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A recent post on the Nutrition and Physical Regeneration blog caused me to wonder about the safety of water fluoridation. Is it really necessary or safe?

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great question, something seemingly so innocent as our own water supply should be investigated. Not just fluoride, but chlorine too (which seems to be even more universally administered to the water supply than the former). – Louisa Mar 13 2010 at 7:22
My husband and I stopped drinking fluorinated water for over 7 years now, 6 years before we went Paleo. Our teeth are always fine, according to the dentist! – Lady_Arwen Nov 8 2011 at 18:38

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NO! I read this article (also cited at the bottom of the blog post you mention), a few years back, it was the one piece of reading that finally convinced me to avoid fluoridated water at all costs, I will now never give fluoride toothpaste to my children or use it myself, it is also interesting to note that fluoride is present in mechanically deboned meat, which I also avoid:

Fluoride has been shown to be mutagenic, cause chromosome damage and interfere with the enzymes involved with DNA repair in a variety of cell and tissue studies (Tsutsui 1984; Caspary 1987; Kishi 1993 and Mihashi 1996). Recent studies have also found a correlation between fluoride exposure and chromosome damage in humans (Sheth 1994; Wu 1995; Meng 1997 and Joseph 2000).

Animal experiments show that fluoride accumulates in the brain and exposure alters mental behavior in a manner consistent with a neurotoxic agent (Mullenix 1995). Rats dosed prenatally demonstrated hyperactive behavior. Those dosed postnatally demonstrated hypoactivity (i.e. under activity or "couch potato" syndrome). More recent animal experiments have reported that fluoride can damage the brain (Wang 1997; Guan 1998; Varner 1998; Zhao 1998; Zhang 1999; Lu 2000; Shao 2000; Sun 2000; Bhatnagar 2002; Chen 2002, 2003; Long 2002; Shivarajashankara 2002a, b; Shashi 2003 and Zhai 2003) and impact learning and behavior (Paul 1998; Zhang 1999, 2001; Sun 2000; Ekambaram 2001; Bhatnagar 2002).

Five studies from China show a lowering of IQ in children associated with fluoride exposure (Lin Fa-Fu 1991; Li 1995; Zhao 1996; Lu 2000; and Xiang 2003a, b). One of these studies (Lin Fa-Fu 1991) indicates that even just moderate levels of fluoride exposure (e.g. 0.9 ppm in the water) can exacerbate the neurological defects of iodine deficiency.

The only government-sanctioned animal study to investigate if fluoride causes cancer, found a dose-dependent increase in cancer in the target organ (bone) of the fluoride-treated (male) rats (NTP 1990). The initial review of this study also reported an increase in liver and oral cancers, however, all non-bone cancers were later downgraded – with a questionable rationale - by a government-review panel (Marcus 1990). In light of the importance of this study, EPA Professional Headquarters Union has requested that Congress establish an independent review to examine the study's results (Hirzy 2000).

Once fluoride is put in the water it is impossible to control the dose each individual receives. This is because 1) some people (e.g. manual laborers, athletes, diabetics, and people with kidney disease) drink more water than others, and 2) we receive fluoride from sources other than the water supply. Other sources of fluoride include food and beverages processed with fluoridated water (Kiritsy 1996 and Heilman 1999), fluoridated dental products (Bentley 1999 and Levy 1999), mechanically deboned meat (Fein 2001), teas (Levy 1999), and pesticide residues on food (Stannard 1991 and Burgstahler 1997).

The early studies conducted in 1945 -1955 in the US, which helped to launch fluoridation, have been heavily criticized for their poor methodology and poor choice of control communities (De Stefano 1954; Sutton 1959, 1960 and 1996; Ziegelbecker 1970). According to Dr. Hubert Arnold, a statistician from the University of California at Davis, the early fluoridation trials "are especially rich in fallacies, improper design, invalid use of statistical methods, omissions of contrary data, and just plain muddleheadedness and hebetude." In 2000, the British Government’s “York Review” could give a no fluoridation trial a grade A classification – despite 50 years of research (McDonagh 2000, see Appendix 3 for commentary).

