Why are Tonsils (and Adenoids) often enlarged

Chronically swollen tonsils (and adenoids - which are a similar lymph tissue), block off the airway from nasal breathing. This means you, or your child, may have to breathe through the mouth - leading to many problems including a small upper jaw and crowded teeth

Swelling of the tonsils, according to Buteyko and breathing people, come from three separate events:


1) Nasal breathing conditions the air by filtering, warming, moisturising and ionizing (nitric oxide) the air, leaving the lymph tissue as a last line of defence before the air hits the bronchi.  When the mouth is open, the tonsils become the first line of defence, carrying a greater part of the burden of fighting what's in the unfiltered air.


2) The lymph system in the head, neck and thoracic regions are powered mostly by the diaphragm, creating the negative pressure in the thoracic cavity which gets the fluids flowing.  Many children, who may coincidentally have their mouths open, use accessory muscles to power the lungs, like the chest and shoulders.  This chest breathing not only does a partial job at filling the lungs, it does a lousy job of moving the lymph around. Hence, the lymphoid tissue doesn't drain as well as it should and swells. Restoring diaphragmatic breathing will help.


3) Finally, many poor breathers are also chronic hyperventilators, meaning they exchange far more air per unit time than they need to nourish the body.  Chronic hyperventilation leads to decreases in carbon dioxide stores, as does chronic open mouth posture (think of the soft drink bottle left out overnight).   Over time, the body adjusts to lower Carbon Dioxide levels, but not without a cost.  One of the side effects of hypocapnoea (Low Carbon Dioxide) is spasm of smooth muscle, including that which lines our vessels, blood, lymphatic (and bladder).  Pooling of fluids in tissues is a result, thus explaining both the nasal congestion and the swollen lymph tissue often seen with poor breathing habits. Asthma, crowded teeth and prolonged bed-wetting are some examples of the problems this may cause


Therefore, if the lymph tissue has not be swollen for so long that it becomes fibrotic, it will begin to shrink within weeks of transitioning to nasal breathing.  


It is, by the way, why it is SO important to help a child transition to nasal breathing immediately after Tonsil and Adenoid removal, let the irritation and hyperventilation continue and swelling of remaining tissue recurs.


Dr Barry Raphael