PTSD and Physical Health: What the Evidence Shows

PTSD can be connected with physical health. Studies have found links with heart disease, diabetes, autoimmune illness, pain, and other conditions.12 Those links deserve attention. They do not prove that PTSD caused one person’s symptoms, and they do not make medical assessment less important.

The useful response is care that works together: assess the physical problem, treat PTSD when present, and keep ordinary prevention in view. You do not need a special blood test to prove that trauma affected you. You also should not be told that a new symptom is “just anxiety” because trauma is in your chart.

New or concerning chest pain, severe shortness of breath, fainting, sudden weakness, or new confusion needs urgent medical assessment. Call 911 for a medical emergency. An article cannot decide whether such a symptom comes from panic, heart disease, medication, or another cause.345

What matters most

• PTSD is linked with heart disease, diabetes, autoimmune illness, pain, and gut and sleep problems. The links are real. They do not prove PTSD caused one person’s symptoms.
• Most of the research is observational. Adjusting for smoking, weight, and depression helps but cannot remove every difference between groups.
• No blood test, inflammatory marker, or biological-age test proves that trauma affected you.
• Whether treating PTSD prevents physical disease is unsettled. A randomized trial of Cognitive Processing Therapy did not show a clear change in its main cardiovascular measure.
• Get the medical workup your symptoms call for, treat PTSD when present, and keep ordinary prevention in view. New chest pain, breathing trouble, fainting, sudden weakness, or confusion needs urgent care.

Zoom

What a link can tell us

Much of this research follows people over time or compares health records. These studies can show whether a diagnosis or symptom pattern is linked with later illness. They are less able to prove what caused the illness.

Researchers try to account for factors such as age, smoking, existing disease, depression, body weight, and health care use. This is called statistical adjustment. It makes the comparison more informative, but it cannot remove every difference between groups.1 Poverty, unsafe housing, discrimination, disrupted sleep, and access to care can be difficult to measure well.

Timing matters too. PTSD may precede a physical illness. A frightening medical event may also precede PTSD. Sometimes the effects run in both directions, with other factors contributing to each.

A risk estimate also needs a denominator. “Twice the risk” does not tell you how common an outcome is, over what period, or for which group. A relative increase in one selected group should not be presented as your personal odds.

Heart and blood vessel health

A study of male Vietnam-era twins followed participants for about thirteen years. Men with PTSD had more coronary heart disease than men without it, even after adjustment. Studying twins helps address some shared family and genetic influences. It does not remove every source of bias, and the sample does not represent women, younger adults, or every trauma history.6

A separate study followed nearly 50,000 women in the Nurses’ Health Study II. Greater PTSD symptoms were linked with later cardiovascular events. Women with trauma exposure but no PTSD symptoms also showed increased risk compared with women reporting no trauma. That detail matters: the findings do not isolate PTSD as the only possible cause. Health behaviors and medical risk factors accounted for part of the observed link.7

These studies support taking blood pressure, smoking, sleep, diabetes, cholesterol, and other usual risk factors seriously. They do not establish that every person with PTSD needs a cardiac scan or invasive test. The right assessment depends on symptoms, age, family history, and the rest of the person’s health.

If a reminder brings on a racing heart, tell the clinician about both the reminder and the physical symptoms. Avoid deciding in advance that only one explanation is possible.

Autoimmune disease: a link, not a verdict

Autoimmune diseases involve the immune system attacking the body’s own tissues. They are a varied group of illnesses, not one condition.

A large U.S. veteran study found more autoimmune diagnoses among people with PTSD than among people without psychiatric diagnoses. Even after accounting for how often people visited primary care, differences in how closely people are examined, other psychiatric conditions, exposures, and factors not captured in records may influence that link. The study cannot determine that trauma caused a single person’s autoimmune illness.8

A Swedish study compared people with stress-related diagnoses with population controls and siblings. The main stress-disorder category included PTSD, acute stress reactions, adjustment disorders, and other stress reactions. Its overall estimate must not be described as a PTSD-only result. A separate PTSD analysis also showed a link with later autoimmune disease.9

The same study reported that, within the PTSD group, longer first-year SSRI use was linked with a smaller, but still raised, risk compared with shorter use. That was not a trial randomly assigning medication to prevent autoimmune disease. People who continue a medicine can differ from those who do not in many ways. The result does not establish a new preventive use for antidepressants.9

Joint pain, rash, fatigue, or other symptoms deserve the medical workup their pattern calls for. A trauma history neither proves an autoimmune diagnosis nor rules one out.

Inflammation does not provide a trauma test

Studies have compared inflammatory markers in people with and without PTSD. Reviews found average differences in some markers, including CRP and certain immune signaling proteins. Results varied across studies, and the studies compared groups at one point in time rather than following individuals.1011

An average group difference is not the same as a useful test for a single person. A marker may vary with infection, body weight, smoking, other illness, medicines, and many other factors. A high value cannot prove PTSD. A normal value cannot show that a person was unaffected by trauma.

