How to Keep a Symptom Diary for the Most Accurate Diagnosis

How to Keep a Symptom Diary for the Most Accurate Diagnosis

When you’re dealing with an illness you can’t figure out or if you visit multiple doctors, a symptom diary is a useful way to track and convey what you’re experiencing. But it can be difficult to know what exactly to include — especially if you aren’t already working with a doctor whose specialty relates to your symptoms.

“The no. 1 thing is honesty,” says Rachel Amdur, MD, a primary care doctor with Northwestern Medicine. When you start the diary, she adds, “Go about living your life, be accurate, and include everything.”

What you’ll track varies based on what your physician is monitoring. For cardiology issues, Philip Krause, MD, cardiologist at NorthShore University HealthSystem, says to track the exact symptom (such as skipped heartbeats, chest discomfort, dizziness, or shortness of breath), when the symptom occurred, and what was happening at the time. The circumstances are extra important for heart issues. A diagnosis could change, for example, based on whether you were short of breath during exercise or while laying down.

If chest discomfort, shortness of breath, or dizziness are new symptoms and not previously discussed with a medical specialist, seek medical attention immediately.

Amdur’s primary care patients more often need to keep a food diary, track their urinary patterns, or both. 

“If we’re talking about stomach bloating, that’s where it’s key to have a food diary,” Amdur says. “You start it before the symptoms occur. Include beverages, gum, anything. The whole idea is to try to link things that you haven’t thought of already.”

Krause agrees that food diaries almost always help with diagnosis. He mentions a patient he recently saw who was monitoring her blood pressure. Typically in a normal range, her numbers began spiking three weeks prior to their visit. By pairing the blood pressure diary with the food diary, Krause and the woman determined that she’d been coping with stress by eating salty foods; her diet pushed up her blood pressure.

Symptom tracking shows trends over time, Krause says. “It enables people to be organized and lay out their non-acute or chronic symptoms according to a timeline.”

Remember, though, that if you’re relying on a health tracker, such as an Apple Watch or FitBit, it won’t capture as much detail as a symptom diary. However, Amdur says that health trackers can be useful for sleep diaries — a time when it’s more difficult to accurately track symptoms by hand.

“You wouldn’t put someone on medication based on a health tracker, but it does warrant further examination,” she says.

In the meantime, you never know the secrets your own notes may reveal.