Something Feels Off:
When Unexplained Symptoms Deserve a Closer Look
Maybe you don’t even know what to call what’s happening.
You’re exhausted even after sleeping. Your eyes burn, sting, water, or feel gritty. Your mouth feels unusually dry. Your joints hurt. Your muscles ache. Your brain feels foggy.
Maybe you’re also experiencing dizziness, headaches or migraines, numbness, tingling, burning feet, nerve pain, digestive changes, or a persistent dry cough.
And now you’re searching online trying to answer one question:
What is going on with my body?
Maybe you’ve wondered whether it’s perimenopause or menopause. Maybe you’ve blamed stress, lack of sleep, getting older, medication, your diet, or simply doing too much. Maybe you’ve started wondering whether Sjogren’s symptoms or another autoimmune disease could be part of the picture.
Or maybe you’re not thinking about any particular diagnosis. You just know you don’t feel like yourself anymore.
When You Don’t Know What to Call Your Symptoms
It’s much easier to search for information when you already know the name of a medical condition. It’s much harder when all you have are seemingly unrelated symptoms.
So you search them individually:
Why am I tired all the time even after sleeping?
Why are my eyes dry and gritty?
Why is my mouth always dry?
Why do my joints hurt?
Why are my hands or feet tingling?
Why do my feet burn at night?
Why am I dizzy?
Why can’t I concentrate anymore?
Why do I have dry eyes, dry mouth, fatigue, and joint pain at the same time?
Many of these symptoms can have more than one possible cause. That’s why looking at the pattern, rather than one symptom at a time, can be important.
Is It Menopause, Stress, Autoimmune Disease—or Something Else?
For many women, perimenopause or menopause may be one of the first explanations considered when new symptoms begin.
But fatigue, brain fog, joint pain, headaches, sleep problems, dizziness, and dryness aren’t exclusive to menopause. They aren’t exclusive to autoimmune disease either.
Medication side effects, thyroid problems, diabetes, nutritional deficiencies, sleep disorders, neurological conditions, autoimmune diseases, and other medical conditions can cause overlapping symptoms.
The goal isn’t to decide for yourself, “This must be menopause” or “This must be autoimmune disease.” The question is whether persistent, changing, worsening, or multiple unexplained symptoms deserve a closer look.
Stop Looking at Every Symptom in Isolation
This is one of the biggest lessons I’ve learned.
One symptom may not tell you much. But what happens when there are five?
You may see an eye doctor for dry, burning eyes. A dentist for dry mouth or new cavities. Your primary-care provider for fatigue and brain fog. Another provider for joint pain or stiffness. And maybe you’ve never mentioned the tingling in your feet because you didn’t think it could possibly have anything to do with the rest.
Each symptom may have its own explanation. But your healthcare provider also needs the opportunity to see the whole picture.
When did the symptoms begin? Which came first? Did several start around the same time? Are new symptoms appearing? Are they becoming more frequent or severe? How are they affecting your ability to work, sleep, think, drive, socialize, or complete normal daily activities?
You don’t need to determine what the pattern means. You just need to notice that there may be one.
Sjogren’s Symptoms Aren’t Always Just Dry Eyes and Dry Mouth
Sjogren’s disease is a systemic autoimmune disease. It is best known for dry eyes and dry mouth, but it can affect much more than the glands that produce tears and saliva.
Sjogren’s symptoms can include fatigue, joint and muscle pain, cognitive problems such as brain fog, dry skin, dry nose or throat, cough, gastrointestinal symptoms, numbness, tingling, nerve pain, headaches or migraines, dizziness, and other nervous-system symptoms. Sjogren’s can also involve organs including the lungs and kidneys.
That does not mean having several of these symptoms means you have Sjogren’s disease. Symptoms can have many possible causes. It means Sjogren’s is one example of why seemingly unrelated symptoms sometimes deserve to be considered together.
Symptoms also vary considerably from person to person. For some people, nervous-system symptoms may appear before better-known symptoms such as dry eye or dry mouth.
