Removing tonsils and an increased risk of autoimmune disease

tonsils, autoimmune disease, Hashimoto's, Hashimoto thyroiditis,
















Tonsils play an important role in our immune system. Tonsils are a pair of lymphoid tissues located at the rear of the throat and function as the first defence against bacteria and virus. The underlying component of B cells in the germinal centers of the tonsil is activated when a pathogen is present.

Studies show that the pre-existing antigen-specific IgA antibodies in the nasopharynx declined sharply after adenotonsillectomy (surgical removal of the adenoids and tonsils) in children,  suggesting that the tonsils are important for generating mucosal immunity. Moreover, recently been noted that besides thymus tonsils are the reservoir of T cells.

It is thus possible that removing tonsils may lead to future dysfunction of the immune system. Swedish study tested the hypothesis that individuals with tonsillectomy face an increased incidence of autoimmune diseases in their later life. All individuals who underwent a tonsillectomy in Sweden during 1997-2012 were included and explored systematically their subsequent risk of 33 autoimmune diseases. In Sweden, patients with autoimmune diseases are normally diagnosed by two doctors: 1) at a primary health care center and 2) a specialist in the hospital. This can guarantee high accuracy of this study as compared to studies that use self-reported questionnaires.

179 875 individuals received a tonsillectomy between 1997 and 2012 in Sweden. The median age at operation was nine years old. Hypertrophy of tonsils and adenoids (59%) was the most common underlying diseases, followed by chronic tonsillitis and adenoiditis (26.7%) and sleep disordered breathing (3.5%).

From the total of 33 specific autoimmune diseases were examined in this study; 16 of them showed an increased incidence, whereas none of them showed a decreased incidence. A total of 5357 patients were subsequently diagnosed with autoimmune diseases after the tonsillectomy, giving an overall Standardized incidence ratios (SIR) of 1.34. The risk of autoimmune diseases was not different for men and women, with an exception of Hashimoto/hypothyroidism and Sjogren’ssyndrome. SIR for Hashimoto thyroiditis for male is 1.99 and for female 1.50.

The risk of autoimmune diseases was further analysed by the underlying indications of tonsillectomy. The overall risk of autoimmune diseases was 1.36 for chronic tonsillitis and adenoiditis, 1.27 for hypertrophy of tonsils and adenoids, 1.34 for sleep disordered breathing, and 1.50 for other indications. For specific  diseases, the incidence of Hashimoto/hypothyroidism and rheumatoid arthritis was increased after tonsillectomy due to all indications. Some diseases, such as Crohn’s disease, Graves’/hyperthyroidism, Hashimoto/hypothyroidism, psoriasis, and rheumatoid arthritis, showed an increased incidence after tonsillectomy at different ages.

Immune dysfunction due to tonsillectomy may partly explain the association  between tonsillectomy and  autoimmune diseases. As recent evidence suggests tonsils might be the reservoir of T cells outside of thymus. However, future studies are needed to further explain the underlying mechanisms.

Have you had your tonsils removed? If yes, let us know below if you see any relation between tonsillectomy and the occurance of your autoimmune condition?



Bitar, M. A., Dowli, A., & Mourad, M. (2015). The effect of tonsillectomy on the immune system: A systematic review and meta-analysis. International Journal of Pediatric Otorhinolaryngology, 79(8), 1184-1191. doi:10.1016/j.ijporl.2015.05.016

Ji, J., Sundquist, J., & Sundquist, K. (2016). Tonsillectomy associated with an increased risk of autoimmune diseases: A national cohort study. Journal of Autoimmunity, 72, 1-7. doi:10.1016/j.jaut.2016.06.007

Leavy, O. (2012). Tonsils turn out T cells too. Nature Reviews Immunology, 12, 232. doi:10.1038/nri3196


54 thoughts on “Removing tonsils and an increased risk of autoimmune disease

  • Tonsillectomy age 12, Symptoms of autoimmune dysfunction from age 16. Diagnosis of Hashimoto’s Age 29 after years of misdiagnosis (first clinical evidence found at 21, but ignored by medical practitioners).

