Despite a resounding win in the Iowa Republican caucus last night, doctors warn Donald Trump has looked tired, gaunt and unsteady on his feet in recent months.

The 77-year-old, normally full of energy and charisma, looked uncharacteristically frail and unsteady as he walked into a hotel in Des Moines after a busy day of campaigning Saturday night.

Dr Stuart Fischer, an internal medicine physician in New York, told DailyMail.com: ‘I’ve never seen that in him. The walking is one issue, but the balance is another. He looked a little bit like he was on a ship at sea.’

During his victory speech on Monday night, commentators pointed out that Mr Trump was less animated than usual and his voice was lower. A similar critique was made about his Presidential announcement back in 2022.

His third election campaign has been marred by a series of gaffes which appear to be increasing with frequency, including mistaking Barack Obama as the current President and bungling the name of the city in which he was speaking. 

Dr Keith Vossel, a neurologist at University of California Los Angeles, told DailyMail.com that the former president looked ‘pretty worn out’ amid an aggressive campaign schedule and mounting legal troubles.

Mr Trump appeared more tired than usual with a slimmer face while in Iowa over the weekend

Mr Trump appeared more tired than usual with a slimmer face while in Iowa over the weekend

‘It shows you that he’s aging, I think that’s the kindest way to put it,’ according to Dr Fischer. 

Trump’s critics have seized on his growing list of gaffes and used them to counter attacks made against President Joe Biden’s age and frailty.

But Dr Vossel said that he doesn’t ‘see anything neurological going on’ when it comes to Trump.

Commentators, fellow politicians, and even former White House deputy press secretary Sarah Matthews have said Trump’s demeanor has become visibly more fatigued in recent months. 

Many have also claimed that Mr Trump’s physique has appeared thinner and his face more gaunt lately. 

There have been rumors that the one-time president has lost weight with the help of blockbuster weight loss drugs such as Ozempic and Wegovy.

Dr Fischer, who has been critical of Trump’s diet and sleeping habits in the past, added: ‘You cannot fool Mother Nature. 

‘If you’ve not had a healthy life, or if you’re unlucky enough to get one of multiple chronic diseases. You will age more quickly, and then the curtain will come down.’

But Dr Fischer warned against overstating Trump’s demeanor in Iowa, pointing to the bitingly cold weather.

Frigid temperatures cause blood vessels to constrict, decreasing oxygen-rich blood flow and leading to cramping and impairing movement and coordination.

Cold temperatures can lead to muscle stiffness and loss of sensation, which could explain his lumbering gait.

Dr Fischer added: ‘Temperatures are really severely low. It’s not like in New York City, where it’s 30 or so. Plus, there’s a wind chill, and you’re catching him coming right in. It could take up to five minutes to fully acclimate when once you get indoors.’

Donald Trump handily won the Iowa caucus on Monday in a crushing victory over GOP rivals Gov. Ron DeSantis , Nikki Haley and Vivek Ramaswamy

Donald Trump handily won the Iowa caucus on Monday in a crushing victory over GOP rivals Gov. Ron DeSantis , Nikki Haley and Vivek Ramaswamy

Mr Trump could also just be showing his age. Declines in motor function and coordination take a nosedive between the ages of 75 and 80. .

Despite Nikki Haley’s and Ron DeSantis’ millions of dollars spent and mad-dashes across Iowa’s 99 counties, Mr Trump won 98 of those counties. But he was not as front-and-center as is custom. 

He participated in an impromptu town hall event over the weekend surrounded by supporters where he remained seated with his shoulders slumped and moderated his tone.

And while delivering a stack of pizzas for a local fire department in Iowa on Sunday, he appeared to be dragging one leg as he walked in the same way as he did at the hotel the night before.  

His hotel entrance on Saturday was the latest instance in which Trump appeared confused and unsteady.

He has repeatedly confused former President Barack Obama for current President Joe Biden, said the US would enter World War II if Biden remained in office, despite there already having been a second world war, and has confused the names of cities in which he campaigns.

Mr Trump’s less lively demeanor and leisurely pace during this election cycle has not had a negative impact on his polling numbers against President Biden, who is too old for a second term according to 77 percent of American voters polled. 

To millions of voters, Mr Trump’s latest stumbles are nothing compared to President Biden’s sizable share of verbal gaffes and falls. 

Doctors for both Biden and Trump have attested to their fitness to hold office, despite doubts among voters. 

Dr Fischer said: ‘His age is not what it used to be, and this may give people pause in terms of the election that we’re dealing with not one, but two people who are not in their prime physically. 

‘Whether they are mentally or not to I’ll leave others to discuss. But this is this is one of the hallmarks of the aging process.’

President Biden has generally been more forthright than Mr Trump about his health status, including medications he takes which could make falls more dangerous.  

The last record of medications Mr Trump takes comes from a 2018 physical, which showed Mr Trump was taking Crestor for high cholesterol, aspirin to prevent heart attacks, antibiotics to treat skin rosacea, Propecia for baldness, and Ambien to help him sleep.

Blood thinners prescribed to reduce the risk of blood clots can make falls potentially more deadly. If a person on blood thinners takes a spill, there is a markedly increased risk of suffering bruising and internal bleeding.

Ambien side effects are known to include fatigue, falls, and confusion. It remains unclear whether Mr Trump is taking the same medications today as he was five years ago.

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