Inattentive ADHD and Tonsils


Remember in the 1960s when everyone got their tonsils out when they turned seven or eight. Tonsillectomies where like bicycles, everyone got one. By the early seventies, doctors were reevaluating that practice and deciding that the tonsils were probably there for a reason and that yanking them out of every kid on the block probably wasn't the greatest idea in the world.

Looking at some of the studies that have been done on tonsillectomies and ADHD, it is possible that those old time surgeons may have been on to something.  It turns out big tonsils can cause more serious problems than fever and sore throat. I just read this incredible abstract from a study that was done in Iran that I have to share with you.  In this study they tested 35 ADHD kids for inattentive ADHD symptoms as well as for hyperactive ADHD and Combined type symptoms before and after tonsillectomy and found that inattention scores fell in some kids by almost 75%, hyperactivity and combined ADHD cores did not fall by as much but those scores were improved as well.

    Now granted the study was small, only 35 kids, but these findings are believable because they are not new and they have been replicated in other studies. The difference between this study and others is the fact that these researchers  measured the amount of Inattentive ADHD and other ADHD symptoms before and after the tonsillectomy and were able to quantify the improvement.

     The biology behind these improvements involves the fact that the large tonsil can cause obstructions or blockages that cause poor oxygen flow to the lung and the brain. Less brain oxygen is a very bad thing and it translates to less attention and less control of our behavior and mood. Blocked airways can happen when you have sleep apnea, asthma, certain types of allergies as well as when tonsils are enlarged and we know from a voluminous (great word) number of studies that these are all conditions with a disproportionate amount of co-existing ADHD.

   This study further reminds us that Inattentive ADHD is not always JUST ADHD. Sometimes the inattention is the result of other underlying conditions. I have written a post on the many conditions that are NOT ADHD but that look like ADHD but if you or your child have breathing issues, snoring issues, or upper airway problems, then a trip to a specialist for evaluation of these problems is in order. Tonsillectomy will not be the choice Inattentive ADHD treatment for everyone, but for those folks that need it, it could help a whole lot!

Effect of adenotonsillectomy on ADHD symptoms of children with adenotonsillar hypertrophy.Acta Med Iran. 2012 Aug;50(8):547-51.Dadgarnia MH, Baradaranfar MH, Fallah R, Atighechi S, Ahsani AH, Baradaranfar A.

Arch Otolaryngol Head Neck Surg. 2009 Jul;135(7):642-6.
Improved behavior and sleep after adenotonsillectomy in children with sleep-disordered breathing: long-term follow-up.
Wei JL, Bond J, Mayo MS, Smith HJ, Reese M, Weatherly RA.

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