Stressed? Maybe You Should Blame Your Tonsillectomy

Studies continue to link the surgical procedure with physical and psychiatric ailments later in life.

You know those times in your life when you’re just feeling… stressed? You’re on the edge — you have no chill — everything just sort of gets to you. If you can step away from the anxiety for a moment you might ask yourself where it’s all coming from. Is it really the stuff in your inbox at work, or is it money issues at home? Is it something with your relationship, or maybe your sleep quality, or your diet? One thing you probably won’t blame for those acute stress reactions is the tonsillectomy you had as a kid. But according to new research, maybe you should.

Tonsillectomy and adenoidectomy are among the most common surgical procedures young people in the US undergo, with about 300,000 cases a year according to recent numbers. That’s down a bit from numbers a decade or so ago but suffice it to say a good chunk of the population is walking around right now without their tonsils.

The data supporting tonsillectomy has never been great. The two big indications for the surgery are recurrent sore throat — data show tonsillectomy reduces this by about 0.7 sore throats per year — and obstructive sleep apnea. The data for improvement of OSA is a bit better than the data for sore throats.

Also, tonsillectomy is a relatively quick, relatively well-reimbursed surgery with indications that are, let’s be honest, somewhat subjective — and so variation is high. One study found that in a single Vermont town, nearly 60% of the population had had their tonsils removed by the time they turned 18. A few towns over, the rate was 20%.

A few factors have led to the decline of tonsillectomy in recent years. Reimbursement rates have gone down a bit. Additionally, better data collection and statistical analysis have shown that the benefits of the procedure are relatively modest.

And then there is a body of medical literature that at first struck me as surprising and almost bizarre — data linking tonsillectomy to subsequent physical and psychiatric disorders.

I teach a course on interpretation of the medical literature — and one of the first…