Tonsillitis in Children: Do You Need to Remove Tonsils or Adenoids?

Does your child suffer from tonsillitis? Have you been told  to remove your child’s tonsils or Adenoids? 

As a parent, there’s nothing harder than watching your child struggle with constant sore throats, ear infections, or breathing issues. If your doctor has recommended removing your child’s tonsils or adenoids, you’re probably wondering if  this is really the best choice for their health.

While these surgeries can offer short-term relief, growing research suggests that removing these small but significant immune organs may come with long-term consequences. As naturopathic medicine continues to emphasize, treating the root cause of illness is often more effective and sustainable than removing symptoms or the organs themselves.

What Do the Tonsils and Adenoids Do?

The tonsils and adenoids are not just “extra” tissues. They are important components of our lymphatic and immune systems. Located in the throat and nasal cavity, these organs are the body’s first line of defense against airborne and ingested pathogens. They help “train” the immune system, especially during childhood, by recognizing and responding to foreign invaders.

Their removal (while medically necessary every once in a while) may lead to a shift in the body’s immune function in the long term, and every parent must take this into account.

When Do Doctors Recommend Tonsil or Adenoid Removal?

Common Symptoms That Lead to Surgery

Singaporean paediatricians and ENTs may recommend surgery when symptoms become chronic or disruptive. Common criteria include:

• Recurrent tonsillitis (seven or more episodes in one year)
• Obstructive sleep symptoms like loud snoring or paused breathing during sleep
• Persistent nasal congestion and mouth breathing caused by enlarged adenoids
• Repeated ear infections, especially with fluid buildup behind the eardrum
• Poor sleep quality affecting growth or concentration
  

These symptoms are often frustrating and worrisome. But surgery is not the only route, and it’s worth investigating what might be driving the issue in the first place.

Case-by-Case Decisions

If your child is experiencing developmental delays or failure to thrive due to airway obstruction, surgery might be medically appropriate. But for many families, especially those facing mild to moderate symptoms, there may be time to explore other approaches first.

Are There Risks to Removing Tonsils or Adenoids?

A landmark study by Byars et al. examined the long-term health outcomes of children who underwent tonsillectomies and adenoidectomies. The results were striking: children who had their tonsils or adenoids removed faced a 2- to 3-fold increase in upper respiratory tract diseases, along with a measurable rise in allergic and infectious diseases later in life.

Even though the body has other mucosa-associated lymphoid tissues that can partially compensate, the loss of these key immune structures still impacts immune regulation. Studies have shown that tonsillectomy can alter levels of antibodies essential for fighting infections. These changes don’t always result in overt immune deficiencies, they suggest a shift in immune function. 

Is There a Naturopathic Alternative to Removing Tonsils and Adenoids?

Yes, there are alternatives to surgery, and this is where naturopathic wisdom shines. Instead of removing parts of the immune system, naturopathic doctors work to strengthen it.

Rather than asking, “How do we stop the sore throats?”, we look at why your child’s immune system may be struggling  

• Is it a food sensitivity causing inflammation?  
• Is your child’s gut health (which is closely tied to immunity) out of balance? 
• Is there an environmental trigger like mold, allergens, or toxins?

Assessing the severity is also essential as sometimes there can be severe adenoid swelling in certain cases leading to developmental and growth impairments which may need  medical/surgical intervention particularly in these cases . So, one has to consider it case by case basis

But for the majority of kids, there are natural, non-invasive options that are worth trying first. And even if surgery is needed, supporting your child’s immune system before and after can make a big difference.

How Do We Focus on Natural and Non-Invasive Options For Your Child?

First, we identify root causes through comprehensive health history, and lifestyle evaluation, removing any obstacles on the way as elaborated above. Then we strengthen immune function naturally through herbal and nutrient repletion in appropriate dosing based on the requirement. 

Third, we can support the body’s innate healing processes through gentle modalities like  homeopathy, herbs and effective modalities such as constitutional Hydro.  Constitutional hydro is a traditional method to strengthen the immune function. We will discuss in greater detail on my next blog.

As a parent, it may be difficult to see your child suffer and if removing the organs does not feel right for your child. it’s okay to ask more questions. Seek a second opinion. Explore natural approaches that work with the body.  Of course a well experienced naturopathic physician will always take the severity of the case and will be able to advise accordingly.

Start With a Consultation

Dr. Radhika Kamat meets with parents in her Singapore-based clinic, and she can speak with you online from anywhere in the world. If you would like to get the perspective from an experienced functional medicine practitioner regarding your child’s tonsils and adenoids, get in touch.

Sources For Reference

1. Association of Long-Term Risk of Respiratory, Allergic, and Infectious Diseases With Removal of Adenoids and Tonsils in Childhood.

• Byars SG, Stearns SC, Boomsma JJ.
• JAMA Otolaryngology– Head & Neck Surgery. 2018;144(7):594-603. doi:10.1001/jamaoto.2018.0614.

2. Clinical Practice Guideline: Tonsillectomy in Children (Update).

• Mitchell RB, Archer SM, Ishman SL, et al.
• Otolaryngology–Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery. 2019;160(1_suppl):S1-S42. doi:10.1177/0194599818801757.

3. Clinical Practice Guideline: Tonsillectomy in Children (Update)-Executive Summary.

• Mitchell RB, Archer SM, Ishman SL, et al.
• Otolaryngology–Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery. 2019;160(2):187-205. doi:10.1177/0194599818807917.

4. Effects of Tonsillectomy and Adenoidectomy on the Immune System.

• Liu Y, Liu T, Li X, et al.
• Heliyon. 2024;10(12):e32116. doi:10.1016/j.heliyon.2024.e32116.

5. Long-Term Effects of Pediatric Adenotonsillectomy on Serum Immunoglobulin Levels: Results of a Randomized Controlled Trial.

• van den Akker EH, Sanders EA, van Staaij BK, et al.
• Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2006;97(2):251-6. doi:10.1016/S1081-1206(10)60022-1.