Let’s suppose you know little about British history and couldn’t explain the difference, say, between a Tudor and a Windsor or an Edwardian and an Elizabethan. Even so, you undoubtedly know a little bit about King Henry VIII—for instance, that he was infamous for his bad temper. (He’s the monarch who had two of his six wives executed.)

You probably also know he was obese. Modern measurements of his suits of armor reveal that, between his 20s and his 50s, the king, who stood 6’1″, had a waist that expanded from 32 to 52 inches, and a chest that increased over the years from 39 to 53 inches.

But what if Henry’s weight issues and hot head were a result—even partially—of enduring chronic pain? Would that change your opinion of the 16th-century king?

Henry, who ascended the throne when he was just 18, was not always the plump ruler we see in portraiture. During his 20s he was a fit, athletic monarch. He was a wrestler and a tennis player—and he injured his left foot playing the game in 1527. But he loved more hazardous pursuits, too. The premiere royal sport back then, jousting, is hardly a round of badminton.

There are inherent dangers in riding a horse while wielding a wooden lance, and Henry suffered two significant jousting wounds—one in 1524 that involved a puncture above his right eye that resulted in migraines—and a more severe one in 1536. Those wounds left him with travails both unseen (lifelong headaches) and seen (weeping sores on his legs that wouldn’t heal).

For a king who already had a penchant for despotism, enduring chronic pain for the last two decades of his life could have led to angry outbursts, fights (for instance, the big one with the Catholic Church, which led to the formation of the Church of England) and worse.

The pursuit of a male heir
The king was irrationally upset with each of his wives for not producing a male heir. In modern times we’ve learned not only that a baby’s sex depends on the father, but that Henry may have suffered from a condition called McLeod syndrome, which interferes with the mother’s ability to deliver a healthy baby. “Henry may have belonged to a rare blood group, called Kell positive,” says a 2011 NBC News report. “Only 9 percent of the Caucasian population belongs to this group. When a Kell positive man impregnates a Kell negative woman, there is a 50 percent chance of provoking an immune response in the woman’s body that attacks her developing fetus.”

“The first baby of a Kell positive father and Kell negative mother is usually fine,” the story continues. “In subsequent pregnancies, babies may suffer from extra fluid in their tissues, anemia, jaundice, enlarged spleens, or heart failure, often leading to miscarriage between about 24 and 28 weeks of pregnancy.”

PainPathways isn’t the first to wonder about a link between Henry VIII’s pain and the harshness of his rule. In an April 2009, feature in The Independent, reporter Michael McCarthy wrote about “The jousting accident that turned Henry VIII into a tyrant.” According to McCarthy:

“Henry VIII became the tyrannical monster remembered by history because of a personality change following a serious jousting accident.…

“After the accident—just before he became estranged from the second of his six wives, Anne Boleyn—the king, once sporty and generous, became cruel, vicious and paranoid.…”

The 1536 injury put an end to Henry’s jousting days and aggravated his already serious leg problems. The accident “may well have caused an undetected brain injury which profoundly affected his personality,” wrote McCarthy, whose story was published in the wake of the History Channel documentary Inside the Body of Henry VIII.

WATCH THE FULL DOCUMENTARY: Inside the Body of Henry VIII

“We posit that his jousting accident … provides the explanation for his personality change from sporty, promising, generous young prince, to cruel, paranoid and vicious tyrant,” said historian Lucy Worsley, PhD, in The Independent story. “From that date the turnover of the wives really speeds up, and people begin to talk about him in quite a new and negative way.”

In the accident, Henry fell from his horse, and the horse—in full armor—landed on top of him. He was unconscious for two hours.

“Even five minutes of unconsciousness is considered to be a major trauma today,” Worsley continued. “Henry may have suffered a brain injury. ‘Damage to the frontal lobe of the brain can perfectly well result in personality change.’”

Henry VIII and chronic painPlagued by many ailments
It was more than headaches and leg sores that impacted Henry’s health; historians believe he contracted malaria at age 30. Its effects returned over the course of his lifetime, and once again the old injuries came into play. Malaria was exacerbated by sporting injuries and the open sores on his legs.

Vanity may have played a role in his leg ailment. “The sores—varicose ulcers, which began on his left leg when he was 36, and later affected his right—may have been caused by the restrictive garters he wore to show off his calves,” wrote The Independent. “They never healed, and increasingly restricted his mobility.” The royal physicians used to lance them with red-hot pokers, which can’t have improved Henry’s mood.

Henry, a legendary bon vivant with a large appetite, seems to have been a committed carnivore who may have eaten up to 13 dishes a day, according to the History Channel biopic. Lamb, chicken, beef, game, rabbit—and even peacock and swan—were likely part of his diet, and “he may have drunk 10 pints of ale a day as well as wine,” according to The Independent.

“Among other theories,” the story by Emily Sohn continues, “experts have proposed that Henry suffered from Type II diabetes, syphilis, an endocrine problem called Cushing’s syndrome, or myxedema, which is a byproduct of hypothyroidism.”

He was a ticking time bomb. Experts aren’t sure what did Henry in but speculate his demise was related to his many ailments. He was bedridden during the last days of his life, and no one would tell him how dire his condition was. The Treason Act (which Henry himself signed into law) prohibited anyone from speaking of the king’s death.

Henry VIII and chronic painNot all bad
Although he enjoyed ruling by fear, there was more to Henry than being a heavy hothead. For instance, he had a strong interest in medicine and public health.

Henry founded the Royal College of Physicians in 1518. While he was on the throne, seven Acts of Parliament were passed to regulate medical practitioners. “Guided by Sir Thomas More, Henry presided over great improvements in public health; installing public water supplies and sewers, and implementing segregation and crude disinfection during epidemics of plague and sweating-sickness,” according to a 2009 feature in the Journal of the Royal Society of Medicine (JRSM).

He was sort of an early holistic healer as well: “Henry also personally prepared medicines in the form of salves and ointments from compounds such as ground pearls and white lead for the treatment of his friends and, later, for himself,” reads the JRSM story.

But no tincture he or his doctors concocted could tame his temper. He lived in pain, and we can infer that the pain impacted his moods. “The effect of chronic pain on the temperament is well recognized,” wrote the authors of the 2009 report in the Journal of the Royal Society of Medicine. “And the actions of many a historical figure have been linked to their personal physical misery.”

Pain changes people’s behavior. In Henry’s case, it may have changed world history.

What was Henry’s problem? There were likely many:

• Type II diabetes
• Acute pain from injury
• McLeod’s disease
• Syphilis
• Cushing’s syndrome
• Obesity
• Anxiety
• Varicose ulcers
• Depression