Research on biological aging and epigenetic clocks asks related questions about patterns measured in cells.2 It remains early for one person’s trauma care. These research findings should not be treated as a PTSD diagnosis or a treatment recommendation from a commercial biological-age test.

You can ask what a proposed laboratory test is meant to answer and how the result would change care. If the purpose is simply to “prove trauma is in the body,” that claim needs better evidence.

Pain, gut symptoms, and sleep deserve their own assessment

Persistent pain and PTSD can occur together. Fear, poor sleep, distress, reduced activity, and attention to threat may influence how symptoms are experienced and managed. Researchers have proposed models in which pain and PTSD help maintain each other. A model can guide questions without explaining every case or showing that pain is imagined.12

The same caution applies to bowel symptoms and fibromyalgia. These conditions should not be diagnosed from trauma history. Pain or digestive symptoms can have several causes, and the presence of PTSD should not close that assessment.

A Danish registry study found that people with a PTSD diagnosis had more later digestive diagnoses than expected in the comparison population. It studied a broad group of digestive diseases. That result should not be rewritten as an exact risk estimate for irritable bowel syndrome, or as proof that trauma causes every gut problem.13

Sleep is another point of overlap. Nightmares and insomnia may be part of PTSD, while sleep apnea is a distinct medical problem that can also be present. Snoring, witnessed breathing pauses, or marked daytime sleepiness are reasons to discuss sleep assessment. Treating trauma does not replace evaluating another sleep disorder.14

Diabetes and body weight

A long-running study of women found that higher PTSD symptom levels were linked with later type 2 diabetes. The study used symptom measures and followed participants over time; it did not randomly assign trauma or PTSD.

Body weight and antidepressant use helped explain part of the link. That does not mean a prescribed antidepressant caused diabetes, or that stopping it would reduce risk. Medication choice, illness severity, behavior, and other factors can be linked. These findings call for thoughtful monitoring and shared decisions, not abrupt medication changes.15

Weight changes can have many contributors, including sleep, pain, work schedules, food access, medicines, and other health conditions. Care should address those circumstances without shame or reducing recovery to willpower.

Ask about ordinary diabetes risk assessment and the practical parts of prevention you can use. The clinician can decide whether testing is appropriate based on your overall risk. PTSD alone does not create one universal laboratory schedule.

Does treating PTSD prevent physical disease?

This is the key unanswered question behind many headlines. Treatment can improve PTSD symptoms and daily life. Whether it also prevents a heart attack, diabetes, or autoimmune illness requires a different kind of evidence.

A 2019 study followed veterans with PTSD who did not already have diabetes. Large PTSD symptom improvement was linked with lower later diabetes risk. But improvement was not randomly assigned. It could follow treatment, natural change, or other influences. The study does not prove that PTSD therapy prevents diabetes.16

A randomized trial tested Cognitive Processing Therapy against a waiting comparison that included brief check-in calls. It examined measures related to cardiovascular health. Some secondary heart-rate variability measures improved, but the primary heart-rate variability measure did not show a clear benefit. Inflammatory and other vascular measures also did not show clear improvement. The trial was not designed to establish fewer heart attacks.17

Newer observational findings also need balance. A 2024 veteran study linked PTSD Checklist scores falling below a screening threshold with a modestly lower adjusted risk of small-vessel complications among people who already had diabetes. There was no clear link with better blood-sugar control across the full group. That is different from preventing diabetes in the first place, and a questionnaire threshold is not the same as a full diagnostic interview.18

In 2025, another veteran cohort examined people who already had cardiovascular disease. Large PTSD symptom decreases were not linked with lower rates of heart attack or revascularization, stroke, or death. That null result does not make PTSD treatment unhelpful. It limits the claim that symptom improvement has been shown to prevent those medical outcomes.19

The practical conclusion is to treat both sets of needs. PTSD care should not replace blood pressure treatment, diabetes care, rehabilitation, or other indicated medical treatment.

What may connect mental and physical health?

Possible pathways include changes in stress responses, inflammation, sleep disruption, health behaviors and medication adherence, and shared biological risks.1 Difficulty accessing care and social circumstances may add to them. Several can operate at once. Research has not established one complete chain from trauma to each disease.

The phrase “trauma is stored in the body” may describe how physical reminders feel. It should not be used as a literal claim that a memory is stored in a sore joint or can be released by a particular body treatment. Physical sensations are real without that explanation.

Trauma can also change the experience of care. A crowded room, loss of control, or a procedure may make an appointment hard to attend. A person may delay help because they expect to be dismissed. Those barriers belong in the plan even when the medical diagnosis has another cause.

