Interview with author of “A New Explanation for the Reproductive Woes and Midlife Decline of Henry VIII”

About a week ago I posted about a new article by Catrina Whitley and Kyra Kramer entitled ‘A New Explanation for the Reproductive Woes and Midlife Decline of Henry VIII’ (Read my original post here). In the article the authors examine the reasons behind Catherine of Aragon and Anne Boleyn’s multiple miscarriages and stillbirths.

King Henry VIII

The article immediately caught my attention because the new theory proposes that Henry VIII was positive for the Kell blood group and also suffered from McLeod syndrome. Where as many people throughout history have ‘blamed’ the women for the silence in the royal nursery, Whitley and Kramer believe the problem lay in Henry VIII.

After reading the article, I found myself wondering about a few aspects of the theory and so have interviewed the authors to help clarify some issues.

I feel that I have to mention that Catrina Whitley specialises in bioarchaeology (the scientific study of human skeletal remains from archaeological sites), archaeology, and paleopathology (the study of ancient disease) and has advised me that if given the opportunity, she could prove her theory!

How you ask? By exhuming Henry VIII!

Yes, you heard correctly. The authors believe that if they were given permission to examine the remains of Henry VIII they could perform DNA tests to check for Mcleod and, potentially, Kell (Catrina is currently investigating this area to ensure that this could be done genetically on human remains or hair), they could ascertain whether Henry’s leg ulcers were caused by osteomyelitis (as this leaves distinct changes on the bone), check for gout, document any injuries from jousting or other sporting accidents, check his dental health and confirm/deny a number of other health issues that Henry is often associated with.

It sounds unbelievable but the authors are very eager and currently working on finding the correct channels with which to proceed with their request.

They realise that because it is Henry VIII permission may not be granted and so they have also advised me that if a single strand of Henry’s hair was accessible (ie. survived somewhere…) then they could use this to check his DNA.

If this is still denied, then the authors also propose making a case to test a near relative of Henry’s for Kell positive blood but have confirmed that they need Henry to check for McLeods.

In addition, if Henry’s skull was in good condition then forensic scientists could also reconstruct Henry’s appearance.

Catrina also believes that Henry VIII deserves ‘a better burial location and marker than a crypt that is shared with several other individuals under the floor.’

Although I see Catrina’s point considering Henry’s reign and position, my initial feeling is why should Henry ‘deserve’ a better burial when the hundreds, possibly thousands of people he sent to their deaths (many of whom we know where innocent of their charges) are buried which much less dignity.

A lot to think about isn’t it! Well, here is a little more. My interview with Catrina Whitley, with contributions from Kyra Kramer.

Q & A with Catrina Whitley

In your article you propose that Henry VIII was positive for the Kell blood group and also suffered from McLeod syndrome. How did this theory come about?

My co-author, Kyra, and I have been enamored with Tudor history since our youth.  My research focuses on and my Ph.D. is in bioarchaeology (the scientific study of human skeletal remains from archaeological sites), archaeology, and paleopathology (the study of ancient disease). Kyra, as an M.A. medical anthropologist, studies reproductive problems from a cultural focus, in particular the negative outcomes caused by male influence.  For almost a year before formulating the theory, Kyra and I enjoyed regular discussions about disease, sickness, reproductive troubles, and genetics.  We also, as huge Tudor fans, enjoyed the series The Tudors, and had frequent discussions about the series.  After the second to last episode of the second season, Kyra asked me “Why do they always blame the women for the loss of the pregnancies?  I think it’s clear that Henry was the source of the problems.”  That semester, I had been teaching a course on Human Evolution and spent an entire six weeks on genetics with the Rhesus blood group being used as an excellent example of selection and pregnancy loss. This background started me thinking about how Henry’s genetics could have been the cause of a lack of children.   Within 24 hours of Kyra and I discussing why the failed pregnancies occurred I had a theory; the Kell Blood Group and that Henry was most probably Kell (KEL1) positive. Kyra immediately agreed with me, and told me she was thrilled that I had deducted such a plausible explanation. Then Kyra stated, not expecting an answer, “Now, tell me this what could have driven him crazy”, to which I replied that he might have had McLeod syndrome. We both realized this theory would have serious historical implications, so after a year of research and writing, we submitted our article for publication.

