FOR many kids over the years, the tonsil removal conversation went something like this: you have been getting too many sore throats, the doctor says the tonsils need to come out, and the good news is you will get ice cream afterwards.
It seemed like a straightforward deal, and for decades tonsillectomy was one of the most routinely performed surgeries on children in the world.
But is it true that having your tonsils removed as a child can affect your health as an adult?
Verdict:
TRUE
Children who have their tonsils removed before the age of nine may face a higher risk of certain respiratory, allergic and infectious diseases later in life, according to one of the largest studies ever conducted on the long-term effects of the procedure.
The tonsils are not the useless lumps of tissue they were once assumed to be.
Positioned at the back of the throat, they are part of the body's first line of immune defence, helping to detect and respond to airborne bacteria and viruses before they travel deeper into the body.
Their immune activity is at its peak between the ages of three and ten, which is precisely the window during which most tonsillectomies are performed.
A landmark 2018 study published in JAMA Otolaryngology, led by researchers from the University of Melbourne and the University of Copenhagen, analysed health records from nearly 1.2 million Danish children born between 1979 and 1999, tracking their health outcomes for up to 30 years.
Of the children studied, those who had their tonsils removed before age nine showed an almost tripled relative risk of diseases of the upper respiratory tract, including asthma, influenza and pneumonia, compared to children who did not have the surgery.
Children who had their adenoids removed showed a two-fold increased risk of the same conditions.
Those who had both removed showed a 17% increased risk of infectious and allergic diseases overall.
"Our observed results support delaying tonsil and adenoid removal if possible, which could aid normal immune system development in childhood and reduce these possible later-life disease risks," said lead researcher Dr Sean Byars, as reported by the University of Melbourne.
A review published in the British Journal of General Practice also noted a separate Swedish national cohort study of 179,875 tonsillectomy patients, which found increased rates of autoimmune conditions including thyroid disease, rheumatic diseases, inflammatory bowel disease and type 1 diabetes following tonsillectomy.
A 2024 review published in ScienceDirect confirmed that the immune activity of the tonsils is particularly important during childhood, when the developing immune system is most sensitive and most reliant on lymphoid tissue to learn how to respond to pathogens.
Now for the BUT, because this one really matters.
None of this means that children with severe, recurrent tonsillitis should simply suffer through it in the name of long-term immune function.
Untreated chronic tonsillitis carries its own serious health risks, and the surgery remains appropriate and necessary in cases where infections are frequent, debilitating or causing complications such as obstructed breathing or sleep apnea.
What the research recommends is that doctors and parents consider delaying the surgery where it is safe to do so, and explore alternatives where possible, rather than moving straight to removal at the first sign of repeated infections.
The ice cream, for what it is worth, is still a reasonable consolation prize either way.
Sources:
1. https://pubmed.ncbi.nlm.nih.
2. https://bjgp.org/content/long-
3. https://www.sciencedirect.com/