  • Tonsillectomy aged 33 and diagnosed with autoimmune several years later: undifferentiated connective tissue disease, symptomatic of reumatitis and chrones . Never had markers prior to tonsil removal..bigest regret to have them removed!

  • Hi, I’m a 19 year old girl who had a tonsillectomy when I was 5 years old. Immediately after I gained weight very quickly, despite my consistent diet from before to after. I hit puberty considerably early at age 9. My symptoms always replicate hypothyroidism, but all my blood tests have been normal (low range) for over 12 years. I have recently developed Complex Regional Pain Syndrome and wonder if this is all linked? I have found many studies suggesting this, but none that have concrete evidence.

    • I do feel your sadness, Lynda. Yes, it is a worldwide issue that often medical professionals do not find necessary to diagnose Hashimoto’s when hypothyroidism is diagnosed. This in my opinion is due to the fact that they don’t have anything else to offer to those patients. Warm regards, Anna

    • Dear Tess, I am so sorry to read about ypu struggle. I don’t know of studies showing a causal link between Complex Regional Pain Syndrome and hupothyroidism. Keep hope alive adn searching. Warm regards, Anna

    • Hi, I was actually looking this subject up because my daughter seems to be having the same exact issues as you. She had hers out at 7. Put in a bunch of weight at fast in the next 2 years and started period at 9. This is too much of coincidence. Nobody in my family started this young and nobody gained weight like this young either. Not to mention we were all very slim growing up. Kids made fun of me because I was so underweight. Thank you so much for posting your reply so I can look into this and if by chance you read this, i wanted to ask if you would mind if we could get in touch through a forum, email, or something. I’ve been sick to my stomach because I know something isn’t right and I can almost guarantee I’ll be pulling teeth trying to find a doctor to listen and agree. Due to the fact that they will be convinced it is all diet and won’t want to look deeper than a regular blood check. Which majority of the time doesn’t show abnormal thyroid levels. Unless they do a special test but I’ve seen doctors over the years blow the patient off when they think their thyroid is under or over active. This info will help me to stay persistent on getting to the bottom of what I can do to help her. I’m sorry you have to experience the same issues w your health and w doctors not listening to u. It’s the worst when your sick not feeling well and somebody who is supposed to help you get better instead blows your off because they think you don’t know what ur taking about or they are so dang Arrogant they think of you didn’t go to med school you are an idiot. You will be in my prayers

  • I suffered off & on for two years with tonsillitis from age 14 to 16 yrs. I was given antibiotics each time and eventually it cleared up just before a tonsillectomy was scheduled, so I never had them removed. Fast forward to age 35 and I had a goitre removed and became hypothyroid within 2 months of the operation. I have been on Levothyroxine for 27 yrs and now at 62, I have raised antibodies but doctors in the UK do not seem to recognise Hashi’s. I now believe that my thyroid problems stem from an EBV infection in my teens which lay dormant until my 30’s. It saddens me that so many people are affected by thyroid problems and still the medical bodies do not seems to have a grasp on any of it.

    • 35/F

      I am wondering the same thing! An infection could cause inflammation of tonsils and adenoids. Perhaps doctors were overlooking the infections which persisted despite removal of enlarged tissue, and it is actually the pathogen which leads to the thyroiditis (not the absence of these tissues).

      I had tonsils and adenoids removed when I was young, as well as tubes put in ears. In my teens, I suffered chronic urticaria (hives), lasting around a decade — after which time, the condition suddenly resolved. Somewhere along the line, I was diagnosed with Hashimoto’s — but it’s a condition both my mother and grandmother have/had. (Diabetes was present in my grandmother’s family). To treat the chronic urticaria, I was placed on a steroid regiment at one point. I’ve been taking T-4 replacement for years. I required higher than average daily doses of Zyrtec to combat the hives (which, at that time, was only available by prescription).

      As I got older, I have battled with chronic fatigue and brain “fog”, which completely disrupted my academic career, despite having been an excellent student as a child.

      Depression and anxiety have also been a familiar presence for two decades. My psychiatrist had tested me for Lyme disease (negative), Celiac disease (negative), sleep apnea (negative), and ordered an MRI to check for degenerative disease such as multiple sclerosis (negative).

