Why have tonsils?

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The medical community has not adequately answered why we have tonsils, but they are made up of lymphoid tissue that produces white blood cells to fight infection. Tonsils may have been more useful in the past, but now they can cause problems such as obstructed breathing and chronic infections. Tonsillectomies have become more acceptable for children with chronically enlarged tonsils, as they generally benefit from the procedure. Whether tonsils provide additional immunity in adulthood is difficult to determine.

Why we have tonsils is a very good question that has not been adequately answered by the medical community. This is not for lack of trying or research. In theory, they’re supposed to promote better health, but for some, that’s not always the case.

The tonsils are the two bumps or rounds of tissue located at the back of the throat and are made up of what is called lymphoid tissue. Lymphoid tissue produces lymphocytes, white blood cells that help fight infection. Traditionally, doctors would consider the production of lymphocytes a good thing, as it would appear to help people fight off disease more easily.

Medical experts summarize that tonsils may once have been more useful than they are now and may be more effective against certain types of infections, such as parasitic agent infections. Yet, especially in children, this tissue can’t handle the barrage of viral exposures common in suburban and urban life. Instead of helping the body fight infection, the tonsils can swell and start to obstruct breathing. Alternatively, some children appear to have chronic infections as a result of trying to fight off illness.

From the early 20th century until the 1920s, doctors simply removed tonsils that appeared to be enlarged. It was almost standard for most children to have them removed in a procedure called a tonsillectomy. This led to a backlash of concern about the need for the surgery, resulting in fewer operations from the 1960s onwards.

After 20 years of not routinely performed tonsillectomies, doctors began to find that children with chronically infected tonsils had some recurring problems. The impact of the fabric on respiration was particularly interesting. Some studies have examined how children who snore were often classified as having behavioral problems in school or considered to have ADHD. When the tonsils were removed, these children generally slept better and many of them performed better in school and were clearly not ADHD.

These studies suggested that by not performing tonsillectomies, doctors were actually doing a disservice to some children who would actually benefit from the procedure. Tonsillectomies have become a more acceptable procedure, especially for those children with chronically enlarged tonsils. In most cases, tissue removal benefits children’s health instead of making them more susceptible to disease.

This suggests that some children don’t really need tonsils and that perhaps they are a “leftover” developmental improvement that is not practical in our day and age. Children with tonsillectomies generally have fewer illnesses instead of more. Chronic infection of the tonsils (tonsillitis) could actually weaken the body, making children predisposed to getting more diseases.
For other people with tonsils, they may not be a problem. If they don’t get infected frequently, they can perhaps provide a small immunity boost in the fight against disease. This is actually unproven, as many other areas of the body also create lymphocytes to fight infection. From years of studying tonsils, most doctors conclude that they can be good for some and bad for others. Therefore, we may not all need them.

Even whether the tonsils provide additional immunity in adulthood is difficult to determine. Research on people who still have them versus those who don’t have hasn’t clearly defined whether having this tissue keeps people healthier as they get older. Tonsils tend to shrink in size as children reach their teens, but adults can still have chronic tonsillitis and may experience snoring or sleep problems when enlarged. Many adults who missed the “standard” stage of medicine now sought tonsillectomies to reduce sleep problems or chronic throat infections.




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