Bumgarner provides an excellent short recap of Kennedy's medical history 2a, although the new medical sources pioneered by Dallek 1 3 are leaving it behind.

Dr. Lee Mandel 4 has recently offered a unifying medical diagnosis for Kennedy: auto-immune polyendocrine syndrome type II (APS II).

Dr. Mandel notes that Kennedy had signs of adrenal failure as early as 1940, and that his autopsy almost certainly indicates this was auto-immune in origin. Kennedy was diagnosed with hypothyroidism in 1955 and was under treatment for years (see below). 4 Comment: [Technical] APS II is a polygenic disorder defined as: (a) auto-immune adrenocortical failure plus (b) evidence of adrenal inflammation plus (c) either auto-immune thyroid disease or type 1 diabetes mellitus. The peak age of onset is 30. (JFK was 30 when his adrenal insufficiency was diagnosed.) Other associated autoimmune disorders include: atrophic gastritis (with or without pernicious anemia), hypergonadotrophic hypogonadism, and celiac disease.

The diagram below summarizes the possible interplay between Kennedy's medical problems. The rest of this page has details.

• Between 1920 and 1928 a Dr. Reardon "took care of ear."
• 1928: German measles
• June 15, 1930: "Examined by Lahey Clinic, tonsils and adenoids OK"
• Aug. 31, 1933: "Tonsils and adenoids out -- Dr. Kahill, St. Margaret's Hospital"

From age 20 to age 43, available data show that Kennedy's weight was more or less constant -- about 155-160 pounds 4, (corresponding to a body mass index of about 21-22 kg/m/m). Between July 1960 and January 1961, however, he gained 15-20 pounds, causing his mother to remark to her diary on Nov. 3, 1960: "Jack looks unusually well. His cheeks have filled out amazingly since I saw him in June. He has lost that lean Lincolnesque look which I secretly like better" 4.

The problem with Travell's recollection is that Kennedy was hospitalized the same day she met him, and the hospital records neither say Kennedy was anemic nor list anemia as a diagnosis 4. Thus, Travell's memory may be inaccurate. Comment: It would not be surprising if Kennedy had pernicious anemia, as it may be part of the APS II syndrome.

In both 1935 and 1939, Kennedy's basal metabolic rate was -11, which Dr. Walter Alvarez regarded as "well within normal limits" 4.

The reason(s) he took this medication are unknown. Certainly, his body was not completely devoid of testosterone, as he fathered four children from 1956 to 1960. It is possible that his testosterone level was reduced by the cortico-steroids he chronically took, or as a consequence of APS II (see above) 4. It has been written that Kennedy took testosterone to keep his weight up 4a. This may be true, as he gained 15-20 pounds between July 1960 and January 1961 4.

Dallek believes steroids were the "principal contributor" to Kennedy's duodenal ulcer (see above) and back problems (see below) 3d. (Steroids cause thinning of bones.) Steroids also altered the shape of Kennedy's face (see below) and, perhaps, body.

Another complication of steroid use is suppression of adrenal gland function. Kennedy was diagnosed with underactive adrenal glands in 1947, a condition known as Addison disease (see below). If Dallek is correct, Kennedy had by then been on steroids for 10 years, although not continuously 3. This makes it extremely difficult to know if Kennedy's Addison disease was the result of chronic steroid use, or whether it was the result of some other process (e.g. auto-immunity).

In January 1956 he underwent cystoscopy under anesthesia 3h. Comment: Was this a sexually transmitted disease? (1) The response to sulfa suggests it was infectious. (2) Kennedy had a large number of sexual contacts before he was even out of college, and (3) it seems unlikely he practiced safe sex 3i. As one female acquaintance remarked, "He was not much for planning ahead" 3j.

He wore a back brace. For example, on the day he was shot, he wore a brace that consisted of a canvas brace with metal stays, together with an Ace bandage with extra padding 7a. Some people think this back brace killed him. (See below.)

Kennedy took 10 days to recover from "symptoms of fatigue and many deep abrasions and lacerations of the entire body, especially the feet" 3k.

Dallek reports that "Doctors who treated Jack's Addison's or read closely about his condition have concluded that he had a secondary form of the disease, or a 'slow atrophy of of the adrenal glands,' rather than a rapid primary destruction" 3o. Dallek is hinting that Kennedy's Addisonism was due to chronic use of steroids, but he does not take a stand.

While a U.S. Senator, Kennedy underwent major surgery on his back even though the effects of Addison disease on the tolerance of surgery was largely unknown at the time. 10. In fact, JFK's case was published in the medical literature in 1955, although this was not publicly realized until 1967 7b. Post-operatively, he developed a urinary tract infection and had a transfusion reaction, characterized by "mild angioneurotic edema." He also had a repeat operation four months later 10.

Comment: Steroids classically cause a facial appearance known as "moon facies." This refers to the round shape the face assumes. Dr. Zebra always checks for moon facies by looking at the outer corner of the eye sockets. If there is facial tissue behind the eyes that projects laterally from the bony outer border of the orbit, then some degree of moon facies are present. Several photographs of Kennedy have this appearance.

To be sure, Addisonism may not be the whole story. Even in youth, Kennedy liked having a tan, saying "It gives me confidence. ... It makes me feel strong, healthy, attractive" 3q.

Kennedy was taking testosterone in 1963 4, and this could have had an (enhancing) effect on his libido. It is not clear when Smathers' statement was made and whether Kennedy was then taking testosterone.

To put things in a different light, if an officer in the U.S. Air Force were taking any one of these medications, he or she would not even be allowed to talk on the radio to aircraft as supervisor of flying. Kennedy, as commander-in-chief, was supervisor for the entire Air Force.

Question: Did the Bay of Pigs result from Kennedy talking, or was it the testosterone talking? MORE

Some think that Kennedy's back brace killed him 7a 1. It kept him erect after Oswald's first bullet went through his neck. Had he been able to fall forward after this first bullet hit, the second, fatal bullet may have missed him.

1. On the ocean liner Queen Mary in September 1947, bringing him home from London where he had received the diagnosis of Addison disease and been hospitalized 3t.
2. When a post-operative urinary tract infection in October 1954 put Kennedy into a coma 3u.
3. Before he was officially pronounced dead on Nov. 22, 1963 -- administered by a Fr. Huber. 15.