Military Trauma and Chronic Illness: The Hidden Health Consequences

6-12-2025

By Dr. Howard Friedman MD | Veteran | U.S. Army Medical Corps | Internal Medicine | HHOM LLC

Some wounds don’t bleed—but they break the body just the same. Veterans carry unseen injuries into exam rooms every day. At HHOM, we listen to what the body remembers

The wound unseen may linger long,

A silent ache in blood and bone.

What war began, the body keeps—

In restless nights and breathless sleep.

And years may pass, yet still it speaks—

Through flare of pain and heart that weeps.—

---Dr. Howard Friedman, MD

Trauma That Outlasts the Battlefield

What happens to the body after war doesn’t always show up on X-rays or lab tests. In my decades working with veterans, I’ve seen time and again: trauma doesn’t end when the deployment does. Whether surviving combat, enduring military sexual trauma, exposure to toxic environments, or facing the quieter battles of isolation and moral injury—these experiences imprint not just on the mind but on the body.

One of the most overlooked systems affected is the HPA axis—the body’s command pathway for stress. The hypothalamus detects threat, the pituitary signals the adrenal glands, and cortisol floods the system. This fight-or-flight reflex keeps a soldier alive in war. But when trauma is unrelenting or unresolved—as is true for many veterans—the stress system never turns off. Cortisol remains high, inflammation smolders, and over time, the body pays the price.

This chronic dysregulation contributes to a cascade of illnesses: heart disease, autoimmune conditions, diabetes, insomnia, fatigue syndromes, and cognitive decline. What some still call “just stress” is actually chronic inflammation, driven by a biological cascade. This is not weakness. It is biology.

Combat and the Stress-Injury Continuum

Combat wounds are not always visible. Exposure to life-threatening situations, witnessing death, enduring survivor’s guilt, or living in a state of hypervigilance can all push the stress system past its limits. PTSD isn’t just a mental health condition—it’s a physiological state marked by sleep fragmentation, hormonal imbalance, and metabolic strain. The toll shows up in blood pressure, glucose levels, and immune dysfunction. This is trauma speaking through the body.

Military Sexual Trauma: The Body Remembers Betrayal

Military Sexual Trauma (MST) has its own devastating signature. Beyond emotional injury, MST can lead to complex PTSD, fibromyalgia, irritable bowel syndrome, chronic migraines, and autoimmune disorders. Women veterans are disproportionately affected—yet still underserved. Medicine is behind in researching the long-term health consequences of MST, especially in women and veterans of color. Evidence-based care must start reflecting everyone’s biology, not just that of white men.

Environmental Exposures: Toxins That Linger

Service often means exposure to toxic hazards—Agent Orange, burn pits, diesel exhaust, contaminated water, volatile solvents, heavy metals. These are not minor risks. They are inflammation triggers with delayed onset. What doesn’t show up right away can manifest years later as cancer, respiratory failure, neurological disease, endocrine disruption, and autoimmune conditions. Chronic exposure equals chronic inflammation, and that equals chronic illness.

The Long Shadow of Isolation and Moral Injury

Returning home doesn’t mean leaving war behind. Reintegration stress, loss of purpose, and alienation from civilian life take a toll. Add moral injury—where actions taken or witnessed violate one's values—and you’ve got a potent, invisible wound. These stressors keep the HPA axis in overdrive. The body remembers not just what happened, but what was never healed.

Inflammation: The Common Pathway

At the root of many chronic illnesses is one word: inflammation. This is the body’s alarm system—but left unchecked, it can become the fire that burns from within. Inflammatory cytokines, gut dysbiosis, HPA disruption, NAD+ depletion—all roads converge here. Veterans often carry inflammation from both outside exposures and internal trauma. That’s why our blogs at HHOM LLC explore external inflammation, internal triggers, anti-inflammatory lifestyle tools like gratitude and sleep, and the science behind veteran-specific health concerns.

What Veterans Deserve: Understanding, Not Dismissal

Too often, veterans are told, “it’s all in your head.” We say: it’s in your head, gut, lungs, heart, joints, immune system—and it’s time medicine caught up. The role of the Nexus Letter is to bridge this gap: to connect the service-related trauma to the illness now disabling the veteran. That’s the work we do at Howard’s House of Medicine. We don’t dismiss. We listen, analyze, and advocate.

Conclusion: The Courage to Heal

Healing doesn’t mean forgetting. It means facing the truth of your experience and letting your body speak it, too. Recognition is the first step toward healing—biological, emotional, and spiritual. As a physician and fellow veteran, I walk this path with you. When you choose to pursue answers, you’re not alone. At HHOM LLC, we bring evidence-based medicine with one goal: to honor your story and support your healing.

—Dr. Howard Friedman MD

Board-Certified | Internal Medicine | Veteran | U.S. Army Medical Corps

Founder of Howard’s House of Medicine (HHOM LLC)

https://www.hhomllc.com

Frequently Asked Questions:

Q: Have you or someone you know experienced physical symptoms that doctors couldn’t explain—but that followed trauma or military service?

A: Yes, far too often. I’ve seen veterans with migraines, autoimmune flares, chronic fatigue, or gut issues dismissed because their tests were “normal.” But the body remembers what war imprinted—especially when trauma goes unresolved. The absence of lab abnormalities doesn’t mean the suffering isn’t real. It means we need to ask better questions.

Q: Do you think the medical system does enough to connect chronic illness with past trauma or service-related exposures?

A: No, it doesn’t. Medicine is still catching up to the science of trauma biology. We separate mental from physical illness too neatly. But in truth, trauma weaves itself into both. Environmental exposures, chronic stress, and moral injury all contribute to inflammatory disease. We need to stop treating symptoms in isolation and start treating veterans holistically.

Q: What would real healing look like for veterans facing chronic illness tied to their time in service?

A: Real healing begins with being believed. Then comes evidence-based care tailored to the full story—physical, emotional, environmental. That means connecting the dots between past exposures and today’s illness. It means doctors writing Nexus Letters that tell the truth. And it means honoring service not just with words, but with treatment that reflects what veterans actually lived through.