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Tonsillectomy may be an indicator of low vitamin D status

Tonsils and Adenoids become inflamed when a child is fighting infection
   Adenoids are lymph nodes above the tonsils
When they become inflamed they need to be aided, by vitamin D?, but not removed
400,000 Tonsillectomies per year in US costing $ 5,400 each average

Image
Note: Would need to breath thru the nose, not the mouth, to get any inhaled vitamin D to adenoids

Huge difference in rate of tonsil removals in different countries
Image


My opinion:
Low vitamin D increases the risk of many immune system problems, such as Tonsilitis
Tonsilitis might be treated vitamin D supplements
Removal of tonsils result in increased risk of various health problems:
    respiratory, cancers, allergies, deep neck infection, etc.
Suspect that Vitamin D spayed orally or inhaled would be better
   Getting vitamin D to the spot that needs it is very important
            Henry Lahore, founder of VitaminDWiki


Increase risk of respiratory diseases: 3X if remove tonsils, 4X if also remove adenoids - June 2018

Association of Long-Term Risk of Respiratory, Allergic, and Infectious Diseases With Removal of Adenoids and Tonsils in Childhood
JAMA Otolaryngol Head Neck Surg. Published online June 7, 2018. doi:10.1001/jamaoto.2018.0614
Sean G. Byars, PhD1,2; Stephen C. Stearns, PhD3; Jacobus J. Boomsma, PhD2

Key Points

  • Questions Are there long-term health risks after having adenoids or tonsils removed in childhood?
  • Findings In this population-based cohort study of almost 1.2 million children, removal of adenoids or tonsils in childhood was associated with significantly increased relative risk of later respiratory, allergic, and infectious diseases. Increases in long-term absolute disease risks were considerably larger than changes in risk for the disorders these surgeries aim to treat.
  • Meaning The long-term risks of these surgeries deserve careful consideration.

Importance Surgical removal of adenoids and tonsils to treat obstructed breathing or recurrent middle-ear infections remain common pediatric procedures; however, little is known about their long-term health consequences despite the fact that these lymphatic organs play important roles in the development and function of the immune system.

Objective To estimate long-term disease risks associated with adenoidectomy, tonsillectomy, and adenotonsillectomy in childhood.

Design, Setting, and Participants A population-based cohort study of up to 1 189 061 children born in Denmark between 1979 and 1999 and evaluated in linked national registers up to 2009, covering at least the first 10 and up to 30 years of their life, was carried out. Participants in the case and control groups were selected such that their health did not differ significantly prior to surgery.

Exposures Participants were classified as exposed if adenoids or tonsils were removed within the first 9 years of life.

Main Outcomes and Measures The incidence of disease (defined by International Classification of Diseases, Eighth Revision ICD-8 and Tenth Revision [ICD-10] diagnoses) up to age 30 years was examined using stratified Cox proportional hazard regressions that adjusted for 18 covariates, including parental disease history, pregnancy complications, birth weight, Apgar score, sex, socioeconomic markers, and region of Denmark born.

Results A total of up to 1 189 061 children were included in this study (48% female); 17 460 underwent adenoidectomy, 11 830 tonsillectomy, and 31 377 adenotonsillectomy; 1 157 684 were in the control group. Adenoidectomy and tonsillectomy were associated with a 2- to 3-fold increase in diseases of the upper respiratory tract (relative risk [RR], 1.99; 95% CI, 1.51-2.63 and RR, 2.72; 95% CI, 1.54-4.80; respectively). Smaller increases in risks for infectious and allergic diseases were also found: adenotonsillectomy was associated with a 17% increased risk of infectious diseases (RR, 1.17; 95% CI, 1.10-1.25) corresponding to an absolute risk increase of 2.14% because these diseases are relatively common (12%) in the population. In contrast, the long-term risks for conditions that these surgeries aim to treat often did not differ significantly and were sometimes lower or higher.

Conclusions and Relevance In this study of almost

  • 1.2 million children, of whom
  • 17 460 had adenoidectomy,
  • 11 830 tonsillectomy, and
  • 31 377 adenotonsillectomy,

surgeries were associated with increased long-term risks of respiratory, infectious, and allergic diseases. Although rigorous controls for confounding were used where such data were available, it is possible these effects could not be fully accounted for. Our results suggest it is important to consider long-term risks when making decisions to perform tonsillectomy or adenoidectomy.