      Moreover, I have suffered acne that drives me mad — now well into adulthood.

      I can’t help but wonder … could all of these issues be the result of any underlying infection that was never diagnosed or properly treated?

  • I had my tonsils removed when I was 6. Not because I was sick, because my sister was a
    Having hers removed and they thought we could do it together.
    I am 57 years old and diagnosed with Hashimoto 6 months ago.

    • Hi Perri van Rossem.

      EXACT same background: tonsillectomy at age 6, not because I was sick, but because my sister was and was having hers removed. (I understand from my mother that the thought and medical recommendation at that time was to have mine removed to prevent the anticipated following in my sister’s footsteps.)

      I am 54. I’ve had allergies all my life, severe headaches and a few migraines in the last five years, and diagnosed with Mixed Connective Tissue Disease (MCTC), a catch-all, non-specific diagnosis four years ago. Recently my autoimmune condition has elevated to Systemic Sclerosis.

      Two questions for anyone suspecting the tonsillectomy/autoimmune link:
      (1) Have any of your health care practitioners linked the two (in other words, have you found any that agree with the intuitive opinion about the connection); and
      (2) has linking the two resulted in any kind of successful treatment protocol? Thanks.

  • Tonsils removed in 1977 age 7, diagnosed with Hashimotos 3 years ago but recognise know that I was symptomatic since shortly after tonsillectomy

  • I had my tonsils and adenoids removed when I was 4 with tubes also placed in my ears. I was diagnosed with hypothyroid in my early 20’s and then later with Hashimotos… I have very low thyroid symptoms, but my numbers have increased through out the years (about 20 years of knowing that I have it). I also have post nasal drip and I still have drainage issues with my ears.

  • Suffered from bronchitis not long after I had my tonsils removed. Now I am a hay fever patient, just like my mom and brother who both also had their tonsils removed as a child. All three of us also suffer from allergies. Coincidence? I don’ think so.

  • I had a tonsillectomy at 6 years of age. I am now 49 and have Hashimoto’s thyroiditis. My symptoms started immediately after the tonsillectomy but diagnosis took many years.

  • I had tonsils removed at 3. Diagnosed with hashimotos at 38 after thyroid cancer diagnosis. Realize now that ITP was present at 14 – 39 and has reversed thee years after total thyroidectomy. I had a page long list of hashimotos related issues that disappeared after removal of thyroid.

    • Heather,
      I hope this message finds you well. I have been diagnosed with Hashimoto’s. Would you say that your quality of life has increased after thyroidectomy? If you could do it all over, would you have found alternative methods of combating your Hashimoto’s such as changing your diet? I am on the fence on deciding to go through with the thyroidectomy and would love to hear from others who had the surgery. Thank you and well wishes with your journey.

  • Have there been any instances where removing chronically swollen tonsils as an adult have helped improve/lower antibodies? I was diagnosed with Hashimoto’s this year (no noticeable symptoms besides a lingering post-nasal drip and swollen tonsils from a very bad cold/sinus infection 6 years ago). My thyroid numbers have improved on a T3/T4 compound, but my antibodies are still very high. My functional medicine doctor and my endocrinologist suspect maybe a low grade sinus infection is playing a part. After seeing my ENT, he thinks the autoimmune attack we’re looking for could be my swollen/infected tonsils and recommends taking them out. I’m 31 years old. Was sick all the time as a kid, and had at least 2-3 bouts of strep throat when I was younger.

  • Tonsils out age 6. Hypothyroidism at 18. Hashimoto’s at 25. Celiac’s, Fibromyalgia, and Cushing’s at age 36… Having spent most of my life feeling unwell, I now realize I definitely had symptoms of thyroid disease and celiac after my tonsillectomy. I also have environmental allergies to just about everything and get sick very easily. I’ve had mononucleosis AND viral meningitis in addition to my semi-annual bouts of bronchitis and sinusitis… I have vertigo, depression, anxiety, and am now apparently showing signs of a muscular skeletal disease in my labs as well… I’m inclined to believe it’s all related, whether it’s from the tonsillectomy or some genetic disease. Otherwise, I guess I’m simply very unlucky.

