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Your doctor should be the first person to know that you take Saint Johnswort to boost your mood or are thinking about starting a family. Why? Your well-being depends on your being upfront with your M.D. about everything including details about your lifestyle and symptoms you may think are insignificant. No amount of physical poking or prodding is going to give your physician a complete picture of your health you have to speak up, says Susan Spear, M.D., senior vice president of medical affairs for Executive Health Exams International, a New York City-based rm that specializes in preventive health.

The trouble is, 40 percent of women don't tell their doctors everything they should, according to a survey at the Center for Bioethics at the University of Pennsylvania in Philadelphia. Of course, being embarrassed to fess up to less-than-stellar habits including occasional cigarette use, which is the health habit women are most likely to hide is one reason why. But sometimes women simply don't realize which symptoms and lifestyle behaviors are important enough to mention. Here, the eight most common omissions patients make and why discussing them with your doctor can be a real lifesaver.

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1. You take supplements and herbal remedies.
Why it matters: Many herbal remedies and supplements can and do interfere with the effectiveness of prescriptions and over-the-counter medications, says Joseph Boullata, Pharm.D., adjunct professor of pharmacology at the University of Pennsylvania School of Nursing. An interaction is possible in nearly one out of three patients taking both a medicine and a supplement, he says. For instance, calcium can reduce the absorption of a number of medications, including thyroid hormones and the antibiotic tetracycline. Saint Johnswort, an alternative herbal remedy for depression, significantly reduces the effectiveness of oral contraceptives and may be harmful when used in combination with some anti-depressants and migraine treatments. Chasteberry (also known as vitex), an herb used to quell PMS, can interfere with the action of birth-control pills.

2. You want to get pregnant later this year.
Why it matters: Unplanned pregnancies can adversely affect your health and the baby's. If you're low on folic acid, for instance, your baby is at risk for neural-tube birth defects like spina bifida (an incomplete development of the brain, spinal cord or their protective coverings). You need 400 micrograms of folic acid a day for three months before you even try to conceive, says Shelly Holmstrom, M.D., assistant professor of obstetrics and gynecology at the University of South Florida in Tampa.

Sharing your plans with your doctor may also help her spot easily treatable causes of infertility such as thyroid abnormalities (detected with a blood test) early on. Your M.D. can also determine if it would be better for you to lose or gain a few pounds before getting pregnant. Being 15 percent above your ideal weight increases the risk of gestational diabetes and high blood pressure, but being too slender can lead to problems too. Women who have a body mass index under 20 have a greater risk of premature delivery, Holmstrom says.

3. You're a social smoker.
Why it matters: If your doctor knows you smoke any amount she's going to be more alert for conditions like bronchitis or elevated blood pressure, which can occur even in young women, because the nicotine in cigarette smoke constricts your blood vessels, says Douglas E. Jorenby, Ph.D., director of clinical services at the University of Wisconsin Center for Tobacco Research and Intervention in Madison. If nothing else about your health has changed except your blood pressure, its probably from the nicotine.

Women who indulge only occasionally often don't even realize that those two or three cigarettes a week can impact their health. There's no safe level of smoking, Jorenby says. Cigarettes contain more than 50 cancer-causing agents, and even limited exposure causes cellular mutations that can increase your risk of lung cancer. And if you're lighting up, chances are you're hanging out in smoky areas where you're being exposed to secondhand smoke as well which, ironically, has an even greater concentration of some chemicals than the stuff you puff into your own lungs.

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