Tell the team what would make care more manageable. A request for explanations, a support person, or discussion before touch may help the team plan. Such changes do not guarantee prevention, and emergency care may allow fewer choices, but the concern deserves a hearing.

Frequently asked questions

Does PTSD cause heart disease?

Studies link PTSD with later heart disease, including in twins and in a large cohort of women. Behaviors and risk factors explain part of the link, and the studies cannot prove cause for any one person.67

Should I get a test for inflammation to prove my trauma?

No. Group differences in markers such as CRP do not make a useful test for one person, and a normal value does not mean trauma had no effect.1011

Will treating my PTSD prevent diabetes or a heart attack?

Unknown. Symptom improvement was linked with lower later diabetes risk in one observational study, but a 2025 cohort of people with existing heart disease found no link with fewer heart attacks, strokes, or deaths.1619

A study linked my antidepressant to diabetes. Should I stop it?

No. That finding was an association within a cohort, not proof of cause. Talk with your prescriber about monitoring rather than changing medicine on your own.15

A primary-care checklist that does not diagnose you

Bring a short list, or discuss these points without writing:

You can ask, “Which symptoms need testing now, and which routine prevention is appropriate for me?” That invites a medical decision without demanding a specific panel.

Also ask what should prompt earlier contact rather than waiting for the next visit. A follow-up plan is more useful when you know what changes matter.

This week, choose one physical health concern or missed preventive-care step and bring it to your clinician. Mention the trauma symptoms too, so both can be considered in the same plan.

This article is for education. It does not replace an individual assessment or treatment plan. Talk with your clinician before changing medication or treatment. Evidence, contact numbers, and U.S. guidance were checked through September 6, 2026.

Related reading on NP FADY

• Your ACE Score: What It Predicts, and What It Cannot
• When Medical Care Leaves You Feeling Unsafe
• The Many Faces of PTSD: Why It Almost Never Looks Like the Movies
• The Silent Night Struggle: Sleep Apnea’s Overlooked Role in Depression
• Nutrition & Lifestyle essays

References

1. Edmondson D, von Känel R. Post-traumatic stress disorder and cardiovascular disease. Lancet Psychiatry. 2017;4:320–329. doi:10.1016/S2215-0366(16)30377-7. https://pmc.ncbi.nlm.nih.gov/articles/PMC5499153/

2. Wachen J, Larsen S, Schnurr P. Trauma, PTSD, and Physical Health. VA National Center for PTSD. Updated August 25, 2025. https://www.ptsd.va.gov/professional/treat/cooccurring/ptsd_physical_health.asp

3. American Heart Association. Warning Signs of a Heart Attack. Reviewed December 12, 2024. https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack

4. NHS. Sudden confusion (delirium). Reviewed May 28, 2024. https://www.nhs.uk/symptoms/confusion/ U.S. emergency numbers used in the body.

5. Centers for Disease Control and Prevention. Signs and Symptoms of Stroke. Reviewed May 19, 2026. https://www.cdc.gov/stroke/signs-symptoms/index.html

6. Vaccarino V, Goldberg J, Rooks C, et al. Post-traumatic stress disorder and incidence of coronary heart disease: A twin study. J Am Coll Cardiol. 2013;62:970–978. doi:10.1016/j.jacc.2013.04.085. https://pubmed.ncbi.nlm.nih.gov/23810885/

7. Sumner JA, et al. Trauma exposure and posttraumatic stress disorder symptoms predict onset of cardiovascular events in women. Circulation. 2015;132:251–259. doi:10.1161/CIRCULATIONAHA.114.014492. https://kclpure.kcl.ac.uk/portal/en/publications/trauma-exposure-and-posttraumatic-stress-disorder-symptoms-predic/

8. O’Donovan A, Cohen BE, Seal KH, et al. Elevated Risk for Autoimmune Disorders in Iraq and Afghanistan Veterans with Posttraumatic Stress Disorder. Biol Psychiatry. 2015;77:365–374. doi:10.1016/j.biopsych.2014.06.015. https://www.biologicalpsychiatryjournal.com/article/S0006-3223%2814%2900457-0/fulltext

9. Song H, Fang F, Tomasson G, et al. Association of stress-related disorders with subsequent autoimmune disease. JAMA. 2018;319:2388–2400. doi:10.1001/jama.2018.7028. https://jamanetwork.com/journals/jama/fullarticle/2685155

10. Passos IC, et al. Inflammatory markers in post-traumatic stress disorder: A systematic review, meta-analysis, and meta-regression. Lancet Psychiatry. 2015;2:1002–1012. doi:10.1016/S2215-0366(15)00309-0. https://pubmed.ncbi.nlm.nih.gov/26544749/