  • Tonsils removed at 5 years. Weight gain from 6 years onwards. Early stages of arthritis at 16. Hashimoto’s diagnosis at 47 after years of misdiagnosis.

  • Tonsils removed in 1975 age 5 years in New Zealand due to recurrent tonsillitis. After 3rd baby in 2009 symptoms of Hypothyroidism began and diagnosed with Hashimotos Thyroiditis in 2012.

  • Tonsils and adenoids removed around age of 8 , Graves Disease diagnosed around age of 39, Arthritis around same time.

  • Is it not possible that this study is biased and is mixing up the cause and the effect? Could it not be possible that people who get their tonsils removed often do so because they are constantly swollen, which is consistent with having a hyperactive immune system, which then later in life is diagnosed as an AI disease? I suffered from severe tonsillitis my entire childhood, and still have problems as an adult. I was diagnosed with diffuse connective tissue disorder four years ago, at age 29. I have not had my tonsils out. But I *do* have everything in common with someone who would have. I just worry that this study is not looking at cause and effect properly.

    • These are useful critical remarks, Natasha. Though, the study hasn’t been settled to measure a causal relationship, neither is claming such. As the authors conclude: ‘The incidence of a group of autoimmune diseases was higher in individuals operated with a tonsillectomy. Immune dysfunction due to tonsillectomy may partly explain the observed association. However, the underlying mechanisms need to be explored in future studies.’ Though, let’s not forget that science shows mopre and more evidence that people with tonsillectomy will lose their ability to produce functional T cells, which may affect their immune system. And finally lead to development of an autoimmune disease. Further, autoimmunity diseases have a stages of developmenet and often tonsillitus may be ralted to earlier stages of the disease, which not necessary leads to clinical autoimmunity condition. There is so much more that we don’t know and to discover, right?

      • I’m curious to know where the information on psoriasis comes from as from all the published articles I can see online, tonsillectomy has had marked improvement for patients that suffer from various forms of psoriasis. I am wondering why this article says that the incidence of psoriasis increased?

  • Hi.
    Yes I got my tonsils removed when I was a kid and then I got the apendix removed when I was 13 . Now I am 51 years and after many years of healthy eating and became an Acupressurist I have not have any healthy issues but I can sense and feel that the removal of my tonsils. I would never have done. Now when I yawn sometimes of my glands goes up in my throat and i know it has to do with my tonsils that were removed.

  • I got my tonsils removed when I was 10 or 11. And now that I am 51 and have a healthy diet.But I can feel that taking my tonsils out it wasnt a very smart choice and If I would older then I would NEVER have done it. i wonder if thats the causr that sometimes when I yawn one of glands go up and it hurts.

  • I had my tonsils and adenoids removed when I was 8, then I had tonsils or adenoids removed again as they grew back, or so I was told! I am 63 now and suffer from hypothyroidism and Hashimotos with high antibodies but my doctor just said that we all have antibodies. I have felt really weak and old since I was 40 years old when I had my first child. Aching joints, stiff, very tired, pains. I had to go private to see an endocrinologist who confirmed I had Hashimotos. My doctor made me think I was hyperchondriac. I don’t get many colds but when I do it lasts weeks. I have bad tinnitus. I feel doctors, now been through two surgeries of doctors, just don’t care, take ibuprofen I was told, then I had a heart attack due to a blood clot they think in 2014. Now it is take a paracetamol!

  • I have severe depression and lack of energy, I had my tonsil removed at age 12 years,I use to be shy and introvert and anxiety even before tonsil removal, but after I started getting too tired even physically. Now if my diet is changed even a little out of the way I feel tremendously depressed and anger and lack of energy.
    Initially i was diagnosed with depression, but depression medicine were not making me normal, eventually I started vomitting every 2nd day after consuming medicine for 18 years.

    Now I had to follow very strict diet, no milk, no wheat, very high fat, high vegetablem no gm , no hybrid

  • Tonsillectomy age 21, Hashimotos diagnosed at 29 (symptomatic from around 25-26). I think looking back I went overactive (age 23-24) before going under active.

  • Tonsillectomy at 25 after having 2 children several years earlier then developed Hashimoto’s at 30 after attempting 3rd pregnancy.

