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Internal medicine and functional medicine physician Shiv K. Goel discusses his article “Mind-body connection in chronic disease: Why traditional medicine falls short.” Shiv explores the limitations of conventional medical models that focus solely on acute intervention while ignoring the emotional roots of chronic conditions. He shares the compelling story of Linda whose physical ailments were deeply connected to decades of suppressed grief and trauma. The conversation delves into the science of psychoneuroimmunology and how unprocessed emotions get stored in the body’s tissues eventually manifesting as disease. Shiv explains why true healing involves not just medication but also meditation and somatic therapy to rewrite the body’s internal narrative. Listen to discover how changing your consciousness can fundamentally alter your biological reality.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Shiv K. Goel. He is an internal medicine and functional medicine physician. Today’s KevinMD article is “Mind-body connection and chronic disease: why traditional medicine falls short.” Shiv, Happy New Year. Welcome to the show.

Shiv K. Goel: Happy New Year, Kevin. Thank you for having me here.

Kevin Pho: All right, so we will talk about your article in a little bit, but first off, just briefly share your story and journey.

Shiv K. Goel: My name is Dr. Goel, and I specialize in internal medicine, functional medicine, aesthetics, and cosmetics. As far as my journey is concerned, I grew up in India in a family of nine with limited resources. I think that shaped everything, including my resilience, my drive, and my deep empathy for people who feel unseen by the system. I trained in anesthesia and critical care in India before I moved to America, where I trained in internal medicine at Mount Sinai School of Medicine in New York.

I spent years as a hospitalist, then I became a medical director at Methodist Hospital in San Antonio. I taught as an assistant professor at Texas Tech, but there is something which kept nagging me. In the ICU, I saved lives in moments of crisis, but in the clinic, I watched patients return again and again with the same chronic issues like diabetes, high blood pressure, obesity, and fatigue. Despite doing everything right and taking medication, and even when the numbers looked good on paper, I felt that people weren’t healing, changing, or feeling that they are alive.

That frustration led me to functional medicine and evaluating the root causes. This led to founding the practice where I work, where I could practice differently. That is why I left the bureaucratic system. I wanted to ask not just what disease you have, but why you have this disease. What is the root problem, and what is really going on beneath the surface? That shift changed everything for my patients and for me.

Kevin Pho: You talk more about that in your KevinMD article, “Mind-body connection in chronic disease: why traditional medicine falls short.” For those who did not get a chance to read your article, tell us a little bit more about what the mind-body connection is and the article itself.

Shiv K. Goel: This article was born from a real patient encounter with Linda. She had seen seven physicians. I think her story is not just her story, but it mimics the stories of so many patients of mine. She was on multiple medications. She was doing everything right regarding diet, pills, and exercise, but nothing was working.

One day she looked at me and asked why nothing was working. That question haunted me a bit because on paper everything looked perfect. Her numbers were being managed fine. But she felt exhausted all the time, not just physically, but existentially. As I listened deeper and spoke to her more and more, I realized her disease wasn’t the problem. It was her symptoms.

When I came to know more about her, it seemed like she had decades of suppressed grief, childhood emotional neglect, and feeling invisible even in her own marriage. She had this constant fear of failure, whether it was at work or in her relationship. The more she tried to give, the more she was burning herself from every end.

As I started researching more about psychoneuroimmunology, which is the science connecting psychological states to physiological functions, I learned that thoughts trigger neurochemical cascades, emotions modulate the immune response, and belief can alter gene expression through epigenetics. All of it is actually linked together because it all begins with how we perceive ourselves. If we are in the perception that we lack something, we have to keep proving something. We have to keep doing something, whether it is to get validation from society, from a relationship, or from work. We keep burning ourselves out and we will never be up to par.

That is why I think a lot of my clients and patients feel like they are just existing, not living. When we address that, whether it is through somatic therapy, meditation, or examining inherited beliefs, things change. This is not just their problem, it is a generational problem which started from their family and the families before them.

