Do you or your child get frequent sore throats or ear infections? Has your physician suggested a tonsillectomy? Before you consent to the removal of functional body parts, you might want to explore the latest science suggesting tonsils are not the “throwaway organs” that some would have you believe.
Your tonsils are part of your lymphatic system, a network of tiny tubes and nodes running through most of your body that serve to drain excess fluids and waste from your tissues. The main cells in your immune system are lymphocytes whose primary purpose is to identify and kill pathogens before they gain a foothold in your body. Lymphatic fluid is aptly named “lymph” and circulates many of these scavenging cells. There are several different types of lymphocytes including T-cells, B-cells, and natural killer (NK) cells. Lymphocytes are stored in your tonsils in great numbers—ready for battle.
Since your tonsils are situated in your throat, they are your first line defense against swallowed or inhaled germs. When lymphocytes detect more germs than usual they multiply, making your tonsils and adenoids enlarge and become tender. Adenoids are similar set of nodes located above your tonsils, behind your nose.
When your tonsils become inflamed (tonsillitis), you know they’re working hard to fight an infection. Sometimes tonsils and adenoids become infected themselves, which brings me to the topic of tonsillectomies.
The Tonsillectomy-Polio Connection
First performed in India around 1000 BC, tonsillectomies grew in popularity in 19th and early 20th Century North America. By 1959, a whopping 1.4 million tonsillectomies were being done every year in the US. Due to growing controversy over the operation’s risks and benefits, the number had fallen to 260,000 by 1987. (1) Today, tonsillectomies remain one of the most common surgeries among children with about 530,000 performed each year in the US, and likely a similar number per capita in Canada. (2) The common medical term for the procedure is “T & A,” because the tonsils and adenoids are often removed together.
In the early 1900s, the immune system was poorly understood, therefore the tonsils were completely disregarded as functional organs. Because physicians didn’t understand their purpose, they assumed there wasn’t one and they began cutting out tonsils left and right—especially in the 1920s through 1940s. As is often true with human ignorance, there were unintended consequences—in this case, people’s immune systems took a hit that showed up as an increased vulnerability to polio.
In the early 1900s, America had plunged into a series of polio epidemics. After a time, it was noted that children who’d had tonsillectomies were three times more likely to acquire bulbar polio than children who retained their tonsils. (3) Bulbar polio is marked by infection of the brain stem. This tonsillectomy-polio association was responsible, at least in part, for the decline in tonsillectomy rates throughout the 1950s, however medical science still did not understand the underlying reason for the association.
I am of the mind that God-given body organs should not be removed just because we don’t understand what they do. To quote a wonderful analogy by journalist Seth Roberts: (4)
“Cutting off part of the body that fights infections because of too many infections makes as much sense as getting rid of fire houses because of too many fires.”
Tonsils Finally Got “the Big Reveal”
We now understand that your tonsils are your first line of defense against ingested or inhaled foreign proteins such as bacteria, viruses, and food antigens. (5, 6) In 2012, Ohio State researchers found compelling data in favor of leaving your tonsils alone: tonsils are virtual “immune cell factories,” especially for T-cell production. It was previously believed that T-cells were made only by the bone marrow and thymus gland, and the tonsils were only a storage unit—so, this was big news.
How important are T-cells? Critically important!
T-cells defend you from infections and are extremely potent against cancer-causing viruses (for example, Epstein-Barr virus and Hepatitis B and C), as well as playing a role in autoimmunity. (7, 8) Removing one of the few organs where these important cells are manufactured seems foolhardy, at least without just cause. In 2014, it was further discovered that B-cells isolated from the tonsil are functionally distinct from those isolated from the blood, with special behaviors, roles and responses. (9)
Furthermore, your tonsils help regulate the bacteria in your mouth by releasing bactericidal substances. (10) Specialized cells on the surface of the tonsil capture pathogens allowing B-cells and T-cells to attack.
