Monthly Archives: December 2017


Tonsils – Episode 110

An image of a caucasian child's mouth, open wide with their teeth, tongue, and uvula visible. This is representative of the way one may open wide for a doctor to inspect the tonsils and throat.

Tonsils Basics

Your tonsils can be found in the back of your throat.  You can open your mouth and look in the mirror and see them on each side of your mouth behind your teeth and tongue.  You can also feel them below your earlobes and behind your jaw bone.

Tonsils are composed of lymph tissue since they are a part of your lymph system.  They store white blood cells that help you fight off infection.  Their activation during sickness is why they swell and get sore.

They are covered with the same mucosal membrane as the rest of the inside of your mouth.  This mucosa layer has pits and crevices called crypts.  These crypts increase the surface area of the mucosa that comes in contact with the lymph tissue and allows more opportunity for infectious material to be directly accessed by the immune system.

Infectious Tonsil Issues

Tonsillitis is the inflammation of the tonsils.  It can be classified as acute or chronic.  Acute tonsillitis is directly related to a viral or bacterial infection.  Chronic tonsillitis can be either a persistent, long-lasting infection or multiple consecutive acute episodes that can appear to be one long sickness.

Swollen tonsils can cause simple activities such as swallowing, talking, and breathing very painful.  You can see your swollen tonsils when you look in the mirror.  They will appear red or possibly blistered.

Mono, an infection caused in adolescents and adults by the Epstein-Barr virus, cause severe swelling in all the lymph nodes, including the tonsils.  This is one of the situations where your tonsils will be so inflamed, you can see the swelling on the outside of your face and neck.  Because such a large portion of your lymph system is involved, including your spleen, this is a serious sickness.

Strep throat is probably the first infection you think about when you think of swollen tonsils.  The bacteria, streptococcus, infect the lining of the tonsils and throat.  This is why the doctor will swab your tonsils when they’re testing for strep.

Non-Infectious Tonsil Issues

A non-infectious reason the tonsils will be large is a condition caused hypertrophic tonsils.  The tonsil tissue and/or mucosa overgrow and become oversized without any infection or immune activation being involved.  Overgrown tonsil tissue can lead to snoring or sleep apnea, and that’s bad.

Another non-infectious issue with your tonsils is called tonsilloliths or tonsil stones.  These stones happen when dead bacteria or food debris gets stuck in the crypts and they become calcified.  They cause a sensation many describe as a crumb stuck in your throat.   They can become quite large and can interfere with swallowing and eustachian tube function.  Because the eustachian tubes run from your eardrum into your throat, if the tonsil is swollen enough, it may close off the tube to the ear and cause ear pressure/pain.  Some tonsil stones are large enough to be visible and may have to be manually removed.  Lastly, due to the composition of the stones (dead bacteria and old food), frequent tonsil stones can be the cause of bad breath.

There’s no way to prevent tonsil stones 100%.  Good oral hygiene can certainly help reduce the frequency of stones, and can also help remove them quickly if they occur.  The most common way of trying to remove a tonsil stone involve coughing, clearing your throat, or hissing.  All three of these ways produce vibrations in the lining of the throat and mouth.  So along with the exhalation of these methods, hopefully, the result is the stone coming out of the tonsil and out of your mouth.

PSA:  Please DO NOT scratch your tonsils with your fingernails to remove a tonsil stone!

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Music Credits: Up In My Jam (All Of A Sudden) by – Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b…Music provided by Audio Library https://youtu.be/tDexBj46oNI


Metallic Taste – Episode 109

A table covered in pennies with varying luminosity. They will add a metallic taste to your water. Ha ha!

Glossary

Aguesia: no taste

Hypoguesia: reduced ability to taste (no the same as when taste changes due to changes in ability to smell)

Dysgeusia: dysfunctional taste (bad, salty, rotten, or metallic taste).  Metallic is most common.

Causes for Change

Chemotherapy and radiation for cancer causes taste changes because the taste buds are rapid-cycling cells and the goal of chemo and radiation is to kill fast-growing cells (cancer cells are definitely fast-growing).

Head trauma or brain damage may damage the path of taste from the mouth to the brain.

Conditions like GERD, diabetes, urinary retention, and dry mouth can cause dysgeusia.  Zinc deficiencies can too (in case you can’t tell, zinc plays a big role in many processes in your mouth).

Over 250 medications can causes changes in taste.  These include blood pressure medications, antibiotics, chemotherapy, asthma medications, and lithium.  Some of them are secreted in the saliva, so the change in taste is because you actually taste the medicine.  Other changes are because the medication disrupts or alters receptor or signal transport (i.e. ion transport – sodium, calcium, potassium, or chloride).

My Own Metallic Taste

I was taking generic Biaxin, AKA clarithromycin, for a sinus infection.  Clarithromycin is in a class of medication called macrolides.  Macrolides work on infections by disrupting the DNA-copying proteins in the bacteria.  They are known as bacteriostatic antibiotics, which means they stop the bacteria from growing and dividing, but do not kill them.  This allows your own immune system to get rid of the bacteria itself.

It was the worst!  Everything tasted so bad.  I had to take it for 10 days, so I spent those 10 days eating the strongest and spiciest foods I could find to try and cover it up.

Your saliva contains clarithromycin in a concentration of ~2.72 mg/L.  To get an idea of how small this amount is, it takes you 12-24 hours to produce 1 liter of saliva.  Only 3-7% of adults report metallic taste with clarithromycin.

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Music Credits: Up In My Jam (All Of A Sudden) by – Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b…Music provided by Audio Library https://youtu.be/tDexBj46oNI