  • I had my adenoids only (not my tonsils) removed at around age 9. I don’t know/remember why. At around 18 I started having globus sensation. Went in to my pediatrician, got bloodwork, thyroid hormone levels were off. Got referred to endocrinologist and got the Hashimoto’s diagnosis the same year. More recently I’ve been having more symptoms that look a bit like lupus but are not conclusive. I never thought about my removed adenoids until I started getting tonsil stones a couple years ago and briefly considered a tonsillectomy to deal with them. Turns out some studies are showing these correlations, and now I wonder if my autoimmune issues may be due in part to that childhood surgery…

  • Hi, I was diagnosed ,finally at the age of 30 with Ankylosing spondylitis.I have spent many years since trying to figure this complex disease out.unfortunately over the years before my diagnosis, my sacraliac joints have fused together on their own☹️.I was told the AS began at the age of 15.I had a tonsillectomy at the end of 1994 ,6 mnths before turning 15!!
    It was only a cpl of days ago that I came across a doc on Gaia that I first heard of how much more of a role tonsils played ,than first thought long ago, leading me here to your forum today

  • Tonsils removed at age of 16 and 6 months ago I am diagnosed with autoimmune hypothyroidism. Doctor says it can not be cured. Need to take medicine life long. Is there any way to cure it?

  • I had my adenoids removed twice! The first time when I was 5. The second time I had my tonsils removed when I was 16 and it was discovered my adenoids had grown back. They were re-removed.
    When I was 26 I was diagnosed with Multiple sclerosis after a bout of Optic Neuritis. MRI confirmed and semi annual condition updates my MS has been medically stabilized but I am always wondering if there is a link… Not to mention I still suffer from constant sinus issues.

  • I was a very thin child until tonsils removed at age 6 (nothing wrong with them but my sister was having hers out ). Within a year I’d gained 75 lbs. I have struggled with weight gain my entire life since then. Altho another sibling has a hypothyroid diagnosis, I’m always told I’m in “normal” ranges. Chronic sinusitis and ear issues for the last 30 years and eosinophil levels up to 1600 the last 2 years. I don’t have allergies or asthma but I believe this ia all connected. I just need a dr who can figure it out!

  • I always had a tonsillitis problem. They use to get infected with pus almost every season change especially during the winter to summer change. My doctors always gave me antibiotics and the problem would get solved. I faced this when I was in my teens and continued till about 20. I am 33 now and 3 years ago was diagnosed with hashimotos.

  • I had my tonsils removed at age 7. A doctor came to our school and give all the children a medical examination. I was not sick or ever had a problem with my tonsils, however, my mother got a letter saying I should have a tonsillectomy. So I was taken to the hospital and had the operation. I was diagnosed with Hashimoto’s thyroiditis at age 55. I was feeling unwell and gaining weight since age 38. I am prescribed Eltroxin and I still feel unwell.

  • Tonsillectomy/adenoidectomy at age 4 1/2 due to chronic tonsillitis and ear infections. Good old mom smoked like a chimney while pregnant with me as did my father.
    Weight and bmi shot up within 6 months after surgery and remained a losing battle all through childhood, teenage and adult years. Diagnosed at 50 with both Hashimoto’s and Graves disease.
    I’ve lived with chronic brain fog, memory loss and mental instability – it’s plagued me a long as I can remember, even as a young child on the playground at recess.
    Makes me wish I were never born.

  • Hello I am now 41 I had my tonsils removed when I was 18 right before I went to college. While at college I became very sick and my blood was so light that it looked like strawberry soda. Nobody knew what was wrong. A few yrs later I had a problem where my cycle lasted for 6 months straight and they wanted to do a hysterectomy I refused because I did not yet have children but I badly wanted to. I am glad that I did not because I probably would’ve bled out on the table. It took until I was 33 and finally gotten pregnant to get a diagnosis of ITP. Shortly after having my son I received a diagnosis of hypothyroidism and lupus.