Knowing that your tonsils produce lymphocytes, it becomes easier to appreciate how removing them could cause immune function to tank, which is likely what happened during the polio epidemic. This begs the question, what else might our tonsils be doing that we don’t know about?
Is Tonsillectomy Ever Really Necessary?
This website — nor any website — can answer that question for you. It’s a critical decision to be made with your doctor.
That said, I personally believe surgery should always be a last resort. The good news is there’s a growing number of physicians breaking ranks with traditional thinking, and offering their patients unique pathways to wellness (other than surgery). My own family medical doctor thinks this way. The Institute for Functional Medicine and American College of Lifestyle Medicine have helped to establish networks of physicians who are likely to give advice unique to what you’ve heard more conventionally.
Thirty years ago, most tonsillectomies were performed to treat chronic infections, but today 80 percent are to relieve obstructive sleep problems. (11)
While unpleasant, a bout of tonsillitis is rarely life-threatening, but in severe cases, complications can arise. Tonsillectomy may be appropriate if the tonsils or adenoids are so large that they obstruct a child’s airway and lead to breathing problems. Blocked airways diminish oxygen levels at night and this can be harmful to a child’s developing brain. (12) Surgery may also be indicated if the tonsils develop an abscess (aka “quinsy”) which, if left untreated, can result in septicemia, a potentially lethal blood infection. In modern times, these are often (but not always) the cases in which tonsillectomies are most recommended.
Even in these scenarios, tonsillectomies are treating symptoms and secondary problems — not addressing underlying causes.
Why are Tonsillectomies still Prevalent?
While I personally do not believe that all doctors are in their careers for the money, let’s face it: Tonsillectomies generate revenue, and many doctors today find themselves wound up in a system which puts the business of medicine ahead of the ideal needs of the patient. Even President Obama made reference to this during a 2009 press conference: (13)
“You come in and you’ve got a bad sore throat, or your child has a bad sore throat or has repeated sore throats. The doctor may look at the reimbursement system and say to himself, ‘You know what? I make a lot more money if I take this kid’s tonsils out.”
Tonsil infections are more often viral than bacterial, with Epstein-Barr virus (EBV) and adenoviruses being common culprits. Most cases of acute bacterial tonsillitis are caused by Streptococcus pyogenes, (14) hence the name “strep throat.”
Even though the majority of tonsillitis cases are viral, for decades the standard treatment has been antibiotics—a treatment that’s completely ineffective against viruses. The same is true for ear and sinus infections. Eighty percent of ear infections are viral, and more than 90 percent of sinus infections are actually fungal.
Overprescription of antibiotics has led to a massive global problem with antibiotic-resistant superbugs, now responsible for a million illnesses and 23,000 deaths annually. Antibiotic reactions account for 140,000 emergency room visits every year. If you have a sinus, ear or throat infection, it’s not difficult to have a culture performed that will determine the efficacy of an antibiotic. Most cases of tonsillitis are effectively addressed with other interventions (see below).
It’s important to realize your body doesn’t always respond adversely to every “harmful” microorganism, provided their numbers are kept low. Streptococcus pyogenes is one of the most common pathogens found in the human mouth, throat and respiratory tract. One of every three healthy individuals carries staph bacteria in their nasal passages, and studies show that about 10 percent of children harbor Streptococcus in their tonsils with no ill effects. (15, 16)
Does Tonsillectomy Increase Your Risk for a Heart Attack?
Besides a few days of ice cream, there are few established benefits of tonsillectomy, but the list of potential risks continues to grow.
