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As part of MAHA, @RobertKennedyJr wants to eliminate fluoride from U.S. drinking water. Fluoride has been in US drinking water since the 1960s, mainly to prevent tooth decay. Is this a good or bad idea? Let's look at the science. 🧵
1/ Fluoride to prevent tooth decay Water fluoridation began in the U.S. in 1945 and expanded widely in the 1960s to help prevent tooth decay, especially in children. The CDC considered water fluoridation among top 10 achivements in the 20th century. Ref (1)
2/ Standards, measurement and risks The current US standard for fluoride in drinking water is 0.7mg/L Ref (1). Earlier WHO report stated that 0.2% of US population is exposed to >2mg/L of fluoride in drinking water Ref (3) Recent report from the National Toxicology Program associated fluoride levels as low as 1.5 mg/L to lower IQ in children Ref (2)
3/ According to @RobertKennedyJr, exposure to fluoride can lead to: i. Dramatic IQ Loss in children/ exp. unborn fetuses ii. Bone cancer (Osteosarcoma) iii. Arthritis, deterioration of bones iv. Thyroide injury v. Calcification of the Pineal gland in the brain Here's a critical analysis of the clinical evidence regarding these claims made about water fluoridation.
3.i/ IQ Loss in chidren especially with exposure in the womb Boys might be losing a couple IQ points in the womb; across the country A Canadian birth-cohort study showed boys born to mothers in areas with fluorinated water had lower average IQ at 3-4 years of age. Average 4.49 IQ decrease (only for boys) associated with each 1mg/L increase in MUF (Maternal Urinary Fluoride) in pregnancy. Ref (5) (observational) Context: average fluoride intake for fluorinated areas was 0.93 mg/daily. Equivalent to fluoride in 1.33 L of standard US tap water, making this effect universal to all US mothers consuming unfiltered tap water. Ref (5) A meta-analysis of 33 studies concluded that water fluoride beyond 1 mg/L (43% above US standard) correlated to 5 point IQ decrease, while water at the US recommeded level 0.7mg/L correlated with a smaler 2.15 IQ decrease, on average. Ref (6) In India, school-age children exposed to >1.5 mg/L water (double the US recommendation) showed lower average IQ. Ref (7)
3.ii/ Osteosarcoma: rare bone cancer, common in childhood and adolescence Pre-clinical evidence from rats and mice suggests a link between fluoride in water and osteosacroma. Ref (8) Clinically We found only one study from India suggesting that tap water fluoridation associated with higher ostesarcoma incidence (Age 10-24 years) Ref (9) However various other studies refuted this claim; A US study analyzing CDC data on osteosacroma patients (age 15-19) found no correlation to fluoride in water. Ref (10) A British study also concluded no significant association between fluoride in water and osteosarcoma in people 0-49 diagnosed with osteosarcoma. Ref (11) Conclusion This claim should be considered refuted, given that multiple human studies have shown no significant increase in Osteosarcoma risk at common water fluronation levels.
3.iii/ A Indian study on 80 arthritis patients showed significant correlation between serum fluoride and knee-arthritis. Ref (12) A Chinese study (186 osteaorthritics patients and 186 healthy cohort) showed each 1mg/L increase in urinary fluoride correlated to 27% increased risk of developing osteoarthritis. Ref (13)
3.iv/ A Chinese study concluded that low-to-moderate fluoride exposure was associated with weaker thyroid function and lower IQ in children (age: 7-13) Each 1mg/L increase in urinary fluoride correlated with 0.09ng/dL decrease in serum thyroide hornome and 0.11ng/dL increase in TSH (also indicating thyroide dysfunction). Ref (14) The study hints at a potential link between the effect of fluoride on IQ, and Thyroid function in children. (14) A meta-analysis of 27 studies found a correlation between higher levels of fluoride in water (2.5mg/L: over 3x US standard) and thyroid disruption in children. Ref (15) A UK observational study reported higher hypotheroidism incidence in areas with fluorinated water Ref. (16)
3.v/ Calcification of the pineal gland in the brain A post-mortem analysis of pineal glands from deceased aging humans showed high levels of fluoride deposition, with correlation between fluoride and calcium (calcification). Ref (17) A US cross-sectional study on NHANES data (2015-2016) suggested a link between fluoride-associated pineal gland calcification and sleep disturbances among adolescents. Higher fluoride (75th vs 25th percentile) correlated with 2x increase in sleep apnea, 24 min and 26 min average delay in bed and waking-up time, respectively. Ref (18) Note: the pineal gland produces melatonin, which regulates circadian rhythm and sleep
4/ To sum it up 4 out of the 5 risks cited as basis to end water fluoridation have evidence from humans to support them, fluoride association with Osteosarcoma being the one exception that is largely refuted. 1. Public water fluoridation is an outdated measure from the past. 2. While it might partially prevent tooth decay, fluoridation exposes the population, especially children to unnecessary health and cognitive hazards. 3. Fluoridation harms the people it is supposed to be protecting the most; children in less affluent households are more likely to consume unfiltered tap water, and not have enough supervision regarding fluoride in toothpaste and mouthwash. 4. Water fluoridation should be replaced with more targeted community efforts to improve children's nutrition, health, and dental hygiene. Examples: - Eliminating sugar from school lunch/snacks. - Awareness about dental hygiene (toothbrushing morning/night, correct ways to brush teeth, flossing, avoiding excessive use of mouthwash)
5/ Dental health beyond fluoridation While it might be time to part ways with fluoride in tap water, never misinterpret this as accepting a compromise on dental health. Dental and oral health and hygiene are keys to sustained health and longevity. Due to chronic inflammation and bacterial spread through the bloodstream. Tooth decay and poor oral health have strong links to cardiovascular disease (CVD), dementia, and other systemic conditions. Gum disease (often due to untreated tooth decay) increases the risk of heart disease by 20%. Similarly, poor oral health increase the risk of dementia by approximately 22-30%. Maintaining oral health, therefore, goes beyond preventing cavities; it is essential in reducing risks for chronic and age-related diseases associated with systemic inflammation and infection Examples of community and school initiatives that improve dental health in children, as part of a wholistic approach in raising a healthy generation well-positioned to benefit fromt the incoming health and longevity revolution. - Eliminating sugar from school lunch/snacks. (added sugar is Nr.1 cause of caries) - Awareness about dental hygiene (toothbrushing morning/night, correct ways to brush teeth, flossing, avoiding excessive use of mouthwash) - Fluoride and other products can still be used, but with care to avoid over-exposure.
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16. <a target="_blank" href="https://jech.bmj.com/content/69/7/619" color="blue">jech.bmj.com/content/69/7/6…</a> 17.<a target="_blank" href="https://karger.com/cre/article-abstract/35/2/125/84621/Fluoride-Deposition-in-the-Aged-Human-Pineal-Gland?redirectedFrom=fulltext" color="blue">karger.com/cre/article-ab…</a> 18. <a target="_blank" href="https://ehjournal.biomedcentral.com/articles/10.1186/s12940-019-0546-7" color="blue">ehjournal.biomedcentral.com/articles/10.11…</a>