Nutrition Health Review

Fall 2017

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Veterans Corner: Health and Wellness Reports From Around the United States

Combining nerve blocks with therapy speeds recovery in military personnel and veterans, clinical trial finds. Findings from a randomized clinical trial suggest that stellate ganglion block (SGB) treatment, a long-acting anesthetic injection to the cervical spine, can improve the efficacy of cognitive processing therapy in veterans with post-traumatic stress disorder (PTSD). Eighty-six veterans and military personnel with PTSD received SGB before or after daily cognitive processing therapy. The PTSD Checklist for DSM-5 (PCL-5) was used to measure PTSD symptoms; a lower score represents greater improvement in symptoms. PCL-5 scores decreased from about 50 at baseline to about 20 after an average of 2 weeks, which lasted for about 1 year after treatment. Treatment response was quicker with receipt of SGB before cognitive processing therapy.  Visit https://medicalxpress.com/news/2026-02-combining-nerve-blocks-therapy-recovery.html to read more. Eye tests reveal brain trauma more than a decade after concussions. Recent research suggests that veterans with a history of concussion might continue to experience differences in brain function decades after the initial injury. In this study, 38 veterans with a history of mild traumatic brain injury (TBI) and 40 veterans without TBI completed eye movement tasks and cognitive tests that measured attention, processing speed, and self-control. Compared to those without TBI, veterans with mild TBI were more likely to have slower, less accurate eye movements and worse performance on some attention-based tasks, with some differences measurable more than a decade after the initial injury. The lead investigator of the study noted that eye movement tests might be valuable in assessing cognitive concerns and informing personalized treatment plans, particularly since magnetic resonance imaging scans can appear normal following mild TBI.  Visit https://news.cuanschutz.edu/news-stories/eye-tests-reveal-brain-trauma-more-than-a-decade-after-concussions to read more. Airborne toxins trigger a unique form of chronic sinus disease in veterans. Researchers have identified a distinct pattern of chronic rhinosinusitis (CRS) among veterans with exposure to military burn pits and other deployment toxins. In veterans with CRS and toxins exposure, the expression of mast cells, a type of immune cell, was found to be increased by about twofold, compared to patients with CRS and no toxins exposure. Expression of mast cells was further elevated in veterans with longer deployment duration vs those with shorter deployment duration. Genes related to mast cells were also increased, and pathways associated with processing and eliminating foreign substances were enriched. A mouse model showed that combustion-related compound exposure heightened inflammation related to allergens, and sustained mast cell accumulation occurred in the sinuses. Visit https://news.cuanschutz.edu/news-stories/eye-tests-reveal-brain-trauma-more-than-a-decade-after-concussions to read more. Research identifies genetic changes linked to bone marrow cancer in veterans exposed to Agent Orange. A recent study found that patients with myelodysplastic syndromes, a group of bone marrow cancers, who had been exposed to Agent Orange had an increased likelihood of harboring high-risk chromosomal abnormalities, which indicates more aggressive disease, compared to patients without exposure. Mutations in certain genes, such as KRAS and TET2, were more common in patients with Agent Orange exposure compared to those without exposure.  Visit https://news.med.miami.edu/sylvester-research-agent-orange-blood-cancers/ to read more.  

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Know Your Nutrient: Magnesium