When did your interest in the Tudors begin?

My interest in the Tudors began as a young child.  History was always my favorite subject, but I was first introduced to Henry VIII at a renaissance faire.  My uncle was a court musician so we attended many times the first year it opened.  After attending, I began asking questions about Henry and life in the Tudor period and became fascinated.  This interest was heightened as a college student when I took a course on The History of Women in Early Modern Europe.  It made me think about the plight of the wives of Henry VIII and the general hardship women endured during the Tudor period.   It was at this point I almost pursued a Ph.D. in History, but my keen interest in researching skeletal remains and ancient disease pulled me away.  I was always curious why Henry and his wives lost so many children and this research gave me the opportunity to delve into and combine two of my favorite subjects, paleopathology and the Tudors. My colleague, Kyra, became interested in the Tudors after reading the Jean Plaidy series in high school.

What is your opinion of Anne Boleyn? Who is your favourite of Henry’s queens?

Anne Boleyn has always been my favorite of Henry’s queens.  I think she was chased by Henry incessantly and saw no other choice but to marry the king.  She was an extremely smart, bold woman who could also see the potential in becoming queen and using her role to benefit that in which she steadfastly believed.  I think she is also a tragic figure and was rather shocked by Henry’s change in attitude, being the first major victim of his diseased state of mind.  I also admire her because she produced one of the greatest rulers in British history and find it sad Henry was not able to recognize the brilliance and astute ruler in his daughter or that a daughter could competently and successfully rule. Although Kyra is also a fan of Anne Boleyn, and is vehement that Anne was maligned, her favorite Queen is actually Anna of Cleves. It was the fact that Anna survived and thrived that makes her so appealing; she is a bright spot in the whole tragic history of Henry’s marriages.

The fact that Henry VIII was unable to produce viable multiple offspring with Catherine and Anne is in keeping with your proposed theory. Although Anne Boleyn was only married to the king for three years and had a healthy girl from only 2 or 3 pregnancies (depending on what historian you agree with) so is it not possible that if she’d had more time she might have had more healthy children? Or could not the immense stress and pressure that she was under to produce a male heir have negatively affected her pregnancies?

Had Henry given her the opportunity, I think she could have produced a healthy male heir as well as many other healthy children.  It is obvious, by observing the health of Elizabeth, their genetic combination could result in a very robust, healthy, and long-lived child.  However, it is impossible to know how many more miscarriages and stillbirths they would have had to endured waiting for the next healthy child.  Each time she became pregnant, it was a 50/50 chance the child would be Kell positive, and thus die. She could have had one, two, three, or more healthy children, or none, depending upon their Kell blood type.

It is possible that stress and pressure could have negatively affected her pregnancies, but the link between maternal anxiety and pre-term birth is controversial (Adler et al, 2007). A healthy fetus is remarkably hearty. I think it is more probable that a negative outcome for the pregnancies would have been related to Kell alloimmunization.  Stress, obviously, did not affect her ability to become pregnant, and, given ample time, I believe she could have provided him the son he desired.  Katherina, too, was under immense stress to provide a male heir and was able to produce Mary as a healthy fifth pregnancy.  I believe Katherina, given more opportunity even considering her advancing age, could have also provided his desired male heir.  It simply depends upon the roll of the dice – 50/50 Kell negative, 50/50 male – what do they get this pregnancy and how many times they try (or can mentally continue to try after suffering so many losses)?