What If Your First Symptoms Are Neurological?
This is one reason some people may never think to search for Sjogren’s disease.
Imagine your first major problem is burning feet. Or tingling hands. Or migraines. Or dizziness when standing. Or unexplained nerve pain. You’re probably searching for neuropathy, migraines, dizziness, or burning feet—not Sjogren’s disease.
The Sjogren’s Foundation notes that nervous-system involvement can include symptoms such as brain fog, headaches or migraines, numbness, tingling, burning pain, peripheral neuropathy, small fiber neuropathy, and dysautonomia. In some people, neurological symptoms can be among the earlier signs of the disease.
None of these symptoms automatically points to Sjogren’s. They can have many possible causes and should be evaluated appropriately. But they also shouldn’t be left out of the conversation simply because someone doesn’t have dramatic dry eyes or dry mouth.
What If Your Bloodwork Is Normal or Your Tests Are Negative?
This is another place where people can become stuck.
You know something has changed. You have symptoms. Testing comes back normal or doesn’t explain what you’re experiencing. And you start wondering whether you should simply stop asking questions.
A normal test result can be reassuring and important information. But it doesn’t make a persistent symptom disappear.
When it comes specifically to Sjogren’s disease, evaluation can involve more than one test. Depending on the individual, clinicians may consider medical history and symptoms, bloodwork, objective eye testing, salivary-function or salivary-gland testing, and, in some circumstances, imaging or biopsy.
Negative bloodwork does not mean you should diagnose yourself with Sjogren’s. It means that if significant symptoms remain unexplained, the conversation about what should be evaluated next may not be over.
Your Symptoms Don’t Need a Diagnosis Before They Matter
You don’t need to know whether your symptoms are caused by menopause, Sjogren’s disease, another autoimmune disease, a neurological condition, a nutritional deficiency, medication, a thyroid problem, or something completely different before you start documenting them.
And you don’t need to diagnose yourself before asking for help.
Start collecting useful information: What are you experiencing? When did it begin? What came first? How often does it happen? Is it changing? What makes it better or worse? What other symptoms happen around the same time? How is it affecting your everyday life?
Think of your healthcare provider as an investigator. You don’t have to solve the case for them. But the more complete the information you bring, the more clues they have to work with.
Searching Your Symptoms Can Be the Beginning—Not the Answer
If you found this article because you’ve been searching symptom after symptom trying to figure out what’s wrong, searching can be a useful starting point.
Sometimes it’s how we discover that symptoms we never thought were related might be worth mentioning together.
But an internet search isn’t the finish line.
The goal isn’t to collect enough symptoms to convince yourself you have Sjogren’s disease—or any other medical condition. The goal is to become better prepared to explain what you’re experiencing and ask appropriate questions.
Not Sure What Your Symptoms Mean? Start Here.
I’m Jody, a patient educator and the creator of Sjogren’s with Jody. I create educational resources to help people better understand their symptoms, prepare for healthcare conversations, and navigate the questions that can come with Sjogren’s disease and unexplained symptoms.
If you’re not sure where to begin, I have two free resources that may help.
Start with the free Sjogren’s Symptom Checklist
if you want to take a broader look at what you’ve been experiencing and identify symptoms you may not have thought to mention together.
If you’re still searching for answers—or you’ve had normal or negative testing but something still doesn’t feel right,
Symptoms Deserve Attention Even Without a Diagnosis can help you identify symptoms and changes worth discussing with a healthcare professional.
You don’t have to know what’s causing your symptoms before you start paying attention to them.
Start with what you’re experiencing. Look at the bigger picture. Then bring that picture to the people who can help you figure out what comes next.
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DISCLAIMER: For educational purposes only. This is not medical advice. This information is not intended to diagnose Sjogren’s disease or any other medical condition. Symptoms can have many possible causes. Please discuss new, worsening, persistent, or concerning symptoms with an appropriate healthcare professional.
Great article. Mouth sores and swollen glands also part and parcel of Sjögren’s symptoms