Magnesium is a mineral that acts as a cofactor in over 300 essential metabolic reactions, such as protein synthesis, blood glucose control, muscle and nerve function, and blood pressure. Additionally, magnesium is involved in the transportation of calcium and potassium ions, which is crucial for normal cardiac rhythm and muscle contraction.1,2  About 60% of magnesium stores are located in the skeleton, while <1% are in extracellular fluids, including blood.1 Normal serum levels of magnesium range from 0.76 to 1.15 mmol/L.2 The recommended dietary allowances for magnesium are as follows:3 Children aged 1–3 years: 80 mg Children aged 4–8 years: 130 mg Adolescents aged 9–13 years: 240 mg Female individuals aged 14–18 years: 360 mg Male individuals aged 14–18 years: 410 mg Female individuals aged 19–30 years: 310 mg Male individuals aged 19–30 years: 400 mg Female individuals aged ≥31 years: 320 mg Male individuals aged ≥31 years: 420 mg Foods high in magnesium include:3 Pumpkin seeds: 156 mg per 1 oz Chia seeds: 111 mg per 1 oz Almonds: 80mg per 1 oz Spinach (boiled): 78 mg per 1/2 cup Cashews: 74 mg per 1 oz Shredded wheat: 61 mg per 2 large biscuits Soymilk: 61 mg per 1 cup Black beans (cooked): 60 mg per 1/2 cup Deficiency and health impact Hypomagnesemia, or magnesium deficiency, occurs when serum magnesium level is <0.75 mmol/L. Early symptoms of hypomagnesemia can be nonspecific and overlap with symptoms of other electrolyte abnormalities (eg, hypokalemia [low potassium], hypocalcemia [low calcium]). Symptoms can include nausea, vomiting, loss of appetite, weakness, tremors, muscle spasms and cramps, cardiac arrhythmia, behavioral changes, and seizures, among others.2,4 Gastrointestinal disorders, malabsorption, renal disease, metabolic or endocrine disorders, and increased renal loss of magnesium can cause hypomagnesemia.1,2,4 Additionally, the use of certain medications, such as proton pump inhibitors, chemotherapeutic agents, diuretics, and antibiotics can cause hypomagnesemia.2,4 Given magnesium’s extensive role in the body, hypomagnesemia is associated with various health conditions. Diabetes. Magnesium is essential for maintaining blood glucose control and normal insulin sensitivity, with low levels linked to insulin resistance. Higher magnesium intake is associated with decreased risk of developing type 2 diabetes.2,4,5 Cardiovascular diseases. The body depends on magnesium for various cardiovascular-related functions, including cardiac rhythm, blood pressure, and vasodilation (widening of blood vessels). There is an inverse association between magnesium and cardiovascular disease (CVD), with low levels of magnesium linked to increased risk of CVD.2,4 Research also suggests a link between low magnesium levels and greater risk of cardiovascular mortality.2,5 Hypomagnesemia is associated with a greater risk of cardiac arrhythmia, stroke,2,4 and electrocardiogram changes.4 Evidence also suggests it might be associated with atrial fibrillation4 and atherosclerosis.5 Neurological conditions. Patients with migraine tend to have decreased levels of magnesium.2,4 Low magnesium might contribute to migraine via vasoconstriction (narrowing of blood vessels) and neuronal excitability.4 Severe hypomagnesemia can lead to generalized tonic-clonic seizures.2,4 Immune system. Hypomagnesemia might contribute to immune system dysfunction, which can then lead to inflammation. Furthermore, hypomagnesemia might be associated with greater susceptibility to COVID-19.5 As a medication. Magnesium sulfate can be utilized as a medication for acute migraine, acute asthma exacerbations, preeclampsia, and seizures caused by preeclampsia/eclampsia.2,4 Bottom Line Magnesium is an essential mineral invovled in many bodily functions and processes. Maintaining adequate magnesium levels is important for health, as hypomagnesemia is linked to a variety of health conditions.  Sources Rude RK. Magnesium. In: Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, eds. Modern Nutrition in Health and Disease. 11th ed. Jones & Bartlett Learning, LLC; 2014:159–175. Gröber U, Schmidt J, Kisters K. Magnesium in prevention and therapy. Nutrients. 2015;7(9):8199–8226. Magnesium – health professional fact sheet. National Institutes of Health Office of Dietary Supplements. Updated 6 Jan 2026. Accessed 10 Mar 2026.  https://ods.od.nih.gov/factsheets/magnesium-healthprofessional/ Al Alawi AM, Majoni SW, Falhammar H. Magnesium and human health: perspectives and research directions. Int J Endocrinol. 2018;2018:9041694.  Pethő ÁG, Fülöp T, Orosz P, Tapolyai M. Magnesium is a vital ion in the body—it is time to consider its supplementation on a routine basis. Clin Pract. 2024;14(2):521–535.  

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What is Bipolar Disorder?

