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DES MOINES, Iowa – Bernie Sanders is in “overall very good health,” according to a letter from his doctor released by the Democratic presidential candidates’ campaign Thursday.

The letter from Dr. Brian Monahan, who has been Sanders’ physician for 26 years, says Sanders is active in his work and recreational life “without limitation.”

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Sanders had his last physical exam in November, according to the letter, when his blood pressure was 136/81 and he weighed 179 pounds. His thyroid profile, blood count, colonoscopy, and electrocardiogram were normal.

The letter also says that over the years, he has been treated for gout, mild hypercholesterolemia, diverticulitis, hypothyroidism, laryngitis secondary to esophageal reflux, lumbar strain, and that he had superficial skin tumors removed. Sanders had hernia surgery last fall and had a cyst removed on his vocal cord, an experience he writes about in his 1997 autobiography. Both are mentioned in the letter.

He takes levothyroxine, a drug that supplement’s hormones produced by the thyroid, and indomethacin, an anti-inflammatory, according to the document.

The letter also states he does not use tobacco and drinks alcohol “infrequently.”

Sanders’ campaign promised to release his medical records before the Iowa Caucuses, now just four days away, and the 74-year old candidate said his health was a fair issue to discuss. However, his campaign took issue when David Brock, who runs several pro-Hillary Clinton super PACs, considered plans to attack Sanders on his health.

Clinton, who is 68, has already released a similar medical record.

This article originally appeared on MSNBC.com.