Nezam El-Tayebat Fact CheckA scientific assessment of the “نظام الطيبات” nutrition system
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Potentially true Overinterpreted Certainty of evidence: low provisional C-ORG-04

Tonsillectomy increases autoimmune disease by 34% (Ji 2016, 179,875 Swedish patients).

In short: The 34% figure is quoted correctly and a similar association has been found in Korea, but it is not shown that tonsillectomy causes autoimmune disease; shared family factors explain at least part of such links, and the absolute increase is small.
Conclusion: The association is real and replicated, but it is not shown that tonsillectomy causes autoimmune disease.
  1. Original statement
  2. Scientific assessment
  3. Scientific evidence in detail
  4. In plain language
  5. Studies on this claim
  6. Regional context
  7. What applies in my country?
  8. References

Original statement

ودعمت دراسة جي السويدية على 179,875 مريضاً ارتباطاً بزيادة 34% في أمراض المناعة الذاتية

verbatim according to source. Translation by the project; the Arabic wording is authoritative.

Translation

Tonsillectomy increases autoimmune disease by 34% (Ji 2016, 179,875 Swedish patients).

Origin

Source status
Archive editors
Attribution
Archive editors (eltayebat.com); not necessarily Elawady's own words
Origin
https://eltayebat.com/rule/unnecessary-organ-removal/
Attribution uncertainty
Editorial summary/narrative and study selection written by the archive operators; the archive states that the cited research documents harm independently of Dr. Diaa's words.
Claimed mechanism

Immune dysfunction after tonsil removal.

Claimed health effect

Autoimmune disease.

Population concerned

Tonsillectomized persons

Geographic restriction by Elawady

not applicable

Scientific assessment

Potentially true – Some evidence points in favour of the statement, but it is not sufficient for a clear judgement.

Certainty of evidence: low – Further research is likely to change the assessment considerably.

1. What was claimed?

34% more autoimmune disease after tonsillectomy.

2. What is demonstrably correct?

SIR 1.34 (1.30-1.37) is reported (A-ORG-02).

3. What is wrong or exaggerated?

The design compares with the general population, not with similar people who did not have surgery; recurrent infections and immune predisposition leading to tonsillectomy could explain the association.

4. What remains unclear?

Whether tonsillectomy itself causes autoimmune disease or whether people who need the operation share an immune or family predisposition (I-ORG-124 suggests at least part of the link is familial).

5. Which studies support it?

A-ORG-02 (SIR 1.34 vs general population); I-ORG-123 (independent Korean national cohort, HR 1.32, 95% CI 1.23-1.41, versus non-operated children with tonsil disease; 86.5 vs 65.3 cases per 100,000 person-years).

6. Which studies contradict it?

I-ORG-124 (Danish family study: relatives of tonsillectomised people also had more Crohn's disease, RR 1.22 for first-degree relatives, arguing against a direct causal effect; limited to inflammatory bowel disease).

7. What applies to Germany and Europe?

Most cited cohorts are Scandinavian (Denmark, Sweden) and directly European; RCTs from the UK and Finland are directly transferable. Guidelines in Europe also emphasize defined indications (not verified here in detail).

8. What is known about Egypt?

No Egypt-specific data on rates or outcomes of tonsillectomy, cholecystectomy, hysterectomy, splenectomy or thyroid surgery were identified in this review.

9. What practical conclusion is appropriate?

A signal worth further study; not proof of harm.

Assessment details

Rationale for certainty of evidence

The association is now replicated: Ji 2016 (A-ORG-02, Sweden, SIR 1.34 vs general population) and Chang 2026 (I-ORG-123, Korea, HR 1.32 vs children with tonsil disease who were not operated). Causation remains unproven: a Danish family study (I-ORG-124) found higher inflammatory bowel disease risk also in relatives of tonsillectomised people, pointing to shared family factors. Observational evidence only; low certainty for the association, very low for causation.

Source quality

Arabic narrative correctly says 'association' (ارتباطاً); English says 'added a 34% rise' (causal-sounding).

Regional transferability

Swedish data.

Individual exceptions

n/a

Regional scope of the claim
general (biological/medical)
Last reviewed
26 October 2026 provisional

Scientific evidence in detail

Overinterpreted – A real finding exists, but the claim draws more from it than the data allow (e.g. association taken as cause, animal data applied to humans, small effect presented as large).

Research question: Does tonsillectomy increase the risk of autoimmune disease (about 34% higher)?

