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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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Sleep Hygiene
All About Sleep

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Blood Brain Barrier [Show Notes]

Basics

The blood brain barrier is the last layer of cells between what’s in your blood and the extracellular fluid around your brain cells.

You’re born with it!  It’s main job is filtration.

2 ways things get through the blood brain barrier:

  • Passive diffusion: small, neutral molecules (water, gases, lipid-soluble)
  • Active transport: glucose, amino acids, drugs (like a revolving door)

Permeability: how easily something can pass through a layer without work

Things that change permeability:

  • Inflammation – stretches layer and makes holes bigger (meningitis, injury)
  • Multiple sclerosis – an auto-immune disease that can degrade the BBB
  • Alzheimer’s – BBB becomes overwhelmed with antibodies and burns out

*Scary Section*

Rabies is a virus that is small and can get through the blood brain barrier but the immune system cells, antibodies from the vaccine, and medicines can’t.
HIV encephalopathy is caused when a mutation of the HIV gets into the brain and use brain cells to replicate (rather than the well-known T-cells of the immune system).  There is also a rare symptom of HIV called HIV-associated dementia.

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microchimerisms – Pregnancy causes the permeability of many areas of the body to change, and this includes the BBB.

Test Yourself

Drugs that have central nervous system effects (good) or side effects (bad) cross the BBB.  See what you know of different medications and what job they’re supposed to do and what negative side effects they cause and see if you can guess if they cross the BBB.

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Don’t Share Your Cold [Show Notes]

Cold Virus

Rhinovirus.  Rhino = nose.  The cold virus accesses the body through the nose and mouth, and it uses the cells in the sinuses and throat to replicate.

Viruses require a host cell to replicate, therefore they don’t live very long outside of a host.  The cold virus can live on a surface for about 3 hours.

During the initial infection and multiplication stages (first 3 days), you are the most contagious even though you have no symptoms of being sick.

Cold symptoms

  • Runny Nose
  • Scratchy throat
  • Cough
  • Sinus congestion
  • Tiredness
  • Mild fever
  • Possible body aches

“Morning sniffles” not a cold.

Your tonsils are a major hub of your immune system. So, when your body recognizes that it’s been infected by a virus, the immune system is activated.  Sometimes, the first symptom people experience with a cold is a sore throat because the tonsils go into overdrive when the immune system is activated.

Prevent a Cold

Always wash your hands (in soap and water or hand sanitizer).  Touching your face can allow germs to enter your body but can spread your germs to other surfaces or people.

Learn to sneeze or cough into your elbows.  It keeps the spray from getting on your hands or surfaces and items around you.

Use sanitizing wipes to clean surfaces you may touch regularly or that you know someone sick has touched.

Why don’t we vaccinate for the cold?

Vaccines are prioritized a few ways.  We want to vaccinate against things that:

  • kill people.
    Colds don’t kill a lot people, they just make us miserable and miss work.
  • spread really fast.
    Flu, measles, chicken pox all spread rapidly through the population due to droplet exposure.
  • have slow-changing characteristics.
    There are 99 different version of the “cold” virus, but each one is fundamentally different.  So you would have to get 99 vaccines!

 

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