Could Fluoride in Your Tap Water or Toothpaste Be Destroying Your Bones?

Updated: November 28, 2022

Pouring water into open hands

Fluoride is — everywhere. Fluorine is a common element in the earth’s crust, so fluorides are naturally present in the soil, rocks, and water all throughout the world. In addition, fluorides are used in many industrial processes, for example, coal burning, oil refining, steel production, brick-making, and the production of phosphate fertilizers (yet another reason to go organic!).

Our main sources of exposure to fluoride, however, are diet (food and water) and fluoride-containing dental products (e.g., toothpaste). Fluoride is found in higher concentrations in soft, alkaline, and calcium-deficient waters, and since the fluoride compounds that occur naturally in drinking water are almost totally bioavailable (90%), they are virtually all absorbed from the gastrointestinal tract.(1),(7)

Although fluoridation of community drinking water to prevent dental caries has been hailed by some as one of the ten most important “public health achievements of the 20th century,” along with the claimed decline in tooth cavities has come an increase in dental fluorosis, a disturbance of the production of tooth enamel caused by exposure to high concentrations of fluoride between the ages of 3 months and 8 years – the time when teeth are developing. (To be precise, the substance used in water “fluoridation” is fluorosilicic acid, an “industrial waste”.)

In its mild, and surprisingly common, forms, fluorosis shows up as tiny white streaks or specks in the tooth enamel. In its most severe form, the teeth are marred and brown discolorations — spots and stains that are permanent and can darken over time. Dental fluorosis is highly prevalent worldwide. As of 2005, 23% of persons in the United States aged 6 to 39 years had mild or greater dental fluorosis.(7)

How does fluoride affect our bones?

Fluoride acts on both osteoblasts and osteoclasts. While fluoride may increase bone mass, the newly formed bone lacks normal structure and strength. Under a microscope, the “crystallization pattern” of bone from deliberately fluoride-treated animals and humans can be seen to be abnormal. In trabecular bone, fluoride causes an increase in bone volume and thickness without a concomitant increase in connectivity, so bone quality is lower despite the increase in bone mass.

What’s trabecular bone?

Also called cancellous or spongy bone, trabecular bone is one of two types of tissue that form our bones. It typically occurs at the ends of long bones, like our femurs (thigh bones), right next to joints and also the insides of our vertebrae. Trabecular bone is composed of tiny, lattice-shaped structures, contains lots of tiny blood vessels and is where our red bone marrow produces blood cells. It’s also where calcium ions are exchanged – either added to or withdrawn from bone.

The other kind of bone tissue is called cortical or compact bone. As its name suggests, cortical bone forms the cortex, or outer shell, of most bones. Much denser, stronger, and stiffer than trabecular bone, cortical bone contributes about 80% of the weight of a human skeleton.

If your bones were M&M candies, cortical bone would be the outer candy shell and trabecular bone the chocolate inside. We have way more trabecular than compact bone, but trabecular bone is less dense, less stiff, softer, and weaker. Now, the key point: in osteoporosis, trabecular bone is more severely affected than cortical bone.

How does fluoride cause bone loss?

At very low and localized concentrations in dental implants, fluoride encourages osteoblast production and new bone formation, but at higher concentrations, new bone formation is blocked. High systemic (whole body) fluoride exposures can cause skeletal fluorosis, a condition in which bones have become too hard and brittle, ligaments calcify, and bone pain and loss result.

After ingestion, fluorine goes to the stomach where it reacts with stomach acid to form hydrogen fluoride. Hydrogen fluoride is absorbed from the gastrointestinal tract and sent into the portal vein, which delivers it to the liver. The liver is like our body’s border control system; it’s where everything goes to get checked and cleared before it’s allowed entry into the bloodstream. Harmful compounds are usually transformed in the liver into something we can excrete and sent out of the body via urine or bile. We do this biotransformation with the help of a variety of liver enzymes that first oxidize the harmful compound and then bind it to a carrier that takes it out. Fluorine, however, is itself such a strong oxidizer – the strongest oxidizer currently known — that it simply scoffs at the liver’s comparatively feeble attempts to oxidize it. It is not removed, but instead passes into the bloodstream and gets distributed to all our tissues, including our bones.(1)

