Q: If You Need Your Tonsils, Why Take Them Out?

A: Tonsils are part of the immune system, but when they are too large or are prone to frequent infections, then surgical removal is a consideration. One or two infections every year is not too worrisome, but having an infection every month can be debilitating for most people. For many children (and some adults), very large tonsils can lead to breathing problems at night. 

 

More Questions About Tonsils

Q: What are tonsils? 

A: Tonsils are paired lymphoid or glandular tissues that sit on the side-walls of your throat just behind your tongue. They are part of a complete circle of lymphoid tissues that is involved in programming your immune system what is foreign and what is self. The adenoids sit in the mid-line at the back of your nose and the lingual tonsils are also in the mid-line at the rear of the tongue, just above the voice box. They are most active from ages 3-5, and this is the time that most problems arise. 

Q: Do you need tonsils? 

A: Yes, especially when you have an infection. Most of the immune system programming occurs in early childhood. As you get older, the tonsil shrink to a much smaller size in adulthood. However, if there is chronic irritation, such as from allergies, colds or acid reflux, they can remain enlarged. Tonsils and adenoids are only a small part of a much larger system of lymph glands and immune mechanisms. 

Q: What happens if my tonsils are too big? 

A: Just because your tonsils are big does not mean they have to be removed. If you have no problems, then with time, they should shrink. But if you have signs or symptoms of a sleep-breathing disorder, such as daytime fatigue, poor concentration, memory problems, attention problems, asthma, cough, nasal congestion, or snoring, then they should be looked at by an ear, nose and throat physician. Sometimes I see young children who snore heavily, with severe asthma, attention and behavioral problems, and who are on Ritalin for ADHD. On exam they are found to have very large “kissing” tonsils. Due to the prevalent myths about tonsils and surgery, the parents refuse any form of surgical therapy. They would rather treat the end result of their child’s sleep-breathing problem (asthma, ADHD) with long-term medications, when surgery could be curative. On the flip side, there are also too many people with tonsils that are taken to the operating room prematurely, with no clinical reasoning whatsoever. 

Q: Can large tonsils cause snoring? 

A: Yes. Anything that narrows the upper airway, from the nose to the voice box, can cause snoring or other breathing problems. In children, large tonsils are a common cause of snoring. Snoring itself in children has been linked to behavioral, memory and concentration problems, asthma, and chronic cough. A significant number of children (and adults) who snore are also found to have obstructive sleep apnea, which can lead to fatigue, depression, high blood pressure, heart disease and many other conditions. It’s also associated with sexual dysfunction and frequent urination at night. 

Q: Doesn’t undergoing a tonsillectomy hurt? 

A: Yes. But with advances in technology, it doesn’t hurt as much. Traditional tonsillectomy using an electrocautery device will leave you with a very sore throat for 4-7 days. You’ll be on soft or liquid diet until the pain subsides, after which you slowly progress to foods of more solid consistency. The best part is that you can eat lots of ice cream. With newer techniques (such as the Coblator) you’ll have only 2-5 days of pain, with some people not taking any pain medications at all. 

Q: What are the potential complications of tonsillectomy? 

A:  As with any operation, there’s always a very small chance of bleeding or infection. If it occurs, then it will be addressed appropriately. Specific to the procedure, there is a small chance that you may have persistent symptoms even after surgery. There are many reasons for this, including not taking enough tonsil tissues out, or it may be due to something entirely different. Two common reasons include post-nasal drip and laryngopharyngeal reflux disease. There’s also a very small risk to general of complications from anesthesia is lower than being hit by a car.

 

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74 thoughts on “Q: If You Need Your Tonsils, Why Take Them Out?

  1. My 10 yr old daughter has been getting headaches almost everyday for awhile now. She feels dizzy and like she’s is going to pass out sometimes. Her Dr has told us her tonsils are really big, so we went n saw a ear nose and throat specialist. He said he would recommended us removing them. But wev never thought about her headeaches being caused from them till just now. Is it possible that is why she’s getting the dizzy spells?

