John F. Kennedy's Addison's disease, which came to light only after his election as president in 1960, was most likely caused by a rare autoimmune disease, according to a Navy doctor who reviewed Kennedy's medical records. The disorder, called autoimmune polyendocrine syndrome Type 2, or APS 2, also caused Kennedy's hypothyroidism, according to a report published yesterday in the Annals of Internal Medicine.
In today's hyperactive media environment where the smallest sneeze of a celebrity is thoroughly analyzed, it is difficult to believe that Kennedy's family and advisers were able to keep his medical history virtually a complete secret. The youngest man ever elected to the presidency at age 43, Kennedy was pictured as healthy and vibrant. In reality, he suffered from a variety of problems that were kept in check by a daily regimen of steroids and other drugs.
Addison's disease is characterized by the withering away of the adrenal glands, which produce adrenaline and other hormones. Symptoms include fatigue, dizziness, muscle weakness, weight loss, difficulties standing up, nausea, sweating and changes in mood and personality. About 20 percent of cases are the aftermath of tuberculosis; the rest are autoimmune in origin.
During the 1960 campaign, Kennedy's opponents argued that he had Addison's, but his physicians released a cleverly worded statement saying that he did not have Addison's disease caused by tuberculosis, and the matter was dropped.
Doctors diagnosed his Addison's in the 1940s, and he suffered two severe collapses because of the disease: one at the end of a parade during an election campaign and the other on a congressional visit to Britain. Records reveal that in 1955 he was found to have hypothyroidism -- an insufficient output of thyroid hormones.
Dr. Lee R. Mandel, an endocrinologist in the U.S. Navy Medical Corps in Chesapeake, Va., was allowed to review Kennedy's medical records at the John F. Kennedy Presidential Library and Museum this year. After synthesizing the information in the records and conducting correspondence with many of Kennedy's physicians, he concluded that both problems were the result of APS 2.
Mandel found that Kennedy, during his presidency, was taking a host of drugs: 500 milligrams of vitamin C twice daily; 10 milligrams of hydrocortisone daily; 2.5 milligrams of prednisone twice daily; 10 milligrams of methyltestosterone daily; 25 micrograms of liothyronine twice daily; 0.1 milligrams fludrocortisone daily; and diphenoxylate hydrochloride and atropine sulfate, two tablets as needed. Liothyronine is a synthetic thyroid hormone. Diphenoxylate/atropine is used to treat diarrhea. The testosterone was given to combat the weight loss and gonadal atrophy associated with the steroids he was given.
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