Alder, J, Fink N, Bitzer J, Hosli I , and Holzgreve W

2007 Depression and Anxiety During Pregnancy: A Risk Factor for Obstetric, Fetal and Neonatal Outcome? A Critical Review of the Literature. Journal of Maternal Fetal Neonatal Medicine, 20(3):189-209.

Catherine of Aragon’s new biographer, Giles Tremlett, believes that Catherine of Aragon may have suffered from an eating disorder. Is it not possible then that this could have negatively impacted on Catherine’s pregnancies?

Well, it’s possible that she had an eating disorder and eating disorders can effect fertility. However, since she is criticized, frequently, by historians for having “lost her figure” with weight gain, anorexia seems unlikely. An eating disorder that can cause weight gain, like compulsive overeating, can effect fertility, but it is more likely to interfere with conception (possibly due to association with polycystic ovary syndrome) than to cause a miscarriage. Katherina conceived with reasonable frequency, until she hit early menopause and/or Henry stopped consummating their relationship. Additionally, other women frequently fasted for religious reasons, yet had normal fertility. One thing is certain though, Katherina’s fasting would not have effected Anne Boleyn’s fertility … the only thing the two women had in common was the father of their babies. Part of the reason people continually try to figure out what Katherina (and Anne) did to have such a poor reproductive history is that few people realize a man’s genetics and health can influence the outcome of a pregnancy beyond conception. The whole of reproduction is socio-culturally located in the female, which is at odds with biological reality.

It has been speculated that Henry VIII had Type II diabetes that affected his health and personality. Could this not be responsible for some of the king’s reproductive ‘woes’ and personality changes in the latter part of his reign?

There is always the potential for co-morbidity of conditions and he could have developed Type II diabetes, particularly at his weight.  Yet, diabetes would not explain any personality changes since it only results in excessive thirst, low sperm count, erectile dysfunction, fatigue, blurred vision, itching, and tingling in the extremities.  In reference to reproductive problems, diabetes is connected to low sperm count and erectile dysfunction.  This would result in an inability to get a woman pregnant rather than causing late-term miscarriages and stillbirths.  Katherina and Anne had numerous pregnancies and they were each easily impregnated by the king.  This is not consistent with problems associated with Type II diabetes.  If Henry did develop Type II diabetes, it could explain the complete lack of pregnancies in his fourth (if it was consummated), fifth and sixth wives, since none have any recorded pregnancies while being married to the King.  Yet, it does not preclude him from also suffering from McLeod syndrome since both are responsible for different conditions suffered by the king.

Some academics argue that Anne Boleyn was RH negative. What is your opinion on this theory?

If Anne was the only wife of Henry to have experienced a series of late-term miscarriages, then it could be plausible.  However, since both Katherina and Anne experienced multiple late-term miscarriages and stillbirths, it is more plausible that one cause is responsible for both of the patterns of child loss.  Kell alloimmunization is second only to Rh alloimmunization to cause fetal loss.  This indicates that if Rh alloimmunization is not causing the multiple mid to late term loss of pregnancies then Kell alloimmunization is the next probable culprit.  In Rh alloimmunization, the Rh negative blood type in the female is the less common Rh blood type since only approximately 15% of Caucasians are Rh negative.  The probability both Katherina and Anne were Rh negative is slim. Alternately, even though only 9% of the Caucasian population is Kell (KEL1) positive, it is the less common male Kell (KEL1) positive blood type that causes the alloimmunization of the Kell negative female.  Since both Katherina and Anne experienced similar obstetric histories, and the father of their children was the same man,  it becomes more plausible that Henry’s blood type is responsible for the difficulties.

In your article you state that, “If a Kell negative mother mates with a Kell positive father, each pregnancy has a 50/50 chance of being Kell positive. The first pregnancy, providing that nothing goes awry from other causes, typically carries to term and produces a healthy infant, even if the infant is Kell positive and the mother is Kell negative.”  Could you clarify for us what you think happened in the case of Henry VIII and Catherine of Aragon’s first pregnancy that resulted in a premature stillborn baby.

