Chronic conditions and women's health
Lifestyle diseases
For ongoing care of high blood pressure, high cholesterol, diabetes and gout
with a medical interpreter
24 hours a day, 365 days a year
OK to consult together
payment information
About
About Lifestyle diseases
We provide ongoing management of lifestyle diseases such as high blood pressure, high cholesterol, diabetes and gout. We can also help if you're about to run out of medication from Japan while abroad.
Why it happens
High blood pressure, high cholesterol, diabetes and high uric acid (gout) develop and progress through lifestyle habits such as diet, exercise, drinking, smoking, stress and sleep, combined with constitution and aging. They often cause almost no symptoms early on, while quietly straining the blood vessels, which can lead to heart attack, stroke or reduced kidney function, so ongoing management is important. It has been noted that an overseas posting greatly changes diet, activity levels and opportunities to drink, making it easy for test results to get worse.
What's happening in the body
Lifestyle diseases don't have a single cause; they progress as many changes build up. For example, if you keep taking in more energy than you use, the excess is stored as fat. When fat builds up around the internal organs in particular, substances released from it are thought to make the hormone that lowers blood sugar work less well. Sugar in the blood is then harder to process, and blood sugar rises. At the same time, the balance of fats in the blood is easily upset. If you keep eating too much salt, the body holds on to water to keep the salt concentration in the blood steady, blood volume increases and blood pressure rises. Ongoing high blood pressure damages the walls of the blood vessels, fats get into the damaged areas, and the vessels become stiff and narrow. This process is slow and causes almost no symptoms such as pain.
Main symptoms
- Often no symptoms (usually found through check-up results)
- Abnormal blood pressure, blood sugar, cholesterol or uric acid levels found at a check-up
- Thirst, passing more urine, weight loss (can occur with high blood sugar)
- Sudden severe pain and swelling, such as at the base of the big toe (can occur with gout attacks)
- Swelling, shortness of breath, tiring easily
- Heavy head, stiff shoulders (can occur with high blood pressure)
When you can wait and see
What you can do yourself
- Record your blood pressure and weight at home regularly
- If you eat out a lot, cut back on fried food, sweet drinks and salty soups
- Take up exercise you can keep up, such as walking for about 20–30 minutes in 1 day
- Consciously limit how often and how much you drink
- Don't stop prescribed medication on your own
Please consult us
If any of the following apply
- You want to keep taking your usual medication
- You want to discuss your health checkup results
- You want regular follow-ups
Seek care right away
If any of the following apply
- Chest pain, pressure or tightness (lasting several minutes or more, or with cold sweats)
- Weakness in the arm or leg on one side, slurred speech, or a drooping face (possible stroke)
- Sudden loss of vision, or unable to see out of one eye
- Breathlessness so severe you can't lie down, or sudden swelling of the legs
- Signs of very high or very low blood sugar (drowsiness or confusion, cold sweats and shaking hands, etc.)
Don't wait for a Cotovia consultation; call the emergency number in your country.
See the emergency guide for each countryIf you're not sure, ask us on LINE
Differential
Telling it apart from similar conditions
Symptoms that look the same may need different care depending on the cause. Use this as a guide to find what's closest to your situation.
High blood pressure
Often almost no symptoms; picked up at a health checkup
We assess it, including measurements taken at home
High blood sugar
As it progresses, thirst, passing more urine and weight loss
We assess it with a blood test. There are often no symptoms early on
Abnormal cholesterol
Almost no symptoms
It's usually found at a health checkup
Thyroid problems
Changes in weight or pulse, tiring easily and sweating more
This can be assessed with a blood test
Sleep apnea
Snoring and strong daytime sleepiness, with blood pressure that's hard to bring down
An assessment with tests is recommended
Emergencies
Chest pain, weakness on one side, slurred speech or a severe headache
Consider emergency services immediately
* This is not a complete list. If you're not sure, please consult us.
When it might be something else
Course
Typical course
This is the general course. Actual progress varies from person to person.
- Arrival to 6 months
Eating and exercise habits change, and your weight starts to shift
Weighing yourself regularly is the easiest way to spot changes early
- 1–2 years
Changes may start to show up at health checkups
If anything is flagged, acting at this stage is effective
- Several years
Strain on the blood vessels builds up without symptoms
Keep getting regular checkups
- Once symptoms appear
Symptoms such as chest pain or paralysis may mean it has already progressed
Managing it before symptoms appear is important
Local Insight
For people living in Southeast Asia
The climate, healthcare and access to medication differ from Japan. Here are points specific to this region.
It has been noted that meals abroad tend to be high in calories and fat, and getting around mainly by car leads to a lack of exercise. A survey of people after returning to Japan reported that more than 2 in 10 had been treated for a chronic disease while abroad.
In Southeast Asia, sweet drinks (coffee and tea with condensed milk, juices) and oily dishes are part of everyday life, so unless you're careful, your sugar and fat intake can easily go up.
More business entertaining and dinners tend to mean more drinking, and there's no automatic system of regular checkups like in Japan, so it's harder to notice when results get worse.
