Keep the Tonsils, Pull the Strep Throat!

Tonsillitis Gluten Allergy Case Study  of a three year-old boy:  As an infant this subject had experienced recurrent ear infections and was prophylactically placed on low dose amoxicillin.  As a two and three year old, this subject would present with tonsillitis bi-monthly.  His submandibular lymph nodes were swollen bilaterally, palantine tonsils were bright red with a whitish exudate, there was difficulty swallowing, malaise, and no fever.  All tonsil infections presented with similar signs/symptoms,  some tested positive for Group A Streptococcus. Amoxicillin was no longer effective. To alleviate recurrent infections, subject was treated with various antibiotics.   Tonsillectomy was discussed.  This patient began a wheat gluten free diet (WGFD). After initiating a wheat gluten free diet, this subject was tonsillitis free …unless he ingested wheat.  Most ingestion was immediately treated with antihistamines every 4-6 hours for the next 24 hours or until sore throat resolved.  Untreated ingestion resulted in tonsillitis and required a 5 day course of azithromax to resolve symptoms. This patient continued on a wheat gluten free diet.  

Tonsillitis Discussion: We often hear about the circulatory system with the heart at its center supplying blood with nutrients to cells.  As the cells burn this food and oxygen, they create waste products which they either dissolve or excrete through their cell walls. It’s the function of the lymphatic system to provide small vessels to remove these waste products and filter them through lymph nodes ultimately returning this fluid to the heart.  This is why when a surgeon checks for cancer, he checks the affected tissue but also the lymph nodes draining that tissue.

Lymph vessels and tissue are present throughout the body.  Because food is ingested through the gastrointestinal (GI) tract and can be a major source of foreign bacteria, etc. the GI tract contains a major portion of the lymphatic tissue.  As food is brought into the mouth, the lymph tissue of the tonsils and adenoids are immediately present to defend the body against pathogens.  These tonsilar lymph tissues filter the harmful bacteria and viruses to keep them from entering the body and carry away the waste filtrate that is produced. Thus, the high level of importance for fluid in our bodies. Within the lymph system are immune system cells called lymphocytes.  These cells travel in the lymph filtrate and are present in tonsil tissue. When pathogens present in food or from the fingers, these lymphocytes respond.  They call other immune cells to the location, burn fuel and secrete waste products, which generates dead cells and inflammation within the tonsil tissue.  The tonsil becomes inflamed, red, swollen, and painful.  Fluids bring relief to the tonsil tissue as they aid in washing away some of the congested filtrate.

When wheat gluten presents to the tonsil tissue it is recognized by the immune system as a pathogen and is attacked by lymphocytes which generate an immune response, inflaming the tonsil tissue. For years, now we have “solved” the tonsillitis symptom by surgically removing the tonsils.  Unfortunately, we have also removed important tissues that are an important line of defense to kill pathogens before they enter the GI tract.  Removing the tonsilar policemen at the gate is merely passing the immune system defense job of the tonsils further down the GI tract,  placing additional stress on the esophagus, stomach, and small/large intestine, and colon lymph tissue.

An important microbiology concept that is helpful to understand is that good and bad bacteria are most always present on our bodies,  as good and bad people are always present within a population.  The balance of good to bad is critical. Our police and parole departments keep crime in check under normal circumstances, but when 50,000 prisoners are released, they are overwhelmed.  The same is true for probiotics and good bacteria keeping disease under control. Streptococcus pneumoniae bacteria are most always present as normal flora on the body, but they are under control.  When wheat gluten causes an overwhelming immune response with immune complex formation and inflammation,  S. pneumoniae may be more likely to cause disease.

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