  • Tonsils removed at 17 years old. Diagnosed with Sarcoidosis at age 28. Diagnosed with autoimmune thyroiditis at age 47. Autoimmune arthritis started at age 48 (inflammation and swelling of joints with negative rheumatoid factors)

  • I had tonsillitis all the time as a kid. They refused to take my tonsils out. Early last year, I got sick with swollen tonsils again and never recovered. I progressively got worse. I was diagnosed with undifferentiated connective tissue disease (though I tested positive for CREST syndrome, I didn’t have enough signs of it at the time to diagnose) along with a whole host of other issues. I’ve also had psoriasis since I was a teenager. I finally just got my tonsils taken out.

    I’m not sure if taking the tonsils out is causative. Doctors don’t randomly take tonsils out, there has to be a real problem with them. Maybe recurring tonsil issues are related to other health issues, whether the tonsils are out or not.

  • Had tonsillectomy aged 7, diagnosed with coeliac at 38 and hashimotos at 40. Have struggled to breathe at night since early 20s, chronic insomnia with sleep apnea, chronic depression. Sure it was parents heavy smoking filling bedroom at night that caused tonsil reaction.
    Never made the connection to the tonsillectomy before, only just thought to search for one.

  • Frequent bouts of tonsillitis until they were removed when I was 12. Developed Pallendromic Rheumatism at 52 which developed into Rheumatoid Arthritis at 58

  • I had my tonsils removed in 1961. I was aged 3. I had very frequent ear infections sore throats. Lots of antibiotics prescribed. I went through childhood suffering with digestive problems constant stomach ache, bad breath, nasal congestion, catarrh, ear aches and achy sore joints which were called growing pains. In adult life the GP has diagnosed fibromyalgia, osteoarthritis, rheumatoid arthritis, irritable bowel and GERD. Adding to the list but not officially diagnosed Sjögren’s and Raynauds syndrome.

  • Hi… had tonsils removed at age 40, (am now 62) had constant sinus issues, which I thought was dust related to my work, which in turn infected my tonsils from sinus drainage… I now know dust from work was only partially the problem as I have now found out I am celiac… I know I am gluten intolerant and have been for a long time because if having any alcohol (beer) or wheat based products I would get bad sinus congestion, aeching joints, stiff muscles etc. (inflamation) all symptoms became worse after tonsils removed… plus muscle twitches started, dry eyes, cold hands, muscle stiffness, aeching joints, etc… was finally diagnosed with hashimoto syndrome 2 years ago and blood tests confirmed also celiac…. improving my diet has helped a lot… no alcohol, no wheat based products… very little processed food… mainly fresh fruit, veggies, meat… gluten free bread is one of the main ones if your celiac… hope this may help some others with similar symptoms… get a blood test for celiac, or hashimoto, or other autoimmune issues before you get your tonsils removed… and try staying off alcohol and stick to a good diet of fresh produce…. it’s helped me s lot… cheers

  • Hi… had tonsils removed at age 40, (am now 62) had constant sinus issues, which I thought was dust related to my work, which in turn infected my tonsils from sinus drainage… I now know dust from work was only partially the problem as I have now found out I am celiac… I know I am gluten intolerant and have been for a long time because if having any alcohol (beer) or wheat based products I would get bad sinus congestion, aeching joints, stiff muscles etc. (inflamation) all symptoms became worse after tonsils removed… plus muscle twitches started, dry eyes, cold hands, muscle stiffness, aeching joints, etc… was finally diagnosed with hashimoto syndrome 2 years ago and blood tests confirmed also celiac…. improving my diet has helped a lot… no alcohol, no wheat based products… very little processed food… mainly fresh fruit, veggies, meat… gluten free bread is one of the main ones if your celiac… hope this may help some others with similar symptoms… get a blood test for celiac, or hashimoto, or other autoimmune issues before you get your tonsils removed… and try staying off alcohol and stick to a good diet of fresh produce…. it’s helped me a lot… cheers

  • Hi im 46 yrs old & got my tonsils removed at 45 since then i had nasal dripping & i have excessive sweat at night pains on my joints my Doctor diagnosed me with arthritis after many test in which they all came normal till now im still in pain

  • Daughter had tonsillectomy and adenectomy at age 6. A few months later saw slight swelling on neck. 2 year after that she was finally diagnosed with Hashimoto’s. How do I increase her T cells and will that help in soothing the auto immune response?

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