There are numerous mishaps that could have resulted in this loss and the loss could have been the result of some random unknown cause.  Kyra and I do, however, envision two other plausible reasons for her loss.  One, Katherina was known to have irregular periods and, since most pregnancies are lost before the first 13 weeks, she may never have even known she was pregnant and quickly conceived and subsequently lost an infant. If her period was simply two weeks late, this could have been a miscarriage and just recorded as “irregular” menstruation.  In the United States 15-20% of known pregnancies end in early term miscarriage (i.e. before 13 weeks), yet, with new techniques for testing hormonal levels that indicate pregnancy, estimates increase up to 60-70% loss of all pregnancies before 13 weeks.  Additionally 80% of all miscarriages occur in the first trimester, making the loss of the first child, just like Katherina first recorded pregnancy,  in the second or third trimester an unusual event.  There is the potential that this child was also Kell positive and an unknown previous pregnancy resulted in alloimmunization, HDN, and death of the fetus.  There are several historians, however, that argue there was no time for a pregnancy prior to their first recorded pregnancy.  Even so, there is the potential this child was lost due to Kell alloimmunization due to trauma during pregnancy that resulted in fetomaternal transfusion (the exchange of fetal and maternal blood).  If the fetus was Kell positive, this blood exchange would have resulted in alloimmunization.  Yet, when could she have suffered trauma during pregnancy?  Katherina became pregnant while on the summer progress.  They were on their summer progress from July to October that year, which means she would have been riding horses or riding in an extremely bumpy cart every few days for almost four months.  Without knowing she was pregnant, Katherina would not have known to “take it easy” while riding, and the rough riding, including jarring and hard bumping while hunting, jumping, and riding cross country over rough terrain could have resulted in minor trauma and fetomaternal transfusion.  Katherina, as cited by Starkey in Six Wives, was known to hunt and was good at riding horses. Numerous hunting excursions were also an important part of the summer progress.

If Henry was Kell positive and Catherine negative, how then did their fifth pregnancy produce a healthy baby?

In every pregnancy, there is a 50/50 chance the child will be Kell negative.  Mary happened to be the lucky winner of that negative blood type.  Unlike a Kell positive child, Katherina’s antibodies would not have seen Mary’s blood as a foreign entity that needed to be attacked.  This is because her Kell negative blood would not have Kell antigens and produce the immune  response.  Therefore, the pregnancy would have progressed as a normal pregnancy resulting in a full term, healthy child.

In your article you also state that, “Our theory is further supported by the fact that the reproductive history of several of Henry’s male maternal relatives follows the Kell positive reproductive pattern. We have traced the possible transmission of the Kell positive gene from Jacquetta of Luxembourg, the king’s maternal great-grandmother. The pattern of reproductive failure among Jacquetta’s male descendants, while the females were generally reproductively successful, suggests the genetic presence of the Kell phenotype within the family.”

Could you clarify whom the male descendants are as this is an interesting point for future research?

Consistent with Kell alloimmunization causing difficulties in male offspring being  able to produce heirs, all of Jacquetta of Luxembourg’s sons, except one who had one daughter from two marriages, had no offspring.  Granted, one became a bishop (though we know this would not have necessarily precluded him from having illegitimate children as so often was the case) and two did not live to adulthood.  Of the remaining four, they lived to adulthood, some married more than once, and had no surviving offspring.  There is the potential that not all of their male children were Kell positive, but the almost complete lack of grandchildren from their sons is highly consistent with Kell alloimmunization reproductive complications. The pattern of Kell alloimmunization reproductive complications also emerges in several of her daughters lines, but to show the pattern would take quite a lot of space.  Most specifically, the pattern clearly appears in Elizabeth, Katherine, and Anne’s genetic descendants.  Kyra and I plan to publish our genealogical research in the near future.  It must be reiterated that not all of Jacquetta and Richard Woodville’s children would have been Kell positive.  Some would have been Kell negative and others Kell positive.  This is the reason the pattern is not present in all of their children that were able to reproduce.

