Our tonsils are soft, oval-shaped nodes, neither flesh nor fat, that stand like bodyguards at the place where the outside enters our insides. They work tirelessly to protect us against viruses and germs that enter through the air we breathe and the food we eat.
Most people only know that sometimes doctors remove tonsils to resolve a problem, such as chronic tonsillitis. Rarely are the potential consequences of this procedure described and neither is the essential role the tonsils play.
Summary of Key Facts
- Tonsils are a part of the lymphatic system that form a ring-like gatekeeper structure in the throat.
- Because of their strategic importance in our immune system, tonsils have both “gatekeeper” and “messenger” roles.
- Tonsillitis is a process of training and maturation of the tonsils.
- Medical treatment of tonsillitis with antibiotics can have limitations and side effects.
- Natural herbs are beneficial in reducing the symptoms of tonsillitis.
- Combining antibiotics with natural herbal therapies may have a synergistic effect.
- There are a few ways to protect the tonsils.
Tonsils as Gatekeepers
The tonsil area is rich in immune cells.
When viruses and bacteria slip through your mouth and nose, the tonsils stand ready, 24 hours a day, guarding the throat—the gate of your body.
Tonsils are lymphatic tissue. They are made up of four parts: the adenoid, the two tubal tonsils, the two palatine tonsils, and the lingual tonsil. Together, these form a robust ring of defense known as Waldeyer’s ring.
The palatine tonsils have about 15 small spaces called crypts, which increase their surface area to increase the capacity to filter external pathogens.
The adenoid, also called the pharyngeal tonsil, is a mass of lymphatic tissue similar to the palatine tonsils that hang from the upper part of the back of the nasal cavity, and along with other parts of the tonsils, can’t be seen. The adenoid tends to shrink after early childhood, and by the teenage years, often disappears almost entirely.
The tonsils’ main job is to trap viruses or germs from the food we eat and the air we inhale. The tonsil area normally gets more blood flow to help fight off common infections.
In short, the tonsils’ role is to protect their territory—you. If these gatekeepers doze off, the enemy, such as a virus, will sneak in. The tonsils use perceptive senses to guard against invaders. They can identify and eliminate the COVID-19 virus and its variants and thousands of other viruses.
Furthermore, according to a study published on March 8 2023 in the journal Nature, tonsil neurons can transmit messenger molecules to the brain to initiate the sickness behaviors during a flu infection that order the body to rest or eat less. This strengthens the tonsils’ role as the body’s gatekeeper and messenger.
We’ve all experienced the power of our tonsils. A common sign of sickness is a sore throat or discomfort in the throat. While we may view it as a minor ailment, we may not be aware that it’s the tonsils warning us of an immune breach and that we should prepare ourselves for battle.
Essential Role in the Immune System
Our tonsils have a layer of epithelial cells that serve as the front-line signal cells detecting and clearing foreign bodies.
These cells are connected by tight junctions, forming a solid barrier against incoming viruses and bacteria. If they sense that invaders may have exceeded their clearance capacity, the epithelial cells will pass the signal to other immunity troops.
There are many specifically designed immune cells specialized in different functions. For example, some cells capture and absorb the antigens produced by viruses and bacteria, some send signals to others, some are good at killing a virus directly, and others can produce antibodies.
Antibodies, a kind of protein, can bind to specific featured fragments of proteins on the surface of a virus. They can neutralize and clear the virus from the body.
Our tonsils house many such cells that can generate various types of antibodies (e.g., IgA, IgD, IgE, IgG, and IgM). Different types of antibodies are like siblings in one big family, generated at various times during an infection or under abnormal conditions, each targeting different cells or tissues.
During fetal growth, the tonsils are among the first regions where many immune cells develop because of their strategic location. They develop early, at about the 14th week of gestation.
Recent research demonstrates that, like the thymus, the tonsils have been shown to express T-cell developmental intermediates that resemble those found in the thymus and bone marrow. That finding could have significant clinical and scientific implications because T-cells are a critical type of white blood cells, immune cells that are the backbone of the adaptive immune response.
Tonsillitis: Process of Learning to Become Stronger
During an exhausting battle against viruses or bacteria, our tonsils may become enlarged, swollen, and red. We will often feel this in the form of discomfort in the throat area. Those are typical signs of tonsillitis. The swelling is caused by a buildup of lymph fluid, viruses, bacteria, and immune cells, and the redness results from increased blood flow to the area.
In 50 to 80 percent of acute tonsillitis cases, viruses such as Epstein-Barr, rhinovirus, respiratory syncytial virus, adenovirus, and coronavirus are the cause. In 5 to 36 percent of cases, the infection is caused by bacteria, with Group A beta-hemolytic streptococci being the most common type in tonsillitis.
Tonsillitis frequently occurs during our younger years, when our tonsils aren’t yet strong enough to combat viruses and bacteria effectively, despite their best efforts. Developing tonsillitis doesn’t necessarily mean our immune system is weak. In fact, it often suggests our immune system is developing and becoming stronger as it learns to fight these invaders.
Recurring tonsillitis during youth indicates dynamics between the tonsils, immune system, and external viruses or germs. Getting tonsillitis doesn’t mean the tonsils aren’t doing their job—it means they are struggling amid the fight. Young tonsils need time to grow stronger. Tonsillitis indicates that the tonsils are overburdened, and it’s a signal for help.
Tonsillitis Treatments and Their Limitations
When the tonsils are exhausted, any method that can help clear viruses or germs, reduce inflammation, or boost immunity will help them recover.
Modern medicine primarily focuses on treating the symptoms of acute tonsillitis by using fluids to rehydrate the body, or drugs, such as pain and fever inhibitors, and corticosteroids to reduce inflammation.