There are new approaches to removing the tonsils—targeted lasers, radio waves, ultrasonic energy and electrocautery—but all carry surgical risks such as anesthesia reactions, postoperative infections, hemorrhage, pain, swelling, and breathing problems. Deaths are exceedingly rare, with the mortality rate reported as one in 15,000 to 35,000 procedures, mostly from anesthesia complications and blood loss. (17)
Once you’ve had your tonsils out you cannot get tonsillitis, but that doesn’t mean you are forever free of sore throats or even strep throat. Is the occurrence less likely? Evidence remains unclear. It appears that in some people, there may be a reduction in the number of throat infections after the operation, while for others there is no change. Adult tonsillectomies are associated with more complications and significant morbidity. So, the tonsillectomy debate rages on. (18, 19, 20)
What may be more concerning are the longer-term effects of tonsillectomy, in terms of permanently altering your immune function. Collectively, evidence points in the direction that having your tonsils removed may deal quite a blow to your immune defenses. Consider the following:
- A large Swedish study found an association between tonsil removal (prior to age 20) and 44 percent increased risk of heart attack. Researchers speculate that removing the tonsils may increase inflammatory damage to the heart and arteries. (21) The link between gum disease and heart disease is well-established, and since the tonsils help control oral bacteria, the heart attack connection is not surprising.
- A 2011 study linked tonsillectomy to weight gain and obesity later in life. (22)
- Tonsillectomy has been associated with increased risk for Hodgkin’s disease, rheumatoid arthritis, depression and several other health problems. (23)
Better Treatments for Troubled Tonsils
The best approach to tonsillitis is to prevent it from occurring in the first place by boosting your immune system through healthy diet and lifestyle. Remember, the strength of your immune system is linked to your gut, so make sure you take care of your microbiome. Here is a five-prong plan for building a strong immune system:
- Vitamin D: Vitamin D is one of the most powerful modulators of the immune system. Make sure you are getting at least 10 to 15 minutes of midday sun exposure daily with 40 percent of your skin exposed, and if that’s not possible take an oral vitamin D3 supplement. Most experts now agree that the average person needs about 5,000 IU per day for health maintenance. However, when you’re sick you will likely benefit from 10,000 to 20,000 IU per day for a few days.
- Vitamin C: Vitamin C is well known for immune support. The Vitamin C Foundation recommends 1000 mg vitamin C three times daily (3000 mg total), for optimal health. If you’re sick, you can bump that up even higher. Consider liposomal vitamin C, which is better absorbed.
- Sleep: Your body needs rest in order to heal. Numerous studies have shown that the average person needs seven to nine hours of restorative sleep per night. Ultimately, listen to your body.
- Sugar: Sugar is your greatest enemy when it comes to immune function. Eliminate simple sugars and refined grains, and substitute healthy sweeteners such as stevia. There is evidence that removing dairy from the diet may help shrink enlarged tonsils and adenoids. Food intolerances have been linked to enlarged adenoids. (24)
- Chiropractic: There is a major connection between your immune system and the health of your spine. If your top four vertebra (C1 through C4) are misaligned, there can be pressure or tension in the musculature that can close off the Eustachian tubes, preventing drainage and exacerbating nasopharyngeal infections.
Zinc is long known to fight viruses, and colloidal silver has powerful antiviral and antibacterial effects. Certain herbs and essential oils are also reported to help reduce tonsillar swelling. Slippery elm, licorice root, marshmallow root, burdock root, sage and echinacea can tamp down inflammation, relieve cough and soothe a sore throat. Lemon, myrrh, oregano, eucalyptus, cypress, and frankincense essential oils can be added to a carrier oil and massaged into the throat area.
Journeying with the Like-Minded
If you or your child is having ongoing tonsil issues, you must decide for yourself how to proceed, and careful consideration your own physician’s recommendations should be part of this process.
I believe there is ample evidence that we need to keep our tonsils. From a philosophical standpoint, it makes sense that our bodies would not house purposeless organs.
I’m not alone in this belief—many holistic health practitioners share this philosophy. My friends and colleagues, Dr. Joe Mercola and Dr. Josh Axe have both written on this subject. Doctors you may have seen on TV, originally from the conventional medical world, including Dr. Mehmet Oz and Dr. Andrew Weil, also share this belief.
Do your homework! The more informed you are, the better you’ll be able to make sound health decisions for yourself and your family.