Once inside bones, fluorine nukes them through a variety of mechanisms:

Fluorine wipes out bone cells’ ability to produce their most important antioxidant defender, called glutathione, and then wreaks havoc, shutting down osteoblasts and causing inflammation that increases osteoclast production and activity.(2),(3)

As fluorine accumulates in bone, it shuts down alkaline phosphatase, an enzyme in bone that is involved in the production of osteoblasts. Researchers speculate that after a long period of fluoride exposure, the structure of the alkaline phosphatase enzyme changes because fluoride binds to this enzyme. Fluorine exposure may also reduce the content of copper, zinc, manganese and other trace minerals that other enzymes involved in building bone require for their activity. The end result here is osteoblast production stops.(4)

Our bones are largely composed of calcium compounds, up to 50% of which are hydroxyapatite. Fluorine can convert hydroxyapatite to fluorapatite, which changes bones’ crystalline structure, delays further mineralization with calcium,  and causes a reduction in bones’ mechanical strength properties.(2)

Hydrogen fluoride reacts with calcium to form an insoluble salt, CaF2. This salt has to be cleared by the body, and as it goes, takes out some calcium from the bone matrix.(5)

Fluoride induces the secretion of parathyroid hormone. Parathyroid hormone sets off the production of osteoclasts. It’s kind of a convoluted process, but one worth summarizing for you here since it shows how our body’s bone-maintaining system is delicately balanced, and sheds some light on why patent medicines, which disrupt normal functioning, can produce very unpleasant results.

What happens is that parathyroid hormone tells osteoblast cells (the cells that produce new bone) to secrete a signaling molecule called RANKL. RANKL plays a role in initiating the process through which osteoclasts (the cells that break down bone) are made. For this reason, when our parathyroid hormone levels are chronically elevated, so is our production of osteoclasts – and we lose bone.

Increased fluoride intake has been repeatedly shown to increase levels of parathyroid hormone circulating in the bloodstream and to cause hyperparathyroidism.(2) The patent medicine works by causing parathyroid hormone production to spike. And the patent medicine works by blocking RANKL, which at first may sound like a good idea, but RANKL activity is required to produce the osteoclasts we need to clear out old brittle bone, and RANKL is also necessary for the activation of our B cells and T cells, key players in our immune system.

Bottom line here: Messing with Nature’s well laid plans for the ways in which our bones constantly rebuild and maintain themselves (which is what all the patent medicines do) is not a good idea! Once again, the research confirms that when we try to one up Mother Nature, we end up shooting ourselves in the proverbial footwell, in this instance, in the “tooth”. Providing our bones with the nutrients they require to do this job by themselves is much safer – and as the COMB study has demonstrated–more effective.

Fluoride is, literally, in your water. What can you do to protect yourself?

Take your AlgaeCal Plus! And be sure to include calcium-rich foods in your diet! The bioavailability of fluoride is generally reduced in humans when consumed with milk or a calcium-rich diet.(1)

Don’t use toothpaste containing fluoride. Check the ingredient list. Fluoride can appear as sodium fluoride (NaF), stannous fluoride (SnF2), olaflur (an organic salt of fluoride), or sodium monofluorophosphate (Na2PO3F). Most of the toothpaste sold in the United States contains 1000 to 1100 parts per million fluoride. In the UK, the fluoride content is often higher; a NaF of 0.32% (1,450 ppm fluoride) is not uncommon.

In 1997, the Institute of Medicine said fluoride intakes of 0.01 mg/day for infants through 6 months, 0.05 mg/kg/day beyond 6 months of age, and 3 mg/day and 4 mg/day for adult women and men (respectively), are adequate to prevent dental caries. IOM set upper limits (UL) for fluoride at 0.10 mg/kg/day in children less than 8 years and 10 mg/day for those older than 8 years.