11. Peruzzolo TL, et al. Inflammatory and oxidative stress markers in post-traumatic stress disorder: A systematic review and meta-analysis. Mol Psychiatry. 2022;27:3150–3163. doi:10.1038/s41380-022-01564-0. https://pubmed.ncbi.nlm.nih.gov/35477973/

12. Larsen SE, Hadlandsmyth KE. Chronic Pain and PTSD. VA National Center for PTSD. Updated January 23, 2026. https://www.ptsd.va.gov/professional/treat/cooccurring/chronic_pain_guide.asp

13. Gradus JL, Farkas DK, Svensson E, et al. Posttraumatic stress disorder and gastrointestinal disorders in the Danish population. Epidemiology. 2017;28:354–360. doi:10.1097/EDE.0000000000000622. https://pubmed.ncbi.nlm.nih.gov/28099266/

14. NHLBI. Sleep Apnea Symptoms. Updated January 9, 2025. https://www.nhlbi.nih.gov/health/sleep-apnea/symptoms

15. Roberts AL, et al. Posttraumatic stress disorder and incidence of type 2 diabetes mellitus in a sample of women: A 22-year longitudinal study. JAMA Psychiatry. 2015;72:203–210. doi:10.1001/jamapsychiatry.2014.2632. https://profiles.wustl.edu/en/publications/posttraumatic-stress-disorder-and-incidence-of-type-2-diabetes-me/

16. Scherrer JF, Salas J, Norman SB, et al. Association between clinically meaningful posttraumatic stress disorder improvement and risk of type 2 diabetes. JAMA Psychiatry. 2019;76:1159–1166. doi:10.1001/jamapsychiatry.2019.2096. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2747848

17. Watkins LL, LoSavio ST, Calhoun P, Resick PA, Sherwood A, Coffman CJ, Kirby AC, Beaver TA, Dennis MF, Beckham JC. Effect of cognitive processing therapy on markers of cardiovascular risk in posttraumatic stress disorder patients: A randomized clinical trial. J Psychosom Res. 2023;170:111351. doi:10.1016/j.jpsychores.2023.111351. https://scholars.duke.edu/publication/1578535

18. Scherrer JF, Salas J, Wang W, Freedland KE, Lustman PJ, Schnurr PP, Cohen BE, Jaffe AS, Friedman MJ. Posttraumatic Stress Disorder and Type 2 Diabetes Outcomes in Veterans. JAMA Netw Open. 2024;7(8):e2427569. doi:10.1001/jamanetworkopen.2024.27569. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822292

19. Salas J, Sheth P, Cohen BE, Freedland KE, Jaffe AS, Schnurr PP, Friedman M, Lustman PJ, Scherrer JF. Large decrease in posttraumatic stress disorder severity and cardiovascular disease outcomes. Gen Hosp Psychiatry. 2025;95:102–108. doi:10.1016/j.genhosppsych.2025.04.011. PMID:40328100. https://profiles.wustl.edu/en/publications/large-decrease-in-posttraumatic-stress-disorder-severity-and-card/

If you or someone you know is in crisis

• Call 911 or go to your nearest emergency room for any life-threatening emergency.
• 988 Suicide & Crisis Lifeline — call or text 988, available 24/7. En español: marque 988 y oprima 2. Veterans: 988 and press 1, or text 838255.
• Crisis Text Line — text HOME to 741741.
• The Trevor Project (crisis support for LGBTQ+ young people) — call 1-866-488-7386, or text START to 678-678.
• National Sexual Assault Hotline (RAINN) — call 1-800-656-HOPE (4673) or text HOPE to 64673; free, confidential, 24/7. Online chat at RAINN.org/hotline.
• National Domestic Violence Hotline — call 1-800-799-SAFE (7233) or text START to 88788; 24/7, help in 200+ languages. Online chat at TheHotline.org. If your phone or computer may be monitored, calling from a safer device is an option.
• Riverside County — Inland SoCal Crisis Helpline 951-686-HELP (4357), 24/7 (Inland SoCal United Way / 211+, in partnership with RUHS-BH); Community Access, Referral, Evaluation and Support (CARES) Line 800-499-3008, 24/7.
• San Bernardino County — Access Unit (Behavioral Health Helpline) 888-743-1478, 24/7; Mobile Crisis/CCRT 800-398-0018 (24/7, all ages) or text 909-420-0560. Arrowhead Regional Medical Center (ARMC) has a dedicated walk-in adolescent psychiatric ER (ages 13–17).
• Children under 13 — call 911 for immediate danger, contact your county's mobile crisis team (they respond to all ages), or go to the nearest pediatric emergency room.
• California Peer-Run Warm Line (non-crisis — someone to talk to) — call or text 1-855-600-WARM (9276); daytime and evening hours, not a 24/7 line.
• NP Fady (non-emergency) — for routine scheduling or questions, call (909) 707-6261. This line is not monitored for emergencies.