Her flawless acting ability and witty nature has meant that Maggie Smith is adored by fans across the globe. Most recently, fans were sent into turmoil over rumours that the next Downton Abbey film will feature a “heartbreaking death,” and Countess Crawley is the prime suspect due to her age. The death was alluded to at the end of the first film which premiered in 2019, in a scene with Lady Mary Violet revealed that she is suffering from “an illness likely to take her life.” Although not life-threatening, in real life, Dame Maggie suffers with a chronic illness which required surgery when she was younger.
Talking to The New York Times in an in-depth interview, the star recalled her battle with Graves’ disease, a condition caused by hyperthyroidism – an overactive thyroid. The 86-year-old was diagnosed with the condition as a child, with it flaring up multiple times over the years.
As the NHS states, about three in every four people with an overactive thyroid gland have the condition. As an autoimmune condition, the body mistakenly attacks your thyroid which causes it to become overactive in the first place.
Graves’ disease can affect anyone, but particularly women below the age of 40. This is precisely what happened to Dame Maggie when the condition worsened 1988 at the age of 33.
Whilst in the middle of a year-long run of a show titled “Lettice” she endured irritating symptoms such as protrusion of her eyes and puffiness around them. Eye protrusion, known medically as Graves’ ophthalmopathy only affects around 30 percent of those with the disease and can be incredibly sore.
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Graves’ ophthalmopathy can also cause other symptoms within the eyes. The Mayo Clinic lists these symptoms, that if suffered may be a sign of Graves’ disease:
- Bulging eyes
- Gritty sensation in the eyes
- Pressure or pain in the eyes
- Puffy or retracted eyelids
- Reddened or inflamed eyes
- Light sensitivity
- Double vision
- Vision loss.
Other systems around the body can also be affected majorly by the condition – not just the eyes. As with any chronic illness, individuals all suffer different symptoms and with Graves’ disease, the symptom list is quite extensive.
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The Mayo Clinic includes:
- Anxiety and irritability
- A fine tremor of the hands or fingers
- Heat sensitivity and an increase in perspiration or warm, moist skin
- Weight loss, despite normal eating habits
- Enlargement of the thyroid gland (goiter)
- Change in menstrual cycles
- Erectile dysfunction or reduced libido
- Frequent bowel movements
- Fatigue
- Thick, red skin usually on the shins or tops of the feet (Graves’ dermopathy)
- Rapid or irregular heartbeat (palpitations)
- Sleep disturbance.
Dame Maggie’s flair up in 1988 was not the only thing she needed to worry about. In November of the same year, she had fallen off a bicycle and fractured her shoulder and upper arm, making the performance in the show even tougher.
Speaking about this time, she said: “It’s been kind of like a fog of despair, really. It was ghastly having a broken arm; ghastly with the play, letting everybody down; and on top of that, I looked absolutely frightening, and didn’t know which way to turn.”
In order to treat the condition, Dame Maggie underwent radiotherapy and optical surgery. This was accompanied by 12 months of near isolation as she recovered, with bruises and stitches all in order to treat the protrusion.
Treatments for Graves’ disease in general are aimed at stopping the production of thyroid hormones and lessen the effects that these hormones have on the body. By going through radiotherapy, specifically radioactive iodine therapy, the level of radiation destroys the thyroid cells.
Due to the side effects of this treatment, it is difficult for individuals to decide whether it is best for them. The Mayo Clinic suggests that those who already suffer from severe eye problems take alternative methods of treatment.
An alternative such as Anti-thyroid medications.
These medications interfere with the thyroid’s use of iodine to produce hormones. However, when they are used alone and not alongside other treatments, a relapse of hyperthyroidism is more common.
The longer you take the drug for, the better the effect on the symptoms. As ever, there are known side effects to the medication including rashes, joint pain, and crucially liver failure.
The other form of treatment is surgery to remove all or part of your thyroid. This delicate procedure can be extremely effective, although in order for your body to have the normal amounts of thyroid hormones that it requires, it is likely that further treatment post surgery will be needed.
The surgery also poses a risk of damaging the nerves that control your vocal cords, due to the close proximity of your thyroid to the parathyroid glands. However, all potential risks will be relayed to you before surgery takes place if an individual chooses this method of treatment.