Doctor Claude Example Conversation

This section goes over what this AI agent actually looks like in my terminal against the condition that several doctors were unable to diagnose.

The goal is simple: can Claude help me identify the right hypothesis faster than the three months and four doctors it actually took to get to the correct tests?

Notes:

1. I censor some medical information about my family members via curly braces {} for their privacy.

2.To maintain medical privacy, I am only sharing one specific case study below, but the results remained consistent across all my tests.

------

I start the diagnostic consultation and describe my presenting complaint:

❯ /doctor-claude:diagnostic_consultation (MCP)

⏺ I'm ready to help you understand your symptoms through this educational consultation.

  What brings you here today? Please describe your main concern or symptom - what you're experiencing, when it started, and what prompted you to seek information today.

❯ i get tired when walking up the stairs and i dont know why

Thank you for sharing that. Fatigue when climbing stairs can have many different causes, ranging from simple deconditioning to various medical conditions. Let me gather some information to better understand what might be going on.

  A few initial questions:

  1. When did you first notice this? Did it start recently, or has this been going on for weeks or months?
  2. Has it been getting worse, staying the same, or improving? For example, could you climb stairs more easily a few months ago?
  3. Do you have any other symptoms when climbing stairs or at other times - such as:
    - Shortness of breath or feeling like you can't catch your breath?
    - Chest discomfort, pressure, or pain?
    - Heart racing or pounding?
    - Dizziness or lightheadedness?

❯ it started a few weeks ago, its been getting a
  little worse, and ive not really been very fit but
  nothing noticeable when im not playng sports. my
  heart does seem to pound at times but not
  consistently. no dizziness or lightheadness, only
  when im hungry

Claude asks about the progression—is it getting worse? How long has it been happening? These temporal questions are critical for narrowing down causes, but they take time that many clinical visits don't allow.

Thank you for that detail. It's helpful that you mention you're still able to play sports without major issues - that's an important piece of information. Let me ask a few more questions to understand this better:

  1. How old are you? And do you have any known medical conditions or take any medications regularly?
  2. What sports are you playing, and how do you feel during them? For example, can you run around during sports without getting unusually tired, or are you noticing fatigue there too?
  3. Have you had any illnesses recently - like a cold, flu, COVID, or any other infection in the past few weeks or months before this started?

❯ im 21 years old, no medical conditions and no
  medications. i play volleyball, and i feel fine
  when its chill but if i do any sport like
  basketball or running then i can only do it for 5
  minutes before getting tired / heart pounding. I
  have had no illnesses recently

A healthy 21-year-old going from normal to only 5 minutes of intense activity is a red flag. This isn't normal deconditioning, and Claude has the time to explore it systematically.

This is important information - a significant change in your exercise tolerance over just a few weeks in a young, healthy person warrants attention. Going from being able to play sports to only lasting 5 minutes during intense activity is a notable change.

  Let me ask a few more targeted questions:

  1. When your heart pounds during exercise, does it feel:
    - Regular and just fast?
    - Irregular, fluttering, or skipping beats?
    - Does it start suddenly or build up gradually?
  2. Have you experienced any:
    - Chest discomfort, tightness, or pain (even mild) during exercise or at rest?
    - Shortness of breath when lying flat or at night?
    - Swelling in your legs or ankles?
  3. Family history: Has anyone in your immediate family (parents, siblings, grandparents) had heart problems at a young age, sudden cardiac death, or required a pacemaker before age 50?

❯ it feels regular and just fast / hard. i havent
  experienced any chest discomfort, tightness, or
  pain. no Shortness of breath when lying flat, and
  no swelling anywhere. {'{family member died of neurological/cardiovascular disease}'} but thats it.

