Mike Pence has released a letter from his doctor vouching for his “excellent” health. The letter summarizes the medical history of the Republican vice presidential nominee and says he can maintain his high level of work and exercise routines “without limitations.”

The letter about Pence, the 57-year-old governor of Indiana, was dated Thursday and came after Donald Trump, Hillary Clinton and her running mate, Tim Kaine, also provided some details of their medical history. The health of the candidates has become an issue since Clinton stumbled at a 9/11 memorial event and revealed afterward that she had been diagnosed with pneumonia.

Pence’s letter is written by Dr. Michael Busk with the St. Vincent Health, Wellness and Preventive Care Institute in Indianapolis. He summarizes Pence’s medical history and results of a physical examination from July 6.

Busk said that Pence had basal cell carcinomas — skin cancer — removed from his face in 2002 and 2010. He also had surgery in August 2015 to repair a hernia. Pence last had a colonoscopy in 2009 and no polyps were found. Busk said the only medication Pence takes is Claritin for seasonal allergies, he does not smoke or drink alcohol, has diet-controlled heartburn and exercises four times a week.

Pence also has a condition known as “left bundle branch block,” which causes the heart’s left ventricle to contract later than the right ventricle. Pence had “extensive evaluations” at the hospital in 2014 following the discovery of that condition, and Busk said “the cardiologists feel you have a very good and strong heart.”

Pence’s main form of exercising is bicycling, and the doctor said he also walks and climbs stairs extensively. Pence is 5-feet, 10-inches tall and weighs 208 pounds. His blood pressure at the July exam was 116/81 and his cholesterol was 216.

“Overall you are in excellent general and cardiovascular health,” the doctor wrote. “You are medically able to maintain your high level of professional work and your physical activity programs without limitations.”

(AP)