7.4 Tracking changes

7.1     What’s normal and what’s not

The table in 7.2 below will help you identify what’s normal, and what’s not. However, many signs or symptoms are indeterminate and can point to different problems, so it is always wise to be sure by checking with your GP. Further reading: What’s normal (and what’s not) as we age.

7.2     Early warning signs and symptoms

There are many health problems – some serious – that don’t have any early warning signs (see section 8 No early warning signs) but most do, as you will see from the table below, where early warning signs and symptoms are combined in the first column.

Sometimes acting quickly is crucially important. It goes beyond early warning signs of a possible heart attack or stroke. For example, if you have had a cataract or lens replacement operation, even 18 months earlier, the following symptoms should not be ignored – increase in floaters in an eye; flashes of light; a shadow (or veil) across the eye; loss of peripheral vision on one side; sudden blurring or distortion of vision. They can be an indication of a detached retina. Even though the risk of this happening after such an operation is small, if it does happen, it’s serious. and, if something is not done about it urgently, you could lose your sight in that eye.

Sign / symptom	Possible related issues or causes	What’s normal	What’s not: when to act
Anxiety or restlessness	Stress, trauma, caffeine, thyroid imbalance, sleep deprivation; can be physical or emotional	Before a presentation or during a stressful week	Constant worrying; panic attacks; racing heart. If persistent, escalating, or interfering with sleep or daily function.
Appetite changes (up or down)	Stress, depression, thyroid imbalance, digestive issues	Fluctuations during stress or illness recovery	If sustained or accompanied by weight changes or mood shifts
Back pain that radiates or worsens at night	Herniated disc, spinal stenosis, arthritis, cancer, infection	Mild soreness after activity	Pain that wakes you, radiates to legs or causes weakness
Bleeding or discharge from cervix	Cervical cancer infections, hormonal changes	Light spotting	Bleeding after menopause, post-intercourse bleeding, foul-smelling or coloured discharge
Blood in stool	Bowel cancer	Isolated bleeding from the rectum but not in stool	Free bowel cancer kits are sent out by the government every 2 years from 50 to 74
Bones fracture easily	Osteoporosis, vitamin D deficiency, hormonal imbalance, certain medications	Minor bruises or aches after impact	Fractures from mild trauma (e.g., fall from standing height), recurring fractures, loss of height
Breast skin changes, lumps or nipple discharge	Breast cancer	Check with GP if any symptoms	Free mammograms from 50-74
Breathing – laboured; shortness of breath	Anxiety, heart or respiratory problem; can be physical or caused by anxiety/panic	Shortness of breath after intense exercise	If sudden, severe, or accompanied by chest pain or dizziness especially if after low exertion
Chest discomfort or pressure	Coronary artery disease, angina, heart attack	Occasional mild discomfort from indigestion or muscle strain	Persistent or recurring pressure, especially with exertion or stress; radiating pain to arm, neck, or jaw
Cold or heat sensitivity	Thyroid dysfunction, anaemia, fibromyalgia, menopause	Mild discomfort in extreme weather	Feeling cold/hot when others are comfortable, sweating abnormalities
Concentration problem or reduced attention span	Cognitive fatigue, anxiety, early dementia	Difficulty focusing in noisy or stressful environments	Inability to concentrate on simple tasks or follow conversations
Coughing or wheezing or breathlessness	Asthma, bronchitis or emphysema	If occasional e.g. breathlessness after intense exercise	When the symptoms persist i.e. they are not just occasional
Digestive issues	Microbiome imbalance, stress, poor diet, irregularity, bloating	Occasional bloating or irregularity after certain foods	If persistent, painful, or accompanied by weight loss or bleeding
Dizzy, light-headed or fainting episodes	Low blood pressure, arrhythmia, heart valve, dehydration, inner ear, anxiety, anaemia	Brief light-headedness when standing quickly	If frequent, unexplained, or causing falls, instability or fainting; or accompanied by nausea, confusion or chest symptoms. Seek help if recurrent and urgently if over 60 or with heart/neuro symptoms
