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Systemic Effects of Fluoridation

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Systemic Effects of Fluoridation JOM Volume 27, Number 3, 2012 Review Article 123 Systemic Effects of Fluoridation Michael Czajka1 1. PhD Candidate in Chemistry, School of Applied Sciences, RMIT University, Box 2476 GPO, Melbourne, Victoria, 3001, Australia Tel: 613-9925-2122, Fax: 613-9925-3747, Email: [email protected] Abstract !is review article is written from a food chemistry perspective. It focuses on the systemic ef- fects of "uoride (rather than the e#ects of "uoride on the teeth) since "uoride research concentrates largely on the teeth to the virtual exclusion of systemic e#ects. !is is surprising given that "uoride is a known systemic toxin. About 400 million people (~6% of the world’s population) drink "uoridated water. !e e#ect of "uoride on the teeth is topical (directly on the teeth) and not systemic, so drinking "uoridated water has no bene$t. Fluoride is a lipid soluble neurotoxin and enzyme poison. Fluoride accumulates in the pineal gland (9,000 ppm on average) and bone. Dental "uorosis is a marker for skeletal "uorosis. At 1 ppm 32 % of US children have dental "uorosis. At 1 ppm some sections of the population (e.g. infants) will ingest too much "uoride. Un"uoridated and "uoridated countries have similar rates of tooth decay. Given that "uoridation of water supplies is not necessary to maintain a reduction in tooth decay and that the side e#ects of ingestion are undesirable, the practice is likely to come under increasing scrutiny. More studies on the systemic e#ects of "uoride are urgently required. Introduction weight of 18.998 g/mol. Fluorine gas (F2) is Fluoride is added to water to protect yellow but does not exist in nature as it is too teeth against decay, yet it is considered a reactive. Fluorine is also the most electro- neurotoxin in the laboratory. Research about negative element. !uoride is primarily focussed on teeth with Fluoride (Figure 1, p.124) can be added little examination of other systemic e"ects to the water supply as hexa!uorosilicic acid (i.e., upon enzymes, bone, brain, thyroid, (H2SiF6), sodium ! uorosilicate (Na2SiF6, a pineal gland, etc). Maximum toxic dosages powder) or sodium !uoride (NaF, a powder). are unclear, as are maximum cumulative Water !uoridation is usually carried out us- dosages. Adding to the confusion, ! uoride ing hexa!uorosilicic acid (~23% in water), is considered non-toxic when added to wa- which is a by-product of the aluminum and ter, but toothpaste tubes have warnings to phosphate industries. seek medical help if you swallow even small Toothpastes most commonly contain amounts. Identifying !uorosis is di#cult and !uoride as sodium !uoride but also use stan- its symptoms can easily be mistaken for ar- nous ! uoride, sodium monophosphate or thritis or possibly chronic fatigue syndrome. ola!ur/decta!ur. As they are not normally Fluoride can be considered a food safety is- ingested they are not a signi$cant consider- sue since it is primarily ingested from water, ation when reviewing the systemic e"ects of and to a lesser extent, foods. !uoride. Almost all ! uoride research has been Fluorine Chemistry conducted on NaF (which dissociates into + - Fluorine (F) is element number 9 on the Na and F ). %e assumption has been that periodic table of elements and has a atomic H2SiF6 and Na2SiF6 dissociate into their 124 Journal of Orthomolecular Medicine Vol 27, No 3, 2012 Figure 1. Hexafluorosilicic acid (H2SiF6), sodium fluorosilicate (Na2SiF6), sodium fluoride (NaF), stannous fluoride (SnF2) and sodium monofluorophosphate (Na2PO3F) Sn2+ Na+ F- F- F- + - + +4 component ions (eg. H , F , Na and Si ) was changed to permit the voluntary ad- when diluted and raised to a pH of 7. If this dition of fluoride to bottled water at levels happened, the e!ects of NaF and other com- of 0.6-1.0 mg/L. Nutrient reference val- plexes would be comparable. However, at pH ues for ANZ populations have been es- 3, the majority of the F is complexed with Si. tablished for different age groups (Table "e e!ects of NaF are di!erent than those of 1, below). the Si complexes: no e!ect was noticed with NaF, but with Si-#uoride complexes lead Does Fluoride Occur Naturally? levels in the blood increased three times in Fluoride occurs naturally in some foods 3 rats. "is is because the pH of stomach acid and in water. "e #uoride levels in water of is around 2: the ions recombine and Si-#u- most countries are low. Countries like China oride complexes, as well as other complexes, and India, on the other hand, have many are produced. areas where the natural levels of #uoride in What levels are Permitted in Foods? water are high enough to cause crippling skeletal # uorosis. "e levels in breast milk Food Standards Australia and New average only 0.033 ppm even when #uoride Zealand (ANZ) do not list fluoride as a intake is high.5 Levels in fresh food are rarely recognized food additive. However, in a consideration, except in tea which can add July, 2009, the ANZ food standards code between 1-9 mg/day of #uoride.5-7 Table 1. Fluoride nutrient reference values for Australian and New Zealand populations4 Population Subgroup Adequate Intake/AI Upper Limit/UL (mg/day) (mg/day) Infants 0-6 months 0.01 0.7 Infants 7-12 months 0.5 0.9 1-3 years 0.7 1.3 4-8 years 1.0 2.2 9-13 years 2.0 10.0 14-18 years 3.0 10.0 Males Females Males Females Adults 19+ years (including 4.0 3.0 10.0 10.0 pregnant /lactating women) Systemic E!ects of Fluoridation 125 How Much Fluoride is in Water? to 80%).8 Many enzymes are a"ected by In Australian water, !uoride is permitted !uoride (e.g., Judd lists 66 enzymes includ- at up to 2 ppm although it is normally main- ing P450 oxidases and enzymes involved in tained at around 0.9-1.0 ppm. Using the UL neurotransmitter synthesis16). When 2-10 of 0.7 mg/day (Table 1) it can be seen that mg/day of !uoride was administered to 15 any bottle-fed infant will surpass the UL individuals with hyperthyroidism (over a for !uoride every day. %e National Health period of 20-245 days), six individuals had and Research Council Dietary Guidelines signi$cant clinical improvements marked by recommends against this practice.8 Other an amelioration of tachycardia and tremor, countries also warn against the use of !uori- and a ceasing of their weight loss.17 %e dated water for bottle fed infants and other reduction in basal metabolic rates was at- high risk groups (e.g., dialysis patients),9 yet tributed to ! uoride inhibiting the thyroid ANZ food standards consider this practice iodide-concentrating mechanism.17 Similar to be safe and have stated on their website: daily intakes of !uoride might also have ad- “Bottled water with added !uoride is safe for verse e"ects upon the basal metabolic rates everyone and can be used to make up infant of euthyroid (i.e., normal thyroid function) formula.”10 individuals. How is Fluoride Increased In Foods? How Does Fluoride Interfere with Boiling water concentrates !uoride (by Enzymes? evaporation).11 Processing foods often in- Fluoride can interfere by attaching it- crease the amount of ! uoride (e.g., adding self to metal ions located at an enzyme’s ac- !uoridated water to a soup or reconstituting tive site or by forming competing hydrogen fruit juice using !uoridated water). bonds at the active site. Energy production is a"ected when this occurs. Fluoride might, Can Fluoride Be Removed? therefore, be a pathogenic factor in caus- %e simplest method of removing !uo- ing clinically signi$cant problems, such as ride is distillation.11 Reverse osmosis is also weakness, drowsiness, and cognitive impair- highly e"ective.11 Both these methods re- ment.18 move all other minerals from the water as well which may not be desirable. Activated Is Dental Fluorosis a Marker for Fluorosis? alumina (Al2O3) cartridges are an alternative It is also known that crippling skeletal method.11 Cartridges require regular chang- !uorosis is caused by excessive !uoride in- ing but there is no easy way to tell when this gestion (Figure 2, p.126). %us, dental !uo- should occur. rosis is a marker for skeletal ! uorosis and other serious physiological e"ects. Even at At What Dose Does Fluoride Have low levels of 1 ppm, 32% of US children are Undesirable Physiological E!ects? a"ected by dental !uorosis.19 Crippling skel- %e National Health and Medical Re- etal !uorosis may be produced by levels of search Council of Australia has deemed 10-20 mg/day over 10-20 years.20 10 mg/day of !uoride as the UL,8 but few toxicological studies have been carried out to What About Less Serious Fluorosis? prove this. Most studies have concentrated Fluoride levels of 0.9 ppm in naturally on the teeth and fewer studies on rest of the occurring water supplies (Xinjiang region of body. %e organs mostly a"ected by !uoride China, Hentian prefecture) may a"ect peo- include the brain,12,13 thyroid, parathyroid ple who are iodine de$cient, causing hear- and adrenal glands,14 and the pineal gland.15 ing loss, mental retardation and bone retar- However, !uoride concentrates in the bones dation.21 It is likely that iodine and !uoride (i.e., about 50% of ingested ! uoride is re- compete for similar binding sites in the hu- tained, but young children may retain up man body.
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