Some relationships work like medicine. Others work like a diagnosis.

A patient came in with weight gain nobody could explain. Every test came back fine. Shiv K. Goel is a board-certified internal medicine and functional medicine physician. This episode is based on his article "How relationships affect health, seen from the exam room," published on KevinMD. He treats the people in a patient's life as part of the same picture as sleep, alcohol, and diet. A difficult supervisor and plain loneliness count as stress the way a marriage does. He is careful to say that a hard relationship does not cause disease. It changes the load the body is carrying, and that load shows up physically. You will hear what he rules out first: thyroid disease, anemia, diabetes, and sleep apnea. You will also hear what a flat cortisol curve tells him about long-running stress, and the questions he asks when nothing turns up. He is not a marriage counselor, and that referral belongs to someone else. He closes with two questions, one for physicians and one for everyone else.

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