Eyes or mouth are dry	Sjögren’s syndrome, lupus, diabetes, thyroid disease, dehydration, medications	Mild dryness from environment or screen time	Persistent dryness with burning, blurred vision or swallowing issues
Eyes – tired behind the eyes	Stress, trauma, poor sleep, low glucose and/or energy, early sign of illness	Occasional eye fatigue after long screen time, poor sleep, or allergies	If persistent, unexplained, accompanied by other symptoms like pressure or pain or affecting vision
Eyes – strained or blurred vision; headaches;	Dehydration or poor lighting but it could be more serious such as diabetes, glaucoma or macular degeneration	Temporary blurring from fatigue, long screen use or poor lighting	If sudden, persistent, worsening or affecting daily tasks accompanied by headaches, get tested
Fatigue: extreme and persistent tiredness or exhaustion	Chronic stress, poor sleep, nutritional / iron deficiency, heart problem, depression, thyroid dysfunction, diabetes or cancer	During a period of being very busy and/or poor sleep	If ongoing for more than 2 weeks or interfering with daily life including work and relationships
Forgetfulness	Stress or poor sleep but could be cognitive decline	Occasionally misplacing items or forgetting minor tasks	If worsening, frequent, affecting safety or progressive decline
Hair thinning or loss	Aging, stress, thyroid disease, iron deficiency, alopecia, hormonal changes, medications	Shedding 50-100 hairs/day	Sudden or patchy loss or scalp inflammation
Headaches	Stress, dehydration, eye strain, hormonal shifts, disrupted sleep, high blood pressure	Sporadic, mild headaches from dehydration or screen time	If severe, sudden, or recurring without clear cause
Hearing deterioration	May be hearing loss with age but it can contribute to dementia	Difficulty hearing soft sounds or in noisy settings	Missing key information in conversations, withdrawing socially
Heartbeat is irregular or palpitations	Anxiety, caffeine, dehydration, arrhythmias, thyroid disease, heart disease	Brief flutter with stress or exertion	Frequent, prolonged, or accompanied by chest pain, dizziness, or fainting; act urgently if you have any cardiac risk factors
Hunger – ongoing	Diabetes, hyperthyroidism, stress, poor diet, pregnancy	Increased appetite after exercise or skipped meals	Constant hunger despite eating, weight changes, or thirst
Illness, sickness, frequent infection	Immune dysfunction, poor sleep, stress, nutritional gaps	1–3 mild colds or infections per year, especially in winter or with young children	If recurring, persisting, unusually severe or slow recovery
Joint pain, swelling or stiffness	Could be an indication of arthritis – see section 8.6 Arthritis	After doing a new or vigorous form of exercise	If it persists, book an appointment with your GP and get referred to a rheumatologist if necessary
Memory lapses or confusion (this is usually for 70+)	Dementia, Alzheimer’s, B12 deficiency, thyroid issues, medication side effects	Forgetting names or appointments occasionally, but recalling later	Repeating questions, getting lost in familiar places, trouble managing finances or daily tasks
Menstrual cycle changes	PCOS, thyroid disease, stress, weight changes, perimenopause,	Cycle length 21-35 days, or bleeding 3-7 days	Missed periods, cycles <21 or >35 days, heavy bleeding, severe pain
Mood changes – irritability, sadness, anxiety or apathy	Could be thyroid, emotional stress, hormonal or early sign of cognitive change	Feeling down after a stressful event or poor sleep	If lasting more than 2 weeks, persistent sadness, loss of interest, or affecting relationships or work
Muscle cramps, poor sleep and digestive issues	Tiredness, low energy		Can be a sign of calcium or vitamin D deficiency
Muscle pain or tension, often in neck, back or shoulders	Stress, poor posture, vitamin deficiency, inflammation or related injury	After physical activity or poor posture	If chronic pain, worsening, or limiting movement. Note that muscle pain can be caused by the muscles trying to stabilise a nearby perceived injury or weakness
Nails – brittle	Thyroid disease, iron/zinc deficiency, fungal infections, aging	Occasional nail breakage due to dryness or manual work	Persistent cracking, splitting, yellowing, or spoon-shaped nails
Nausea or vomiting without clear cause	Gastroenteritis, migraine, pregnancy, medications, metabolic disorders, cancer	Mild nausea from motion or overeating	Persistent vomiting for longer than 48 hrs, blood in vomit, weight loss
