Quiz

Presidential Health: Secrets, Surprises, and Controversies

Albert B. Lowenfels, MD

Disclosures

August 14, 2017

A Disease or a Syndrome?

Figure 3. John F. Kennedy. Image from Dreamstime.

Although considered by the public to be strong and healthy, most people never knew that President Kennedy (1917-1963) suffered from several serious diseases.[5] In 1947, he collapsed while on a trip to England, where he was diagnosed with Addison disease, an entity first described by the English physician Thomas Addison in the middle of the 19th century. Addison's original patients all had tuberculosis, now a rare cause of this disorder. Upon returning to the United States, Kennedy began taking cortisone, and in 1955 after a diagnosis of hypothyroidism, he began taking a synthetic thyroid hormone. The combination of two glandular disorders strongly suggests an autoimmune disorder called autoimmune polyglandular syndrome, specifically type II.[6]

During the 1960 presidential campaign, Kennedy's staff denied that he had Addison disease. Despite this public denial, Kennedy took multiple endocrine hormones throughout his life to control his symptoms. Autoimmune polyglandular syndrome has a genetic component: Kennedy's sister had Addison disease and his son John F. Kennedy, Jr. had Graves disease.[7] Final confirmation of the diagnosis of adrenal insufficiency came at the time of his autopsy, when his adrenal glands were discovered to be almost completely atrophied.[8]

Although Addison disease is a relatively rare disorder, several other well-known persons may have had it, including Osama bin Laden, whose symptoms included bouts of weakness, hypotension, back pains, dehydration, and a craving for salt.[9]

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