  2. Hello! On July 4th, I was at the movies and suddenly I felt like something was in my throat and felt like it was clogged up causing hard ache , breathing problems. What is it and what can I do to solve the problem?

  3. Casie,

    I can’t say without examining your daughter, but in general, having large tonsils can prevent proper breathing and quality deep sleep. Obstructive sleep apnea can cause headaches. Migraines are the #1 reason for balance problems in children. Migraines can also affect the inner ear as well. Good luck.

  4. I have had a chronic cough for over ten years now. It has gotten so bad that I was disabled due to it and other conditions combined. I have hearing loss,asthma,sleep apnea,high blood pressure,diabetes,ect. I cough sooooo hard it pulls muscles throughout my body, I turn red and almost pass out. I have to find something to help ??? But what can I do, the doctors have said if I were to get my tonsils out I could bleed to death due to the cough ??? My doctor has had me on lidocaine recently and it seems to take most of the violent coughing away, leaving me with just a slight cough during the time the troat is deadened. Is there a way the doctors could possibly safely remove my tonsils ????
    What is your opinion ???

  5. Dr. Park,

    I was supposed to get my tonsils removed when I was a kid but my doctor retiried before he could. my new doctor said there was no need. I have been getting both tonsilitis and strep throat since I was 12. I get both 5-6 times a year. I’m now 19 and am thinking about getting my tonsils removed. Is there anyway I can go and request them to be taken out? I am missing school because i keep getting sick. I can’t talk or shallow. I really think it would be better for me if the were gone.
    please help.

    -Rachel

  6. sir,

    My son is nearing five years old,he is getting small red wound patches in throat at that time fever comes it will witstand for 4 days and red patches will hide fever also gone.it is keep on coming in two times in month ,pls give me remedy to my son,i was very felt very much.

  7. Hi, my name is Mary and my daughter is only 2 years old.
    She’ll be three in January. She started to have a fever a few days before Halloween. I didn’t think much of it and gave her children’s Tylenol. Until she couldn’t eat or swallow and started coughing and then vomit after she coughs. And now she’s having difficulties sleeping through the night and is whispering to speak. I had a feeling it was her tonsils. And I asked her to open up her mouth. And there they were swollen and bright red. Though her tonsils aren’t that large, but she complains of pain while swallowing. I searched online of what to do, but I am afraid. Because she is so small. And I haven’t gone to the doctors to let them examine her yet. I am waiting to see if she’ll get her voice back… What should I do? And if surgery is required, can a parent watch it get done? I don’t want to leave her side at all if she needs it.

    Concern mother – MARY (11-1-2012)

  8. Dr Park,
    My daughter is 5 years old and has kissing tonsils. About 2 years ago she had the largest adeniods the doctors had seen at Mass Eye and Ear. Her tonsils were so small you barley knew they were there. Overtime her symptoms came back. Snoring loudly, eating small meals, coughing while laughing and even stops breathing during sleeping. Our ped referred us to another ENT for tonsil removal but I am concerned as to the underlying problem. What could have caused this? Are there tests available? Could it be a food or environmental allergy? Does she really need to have surgery? Please any help would be appreciated. I am worried about her health.

  9. Rebecca,

    Since every child is different, I can’t say for sure without examining her, but adenoid or tonsil regrowth does happen occasionally. Typically, it’s most commonly due to allergies or reflux. However, having underlying obstructive sleep apnea can aggravate inflammation and swelling of these “lymphoid” tissues despite complete adenotonsillectomy. In these type of situations, I generally order a sleep study. If you deal with any obstructive sleep apnea afterwards, then there’s less of a chance that the adenoids will grow back.