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Flouride toothpaste shouldn't be used by hypothyroid people- it interferes with meds. – henny Mar 13 2010 at 14:12
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As the parent of a child who died from osteosarcoma (bone cancer) I was horrified to find out the background of fluoride. It has been shown in scientific research for quite a long time that fluoride causes or contributes to this deadly disease. Chris Bryson's book "The Fluoride Deception" carefully shows how and why water fluoridation was and is promoted. Europe stopped the practice over a decade ago because of the harm to health. I wrote a book about our experiences titled "How to Survive (and Thrive) In a Toxic World by Jeannette Russell hoping to help other parents avoid our tragedy. It is available on Amazon.

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Water fluoridation is an illogical concept: it is to help with tooth decay, yet we are swallowing it! Fluoridated toothpaste has already solved the issue of applying fluoride to the teeth without the need to ingest it.

There is no known nutritional requirement for flouride. If you are eating paleo, there is little point in fluoridating your teeth.

But the question still remains: is fluoridated water harmful to health?

One thing to consider for health issues is: what does Europe do? Europe generally takes a precautionary approach to health- things are supposed to be proven save. They also aren't as biased as the U.S. on this issue. Our government has been championing fluoridation and CDC lists water fluoridation as one of the 10 greatest public health achievements of the last century. This means that just like the "saturated fat is evil" dogma, fluoridation is now something that has to be defended, regardless of the reality of the science. Water fluoridation is almost non-existent in Europe.

The most common form of fluoride placed in our water is a toxic industrial waste product (they have found a cheaper way to get rid of it now!), not the same as the forms found naturally in water.

We do know that fluoride is highly reactive, and one direct effect is that it can make bones more brittle. It also competes with iodine, creating thyroid issues. Ironically it actually damages the teeth of children (fluorosis). Everything we know about it tells us it is a toxin to our body. Our body is more than capable of handling small amounts of toxins, but we are probably all overloaded now.

The only question that I think remains is: how bad is it? Maybe not that much. Maybe some people are very sensitive. Fluoride is something we should work to eliminate from the water supply (your are being taxed for this privilege), and something that for optimal health we should avoid. You may have higher priorities, especially considering the cost and hassle of filtering fluoride.

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Agree with most of what you said, except re elemental fluoride (fluorine). Elemental fluorine (F2) is unstable, so most fluorine, either industrial or in nature, is in the salt, or ionic form (F-, or fluoride ion). – Ed Mar 14 2010 at 19:18
thanks for the correction, I was getting my technical terms messed up – HealthRediscovery Mar 14 2010 at 20:15
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To the anti-libertarians, with respect:

I'm always curious when I read someone's opinion that seems to be coming from a place of concern, yet ends with forcing others to participate and/or fund initiatives they feel are worthy.

I am reminded of Auberon Herbert's quote: "By what right do men exercise power over each other?"

And the argument that we got here somehow ("the world we inhabit") doesn't hold water - doing something immoral until it is habit does not make it charity.

Zev, just because you think there's a place for "science-based public health policies" [sic], by what right do you presume to force measures on others? I don't know you personally, but I think it would be safe to assume you wouldn't directly force your neighbor into participating in such a scheme, or funding it. But using a third party enforcer, government, is somehow okay? How?

Also, I'd be happy to consider evidence of the overwhelming success of fluoridation. I would think that bar would have to be pretty high to justify medicating entire populations. For some science on it, here is another article, by Donald Miller, Jr., MD. There are good references at the end of his article.

Dave Mc

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jdr.sagepub.com/cgi/reprint/82/5/ --overwhelming success in Ireland. "sic?" where's my misspelling? thanks for the link, though, Dave--I'm still not seeing a fluoride-caused epidemic, and this still seems like a fringe, non-urgent issue. – Zev Averbach Mar 15 2010 at 15:56
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Sorry, Zev, it's the cynic in me - "science-based public health policies" seems like an impossibility. My point is that I don't care whether there is a epidemic or not, the issue is whether you get to choose to be medicated or not. Would you feel the same about mandatory vaccination? Or how about mandatory statins for people once they reach a certain ldl level? It is the principle at work here, IMHO... – Dave Mc Mar 17 2010 at 16:39
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In my opinion after reading articles such as the above, I don't think flouride should be added to water supplies. There is no freedom of choice when that is done.