By Sarabeth Lowe, MPH Ms. Lowe is a Communication Specialist at the University of Delaware Disaster Research Center. Mood and emotions play important roles in our daily lives. We all experience periods of positivity and energy interspersed with bouts of sadness or irritability. For people with bipolar disorder, however, these fluctuations in mood are more than typical ups and downs. Both extremes are so intense and unpredictable that they disrupt day-to-day life and can have serious social, financial, and mental and physical health consequences.1–7 What Is bipolar disorder? Bipolar disorder is a mental health condition that causes intense mood swings.4–10 These periodic, intense emotional states, which can last from days to weeks, are called mood episodes. They are categorized as manic/hypomanic episodes, where a person feels “up” (ie, high-spirited, irritable, or energized) or depressive episodes, where a person feels “down” (ie, sad, apathetic, numb, or despairing).6,7 People can also experience mixed episodes, where manic and depressive symptoms occur together. Contrary to how the term is sometimes used in conversation, this diagnosis does not describe someone who is highly emotional; it refers to someone who experiences these extended periods of mood and energy that are excessively high or excessively low, with normal periods in between.4 Bipolar disorder typically begins in adolescence or early adulthood. It is estimated to affect 2.8% of adults in the United States, with men and women equally affected.11 The exact causes of this disorder are unclear, but research shows that biological and environmental factors play a role.6 Genetics, trauma events or acute stress, and brain structure and function are thought to be contributing risk factors.2–9,11,12 Diagnoses: A double-edged sword The latest version of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) is the American Psychiatric Association’s professional reference book on mental health and conditions. It specifies 3 main bipolar diagnoses, which are based on the type, duration, and severity of mood episodes.3–6,8–10,12–16  Bipolar I disorder. Bipolar I disorder is characterized by 1 or more episodes of mania that last at least 7 days or when manic symptoms are so severe that hospital care is needed. Most people diagnosed with bipolar I disorder will have episodes of both mania and depression, though an episode of depression is not necessary for a diagnosis. Mixed episodes and rapid cycling—experiencing 4 or more episodes of mania or depression within a year—are also possible.2,4–6,12,14–16  Bipolar II disorder. Bipolar II disorder is defined by a pattern of depressive and hypomanic episodes, a less severe and more brief form of mania that doesn’t include psychotic episodes.4–6,11,12,14–16 People with this subset never experience a “full” manic episode and often spend extended periods in a persistent, low-grade depressive state. Notably, bipolar II disorder is not a “lesser” form of the condition; it is a separate diagnosis.4,10,17  Cyclothymia. Cyclothymia is a milder form of bipolar disorder involving many “mood swings,” with hypomania and depressive symptoms that occur frequently but are not intense enough or do not last long enough to qualify as hypomanic or depressive episodes.2,4–10,15,16 Diagnoses of “specified” and “unspecified” bipolar and related disorders are given when a person does not meet the criteria for bipolar I disorder, bipolar II disorder, or cyclothymia but has still experienced periods of clinically significant abnormal mood elevation.2,5,10,12,18 Specifying these subdiagnostic categories is important because they help mental health practitioners provide a standardized and more dimensional way to assess symptoms and their severity, ensuring that people receive the most appropriate and effective treatment.19,20 However, many experts say that this dichotomous perspective (ie, you have bipolar disorder or you don’t—there is no middle ground) fails to capture the wide spectrum of bipolar experiences. This can lead to misdiagnoses, underdiagnoses, ineffective treatment, and delayed care. A growing number of researchers, practitioners, and clinicians argue that having a spectrum-based approach to diagnosing bipolar disorder would capture this nuance.8,10,19–24 Signs and Symptoms Symptoms of bipolar disorder fall into 2 categories, mania and depression, and can include:2–7,11,14–16,24  Symptoms of a manic episode: Feeling very up, high, elated, extremely irritable, or touchy Feeling jumpy or wired, or being more active than usual Racing thoughts Decreased need for sleep Talking fast about a lot of different things (“flight of ideas”) Excessive appetite for food, drinking, sex, or other pleasurable activities Feeling able to do many things at once without getting tired Feeling unusually important, talented, or powerful Symptoms of a major depressive episode:  Feeling very down, sad, or anxious Feeling slowed down or restless Trouble concentrating or making decisions Trouble falling asleep, waking up too early, or sleeping too much Talking very slowly, feeling unable to find anything to say, or forgetting a lot Lack of interest in almost all activities Unable to do even simple things Feeling hopeless or worthless, or thinking about death or suicide   Overlapping symptoms:  Difficulty maintaining work responsibilities, social activities, or relationships However, no case of bipolar disorder looks exactly the same. Changing mood states don’t always follow a set pattern, and symptoms and their severity can vary.2,14 A person with bipolar disorder can have distinct manic or depressed states. They also may experience the same mood state several times with periods of euthymia, a neutral space between manic and depressive episodes often associated with a reduction in symptoms, in between.14,25–27 People can also have extended periods, even years, without symptoms or experience both extremes simultaneously or in rapid sequence.2–7,11,12,14–16,21 Still, bipolar disorder is a chronic condition that can be treated and managed in several ways. Treatment and Outcomes Just as the symptoms of bipolar disorder look different from person to person, the long-term path of mood disorders also varies. Some people’s symptoms might improve over time, while others’ might worsen. Because it is a chronic illness with often recurring mood episodes, ongoing preventive treatment is recommended.6,29 Some patients might get well without medication, but that is not possible for everyone, especially for those with more severe forms of bipolar disorder. Medication, particularly mood stabilizers and antipsychotics, is often the mainstay of treatment, with the benefits often