  10. I noticed my son had bad breath day before yesterday despite brushing his tongue and teeth Properly. Yesterday when he woke up he complained of neck pain, his neck was swollen and he snored badly through the night. He still has d bad breath too

  11. I have been told I have chronic tonsillitis, and though I have no discomfort or swelling and I don’t get strep the doctor has offered surgery as the only option. The only problem I am having is tonsil stones and because of the tonsil stones, bad breath. I can’t really find any information about chronic tonsillitis. I have been told the tonsil stones come from debris getting stuck in the crevises so I have been gargling often to try to wash debris away and this doesn’t seem to be helping. I was also told that if I have my tonsils out I will be restricted to the couch for at least 2 weeks, possibly 4, and not able to do anything around the house even. I am wondering if you can shed some light on this as far as what is going on with my tonsils, if I should proceed with surgery, and if so what a realistic post-op scenario would be like. (If it matters I am a 31 year old stay at home mom of 2). Thanks for any help you may be able to provide!

  12. Dr Park, my daughter is 10 & having very large adenoids. Her tonsils are not very large but suffers from recurrent infections. She has breathing problem for blocked nose, sleep apnea, eating problems and often fever. ENT doc. adviced for both tonsillectomy & adenoictomy. As her tonsils are not very large, I am considering the only adenoictomy. I am afraid after hearing from some who are suffering from weight gaining & being sluggish after tonsillectomy. Would the only adenoictomy help to stop throats & recurrent tonsil infections? Pls ans me asap. She is very skinny and weak. Some advised to stop dairy product to reduce this problem, so I sopped giving her milk.What should I replace for milk? Her ears also sometimes getinfected.I am tired giving het antiboitics years after years. I need your advice.

  13. Dr. Park,

    I was diagnosed with sleep apnea about 9 months ago and faithfully wore the mask. However, my insurance company would only allow a certain amount of money for sleep apnea and apparently, I exhausted it. For the past 6-7 months, I have had trouble swallowing–I feel like some pills and sometimes food gets caught in my throat about where the tonsils are. Yesterday, I went to an ENT and he put a lighted scope down my nose. I have been on acid reflux medicine for over 3 years now and was diagnosed about that time with Barrett’s esophagus. The ENT told me that enlarged tonsils can be caused by the fact that the medicine they have me on for reflux (Protonix) isn’t working well. But I have tried about 4 different medications for reflux and all have caused side effects. I have a barium x-ray coming up this next week. My question to you is: does surgery for a tonsillectomy on a 51-year old adult ever help with the kinds of problems I am having? Thank you for any help you might be able to give me. I am extremely worried about things getting stuck–it causes me lots of anxiety.

  14. Dr Park,
    I have concerns about my son’s health.
    He is 26. He has large tonsils. It happened that about 3.5 months ago he had infection and his tonsils became large and it was also accompanied with ear infection (otitis). He went to the doctor and was prescribed Amoxycicline. Before the infection was completely treated, he had to fly and we didn’t know that it will make the condition worse. During the flight and especially when the plane was landing, he experienced unbearable pain and tension in the tonsils and ears. The infection bursted and the tonsils became large. Also, he couldn’t hear properly for about a week, because of the ear infection. He went to the doctor again; he prescribed him Amoxyciclin again but it helped to a curtain degree – It couldn’t clear the infection thoroughly. Then he went to another doctor, who prescribed him Penicillin tincture, but it didn’t help and then another doctor, who prescribed him Clyndomicine and then the infection of the tonsils and ears was cured. However, the tonsils remained large and the doctor suggested that they should be removed, as, according to him, ‘they did not exercise their normal functions as they were intended to’. The infection was cured about 1.5 months ago and he feels OK now, but the tonsils are large. We would be very grateful to hear your opinion. Does he need to remove the tonsils or to wait and see if they are going to cause him problems often in the future?
    Also, there is another problem. His blood pressure is high 145 over 88. We took it several times and every time it varies from 156 to 138 (upper limit) over 88 / 90 (lower limit). We are wondering, if it that is related to the tonsils.
    I look forward to hearing from you.
    Thank You in advance.
    Best Regards,
    Nicole

  15. I have a ? I am a 22yr old woman jus jus had my tonsils &adnoids removed 2days ago I still cnt eat very much &was wondering y my doc gave me steroids instead of an antibiotic ??

