A 77 year old woman presented with a complaint of persistent diarrhea. While eliciting the history, sweating was noted. This was further explored and on questioning, the patient also reported poor sleep with symptoms of profound heat intolerance and significant weight loss in the last 6 months despite a normal appetite. On examination, the patient was found to have generalised sweating. While this presentation highlights textbook symptoms of thyrotoxicosis, the question of diagnosis of conditions presenting with hyperhidrosis was raised. This in turn led to a search for criteria to improve the diagnosis of hyperhidrosis in the primary care setting. Other issues discussed include the differential diagnoses of hyperhidrosis, red flags that can present with hyperhidrosis and potential complications of hyperhidrosis as a chronic disease.