Baffled by the extraordinary coincidence of both the President and First Lady developing Graves’ disease, experts are analyzing the water supply at the White House, Camp David, the Bush vacation home in Maine and the vice president’s residence, where the Bushes lived for eight years, the White House said Tuesday.

The Secret Service has been asked to search for unusual levels of iodine and lithium, which have been associated in some instances with thyroid problems, Bush Press Secretary Marlin Fitzwater said during a briefing in Kennebunkport, Me., where the President is vacationing.

In a statement issued later in the day, Fitzwater said that Dr. Charles L. Christian, a New York specialist, “has been asked to review the medical history of the First Family, including Millie,” the White House dog. The Bush family pet has lupus, which, like Graves’ disease, is an autoimmune disease, in which the immune system attacks the body’s own organs or tissues.

President Bush, speaking to reporters after a golf game, expressed amazement that his water supply is being checked.


“You’re kidding,” he said, adding that his physicians have told him that “the odds against two people in the family having (Graves’ disease) . . . are 1 in 3 million. But many people live in the same house together, one of whom has thyroid (trouble). So I’m not going to lose confidence in the water at the White House until we know a little more about this.”

Bush said he never worried about the water he drank while living in the vice president’s house--"tasted good to me"--and joked about the qualifications of the Secret Service personnel who are conducting tests on his water.

“What do they know about water?” he said.

Asked whether the White House is taking new precautions as a result of the tests--such as bringing in bottled water--the President replied: “I usually take that anyway.”


Dr. Lawrence Mohr, one of Bush’s White House doctors, said the tests are being conducted “largely to answer the kind of speculation that is being propagated right now.”

“We have no reason to suspect that there’s any problem. We think the probability of that being a cause of this is very small. But largely just to allay any speculation, we are having that done.”

Graves’ disease, a form of overactive thyroid, was identified as the cause of the irregular heartbeat that Bush experienced earlier this month. First Lady Barbara Bush was diagnosed with the same ailment in 1989.

Thyroid specialists not connected to the case said it is unlikely that the Bushes’ water supply would yield any clues. Most experts believe that there is a genetic component that makes people vulnerable to Graves’ disease and that something later happens to trigger its onset.


“They meet some sort of insult,” said Dr. Terry Davies, chief of endocrinology at Mt. Sinai School of Medicine in New York. “What is the insult? There is a lot of speculation that it is an infectious agent, such as a virus, or an environmental contaminant.”

Dr. James Ramey, an endocrinologist and associate clinical professor of medicine at George Washington University Medical Center, said psychological stress “has also been implicated, but the data is not solid.”

Iodine and lithium can precipitate thyroid disease in people who already have thyroid problems, but they are not known to actually cause the disease in otherwise healthy individuals, experts said.

“We have a very high iodine diet in this country, so the water supply would have to be grossly polluted for it to have a significant impact,” Davies said.


Dr. James R. Hurley, a thyroid specialist at Cornell University Medical College, agreed that iodine is an unlikely culprit. “Iodine intake per se doesn’t seem to cause Graves’ disease,” he said.

Davies said that “common diseases commonly occur in spouses. This is an extraordinary coincidence, but it occurs.”

Experts also discounted the probability of a connection between the Bushes’ ailment and the lupus suffered by first dog Millie. Although both are autoimmune diseases, they are otherwise unrelated, the experts said.

Lupus is a systemic disease, or one that affects all the tissues in the body, whereas Graves’ disease is a condition that afflicts only the thyroid. “They are different types of disorders,” Davies said.


Marilyn Quayle, wife of Vice President Dan Quayle, said Tuesday that water samples had been taken last week at the vice presidential residence and that the family had been asked to take blood tests. Interviewed on CNN, she said that the Bushes’ thyroid conditions “seem a little bit much of a coincidence. I don’t worry over much about it, but I think it’s something that does bear looking into.”

Fitzwater said the President had gained a few pounds during his Maine vacation. As of Monday, his weight had increased to 193 pounds from 185 during the height of his illness, Fitzwater said. He said that Bush’s physicians were continuing to administer an electrocardiogram every morning, “and his heart rate has been normal every day.”

Speaking with reporters on the golf course, Bush said that he had been feeling tired at the end of the day Monday but that he felt fine Tuesday. “It’s just you have to pace yourself a little,” he said.

“In terms of feeling good though, I really do. I’m not just putting that on. I feel very good. I almost feel like getting some aerobics up this afternoon, on the bike or a short jog, because I don’t feel good unless I have that kind of exercise.”


Bush, who was scheduled to return to Washington today after giving a speech at the Air Force Academy in Colorado Springs, Colo., said he has been getting more rest in Maine. “I’ve been taking a little sleep after lunch up here, which is good,” he said. “Sleeping very well. Going to bed real early, much earlier than I normally do.”

Asked if he had regained some of his lost weight while on vacation, Bush replied: “Yeah--darn it.”

He attributed the weight gain to the medication he has been taking to normalize his thyroid, which regulates the body’s metabolism.

“I loved it at 185,” Bush said. “But I’d rather be well at 195 than having these problems at 185.”


BACKGROUND

The thyroid, a small organ in the neck, secretes a hormone called thyroxine that regulates how fast tissues throughout the body burn sugar and produce energy. Graves’ disease is a relatively common, non-life-threatening condition in which an immune system abnormality causes the body to manufacture antibodies that stimulate the thyroid to overproduce the hormone. It typically is treated with doses of radioactive iodine.