After about three months, I started her on a program of breathwork, mindfulness, and stress reduction techniques. Her blood pressure normalized without medications, her hemoglobin A1c dropped, and she lost 30 pounds. This was not by depriving herself of food, but through transforming her relationship with herself.

I wrote this article because I believe we are missing something profound in medicine. We are treating downstream effects while ignoring the upstream causes. Patients like Linda are paying the price, and not just the patients. I have seen even physicians pay the price. We cannot heal or truly treat patients when we haven’t healed ourselves. How many people really think about that because they themselves are burning from both ends?

They do not have time to make a living in a time when the insurance companies and the system are giving them the hardest time. You end up seeing 30 or 40 patients a day. You start your day in the morning and do not even have time to think about whether you have had breakfast or not. By the time you come home, it is night. How are we going to make any change? When it comes to the patients, they often say that their doctor doesn’t even have time for them, or a nurse practitioner sees them for five minutes. Where will the change come from? That is why I decided to write this article.

Kevin Pho: In that case that you told us about Linda, you bring up the concept of psychoneuroimmunology and how processing unprocessed emotions, suppressed grief, and trauma can affect patients physiologically. In Linda’s case, it improved her blood pressure, A1c, and other labs. What other physiological manifestations could be improved by processing these unprocessed emotions, trauma, and grief? What other examples of physiological improvements can you tell us?

Shiv K. Goel: I think there are so many of them. If you look at the stress response, our adrenal gland is an endocrine organ which manages stress. When we address the stress or the psychosomatic and immunological issues which are causing a vicious cycle, things improve. I will explain it to you.

Our adrenal gland is made to mount a stress and fight-or-flight response in the morning when we wake up. It used to be for hunting and similar activities. When we have chronic stress happening, or unresolved grief, or a pattern which is under the surface, our body remains in that elevated state. It starts to push pregnenolone, which is the main hormone from which everything starts, whether it goes into the cortisol direction or the sex hormone direction. The axis shifts towards that.

As a result, you have low progesterone, estrogen, and other hormones, and you have more corticosteroids in the body. This causes your body to remain in an elevated state. Over a period of chronic stress, that adrenal gland goes into fatigue completely. You stop mounting that response when you wake up in the morning. As a result, you feel fatigue. You feel like you haven’t had a rest. You feel like you have a deep bone exhaustion, a soul-deep exhaustion. No matter how much you rest, and no matter how much you improve your diet, your blood pressure is going to remain up. You are going to have pulmonary hypertension, anxiety, and depression because our hormones also do neuromodulation and affect our neurotransmitters as well.

This results in further issues. That is why we see a lot of road rage. That is why I see people having a lot of anxiety issues, panic disorders, and even a lot of idiopathic disorders such as restless leg syndrome and irritable bowel syndrome. Everything is connected. It is just a cascade of things which start to happen.

Patients are going to have increased insulin resistance, which leads to a greater propensity for diabetes mellitus, increased weight gain, and decreased immunity, especially in the GI tract because the IgA levels go down. Everything begins at the level of the mind and thought. We do not even have time to quiet our mind and listen to our body because our body realizes it before the mind does.

Kevin Pho: So what do you do in your exam room to process some of these emotions, trauma, and grief? Do you have training from a behavioral health standpoint? Do you refer patients out? What kind of approach do you use, especially if there is a strong mind-body connection?

Shiv K. Goel: In my experience, one needs to hear. I just create a space. I create a space for them to feel safe. I create a space for them to be heard. I do refer people for evaluation from a psychiatrist if needed. But a lot of times, the number of psychiatric disorders is increasing. What do psychiatrists do? They just prescribe medications, which is not a solution. It is an epidemic of stress which has crossed over. Just referring people from here to there without even listening to them is not enough.

My first and most important thing is that I create a space. I let them speak and I listen to them. I think about 80 percent of the time I know what is going on. They do not even have anyone to hear them out. Being a functional medicine physician, I think about how we can streamline this process so we don’t have to spend hours with the patient. We can integrate some techniques to navigate this process faster.

