How can someone tell if their symptoms are anxiety related or from a real disease? example: nausea, dizzy, off balance.

Those sound like: Anxiety. They are possibly present in real diseases, but not likely w/out other symptoms (or less visible signs). This is a loose general rule of thumb - no guarantee - but, if they pass on their own under different conditions - a phone call, a task, an amusing entertainment, etc., they are not likely to be disease. If you can't be relieved by circumstances, give it 1-2 days and call a Dr. Best!