  16. Dr. Park,

    All though I haven’t been to a doctor about it, I know my tonsils are too big and i’m almost positive that I have sleep apnea because even though I sleep my 8 hours I am tired everyday at work. I have many problems with my jaw also, which makes me think that my jaw is too small. My question would essentially be: Is there anything that can be done about my jaw being too small?

  17. I have been suffering from Chronic Tonsillitis recently I looked at my throat and I noticed this red line(almost like a cut on my tonsil)only one Tonsil has this red line/cut.What could this be?

  18. Hi Dr Park,

    I’m 36 years old and I’m scheduled to have a tonsillectomy/adenoidectomy because they are enlarged/cryptic and they seem to get in the way. I also frequently get tonsil stones. The thing that worries me is that I have read some theories that tonsils are required to help prevent disease in the long run. One has even said that tonsils help prevent cancer. There is a study that provides evidence that a critical type of immune cell can develop in human tonsils. The cells, called T lymphocytes, or T cells, have been thought to develop only in the thymus, an organ of the immune system that sits on the heart (http://preventdisease.com/news/12/030612_Why-You-Should-Never-Remove-Your-Tonsils.shtml). What are your thoughts on this?

    Thanks!

  19. Brad,

    You have to balance the pros vs. potential cons. There’s no easy solution for tonsil stones. Rarely, they do resolve on their own, but most do not. Having large tonsils can also cause breathing problems, even if it’s not officially obstructive sleep apnea. Poor breathing leads to poor sleep quality.

    Regarding the tonsils and the immune system, your immune system is mostly educated in your early childhood years. Plus you have many other areas of lymphoid tissues that act to fight infections, such as deep in your neck, armpits, groins and all throughout your body. Not breathing and sleeping well have proven detrimental risks, whereas the reasons for not removing tonsils are only small, theoretical risks. For a final decision, it’s important to talk to your surgeon, since the decision has to be made on an individualized manner.

  20. I’m curious if large tonsils can affect a woman’s hormones? Or if I could have some kind of infection because my left tonsil is always huge and will swell slightly if I have an ear infection but even after it is back to its ‘normal’ size. I had a dr a few years ago say she would have them taken out if only the right one would swell too. She was just a physician and not a specialist. I keep getting sore throats that never turn into anything else. I don’t have any other symptoms other than headaches from the pain in my throat. I never end up with a cold or strep throat. Eventually it goes away but then a few weeks later I will have a sore throat again. It feels like its in the top of my mouth but not where I can see anything. Thank you in advance for any info!

  21. tonsils are huge, have had sleep apnea since childhood, need to have them removed. Am 58 in good physical shape weigh 115, but a smoker for 30 years. should i do this.

  22. Hi curator!! I was diagnosed with the infamous Mono Virus, and on top of that Acid Reflux (Gerd).I went to see my ENT last week and he checked me out with a scope thru my nose to make sure i didnt have anything more serious going on.H told me that the reason why my tonsils were so inflammed and swollwn was due to the fact that I had really bad Acid Reflux and the Mono virus has a bad hold on my tonsils and throat is also so swollen that it’s hard to swallow food and breath at night when i go to sleep.I’m just so scared now to lay down at night because i cant breath it feels like someone has both hands around my neck when im trying to sleep.My Ent says to give it 6 more weeks to see if the swelling goes down but i dont think that it is going to go down and i want to call him before the week is out to see if we can get this thing started before the 6 weeks.U know too get them taken out because it’s making me have really bad congestion in my nose as well.Just scared and right now im on Prednisone for the swelling of the tonsils and throat.Which b/c of the Mono Virus isnt doing much good for it Im going to call in tomorrow to see if i can get in there next week so we can plan the operation to get the tonsils taken out been gointhru this since February of 2016.Cant take it anymore.