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The Ripple Effect: 3 Ways Climate Change Affects Food Security

By Sarabeth Lowe, MPH Ms. Lowe is a Communication Specialist at the University of Delaware Disaster Research Center. The health impacts of climate change are well established. Researchers have long documented the direct, deadly impacts of global warming, such as laborers succumbing to heat exhaustion or people drowning in flood waters. However, a growing body of research is shedding light on the various indirect and far-reaching ways climate change affects health. One of these more subtle pathways is its impact on food security.1–4 What is food security? According to the World Bank Group, food security is achieved when “all people, at all times, have physical and economic access to sufficient safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life.”6 The United States Department of Agriculture echoes this sentiment, defining food insecurity as “limited or uncertain availability of nutritionally adequate and safe foods” or the “ability to acquire acceptable foods in socially acceptable ways.”6,7 Notably, food security is multifaceted with 4 main pillars (Table 1).5,8,9 Availability is the “supply” side of food security, such as levels of production and stock. Access means having equitable, unrestricted, and regular access to food; this can be impacted by the presence of food deserts, income, socioeconomic status, and food prices. Utilization involves the biological (ie, how your body uses the nutrients in your food, supporting your overall health and wellbeing) and logistical (eg, food preparation, diet diversity, and intrahousehold distribution, etc.) facets of food utilization. The fourth pillar is stability. Food insecurity isn’t static and can change over time in response to shifts in these 3 dimensions. Some of these specific factors include weather conditions, political instability, and economic factors (eg, unemployment, rising food prices).5,8,9 It’s difficult to overstate how tightly intertwined food security and climate change are. From farm to fork, various climatic factors, including drought, sea-level rise, and higher temperatures, affect the availability, quality, and affordability of crops and livestock that support our diet.4,9–11 Furthermore, the interactions between climate change and food systems are reciprocal and cyclical, meaning that their impacts go both ways; the function of our global food system is both a major driver of climate change and increasingly vulnerable to it.8–13 For example, natural hazards and extreme weather patterns related to climate change threaten the viability of agricultural practices, supply chains, and crop and livestock resilience.9 How does climate change affect food security? Crop yield. Increasing temperatures have wide-ranging impacts on food yields and production, especially as they relate to the damage and destruction of crops. The food system contributes more than 30% of the heat-trapping gases emitted by human activities globally each year.9,14 Though previous studies have suggested that climate change may lead to crop yield increases in some temperate regions in the near term, new research shows that increasing temperatures will decrease food production in the long term.9,15–18 Results from a 2025 study published in Nature suggest that every additional degree Celsius of global warming will decrease the world’s ability to produce food by 120 calories per person per day.16,17 For context, that’s about 4.4% of daily consumption. Research also shows that climate change will decrease the production of key heritage foods and staple crops, such as corn, maize, rice, and wheat.1,8,9,11–13,18  Livestock production is another component of our food system that has a negative environmental impact. It is also one of the leading industrial contributors to greenhouse gases, accounting for an estimated 14% to 18% of global emissions.8,19–21 The distribution of land use between the livestock and farming sectors is skewed, with some estimates showing that nearly 80% of the former is used to support domestic animal farms.19–21 This imbalance only worsens the other environmental impacts of the livestock industry, including deforestation, land degradation, soil erosion, natural resource depletion, biodiversity loss, and air, water, and land pollution from animal waste and industrial farm runoff.8,9,12,20,22–26 These downstream consequences contribute to food insecurity in several indirect ways, such as food quality and water contamination. Biodiversity. Several current agricultural practices undermine biodiversity, an important pillar of achieving food security.9,26–28 According to the United Nations Food and Agriculture Organization, agriculture drives almost 90% of global deforestation, a significant driver of habitat loss and, thus, plant diversity and species extinction.28,29 At the same time, the land being cleared to grow crops often employs monoculture farming (ie, planting a single crop species, such as corn, over large areas of land for consecutive seasons).28,30 Today, only a handful of plant species, including rice, wheat, and maize, account for the vast majority of global crop production.28,31–33 This reliance on a narrow set of crops undermines our food system’s resilience and makes it extremely vulnerable to pests, pathogens, and climate extremes. An example of this is the 19th-century Irish potato famine, when reliance on a single crop with low genetic variation led to catastrophic agricultural losses due to disease.28,34–36 Biodiversity is a natural buffer against environmental changes. For example, greater plant diversity can help compensate for fluctuations in other crop yields, enhance ecosystem resilience, improve soil health, and attract more pollinators, which support and strengthen the growth of other important crops.28,36,37 A variety of animals, including insects, livestock, fish, and ruminants, also support food security. While they are important sources of meat, other animal byproducts, such as eggs and milk, also support a balanced diet and provide numerous critical micronutrients.37–39 Nutrient content. Climate change has spurred environmental conditions that have decreased the nutritional value and safety of certain crops.1–3,8,9,11–14,40–45 A groundbreaking meta-analysis published in 2025 looked at 32 nutrients across 43 different crops and found that rising levels of carbon dioxide (CO2) in the atmosphere caused a clear shift in plant composition across a wide range of species.41,42 Higher CO2 levels have increased plants’ carbon uptake, which increases the amount of carbohydrates, like sugars and starch, while decreasing the amount of protein and critical nutrients, such as iron and zinc. Put simply, each bite of food is becoming comparatively higher in calories but lower in nutrients. 