Research question in detail (PECO)
Population
People who underwent tonsillectomy
Intervention or exposure
Tonsillectomy
Comparison
General population; non-operated people with tonsil disease; relatives
Geographic scope
universal biology
Outcomes
  • Autoimmune diseases
  • IBD

Study results as reported by the authors. Our assessment follows below.

What speaks for the claim?

What speaks against the claim?

What does the overall evidence say?

Editorial assessment based on the studies above – not itself a study result.

Which position is better supported?

The association (about 30% relative excess) is real and now replicated in two countries; whether tonsillectomy causes it is not established, and a family study suggests shared susceptibility explains at least part.

Why some studies weigh more

Replication across Sweden and Korea strengthens the association; the family design is the best test of causality available.

Is a causal relationship established? Possible, not established Plausible immunological role of tonsils, but familial confounding shown for IBD.

Remaining uncertainty

Causal share; absolute risk is small (about 1 extra case per 4700 person-years).

Justified conclusion

Association correctly quoted; 'increases' (causal) is not proven.

Why do studies seem to disagree?

Chang/Ji (association) and Bager (family confounding) do not truly conflict: both find an association; Bager shows that it appears even without own surgery.

Does this depend on the country?
General biological effects
Universal.
Eating habits
Not relevant to this claim.
Origin of the food
Not applicable.
Contaminants
Not applicable.
National production conditions
Not applicable.
Legal rules
Not applicable.
Actual monitoring data
No Egypt-specific monitoring data identified.

A regional difference that changes the conclusion is not supported by robust data.

Statistical re-check
  • Is '34%' a correct reading of SIR 1.34? – Yes, relative excess vs general population (not an absolute risk) recalculated
  • Crude rate ratio and absolute excess – 1.32 crude (=HR); +21.2 per 100,000 PY recalculated
Certainty of the overall evidence (GRADE, simplified)
Main outcome
Autoimmune disease after tonsillectomy (association)
Starting level
low (observational studies)
Reasons for downgrading
  • risk of bias (confounding)
Reasons for upgrading
  • consistency across two national cohorts
Result
low

Simplified assessment by a single reviewer, following the GRADE approach; not a formal GRADE panel. GRADE rates the body of evidence for one outcome, not individual studies.

Search strategy

Documented literature searches for this review (search strings in the original database syntax).

DatabaseDateSearchLooking forHitsIncluded
Europe PMC26 October 2026(TITLE:tonsillectomy OR TITLE:adenotonsillectomy) AND (TITLE:autoimmune OR TITLE:"multiple sclerosis" OR TITLE:"inflammatory bowel" OR TITLE:"Crohn") AND (TITLE:"meta-analysis" OR cohort OR "population-based")both directions13

Open questions

Sibling-comparison studies for autoimmune disease.

How deeply was this checked?

3 linked studies: 0 checked in full text (0 of them with a structured risk-of-bias assessment), 3 on the basis of the abstract, 0 bibliographically only. No formal assessment with two independent reviewers and no independent human expert review has taken place yet.

Last scientific review: 26 October 2026

History of the verdict
  1. 25 October 2026 · Phase 1 · Initial assessment: Potentially true (very low)
  2. 26 October 2026 · Phase 4 (systematic evidence review) · Verdict changed: Potentially true (very low) → Potentially true (low)
    Certainty raised from very low to low because the association is now replicated in an independent national cohort with a disease-based comparison group (I-ORG-123). Verdict stays “Potentially true” because a Danish family study (I-ORG-124) indicates familial confounding, so causation remains unproven.
    New sources: I-ORG-123 I-ORG-124

In plain language

A Swedish study found 34% more autoimmune diseases in people who had their tonsils removed, and a large Korean study found a similar increase of about 32%. So the link is probably real. But a Danish study showed that even relatives of people who had the operation get some of these diseases more often, which suggests shared family factors rather than the operation itself. The extra risk per person is small.

Studies on this claim

Studies supporting the claim (2)

  • Sweden: autoimmune diseases after tonsil removal

    Ji J et al.. J Autoimmun 2016 · PMID 27344241 · DOI 10.1016/j.jaut.2016.06.007
    Cohort studycited by the Tayebat archiveabstract checked★ key study

    People who had tonsils removed were diagnosed with autoimmune diseases 34% more often than the general population.

    Tonsillectomy increases autoimmune disease by 34% (Ji 2016, 179,875 Swedish patients).