Anyone who wishes to use flouride can have it applied topically at the dentist. Anyone who doesn't want to have it shouldn't have to drink it unwillingly.

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AnnaA, that is just too much common sense, don't ya think? :-) – Michael Mar 13 2010 at 6:36
Common sense is my forte! KISS too- keep it simple stupid – henny Mar 13 2010 at 14:10
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I regard the fluoridated water concern as very much on the fringes of health and nutrition debates, lying somewhere between "wifi allergies" and homeopathy.

Pardon my knee-jerk, civilian take on it. I acknowledge the quantity of references provided in Louisa's answer, and I concede my inability to gauge their quality with anything approaching expertise.

However, my general impression is that the animal studies use megadoses of fluoride that would never take place in human populations. Furthermore, fluoride is naturally present in groundwater in many places around the world; this lends itself to speculation, at least, that some of our paleolithic ancestors consumed it without catastrophe--unless someone has dug up caveman bones with skeletal fluorosis?

Finally, my intuitive scoffing at this issue is based on the paranoid nature of many of the websites that scream about it: Their cherry-picking of facts and the general tone is not unlike 9/11 Truth, Obama "Birthers", FEMA camps: "Our government is poisoning us," etc.

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Hi Zev. Some conspiracy theories are true. Government entities are capable of grave errors and, at times, intentional evil. Since government controls much of our water supply, education system, health care and economy, it's healthy to be deeply skeptical of government-backed conventional wisdom. For example, it's mostly federal funding that has propped up the moribund "cholesterol hypothesis." – Ed Mar 13 2010 at 18:17
Agreed regarding the grave errors--further agreed regarding intentional evil: the Muskegee and Agent Orange episodes come to mind. However--with all due respect--I'm not seeing a preponderance of credible evidence for this being an example of either. – Zev Averbach Mar 13 2010 at 18:25
I think you meant Tuskegee - the syphilis experiments. – rht Mar 15 2010 at 1:47
thx--indeed, Tuskegee. – Zev Averbach Mar 15 2010 at 15:42
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Zev: I tend to agree but I would like the option of non-fluoridated tap water which is all I drink, after running it through a Brita filter which does not remove it. I'd have to install an expensive reverse-osmosis system or something, and as mentioned above it should be an opt-in thing: if you really think you need it, have the dentist apply a topical treatment, or use fluoridated toothpaste.

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I agree with AnnaA above - medicating a whole population without their consent is bullsh*t.

Good ole Murray Rothbard has a decent review of the issue here.

Dave Mc

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I had always been a skeptic when it came to the dangers of water fluoridation. Seemed like it could have been a bunch of fear mongering, as more often than not the Nazis were brought up during a discussion of the subject.

That all changed this week. I was having to drink more and more water recently, to the point where it seemed like I was always thirsty. As a result, I was having to make a trip to the bathroom about every hour. The endless thirst was really starting to get old.

I did a little research and decided to try some distilled water. Night and day. I've normally refilled my 12 oz glass of water about 3 or 4 times by now. I've yet to refill it. I had gained a some weight recently and was having trouble shedding this as a result of hunger cravings that really made no sense knowing what I know about physiology (thanks to you good people) and what I was eating. Cravings gone.

Here is a link to a tragic video about fluoride-poisoned horses:

http://www.youtube.com/watch?v=t9RXfOuylWo

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I don't think so. I liked this paper on the topic from THINCs member Dr. Joel Kauffman.

http://www.jpands.org/vol10no2/kauffman.pdf

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As I understand it, fluoride occurs naturally in water in both greater and lesser quantities than is added in tap water. It is added back to tap water with the same sort of rationale as has been used by some in the Paleo world to justify magnesium supplements. Why is adding back magnesium good and adding back fluoride bad?

It seems to me that the 'ideal' drinking water would be stuff that closely resembles clean, natural water which likely would be water that is purified of the really nasty stuff -- human waste, mercury, fertilizer, birth control, etc. -- with the natural stuff that was inadvertently removed added back -- magnesium, flouride, etc.. Of course, an untouched, natural water source would be great but I'm not sure such a thing exists anymore with rain potentially contaminating even remote sources.

