President Bush’s Graves’ disease story and the potential triggers of his thyroid condition

Excerpt from the Thyroid Solution by Ridha Arem M.D.

President George H. W. Bush had an overactive thyroid caused by Graves’ disease, an autoimmune thyroid condition, during his presidency. There has however been speculation on whether a virus or the stress of the Gulf War in 1991 or both could have triggered or unmasked the president’s Graves disease.

The speculation about stress triggering President Bush’s overactive thyroid was prompted by the fact that his symptoms became evident approximately two months after the Gulf War cease-fire (February 24, 1991). While jogging at Camp David on Saturday May 4, Bush experienced shortness of breath and an irregular heartbeat. This led doctors at Bethesda Naval Hospital to test his thyroid, which was found to be mildly overactive. Prior to the diagnosis, President Bush had experienced a few symptoms, which began two to three weeks before his admission to the hospital. Toward the end of March, he had decided to lose weight and exercise more. However, Bush’s loss of seven or eight pounds over a two-week period was disproportionate to his dieting and exercise. His secretary had also noted a trembling of Bush’s right hand, which caused some difficulty writing. Bush’s entourage at the time - including his wife, his trusted aide Patty Presock, General Brent Scowcroft, and others on the White House and residence staff - had not noticed any emotional distress prior to diagnosis of the president’s Graves’ disease. 

There has also been speculation that President Bush’s overactive thyroid had preceded the war. Some news reporters described the president as animated by an incredible level of energy immediately after Iraq’s August 2, 1990, invasion of Kuwait. His heightened interest in sports activities, fast pace, and his overactivity led some to speculate that he might have been suffering from an overactive thyroid as far back as August 1990 – almost six months prior to the war. This would put the onset of Graves’ disease during the months of preparation leading up to the war, one of the most intense periods in Bush’s presidency.

It must be noted that a number of alternative mechanisms have been identified that may well have played a more important role in triggering Bush’s ailment. Two years before President Bush was diagnosed with Graves’ disease, First Lady Barbara Bush had been diagnosed with the same condition. Cases in which partners are diagnosed with Graves’ diseases are known as “conjugal Graves’ disease.” Conjugal Graves’ disease may be due to environmental factors, such as toxins in the home or workplace, or even too much iodine and other chemicals in the water. The search for such factors in the White House was fruitless. Viral infections are also considered environmental in nature and can be implicated if there is a genetic predisposition, which both George and Barbara Bush could have.

Coincidentally, the Bushes’ dog, Millie, was suffering from lupus. When the news broke that the Bushes’ and their pet all had autoimmune disorders, the president’s personal physician, Dr. Burton Lee, received numerous letters reporting cases of pets suffering from lupus whose owners have Graves’ disease.

There is increasing evidence that links infection, specifically infection by retrovirus, with Graves’ disease. The possible link between a retrovirus and Graves’ disease can be measured through the level of antibodies in the patient’s system. It turned out that both the Bushes had significant levels of antibodies to the virus in their systems. These findings were never made public, however, perhaps because these results did not provide clear-cut proof that the virus was the direct cause of their condition. The medical evidence does strongly suggest, though, that in the cases of the president and Mrs. Bush, infection by a virus contributed to their Graves’ disease. 

Former president George H. W. Bush’s case illustrates how difficult it is to prove that stress was a factor in triggering the condition. Did infection by a retrovirus cause Bush’s Graves’ disease, or did it result from stress generated by the Gulf crisis? Perhaps the most likely scenario is that it was a combination of the two.

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