    Does the study support the specific claim? Partly · Methodological quality: low · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Autoimmunity

    How was the study done?

    Cohort vs population

    How many people, animals or samples were studied?

    179,875

    What was actually found?

    Higher incidence

    How large was the observed effect?

    SIR 1.34

    What do the results mean in everyday life?

    Possible link; cause unclear

    What are the study's limitations?

    No matched controls

    What does it say about Elawady's specific claim?

    Association only

    Do the results apply to Germany and Europe?

    European

    What can explicitly not be concluded from this study?

    Causation

    Scientific details →

  • Childhood tonsil surgery and later autoimmune disease in Korea

    Chang YS et al.. Front Med (Lausanne) 2026 · PMID 42643288 · DOI 10.3389/fmed.2026.1892240
    Cohort studyindependent cross-checkabstract checked★ key study

    Children who had the surgery later had about 32% more autoimmune diseases than similar children who did not, but this does not prove the surgery caused them.

    Replicates the association (HR 1.32) in an independent national cohort with a disease-based comparator.

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Check whether childhood tonsil/adenoid surgery is linked to autoimmune disease

    How was the study done?

    National cohort

    How many people, animals or samples were studied?

    84,030 operated and 336,120 non-operated children

    What was actually found?

    Autoimmune disease 86.5 vs 65.3 per 100,000 person-years

    How large was the observed effect?

    HR 1.32 (1.23-1.41)

    What do the results mean in everyday life?

    Small absolute increase; cause unclear

    What are the study's limitations?

    Claims data, residual confounding

    What does it say about Elawady's specific claim?

    Supports the association, not proof of causation

    Do the results apply to Germany and Europe?

    Moderate

    What can explicitly not be concluded from this study?

    Cannot separate surgery from underlying immune tendency

    Scientific details →

Studies contradicting or limiting the claim (1)

  • Tonsil removal and bowel inflammation: the family test

    Bager P et al.. Epidemiology 2019 · PMID 30461527 · DOI 10.1097/EDE.0000000000000946
    Cohort studyindependent cross-checkabstract checked★ key study

    Even relatives of people who had their tonsils out had more Crohn's disease, suggesting shared family factors rather than the surgery itself.

    Family members of tonsillectomised people also have higher IBD risk, arguing against a direct causal effect.

    Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Test whether the tonsillectomy-IBD link is causal

    How was the study done?

    National cohort with family linkage

    How many people, animals or samples were studied?

    7 million Danes

    What was actually found?

    Higher IBD risk after own and after relatives' tonsillectomy

    How large was the observed effect?

    Crohn RR 1.52 (own) and 1.22 (relative)

    What do the results mean in everyday life?

    The link is probably partly due to family factors

    What are the study's limitations?

    IBD only

    What does it say about Elawady's specific claim?

    Contradicts a causal reading of the claim

    Do the results apply to Germany and Europe?

    Directly applicable

    What can explicitly not be concluded from this study?

    Cannot exclude a small direct effect

    Scientific details →

Studies with mixed or unclear results (0)

No studies in this group.

Regional context

Germany / EU

Most cited cohorts are Scandinavian (Denmark, Sweden) and directly European; RCTs from the UK and Finland are directly transferable. Guidelines in Europe also emphasize defined indications (not verified here in detail).

Egypt

No Egypt-specific data on rates or outcomes of tonsillectomy, cholecystectomy, hysterectomy, splenectomy or thyroid surgery were identified in this review.

What applies in my country?

General scientific assessment

Potentially true The association is real and replicated, but it is not shown that tonsillectomy causes autoimmune disease.

This statement concerns biological or medical relationships. The scientific assessment above applies regardless of the country; country-specific food data do not change it.

References

  1. Tonsillectomy associated with an increased risk of autoimmune diseases: A national cohort study.. Ji J et al.. J Autoimmun 2016 · PMID 27344241 · DOI 10.1016/j.jaut.2016.06.007
  2. Association between childhood tonsillectomy and increased risk of autoimmune disease: a nationwide population-based cohort study.. Chang YS et al.. Front Med (Lausanne) 2026 · PMID 42643288 · DOI 10.3389/fmed.2026.1892240
  3. Increased Risk of Inflammatory Bowel Disease in Families with Tonsillectomy: A Danish National Cohort Study.. Bager P et al.. Epidemiology 2019 · PMID 30461527 · DOI 10.1097/EDE.0000000000000946

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