I guess the ultimate Paleo answer would be to look what's in the water consumed by healthy hunter gatherer populations and what's (naturally) in the water located near paleolithic archeological sites. It doesn't seem unreasonable that humans in the 'wild' would naturally fluorish near optimal water sources, whether by instinct from taste or by the mere fact of better chances of survival. The amount of fluoride added back is in the middle range of what occurs naturally so it doesn't seem like a bad guess. If it were 10 times or 100 times the natural amount, then it might be cause to worry, which is likely the amounts used in those studies (probably more like 1000 times).

The fluoridation of water might be a strange case where government policy and Paleo actually coincide! I can agree with the libertarian argument though -- why not keep the supplements out of the water and just let people buy flouride/magnesium/etc. supplements to add to their tap water and let the market decide?

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Adding back Magnesium could be a good idea because there is actually a nutritional requirement for magnesium. The rational for fluoride is it helps our teeth, but you don't need to ingest it since topical fluoridated toothpaste is available. – HealthRediscovery Mar 14 2010 at 18:14
Right, but my point is that fluoride is in natural water in similar quantities as added back by government programs. To get water without fluoride in it, you'd have to take natural water and remove the fluoride. That's the stuff that humans drank going back for all of our evolutionary history so it's hard for me to see much of an argument against it. Even if it's useless, it's always been there. – Paleo Dave Mar 14 2010 at 20:27
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Well, not exactly. The kinds of fluoride added to our water - sodium hexafluorosilicate, hexafluorosilicic acid - are different compounds than naturally occurring fluoridem which is calcium fluoride mostly. And the original tests done to purportedly show a reduction in cavities were done with yet another compound, sodium fluoride. It's unlikely that these different substances have an identical effect on biological systems. – Dave Hirschman Mar 16 2010 at 18:19
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re: "the libertarian argument" and "opt-in", with respect:

I think taking personal responsibility for one's health and being actively engaged in optimizing one's health are great sentiments. In a perfect world we'd all have time and know-how to sort through science and pseudo-science, fluoridate our own water should we choose this supposedly perilous path, and spend $400, $800, and $1200 a month on grass-fed meat.

In the world we actually inhabit, though, I think there's a place for science-based public health policies such as water fluoridation, which seems to have successfully improved the teeth of several generations of Americans. If there's been a hidden health epidemic as a result, please provide evidence for it. Otherwise, "opt out."

Furthermore, if government intervened to, for example, incentivize sustainable farming and disincentivize factory farming, this would be fantastic and beneficial for the environment and all meat-eaters' health--Libertarians would be hard-pressed to achieve such an outcome, but they could always "opt out" and import factory meat from abroad.

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I was with you until the last paragraph. You're right that there doesn't seem to be much evidence of a hidden health epidemic with fluoride. Also, the "opt out" option is there already -- buy an appropriate filter or buy bottled water (which might contain some natural amount of fluoride). The problem with your last paragraph is that it's the government that's largely responsible for intervening to incentivize factory farms. Government subsidies make corn the cheapest calories and that's why it's fed to livestock and put in our food. – Paleo Dave Mar 14 2010 at 3:57
i'm with you for your entire paragraph; let's rescind those subsidies. – Zev Averbach Mar 14 2010 at 4:19
Amen to rescinding subsidies. Central governments do not have the wisdom to pick winners and losers, nor should they have that power IMHO. The present system incentivizes lobbying more than anything else. – Ed Mar 14 2010 at 19:09
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Okay, assuming it's prudent to avoid floridated water, what are the alternatives?

  • Bottled water: Environmentally unsustainable (huge CO2 footprint), not to mention nasty chemicals in the plastic, e.g. BPA.

  • The reverse osmosis filter people have discussed above.

  • ???

Michael

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Reverse osmosis appears to work. If you are having problems, I would worry less about your CO2 footprint and more about your kidneys. Maybe bang down the door of your local representative as well :). – Rick Mar 18 2010 at 4:21
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The alternative is to have the government to stop putting fluoride into the water supply. ;D – David Csonka Mar 18 2010 at 13:20

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