We are in 2026 today. We just passed 2025, which was the year in which people started to awaken. They started to realize things. This is my message to all fellow physicians too: heal first. Life is not here just to exist, be born, be a physician, and die. If we are here to make a difference, we have to start making a difference from within. We cannot heal anybody for real until we heal ourselves.

That is why I think what Linda said is what I felt in my life. That is what I see so many of my colleagues feel. They have everything, including money and good lives, but they still feel exhausted. They still do not feel that contentment and happiness because of the same thing. We keep chasing things outside. We don’t even have time to just sit down and listen to our body.

Trauma doesn’t just come from external factors. The definition of trauma itself is not just an external factor. We are creating trauma ourselves so many times without realizing it. Until we heal and until we understand the psychoneuroimmunology of every thought process, how we perceive things, and how the biology reflects our inner world, we cannot truly bring healing into the world.

Kevin Pho: As you said, if you’re working to streamline the process, I am a primary care physician, and as you know, a lot of primary care physicians are under a lot of pressure to see more patients in a limited amount of time. Do you have any specific questions or techniques that we can use to approach this issue in a traditional medical setting where we only have 15 to 20 minutes with a patient?

Shiv K. Goel: In traditional medicine, you cannot do much in 15 minutes. That is why I switched to functional medicine. But what functional medicine achieves in 45 minutes, you can definitely achieve in 15 to 20 minutes as long as you know how to navigate it. You need to understand the intersection of consciousness and healing, epigenetics, and the use of AI in functional medicine.

We are in 2026, and I am building an AI system that helps people see the pattern in their story and the connection between their sleep, stress, hormones, gut health, and lifestyle. That reveals the root cause of their issues. It is not to replace the physician, but to extend our capacity to truly understand each patient and reach those who can’t extend this kind of care. By integrating a workflow system through AI, you can save time. Patients can go online or through an email link to a questionnaire. A lot of them enjoy it because it starts with multiple-choice questions and then becomes open-ended where they can write anything. It creates a synthesized report that comes to you. You can evaluate it before the patient’s appointment, saving 30 to 40 minutes, and you know exactly what is going on. A lot of times patients feel comfortable doing that at home because sometimes they feel judged or intimidated in front of a physician.

I think this is something which more and more people should adopt. The second thing is epigenetics, basically how trauma can be inherited and, more importantly, how it can be released and how we can undo that process. There is a lot of research happening on that.

In the end, the treatment modalities are up to the patients. We develop a few techniques such as box breathing and mindfulness techniques. Each person has a different take on it because we cannot give the same formula to everybody. They have different issues, and they are at different levels and stages of their stress and trauma. That is how we do it here.

Kevin Pho: We are talking to Shiv K. Goel. He is an internal medicine and functional medicine physician. Today’s KevinMD article is “Mind-body connection and chronic disease: why traditional medicine falls short.” Shiv, let’s end with some take-home messages that you want to leave with the KevinMD audience.

Shiv K. Goel: Yes. I think my take-home message is that it is not just for patients; it is for every physician listening. The body does not lie. It faithfully reflects what the mind and the spirit have been carrying, sometimes for decades. That is true for our patients as well. Here is the harder truth: it is also true for us. Before we try to heal anyone else, we have to heal ourselves first because if the healer hasn’t healed, how are we going to bring real change?

What Linda taught me wasn’t just about her. It was about me. The disconnect between the mind, body, and spirit was somewhere inside me too. The burnout, the exhaustion, and the sense that I was going through the motions but missing something essential were all there. I had to face that in myself before I could truly hold space for someone else.

Through Kevin’s podcast, I want to invite every physician listening to be more open. We all have a responsibility to ourselves first. Even healers need healing, and we cannot guide patients towards wholeness if we haven’t begun that journey ourselves. The beautiful paradox is this: a lot of times we heal ourselves while healing others. Often, while I am healing my patients, I am actually healing a part of me. Every patient who trusts us with their story gives us a mirror. Every moment of true presence is an opportunity for our own transformation.

Kevin Pho: Thank you, Shiv. Thank you so much for sharing your perspective and insight. Thanks again for coming on the show.

Shiv K. Goel: Thank you, Kevin. Thanks for having me here.