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Gone, Gone, Gone: Pharmacy Deserts—and Their Implications for Public Health—Are on the Rise

By Sarabeth Lowe, MPH Ms. Lowe is a Communication Specialist at the University of Delaware Disaster Research Center. If you’ve ever been stuck in a line at your local pharmacy, it’s easy to feel frustrated. But before you let out that sigh building in your chest, take a moment to cultivate some patience. Pharmacists do more than dispense medication and vaccinations; they are a wealth of knowledge and uniquely qualified to provide fast, accurate, and reliable medication advice.1–5 As an added bonus, they’re accessible and one of the most trusted professions in the country.6,7 In a world where Americans visit their pharmacy nearly twice as often as other healthcare providers and health costs continue to skyrocket, the role of your local pharmacist might be more important than ever.1–5,7–10  Even though these professionals are an important pillar of our public health system, pharmacists are easily overlooked and underappreciated. In addition to their considerable work responsibilities, community pharmacy staff also experience high rates of verbal abuse, physical aggression, crime, and other forms of workplace violence, a global trend that continues to rise.11–13 At the same time, another worrying trend is well underway: the number of pharmacies continues to shrink. What Is a Pharmacy Desert? Between 2010 and 2021, more than 26,000 pharmacies in the United States were shuttered – that’s nearly one-third of all retail locations or about one pharmacy in every town in America.1,3,9,14 Since 2021, CVS, Rite Aid, and Walgreens – 3 of the largest drugstore chains in the country – have closed more than 3,000 locations.15–17 With more of these closures slated in the coming years, more Americans will be living in pharmacy deserts, a reality that has significant and dangerous implications on public health.1,3,9,17,18 Much like food deserts – areas where people lack access to affordable, healthy food – “pharmacy desert” is a term used to describe a community with too few pharmacies to support its population.19–22 The exact definition has evolved over the years to help capture more barriers, such as physical distance, that impede access to these critical health care fronts. According to a 2025 study published in JAMA, 17.7% of Americans live in a pharmacy desert, and nearly 9% of people live in an area served by a single pharmacy. The same study also found that these disparities were especially pronounced in small rural areas and less populous states, including New Hampshire, South Dakota, West Virginia, Maine, and Vermont.19,20 An Evolving Role Whether it’s a corporate chain operation or a mom-and-pop business, the role of community pharmacies, and pharmacists, has evolved.18,23,24 Stores that once served as simple pickup points have evolved into hubs for health, wellness, and retail. The same advancement can be said for the professionals working those storefronts. Pharmacists today do more than dispense prescriptions and consult with physicians and patients; they give vaccinations, advise clients on potential medication interactions, help people manage chronic conditions, perform health screenings, test for infectious diseases, provide access to contraceptives, and educate the public on various health matters.25 The role of pharmacists in preserving public health has been greatly expanded over the years, especially since the COVID-19 pandemic. This has been true at both the state and federal levels. A bipartisan law aimed at expanding pharmacists’ scope of practice, H.R. 3164: Ensuring Community Access to Pharmacist Services Act, is working its way through Congress.26–28 Some experts say that granting pharmacists full practice authority would be a boon to public health because it could help mitigate the effects of a shrinking pharmacy workforce and compensate for the decrease in primary care providers.29,30 Such a law could expand access to preventative health services, improve the management of common illnesses and chronic diseases, and streamline testing and treatment for a wide range of conditions.23–25,29,30 However, other authorities, including the American Medical Association, argue that expanding pharmacists’ scope of practice (without physician oversight) would lead to “siloed, delayed and incomplete care,” ultimately resulting in worse patient outcomes and higher healthcare costs.26 Why It Matters In addition to providing all of the services mentioned above, local pharmacies facilitate greater access to healthcare, which is especially relevant and significant because it helps strengthen health equity, a state in which everyone has a fair and just opportunity to attain their highest level of health.2,4,5,31–34 Achieving this requires more than just throwing resources at a problem—it calls for focused, ongoing societal efforts to address historical and contemporary injustices, remove obstacles to health and healthcare, and eliminate preventable disparities. A local pharmacist who is already deeply embedded in the community and familiar with its needs can meet people where they are.35,36 In doing this, pharmacies anchor our health system.3 About one-third of Americans—nearly 100 million people—don’t have a primary care provider.1,37,38 Local pharmacists help fill that gap. When the neighborhood pharmacy shuts its doors, people lose access to an important healthcare and literacy resource, and they can fall through the cracks.  Research shows that pharmacy deserts are more common in marginalized and medically underserved communities.2,4,5,9,14,18–22,25,31,35 This only reinforces inequities and accelerates health disparities. Missing medication refills might seem inconsequential, but small actions like that have ripple effects across the healthcare system. Pharmacy deserts can lead some people to delay preventive screenings or forgo care altogether. For example, for people with chronic conditions, like diabetes, heart disease, or asthma, skipping a dose of medication could land them in the hospital or lead to a life-threatening emergency. In 2024, retail pharmacies distributed more than 1.5 million prescriptions of naloxone (Narcan),39 the life-saving overdose prevention drug, and the approval of over-the-counter (OTC) naloxone may have contributed to reduced costs.40 In general, pharmacy deserts will lead to poorer health outcomes and disproportionately impact disenfranchised and marginalized populations.2–5,9,17–22,31,36,37 Unfortunately, it’s these vulnerable groups that bear the brunt of the consequences.  What To Do If Your Pharmacy Closes  Pharmacy closures can be stressful, especially if you take medications regularly or live in an area with limited healthcare options. Luckily, there are a few steps you can take to prepare for this

