What are tonsillitis and tonsilloliths?
The tonsils are two small glands that sit on either side of the throat. In young children, they help to fight germs and act as a barrier against infection.
When the tonsils become infected, they isolate the infection and stop it spreading further into the body. Tonsillitis is commonly caused by viruses like those that cause colds and flu, or bacteria like streptococcus. The dead cells and mucous can become trapped in the tonsils; tonsilloliths are hard stones that are formed if this debris then calcifies. Typically, tonsilloliths only occur with people who experience chronic, repeated bouts of tonsillitis.
Miler and Hajek write (https://doi.org/10.1016/j.mehy.2017.09.006) that there are documented pieces of research claiming that “vaping may increase vulnerability to respiratory infections,” but that this hasn’t been borne out by evidence within the human population. They highlight that the studies completed on small animals and cell cultures have potential flaws: “the susceptibility to infections could be due to chronic and massive nicotine overdosing and stress, while in the cell study, the damage to epithelial cells harvested from 8-10 year old donors resulted from incubation in e-liquid (not e- cigarette aerosol).”
The pair note that some vapers experience temporary side effects to vaping when starting out, but symptoms do not appear to persist long-term. Also, it has been logged in studies that asthmatics and patients suffering from COPD recorded significant improvements when switching from smoking to vaping.
What could account for patients reporting health improvements when vaping?
“One of the key ingredients of e-liquid is propylene glycol that is known to have anti-microbial effects.”
Miler and Hajek detail the case of a 26-year old, female computer scientist, who had “frequent episodes of tonsillitis that started when she was about seven years old. She also suffers from recurrent tonsilloliths, from about the age of 17.”
The daily symptoms were not pleasant but her GP refused to recommend having the tonsils removed by surgery. Instead, the GP suggested she wait for the condition to clear up on its own (as it often does). But it didn’t, it continued and so did her suffering. Eventually she gave up seeking medical help and considered it would be a lifelong condition she would have to put up with: “Her tonsils would be red and swollen, often with white spots, and her voice would be hoarse. This would be accompanied by pain or discomfort when swallowing. She would cough up dark yellow/brown phlegm and have some discharge from her nose throughout the day.”
Her partner switched from smoking to vaping and she tried it out of interest. Then she inherited her partner’s old device and after three months noticed that she was feeling benefits in the morning. After eight months she noted that her tonsillitis had not come back and her tonsilloliths were continually getting better.
The pair write: “There is a possibility is that propylene glycol in EC aerosol affected a microbial strain that was causing LM problems. Nicotine at low concentration is also known to have anti-inflammatory effects and this may have played a role as well.” They suggest that this could form the basis of future research.