In your article you state that ‘most women carried their pregnancies to term’. Could you share with us the source of this interesting information?

Although the majority of pregnancies end very early (as stated earlier, 60-70%  of all pregnancies are lost before 13 weeks) most women in this era were not even aware they had miscarried at that point, since they did not really know they were pregnant until they felt the baby quicken, at around 20 weeks. Before that time, pregnancy was confirmed by hope, swelling and guesswork. After 20 weeks it is much less common to lose a pregnancy. So by the time women were reporting a pregnancy, they had a “goodly belly”, and they were far enough along to have good odds of bringing a fetus to term. While the first two years of infancy were the most lethal, only about 6% died at birth, making death as a neonate infrequent (Fleming, 2006:39),  Horrifically, in the Middle Ages, about 27% of all children died within the first year and another 12.4% died between one and four (Orme, 2001:113). . The losses suffered by Henry’s first two Queens did not conform to the expected pattern of child mortality.

Fleming, Robin

2006            Bones for Historians: Putting the body Back in Biography, In Writing Medieval Biography: Essays in Honor of Frank Barlow, ed. D. Bates, J. Crick, and S. Hamilton, pgs. 29-48. The Boydell Press, Woodbrige, UK.

Do sufferers of McLeod Syndrome undergo both physical and psychological changes or can one exist without the other?

Not all McLeod sufferers, just like any other disease, exhibit all of the symptoms.  Most McLeod sufferers will exhibit psychological symptoms and researchers even suggest that the psychological symptoms are the clinical manifestation of the disease.  Cardiac problems do affect most McLeod patients and is considered one of the leading causes of death in individuals affected by McLeod due to the disease causing an enlarged heart or congestive heart failure.  The symptom of chorea, which is uncontrollable movements and ticks, manifests in varying degrees and some individuals only exhibit slight movement simply resulting in the individual shifting their posture.  If Henry exhibited this slight movement, given his size and leg ulcers, I do not think any of his court would have contributed his uneasiness and shifting to anything other than discomfort from his size or wounds and would have missed a McLeod symptom.

Do you think it’s possible that Henry VIII did not undergo any great personality change in his later years and that instead it was the chronic pain that he suffered that caused him to be increasingly irritable and ill tempered?

I do not think this is likely.  His significant shift in personality is also noted by many excellent historians that focus on Henry’s life, including Starkey (Henry: Virtuous Prince) and Lipscomb (1536: The Year that Changed Henry VIII). It is not that Henry simply became irritable and short-tempered.  Henry became paranoid and irrational.  His paranoid behavior is manifested in his increasing execution of those close to him. He turned forty in 1531, and shortly thereafter he became cruel to Katherina, when he had previously been as kind as possible during the Great Matter. Additionally, before 1531, those who disagreed with him about the Great Matter were, at worst, exiled. By 1535 he had started executing those who disagreed, most famously John Fisher and Thomas More. In 1536 he seems to have slipped over the edge into deep paranoia, because he could easily become convinced that almost anyone was plotting against him. One of the men executed for “adultery” with (the clearly innocent) Anne Boleyn was Henry Norris, and he had been one of Henry’s closest friends for almost three decades. Then there was his slaughter of his maternal kin, including a cousin that had grown up with him in the royal household and shared his room when they were boys … it was the equivalent to killing a brother. Also, his precipitate beheading of Cromwell was atypical of his behavior before forty, and his sudden revulsion toward Anne of Cleves was irrational in the extreme. During the final five years of his life, he constantly set traps for his courtiers and ministers to fall into, including a famous incident with Kateryn Parr. He was once hailed as a “lover of justice and goodness”, but by his death he was an erratic tyrant.

Thank you so much for your time Catrina!

It is amazing that after almost five centuries there is still so much about the Tudors that can be debated and discussed- truly wonderful!