Obesity	See “weight gain”
Palpitations	See “heartbeat is irregular” above
Reasoning ability reduced	Mild cognitive impairment, neurological changes	Occasional trouble with complex decisions	Struggling with basic problem-solving or logical thinking
Sense of touch	Diabetes, Parkinson’s disease, mini-strokes, and arthritis.	Some deterioration occurs with age	The health conditions in the second column can damage your sense of touch beyond age-related changes.
Skin changes (rash, dryness)	Allergies; auto-immune conditions; missing nutrients; microbiome imbalance.	Dryness in winter or mild irritation from new products	Spreading rash, persistent dryness, pain or signs of infection
Skin changes (new or existing moles)	Skin cancer including possible melanoma	Ordinary looking new moles can appear when we get older	Changes in colour, size or shape of moles or freckles https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/check-for-signs-of-skin-cancer
Sleep disruption	Stress, sleep apnoea, poor sleep hygiene, hormonal shifts	Trouble sleeping before a big event or after caffeine	If ongoing, frequent wakings, affecting energy, mood, or concentration
Snoring loudly, gasping or choking during sleep	Sleep apnoea, cardiovascular risk, obesity, nasal obstruction	Mild snoring after alcohol or fatigue	Loud snoring with pauses, choking, daytime fatigue, morning headaches
Speech: using the wrong words or trouble finding the right word	Hearing loss or a cognitive change	Searching for words occasionally	Frequent word-finding difficulty, trouble forming coherent sentences
Swallowing difficulty	Stroke, Parkinson’s, oesophageal disorders, reflux, cancer, infections	Occasional throat dryness or mild choking	Food sticking, coughing during meals, weight loss, aspiration
Swelling in legs or ankles	Heart failure, kidney issues, poor circulation	Mild swelling after long periods of sitting or standing	Persistent or worsening swelling, especially with shortness of breath or weight gain
Testicles have lumps	Cysts, infection, hernia, testicular cancer	Slight asymmetry or soft movable lumps	Firm, painless lump, swelling, heaviness or pain
Thirst – unexplained increase	Type 2 diabetes, kidney dysfunction, hormonal imbalance (e.g., diabetes insipidus)151617	Thirst after exercise, heat, or salty food	Persistent thirst with frequent urination, fatigue, blurred vision
Unexplained changes or something unusual	Cardiovascular issues, neurological conditions, metabolic imbalances	Occasional mood shifts or temporary fatigue	Sudden or persistent changes that differ markedly from what’s normal e.g., frequent belching, unexpected weakness, or altered gait
Urinating frequently	Could mean benign prostate hyperplasia, prostate cancer, urinary tract infection, kidney disease or diabetes	Urinating 5-8 times per day and once per night
	More than 5 to 8 times per day or once per night should be raised with your GP
Vision	See “Eyes” above
Weight gain	Diabetes; heart disease; medication side effects; thyroid; depression; fluid retention	Seasonal fluctuations up to 2 kg
	Gradual increase of 3 or more kilograms without lifestyle changes

Family history, lifestyle and personal risk factors (such as being over-weight) may warrant acting earlier than suggested in the table (extra vigilance and earlier, or more frequent, testing).

Personal story – heart disease:

7.3     Symptom clusters: why patterns matter

While many symptoms on their own may seem minor or easily explained – tiredness, bloating, or a persistent cough – it’s often the combination or pattern of symptoms that provides the strongest clue that something more serious may be unfolding. These clusters can point to underlying conditions that might otherwise be missed if symptoms are considered in isolation. For example, a persistent headache might be dismissed, but if paired with vision changes and nausea, it could signal a neurological issue.

7.4     Tracking early warning signs and changes over time

Tracking changes – e.g. in mood, energy, digestion, or clinical markers like PSA (Prostate Specific Antigen) – can reveal trends that are invisible in a one-off snapshot. For instance, a rising PSA over several months is likely to be more indicative of prostate cancer risk than a single elevated reading. Keeping a record of symptoms, even those that seem minor, will enable you to notice patterns that are more significant than one sign or symptom in isolation.