Thank you for that information. A progressive decline in exercise tolerance over a few weeks in a 21-year-old is something that warrants evaluation to understand the cause. Let me ask a few more questions:

  1. Even if you haven't felt notably sick, have you had any mild symptoms recently such as:
    - Low-grade fever or feeling feverish?
    - Fatigue beyond just the exercise intolerance?
    - Any digestive issues, changes in appetite, or unintentional weight changes?
  2. Diet and lifestyle:
    - Have you made any changes to your diet recently?
    - Are you getting adequate sleep (7-9 hours)?
    - Any use of energy drinks, supplements, pre-workout products, or other substances?
  3. Any other symptoms at all - even seemingly unrelated things like:
    - Feeling unusually warm or cold?
    - Changes in how you feel at rest (anxious, jittery, slower than usual)?

❯ no low grade fever. fatigue yes, a litte bit, but
  not life changing. my weight has been decreasing
  rapidly. I havent made any diet changes, ive been
  getting adequate sleep, no use of energy drinks,
  suppkements, or pre-workout. I feel hot and sweaty
  all the time, and im a bit anxious but ive always
  been anxious. wait also now that i think about
  this, there have been 2 episodes of me trying to
  fall asleep and my heart is thumping

This is the moment where everything clicked. I remember mentioning these same things across multiple appointments, but in 15-minute visits, it's hard to see how scattered complaints connect.

This additional information is quite helpful - the combination of rapid weight loss, feeling hot and sweaty, heart pounding episodes, and some of your other symptoms starts to paint a more specific picture. Let me ask a few more targeted questions:

  1. About the weight loss - how much weight have you lost, and over what time period? For example, 5 pounds? 10 pounds? More? Over the past few weeks or longer?
  2. Have you noticed:
    - Any shakiness or tremor in your hands?
    - Has your anxiety gotten worse recently, or is it about the same as it's always been?
    - Any trouble concentrating or feeling more restless than usual?
  3. Have you noticed anything with your neck - any swelling, fullness, or discomfort in the front of your neck?

❯ 5 pounds over the past few weeks. i havent noticed
  a tremor in my hands but they do shake a tiny bit
  when i hold them out. i cant tell if my anxiety has
  gotten worse or not, maybe? and i havent noticed
  any trouble concentrating or anything. Havent
  noticed any neck swelling

Claude now has enough information to form a hypothesis. Watch what happens next—it searches medical databases to confirm the pattern it's seeing.

Thank you - this is helpful information. The pattern of symptoms you're describing - rapid weight loss, feeling hot and sweaty, heart pounding, tremor, and declining exercise tolerance - is starting to suggest some specific possibilities that I want to explore.

  Let me search for some medical information to better understand what might be going on.

⏺ doctor-claude - search_medical_info (MCP)(query: "hypert
                                           hyroidism thyro
                                           toxicosis",
                                           source: "both")
  ⎿  [
       {
         "source": "medlineplus",
     … +220 lines (ctrl+o to expand)

⏺ doctor-claude - fetch_medical_article (MCP)(url:
                                             "https://medl
                                             ineplus.gov/e
                                             ncy/article/0
                                             00356.htm")
  ⎿  # Hyperthyroidism

     **Source:** medlineplus
     … +172 lines (ctrl+o to expand)

⏺ doctor-claude - fetch_medical_article (MCP)(url:
                                             "https://www.
                                             ncbi.nlm.nih.
                                             gov/books/NBK
                                             537053/")
  ⎿ #
    HyperthyroidismTwitterFacebookLinkedInGitHubNCB
    I Insights BlogTwitterFacebookYoutube
    … +7 lines (ctrl+o to expand)


⏺ Thank you for those additional details. Let me ask some questions:
  1. Eyes and mood: Any changes in how your eyes look or feel, or increased irritability beyond your baseline?
  2. Family history of thyroid issues: Has anyone in your family had thyroid problems or autoimmune conditions?

  While you answer those, let me share what this pattern of symptoms is suggesting to me based on the medical information I've reviewed.

❯ My girlfriend said my eyes look wide
  but nobody else says anything is wrong. {'{family member has thyroid disease}'}

And there it is—the family history that none of my doctors asked about. Genetics are very important, so if thyroid disease wasn't already a top suspect, it is now.

⏺ Thank you - this is very helpful context. The family history of thyroid disease is particularly relevant.