Press Release

  • "a tonsillectomy, is the one of the most common paediatric surgeries performed worldwid"
  • 1 in 5 surgeries later had respiratory problem
    "Only 5 individuals needed to have the operation to cause an extra upper respiratory disease to appear in 1 of those individuals", Dr Boomsma added.
  • "But we now know that adenoids and tonsils are strategically positioned in the nose and throat respectively, in an arrangement known as Waldeyer’s ring. They act as a first line of defence, helping to recognise airborne pathogens like bacteria and viruses, and begin the immune response to clear them from the body"


Study reported on by GreenMedInfo (Founder of which had severe respiratory problems after A&T removal)
“Children who had undergone tonsillectomies were found to have a nearly three-fold increase in the risk of developing certain diseases of the upper respiratory tract, including

  • asthma,
  • influenza,
  • pneumonia,
  • chronic bronchitis, and
  • emphysema.

Removal of adenoids in addition to tonsils more than quadrupled chances of developing

  • allergies,
  • inner-ear inflammation, and
  • sinusitis

Non peer reviewed version of above study - with free PDF - July 2017

Increased risk of many early-life diseases after surgical removal of adenoids and tonsils in childhood
Sean G. Byars, Stephen C. Stearns, Jacobus J. Boomsma: doi: https://doi.org/10.1101/158691
Image
Relative risk magnitude and direction correspond to red (increased relative risk) and blue (decreased relative risk) colors (see key, top right) derived from Cox regressions capturing the risk of diseases (vertical axis) within the first 30 years of life depending on 21 covariates (horizontal axis). Within each circle there are three divisions corresponding to
surgery type (see mid-right key). A black border indicates whether risk for that particular disease-covariate combination was significant after Bonferroni correction for 78 tests; a complete black border surrounding a circle indicates that risks were
significant for all three surgeries. Disease risks for the covariate ‘region most lived in Denmark’ are relative to Hovedstaden (Copenhagen region).
 Download the PDF from VitaminDWiki


Removing Your Tonsils Is a Bad Idea - Mercola June 2018

Removing Your Tonsils Is a Bad Idea

  • "Although the number of tonsillectomies has declined drastically in the last 30 years, the surgery continues to be one of the most commonly performed on children,2 with more than 530,000 done each year on children under 15 in the U.S"
  • ...England's National Health Service (NHS) has classified the surgery as "of limited benefit,"4 with some commissioners unwilling to pay for surgery unless a child has had eight cases of tonsillitis documented by a physician visit in one year..."

Adenoids and Tonsils worse with low vitamin D, worse in the winter when D is low - Jan 2017

Vitamin D Levels in Children with Adenotonsillar Hypertrophy and Otitis Media with Effusion
 Download the PDF from VitaminDWiki


Vitamin D levels lower if increased Tonsilitis: 57 nmol: < 3 per year, 48 nmol: 3-7/year - March 2017

Relationship Between Serum Vitamin D Levels and Childhood Recurrent Tonsillitis
DOI: 10.17140/OTLOJ-3-135
Mustafa suphi ElbistanliMustafa suphi ElbistanliSelcuk GunesSelcuk GunesYakup YeginYakup YeginShow all 7 authorsFatma Tülin Kayhan
 Download the PDF from VitaminDWiki


Adenotonsillar hypertrophy associated with Lower vitamin D - 2018

Is there an association between vitamin D deficiency and adenotonsillar hypertrophy in children with sleep-disordered breathing?


Image Image

 Download the PDF from VitaminDWiki


Tonsillopharyngitis: Vitamin D = 143 nmol, control = 192 nmol - 2012

The role of vitamin D in children with recurrent Tonsillopharyngitis
Strangely the Vitamin D levels are much higher than normal for both groups
 Download the PDF from VitaminDWiki


Tonsillectomy, vitamin D, and subsequent Cancer Grant - 2009

 Download the PDF from VitaminDWiki


Tonsillectomy increased premenopause Breast Cancer risk by 1.5X - 2009

Tonsillectomy and breast cancer risk in the Western New York Diet Study.
 Download the PDF from VitaminDWiki


Tonsillectomy increased risk of ALL cancers by 1.5 X and Breast Cancer by 2.6 X - Jan 2015

A nationwide population-based cohort study on tonsillectomy and subsequent cancer incidence
PDF is available free at Sci-Hub   10.1002/lary.24864


Vitamin D and tonsil disease- -preliminary observations - Feb 2011

Int J Pediatr Otorhinolaryngol. 2011 Feb;75(2):261-4. doi: 10.1016/j.ijporl.2010.11.012. Epub 2010 Dec 4.
Reid D, Morton R, Salkeld L, Bartley J.
Division of Otolaryngology-Head and Neck Surgery, Counties-Manukau District Health Board, Auckland, New Zealand.