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All About Tonsils

Most people don’t give much thought to their tonsils. Hidden in the back of the throat, these tiny organs are out of sight and out of mind. Often, it isn’t until something goes wrong with their tonsils that people pay them much mind. They were even once thought to be vestigial structures. Tonsils, however, are more than meets the eye. In this article, we will review the tonsils’ function and anatomy, relevant health conditions, and more. Quick Facts About Tonsils Tonsils are part of the immune system and help detect pathogens Located in the back of the throat within the pharynx Made up of mucosa-associated lymphoid tissue (MALT) Include four types: palatine, pharyngeal (adenoids), lingual, and tubal Common conditions include tonsillitis, tonsil stones, and peritonsillar abscess In some cases, surgical removal (tonsillectomy/adenoidectomy) may be necessary What Do Tonsils Do? Tonsils are a group of tissues that serve as the body’s first line of defense against pathogens entering through the nasopharynx and oropharynx, which are tubes that connect your nose and mouth to your throat.[1] This collection of tissue is known as mucosa-associated lymphoid tissue (MALT). MALT has a specific and important role in helping the body fight infection. How Tonsils Support the Immune System Its primary function is to participate in the secondary immune system by sampling antigens and local pathogens that enter the mouth and nose and stimulate further immune response.[2]  Anatomy of the Tonsils Understanding where tonsils are located and how they are structured helps explain their role in protecting the body. Types of Tonsils and Their Location The body has four different types of tonsils all located in the pharynx, which is the upper part of your throat located behind your nose and mouth.[3] Palatine Tonsils: Most people are familiar with the palatine tonsils. This fleshy, oval-shaped pair sits far in the back of the throat on either side of the uvula. It is the only set you can see without assistance.[4],[5] The Pharyngeal Tonsil: a single tonsil also known as the adenoid, is located in the nasopharynx above and behind the soft palette. Lingual Tonsils: The third set of tonsils, which are located at the base of the tongue, are the body lingual tonsils. Tubal Tonsils: Finally, tubal tonsils are set in the nasopharynx wall near the opening to our eustachian tubes, which connect the middle ear with the nasal-sinus cavity.[1] What Is Waldeyer’s Ring? Together, these tonsils form a circular band at the back of the throat called Waldeyer’s ring. Their unique ringed arrangement allows them to effectively guard the entrance to the digestive and respiratory systems, two of the body’s most important systems that interact with the outside world.[5]–[7]  Normal Size and Appearance Healthy palatine tonsils are pink or red in color and don’t take up much room in the throat.[4] While their size might vary slightly across the general population, most end up being about the size of a lima bean in adulthood.