  Based on the pattern of symptoms you've described, I want to share what this picture suggests:

  Leading Diagnostic Possibilities

  The combination of symptoms you're experiencing - progressive exercise intolerance, heart pounding, rapid weight loss, heat intolerance with sweating, tremor, increased stool frequency, and possible eye changes - is quite consistent with hyperthyroidism (overactive thyroid). This would be a leading consideration on the differential.

  Hyperthyroidism occurs when your thyroid gland produces too much thyroid hormone, which essentially speeds up your metabolism. The family history is relevant because autoimmune thyroid conditions (like Graves disease, the most common cause of hyperthyroidism) can run in families - your {'{family member\'s thyroid disease}'} suggests a genetic predisposition to thyroid autoimmunity.

  How this explains your symptoms:
  - Exercise intolerance/pounding heart: Excess thyroid hormone increases heart rate and cardiac workload
  - Weight loss: Increased metabolism burns calories faster
  - Heat/sweating: Increased metabolic rate generates more body heat
  - Tremor: Thyroid hormone affects the nervous system
  - Increased stools: Speeds up digestive transit
  - Possible eye changes: Some forms (like Graves) can affect eye muscles and tissues

  Other possibilities to consider:
  While hyperthyroidism fits your symptom pattern well, other conditions that can cause similar symptoms include cardiac arrhythmias, anemia, or other metabolic conditions. These would need to be distinguished through clinical evaluation and testing.

  What Evaluation Would Involve

  Hyperthyroidism cannot be confirmed without blood tests - specifically thyroid function tests (TSH, free T4, and T3). A clinician would also likely check for thyroid antibodies to determine the specific cause. These are simple blood tests that can establish the diagnosis.

  Urgency and Next Steps

  This warrants evaluation by your primary care provider within the next few days to a week. While this is not an emergency at your current symptom level, it's something that should be addressed promptly because:

  1. Untreated hyperthyroidism can worsen over time
  2. Your declining exercise tolerance suggests progression
  3. Treatment can significantly improve your symptoms

  When to seek same-day or emergency care:
  You should seek urgent evaluation if you develop:
  - Severe rapid heartbeat (especially if irregular or accompanied by chest pain)
  - High fever (>101°F)
  - Severe confusion, agitation, or changes in mental status
  - Extreme weakness or inability to function
  - Severe shortness of breath at rest

  These would suggest a more serious complication, though based on your current symptoms, this seems unlikely.

  What to Expect

  If hyperthyroidism is confirmed, it's a very treatable condition. Common management approaches include medications that reduce thyroid hormone production, and your provider would discuss the best strategy for your specific situation.

  What you should do:
  1. Schedule an appointment with your primary care provider in the next few days
  2. Request thyroid function testing - you can mention your symptoms and family history
  3. In the meantime, avoid excessive caffeine or stimulants which might worsen palpitations
  4. Continue to monitor your symptoms

  Does this explanation make sense? Do you have any questions about what I've described, or is there anything else you'd like me to clarify?

The verdict

One conversation later, a hypothesis that pointed directly at the right test.

To be clear: Claude didn't diagnose me—that's not what AI does, and it's not what it should do. What it did was take my scattered symptoms and surface a coherent hypothesis that a clinician could validate. The actual diagnosis still required a doctor to evaluate whether the clinical picture justified ordering thyroid function tests, and lab results to confirm.

This is an N=1 case study, not proof that AI outperforms clinicians. But it does reveal something structural: Claude could spend 10 minutes asking 40+ questions without worrying about clinic flow, billing codes, or the cognitive load of back-to-back patients. It didn't anchor on the first plausible explanation. It wasn't constrained by a 15-minute slot.

It's not that Claude is smarter than doctors—it's that it's unconstrained in ways the healthcare system no longer allows humans to be. It can do the kind of exhaustive history-taking that used to be standard practice but is now structurally impossible in most clinical settings.

Would a doctor have ordered the thyroid panel if I'd walked into that first appointment with this hypothesis and asked informed questions? Almost certainly—the clinical picture justified it. The hypothesis didn't cause the diagnosis, but it could have accelerated the path to the right test.