Antibiotics are prescribed if there’s a possibility that bacteria is causing the infection, but it’s often hard to tell just by looking at the symptoms. Moreover, relying on antibiotics can lead to antibiotic-resistant bacteria, which can be harmful. These drugs also damage the microbiome, which plays an essential role in immune function.
Some medications used to treat acute tonsillitis have side effects, such as gastrointestinal bleeding caused by nonsteroidal anti-inflammatory drugs and breath suppression caused by opioids.
Removing the tonsils through surgery is sometimes used to treat recurring acute tonsillitis, but it isn’t usually done during the acute phase of the infection and can have limited long-term benefits.
In addition to antibiotics and other medical interventions, natural herbs can help the tonsils fight back and heal. Combining different forms of therapy may result in a synergistic effect because they work through different mechanisms of action.
Synergistic Ways to Support the Tonsils
Echinacea With Azithromycin
A prospective randomized, controlled study of 300 children with recurrent tonsillitis aimed to measure the effectiveness of prophylactic treatments to prevent recurrence. The study found that the combined use of commercially available echinacea with the antibiotic azithromycin produced better results than azithromycin alone. Azithromycin has been reported to cause adverse events, including lethal heart events, so caution is necessary.
Echinacea comes in various forms, such as supplements, liquids, creams, mouthwashes, and throat sprays. The dosage of echinacea varies depending on the type of product used. It’s important to consult a health care provider to determine the appropriate product type and dosage for a particular condition.
Green Tea
Green tea is a rich source of antioxidants with anti-inflammatory properties. Green tea can also help relieve sore throat symptoms, common of pharyngitis (inflammation of the back of the throat), which often accompanies tonsillitis. Researchers reported in Anesthesiology and Pain Medicine that gargling green tea helps ward off sore throat symptoms in postoperative patients.
Licorice Root, Barberry Root, Thyme, and Oregano
An in vitro (test tube) study investigated hot water infusions of 13 different herbs that can help defend against streptococcal-caused pharyngitis, the most common type of bacterial infection in the throat. Pharyngitis and tonsillitis are closely linked conditions that often share the same cause and treatment. The most effective herbs for pharyngitis according to the study include:
- Licorice root, the fastest and most potent
- Barberry root
- Thyme
- Oregano flowering shoots
Dandelion, Mint, and Skullcap
One systematic review, published in the esteemed Cochrane Database of Systematic Reviews, analyzed 12 randomized controlled trials assessing Chinese herbal medicines for the treatment of sore throat and tonsillitis involving 1,954 participants. The following remedies were found to be more effective than antibiotics in their studies.
Dandelion was more effective than sodium penicillin for acute purulent tonsillitis.
Another treatment mixture was more effective than gentamicin atomized inhalation (nebulization) for acute pharyngitis. It primarily contained the following herbs:
- Mint
- Skullcap
- Wild chrysanthemum
- Honeysuckle
- Houttuynia cordata
Sho-Saiko-To
A recipe called “Sho-saiko-to” has long been recorded in traditional Chinese medicine textbooks to treat pharyngitis or tonsillitis. The recipe is composed of six herbs:
- Bupleurum root
- Scutellaria root
- Ginseng root
- Pinellia tuber
- Glycyrrhiza root
- Ginger rhizome
Japanese researchers tested an adapted recipe, Sho-saiko-to-ka-kikyo-sekko, and reported that it reduced the episodes of chronic tonsillitis for more than two years in a small clinical trial. In some cases, patients even canceled planned tonsillectomies. This recipe added gypsum, Platycodon root, and jujube fruit.
Chinese Herbs
A meta-analysis of 110 randomized controlled trials looked at 12,152 patients with acute tonsilitis. It found that combining Chinese herbal injections with Western medicine resulted in an 89.5 percent improvement in clinical effectiveness, reductions in time to relieve sore throat, red and swollen tonsils, and tonsillar exudate ranging from 76.8 percent to 94.8 percent, and had an incidence of adverse reactions of less than 4.62 percent.
The following key active ingredients were listed:
- Forsythia suspensa
- Vahl
- Lonicera japonica Thunb
- Scutellaria baicalensis Georgi (key ingredient; Baicalin)
- Isatis tinctoria L
- Gardenia jasminoides J.Ellis
Tips to Protect Tonsils
Because tonsils play such a significant role in defense against viruses and germs, maintaining and optimizing their function is advisable.
Most viruses and bacteria are transmitted through the air. Our tonsils are easily overwhelmed when we live in an environment with many pathogens.
- One simple suggestion is to keep our living spaces clean and well-ventilated to reduce the risk of exposure. Additionally, avoiding smoke is crucial, as toxins in smoke are harmful.
- Maintaining proper hydration is also a critical factor in promoting throat health. Adequate air humidity and sufficient water intake can help keep our tonsils healthy.
- Food and drink are other sources of pathogens that can affect throat health, as everything we consume passes through this area. To minimize the risk of exposure, eat organic, nutritious, whole foods. Eating plenty of vegetables and fruits supports the basic functioning of our immune system.
By incorporating more naturally derived remedies into our daily routines, we can also boost our immune system and better support our tonsils to help prevent respiratory illnesses.
In the next article:
Tonsillectomy, or surgical removal of the tonsils, is one of the most common surgical procedures in the United States. While the benefits of reduced throat infections were evident within one year after tonsillectomy, they did not persist beyond one year.
A study followed a large cohort of more than 1.18 million Danish children for 10 to 30 years—the results were surprising.
Acknowledgment: We thank Dr. Jonathan Liu for his review of the herbal recipe in this article.
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