OBJECTIVE: To estimate the prevalence of 25(OH) vitamin D deficiency in children undergoing (adeno)tonsillectomy.
METHODS: From 1st November 2008 to 20th December 2008, 33 children aged from 4 to 16 and resident in Auckland, New Zealand (latitude 36° 52' S) undergoing (adeno)tonsillectomy for difficulty breathing/sleep apnoea and/or recurrent tonsillitis had 25(OH) vitamin D, iron and zinc levels measured.
RESULTS: Of the 32 patients who had 25(OH) vitamin D levels measured, 15.6% were vitamin D deficient (25(OH) vitamin D<50nmol/L), and 78% had levels, <75nmol/L. 25(OH) vitamin D level was inversely correlated with Fitzpatrick skin type (Spearman's rho=-0.713, p<0.01), body mass index (BMI) (Spearman's rho=-0.434, p=0.013) and tonsil size (Spearman's rho=-0.417, p=0.017). However regression modeling demonstrated that only Fitzpatrick skin type (β=-0.687, p=0.001) and BMI (β=-0.256, p=0.044) were significant predictors of vitamin D levels (R(2)=0.572).
CONCLUSIONS: Seventy-eight percent of Auckland children undergoing (adeno)tonsillectomy had a 25(OH) vitamin D level<75nmol/L, a level which is associated with an increased incidence of upper respiratory tract infection. Low 25(OH) vitamin D levels were related to a darker skin, increased BMI and larger assessed tonsil size. The association of larger tonsil size with lower 25(OH) vitamin D status needs further evaluation but offers a potential explanation why black and Hispanic children are more likely than white children to have (adeno)tonsillectomy for snoring or obstructive sleep apnoea.


Vitamin D levels in children undergoing adenotonsillectomies - Sept 2010

Int J Pediatr Otorhinolaryngol. 2010 Sep;74(9):1075-7. doi: 10.1016/j.ijporl.2010.06.009. Epub 2010 Jul 16.
Esteitie R, Naclerio RM, Baroody FM.
Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medical Center and The Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA.

OBJECTIVE: Because of the recent data supporting an immunoregulatory role for vitamin D, we evaluated levels of vitamin D in children undergoing adenotonsillectomies (T&A) and controls.
METHODS: We prospectively collected data from 47 children undergoing T&As and 15 undergoing unrelated elective procedures at a tertiary care children's hospital. Demographic and disease specific data was obtained in addition to a blood sample for the measurement of 25-hydroxy (OH)-vitamin D.
RESULTS: There were no differences in vitamin D levels between the groups and levels did not correlate to any disease parameters in the children undergoing T&A. The only significant differences were related to race in that African American children had significantly lower vitamin D levels compared to Caucasians.
CONCLUSION: This pilot study did not show an association between serum vitamin D and the need to have adenotonsillectomy.

Copyright 2010 Elsevier Ireland Ltd. All rights reserved. PMID: 20638140


Vitamin D levels in children with recurrent tonsillitis - March 2011

Int J Pediatr Otorhinolaryngol. 2011 Mar;75(3):364-7. doi: 10.1016/j.ijporl.2010.12.006. Epub 2011 Jan 7.
Aydın S, Aslan I, Yıldız I, Ağaçhan B, Toptaş B, Toprak S, Değer K, Oktay MF, Unüvar E.
Department of Otolaryngology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey. drsalihaydin at gmail.com

AIM: Although recurrent tonsillitis can be the consequence of defects in immune system, the exact etiology of recurrent tonsillitis is not clear. In this study, our aim was to determine the serum vitamin D levels and vitamin D receptor polymorphism among children undergone tonsillectomy due to the recurrent tonsillitis.

METHODS: A 106 children undergone tonsillectomy due to recurrent tonsillitis and a 127 healthy children aging between 2 and 12 years were enrolled in this study, to determine serum 25-hydroxyvitamin D level and vitamin D receptor gene polymorphisms (Apa1, Taq 1, fok1). Serum vitamin D level was measured with ELISA (nmol/L) and receptor gene polymorphism was determined by PCR. Vitamin D serum level below 80nmol/L was accepted as insufficient.

RESULTS: The average serum vitamin D level was 176±79nmol/L in recurrent tonsillitis group and 193±56nmol/L in control group. There was no significant difference between the groups (p=0.13). In recurrent tonsillitis group, 18% (n=15) of children had their serum vitamin D levels below 80nmol/L. The vitamin D receptor gene polymorphism (APA1, TAQ 1, FOK 1) in each group was compared (AA, Aa, aa, TT, Tt, tt, FF, Ff, ff). There was no significant difference between the two groups. The vitamin D serum levels and receptor sub-genotypes are also compared, and there was no significant difference between the groups.

CONCLUSION: There is no difference between the serum vitamin D level and receptor gene polymorphism among children with recurrent tonsillitis and healthy children. But vitamin D insufficiency is more prevalent in children with recurrent tonsillitis group (18%).