[1],[3],[8] Tonsil Structure (Crypts and Surface) One characteristic that does not change across the lifespan is their irregular surface. Some people might be surprised to find that ridges and small “holes” called crypts line their tonsils. These folds are typical and naturally occurring. However, it is this anatomical structure, as well as their role in the immune system, that makes the palatine tonsils and adenoid susceptible to infection. Common Tonsil Conditions Redness and inflammation are two trademark signs that the palatine tonsils are infected by a virus or bacteria.[1],[3],[5]–[8] Sometimes, adenoids become infected and swell simultaneously. These symptoms can cause significant pain and even obstruct breathing and swallowing. While several conditions can affect this organ, tonsillitis, tonsil stones, and peritonsillar abscesses are the most common. Tonsillitis What Is Tonsillitis? Tonsillitis is a generic term that describes swelling of the palatine tonsils.[6]–[11] It is the most common condition affecting these organs and is more common among children than adults.[3],[5],[10] About 70 percent of these cases are caused by viruses, such as the flu and the common cold, but bacterial infections can also cause the tonsils to swell.[1],[9] Symptoms Inflammation and redness are the most common signs of tonsillitis, but other symptoms, including throat and ear pain, swollen glands, fever, bad breath, chills, and a white or yellow coating on your tonsils, can also be present.[11],[12] Types These cases fall into three categories: acute (isolated cases where symptoms last between 3–14 days), recurrent (multiple cases per year), and chronic (cases where symptoms last more than 14 days).[1],[3],[9]–[14] Treatment Treatment for tonsillitis often depends on the severity of frequency of infection. Most cases can be treated at home with salt water or medicated gargles, over-the-counter pain medicine, increasing indoor humidity, and drinking warm liquids.[15] A doctor will only prescribe antibiotics when tonsillitis is caused by a bacterial infection, such as strep throat. Tonsil Stones What Are Tonsil Stones? Tonsil stones, or tonsilloliths, are small white or yellow pebble-like lumps that appear on the surface of palatine tonsils. These deposits are typically unilateral, appearing on either the left or right tonsil, and are made up of bacteria, food debris, and minerals, like calcium, that harden and lodge in the ridges and crypts.[13]–[16] Tonsilloliths are relatively common, with most cases occurring in adulthood and people with recurrent tonsillitis.[17] Cases are usually innocuous and sometimes asymptomatic. However, their side effects can be a nuisance. Symptoms The most common symptom is bad breath, but some people also develop a cough, sore throat, or difficulty swallowing.[14],[15],[18] Treatment As with tonsillitis, removing tonsil stones usually does not require visiting a doctor. Some studies suggest gargling salt water or manually dislodging them with a water flosser, but most cases resolve over time without intervention.[13],[14] Larger or recurrent stones, however, may require removal by an otolaryngologist, a healthcare provider who specializes in ear, nose, and throat disorders. Peritonsillar Abscess What Is a Peritonsillar Abscess? Also known as quinsy, peritonsillar abscess (PTA) is a bacterial infection that causes pus to collect next to the tonsils in the back of the throat.[1],[3],[19]–[22] It

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Know Your Nutrient

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