In a paper published in the September 2018 issue of the Mayo Clinic Proceedings, Brigham and Women’s Hospital researcher Mandeep Mehra and University of California, Santa Barbara’s Hilary Campbell summarized the possible medical conditions visible in the portrait of Lisa Gherardini, the woman pictured in Leonardo da Vinci’s Mona Lisa, and proposed their interpretations.

The Mona Lisa, also referred to as La Gioconda (or La Joconde), has endured centuries of fascination by artists, researchers, medical professionals, and even thieves.

A wealthy silk merchant in Florence, Italy, Francesco del Giocondo commissioned Leonardo da Vinci to produce this masterpiece of his wife following the birth of their child, Andrea, in 1502.

Although evidence is fragmentary, general belief is that work on the painting began in 1503. Subsequently, the painting was taken to France in 1516, completed there, and adorned the court of King Francis I until its permanent display in the Louvre in 1797.

The Mona Lisa attracted medical attention in 2004 when a team of rheumatologists and endocrinologists suggested that skin lesions and hand swellings visible in the portrait may be indicative of a lipid disorder and heart disease.

Specifically, they asserted that familial hyperlipidemia and premature atherosclerosis could have caused Lisa Gherardini’s death. They also proposed that Mona Lisa’s famous smile may have been the result of Bell’s palsy.

After examining the painting, Dr. Mehra and Campbell found that clinical hypothyroidism is a more likely diagnosis given that Lisa Gherardini lived to be 63.

“The enigma of the Mona Lisa can be resolved by a simple medical diagnosis of a hypothyroidism-related illness,” Dr. Mehra said.

“In many ways, it is the allure of the imperfections of disease that give this masterpiece its mysterious reality and charm.”

Had Lisa Gherardini suffered from heart disease and a lipid disorder, it’s unlikely she would have lived to such an advanced age given the limited treatments available in 16th century Italy.

Dr. Mehra cited the Mona Lisa’s thinning hair, yellow skin, and possible goiter as visual evidence of hypothyroidism.

“The diet of Italians during the Renaissance was lacking in iodine, and resulting goiters (swollen thyroid gland) were commonly depicted in paintings and sculptures of the era,” he said.

“Additionally, Lisa Gherardini gave birth shortly before sitting for the portrait, which indicates the possibility of peripartum thyroiditis (inflammation of the thyroid after pregnancy).”

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Mandeep R. Mehra & Hilary R. Campbell. 2018. The Mona Lisa Decrypted: Allure of an Imperfect Reality. Mayo Clinic Proceedings 93 (9): 1325-1327; doi: 10.1016/j.mayocp.2017.12.029