Copyright © 2010 Elsevier Ireland Ltd. All rights reserved. PMID: 21215466


The role of vitamin D in children with recurrent Tonsillopharyngitis - 2012

Italian Journal of Pediatrics 2012, 38:25 http://www.ijponline.net/content/38/1X25
Ismail Yildiz1, Emin Unuvar1,5, Umit Zeybek2, Bahar Toptas2, Canan Cacina2, Sadik Toprak3, Ayse Kilic and Salih Aydin4

Background: The exact etiology of recurrent tonsillopharyngitis in children is not clear. Recurrent tonsillitis in children has multifactorial etiology like most of the diseases in childhood. In this study, our aim was to determine the potential role of vitamin D in recurrent tonsillitis by measuring serum 25-OH vitamin D levels and determining the vitamin D receptor polymorphism among children with recurrent tonsillitis.

Methods: Eighty-four children with recurrent tonsillitis and seventy-one healthy children aging between 2 and 10 years were enrolled in this study. Serum 25-OH vitamin D level was measured with ELISA and vitamin D receptor gene polymorphism (Apal, Taq 1, Fokl) was determined by PCR. Serum 25-OH vitamin D level below 50 nmol/L was accepted as deficiency. The vitamin D receptor gene polymorphism in each group was compared.

Results: The mean age was 5.6 ± 2.4 and 6.1 ±2.7 years in study and control group, respectively. The average serum 25-OH vitamin D level was 142.7±68.1 nmol/L in study group and 192.3 ±56.1 nmol/L in control group. There was significant difference between the groups (p < 0.01).

  • In study group, 4.7% (n=4) of children had serum 25 OH vitamin D levels below 50 nmol/L.
  • None of the children in control group had serum 25-OH vitamin D level below 50 nmol/L.

There was no significant differences in vitamin D receptor gene polymorphisms between groups.

Conclusion: Serum 25-OH vitamin D levels in recurrent tonsillitis group were lower than those in healthy children. But, there was no difference in the incidence of vitamin D receptor gene polymorphism between the two groups.
 Download the PDF from VitaminDWiki


Vitamin D in recurrent tonsillitis: meta-analysis - expected 2019

The role of vitamin d in recurrent tonsillitis: systematic review and meta-analysis
_PROSPERO record Ahmad Mirza, mirza.aa at outlook.com


Deep neck infection 1.5X higher risk following Tonsillectomy - April 2015

Tonsillectomy and the Risk for Deep Neck Infection—A Nationwide Cohort Study
 Download the PDF from VitaminDWiki
478.22 (parapharyngeal abscess), 478.24 (retropharyngeal abscess), 682.11 (cellulitis and abscess of neck), 528.3 (cellulitis and abscess of
oral soft tissue) and 475 (peritonsillar abscess)


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Attached files

ID Name Comment Uploaded Size Downloads
10185 Adenoids side view.jpg admin 14 Jul, 2018 19:32 11.27 Kb 11
10135 Risk following tonsil removal.jpg admin 09 Jul, 2018 13:39 158.42 Kb 27
10134 ncreased risk of many early-life diseases after surgical removal.pdf admin 09 Jul, 2018 13:38 2.24 Mb 4
10133 Deep Neck Infection.PDF admin 09 Jul, 2018 13:16 227.08 Kb 4
10132 Tonsillectomy and breast cancer risk.pdf admin 09 Jul, 2018 02:52 172.48 Kb 4
10131 recurrent tonsillopharyngitis.pdf admin 09 Jul, 2018 01:36 1.17 Mb 2
10130 TH fig 2.jpg admin 09 Jul, 2018 01:13 14.90 Kb 32
10129 TH.jpg admin 09 Jul, 2018 01:13 12.81 Kb 32
10128 s12887-018-1178-8.pdf admin 09 Jul, 2018 01:12 716.78 Kb 4
10127 Childhood Recurrent Tonsillitis.pdf admin 08 Jul, 2018 22:41 530.31 Kb 5
10126 Tonsils vs country.jpg admin 08 Jul, 2018 19:57 14.68 Kb 35
10125 Adenoids.jpg admin 08 Jul, 2018 18:53 26.81 Kb 27
10124 Adenotonsillar Hypertrophy.pdf admin 08 Jul, 2018 18:07 281.66 Kb 5
2791 The role of vitamin D in children with recurrent Tonsillopharyngitis.pdf PDF admin 14 Jul, 2013 01:19 527.66 Kb 190
2034 Tonsillectomy, vitamin D, and subsequent Cancer - Grant 2009.pdf PDF admin 30 Jan, 2013 03:00 76.23 Kb 251
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