Medications with the same brand names as in Japan may not be available locally. If you have your medication record book or prescription information in English, we can discuss switching to an equivalent class of medication. Consulting early is recommended so you don't go without medication.
Care
What Cotovia can do
- Consultation and tests as needed (testing is at the doctor's discretion)
- Prescribing and adjusting ongoing medication (prescribing is at the doctor's discretion)
- Lifestyle advice
Tests you may have
Not knowing what will happen can make people hesitate to seek care, so here's what actually takes place.
Blood pressure measurement
Checking your blood pressure
Blood test
Assessing blood sugar, cholesterol, liver function and kidney function
Urine test
Checking for effects on the kidneys
ECG
Assessing strain on the heart
Health check-ups
Assesses several items at once
Treatment options
Dietary changes
Reviewing your intake of calories, salt and fat
We work out realistic changes together for when you eat out a lot
Making exercise a habit
Burns energy and improves blood sugar and blood pressure
In hot regions, exercising indoors or early in the morning is realistic
Medication
Keeps levels under control
Considered alongside lifestyle changes. Prescribing is at the doctor's discretion
Regular tests
Checks progress and adjusts treatment
You can't rely on symptoms, so checking the numbers is important
* Tests, procedures and prescriptions are decided by the doctor after a consultation. Services may vary by country and location.
Preparation
Before your visit
When seeing a doctor abroad, simply organizing what you need to say makes a big difference.
What to bring
- Passport or residence card
- Insurance card and your insurer's contact details
- Your medication record and the medication you take
- Results of any health checkups in Japan
- Any records of blood pressure measured at home
What to tell us
- How your weight has changed since you were in Japan
- How often you eat out or attend business dinners
- How much and how often you drink, and whether you smoke
- Your exercise habits and how they changed after your posting
- Whether anyone in your family has the same condition
Self Care
What you can do yourself
Along with seeing a doctor, here are things to keep in mind in daily life.
Prevention
- Make a habit of getting a checkup and blood test at least 1 time a year
- Learn the features of local food (sweet drinks, oily cooking, strong seasoning) and choose carefully
- Where you mostly get around by car, make time to walk
- Don't let lack of sleep and stress build up
How to Consult
How to be seen
Choose from 3 ways to be seen, depending on your symptoms and schedule. If you're not sure, we'll guide you on LINE.
Online consultations
See a doctor by video call from home or the office. Medication delivered or from a pharmacy.
Available for this symptom
In-person care
In-person consultations at our clinics and partner hospitals, including tests and procedures.
Available for this symptom
Cotovia Counter
Support with an interpreter for visits to general hospitals.
Available for this symptom
If an online consultation finds that tests or procedures are needed, we'll guide you to in-person care or Cotovia Counter.
From consultation to receiving medication
Add us on LINE and consult
Tell us your symptoms, and we'll recommend the right way to be seen.
Book and be seen
See a doctor online or at the nearest location, with an interpreter present.
Receive your medication
Have it delivered or pick it up at a pharmacy or the clinic (varies by country).
Follow-up
You can also consult us on LINE about how you're doing afterward.
Special Care
People who need extra care
People who were receiving treatment in Japan
The same medication may not be available locally. Bring your medication record book and consult us before you run out
People planning a pregnancy
Some medications can't be used. If you're planning a pregnancy, please consult us in advance
People with a family history of the condition
It can affect how likely you are to develop it. Early testing is recommended
People planning to return to Japan
Organizing your test results and prescriptions makes it easier to continue care in Japan
FAQ
FAQ
Common questions before a visit, and common assumptions that lead people to judge for themselves.
QCan I continue the medication prescribed by my doctor in Japan?
If you show us your medication record book or prescription details, we can discuss continuing an equivalent medication. Availability may vary by country.
QWhere can I get a health checkup?
This varies by country and location. We can advise you on facilities where you can get one and help you plan around checkups in Japan.
QI don't have any symptoms. Is it OK to leave it?
Lifestyle diseases rarely cause symptoms early on, but strain on the blood vessels builds up. Regular checks are recommended even without symptoms.
QWhat should I do when I have a gout attack?
Treating the pain and managing uric acid levels afterward need to be considered separately. Please also ask the doctor what to do during an attack.
Common misconceptions
Myth No symptoms means you're fine
Fact Most lifestyle diseases cause almost no symptoms until they have progressed
Myth Once you start medication, you can never stop
Fact Improving your lifestyle may allow the dose to be reduced or stopped. Please don't stop on your own
Myth You're not overweight, so there's nothing to worry about
Fact Blood sugar and cholesterol problems can occur regardless of body shape
Myth You can get a health checkup when you go back to Japan
Fact Missing your yearly checkup delays noticing changes. Checkups are available locally too
Myth In a hot country you sweat, so you don't need to worry about salt
Fact If you keep taking in more salt than you lose through sweat, it will affect your blood pressure
Feel free to ask us on LINE first
It's fine to contact us even if you're not sure you need to see a doctor. We're available in Japanese 24 hours a day, 365 days a year.
- Symptoms
- When it started
- Your country of residence
- How you'd like to be seen
Sending these 4 things helps us respond faster. It's fine if you don't have them all.
Ask us on LINE