There is no reason to consume even the lowest amount of fluoride recommended by the IOM. In the May 2012 issue of Nutrition & Healing, Dr. Wright summarizes more than 30 years of research showing that xylitol, a natural sugar our bodies produce in tiny amounts, which is also found, again in very tiny amounts, in berries and vegetables, not only prevents plaque formation and cavities, but has even been shown to reverse developing cavities and restore healthy tooth enamel—safely.(1)

Studies demonstrate that 4 to 12 grams of xylitol per day is effective, and this is most easily delivered in xylitol-containing chewing gums, which keep the xylitol they contain in contact with teeth far longer than toothpaste or mouthwash. Read product labels; if a piece of gum contains 1 gram of xylitol, then chew 4 pieces throughout the day – or even once more. Dr. Wright’s clinical experience suggests chewing a piece of gum five times a day is ideal.

The following table lists the foods and beverages consumed in the U.S. with the highest fluoride content. Take a look and estimate how much fluoride you are ingesting each day. The full listing of 400 foods across 23 food groups can be accessed on-line at the National Fluoride Database:

Fluoride Content of Commonly Consumed Foods and Beverages

Food Micrograms of Fluoride in 100 grams (3 oz)
Wine, red 105
Wine, white 202
Carbonated water, fruit flavored 105
Coffee 91
Fruit juice drink, apple 104
Grape juice blend (apple & grape) Juicy Juice 102
Grape juice white 204
Tea, brewed, microwave 322
Tea, instant, powder, prepared with tap water 335
Tea, brewed, decaffeinated 269
Water, tap (Mid-west), municipal 99
Water, tap (Mid-west) well 53
Water, tap (Northeast), municipal 74
Water, tap (Northeast), well 9
Water, tap (South), municipal 93
Water, tap (South), well 10
Water, tap (West), municipal 51
Water, tap (West), well 24
Oatmeal, cooked 72
French fries, MacDonald’s 115
Crab canned 210
Shrimp, canned 201
Shrimp, fried 166
Fish sticks, baked 134
Raisins 234
Potato chip, baked 106

Adapted from the National Fluoride Database, a comprehensive, nationally representative database of the fluoride concentration in foods and beverages consumed in the United States hat are major fluoride contributors.

References :

  1. Whitford GM. Intake and metabolism of fluoride. Adv Dent Res. 1994 Jun;8(1):5-14. PMID: 7993560
  2. Bergandi L, Aina V, Malavasi G, et al. The toxic effect of fluoride on MG-63 osteoblast cells is also dependent on the production of nitric oxide. Chem Biol Interact. 2011 Apr 25;190(2-3):179-86. Epub 2011 Feb 15. PMID: 21329685
  3. Bergandi L, Aina V, Garetto S, et al. Fluoride-containing bioactive glasses inhibit pentose phosphate oxidative pathway and glucose 6-phosphate dehydrogenase activity in human osteoblasts. Chem Biol Interact. 2010 Feb 12;183(3):405-15. Epub 2009 Nov 27. PMID: 19945446
  4. Song YE, Tan H, Liu KJ, et al.  Effect of fluoride exposure on bone metabolism indicators ALP, BALP, and BGP. Environ Health Prev Med. 2011 May;16(3):158-63. Epub 2010 Oct 2. PMID: 21431799
  5. DePaula CA, Pan Y, Guzelsu N. Uniform partial dissolution of bone mineral by using fluoride and phosphate ions combination. Connect Tissue Res. 2008;49(5):328-42. PMID: 18991086
  6. Jha SK, Mishra VK, Sharma DK, et al. Fluoride in the environment and its metabolism in humans. Rev Environ Contam Toxicol. 2011;211:121-42. PMID: 21287392
  7. Everett ET. Fluoride’s effects on the formation of teeth and bones, and the influence of genetics. J Dent Res. 2011 May;90(5):552-60. Epub 2010 Oct 6. PMID: 20929720

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This article features advice from our industry experts to give you the best possible info through cutting-edge research.

Lara Pizzorno
MDiv, MA, LMT - Best-selling author of Healthy Bones Healthy You! and Your Bones; Editor of Longevity Medicine Review, and Senior Medical Editor for Integrative Medicine Advisors.,
Dr. Liz Lipski
PhD, CNS, FACN, IFMP, BCHN, LDN - Professor and Director of Academic Development, Nutrition programs in Clinical Nutrition at Maryland University of Integrative Health.,
Dr. Loren Fishman
MD, B.Phil.,(oxon.) - Medical Director of Manhattan Physical Medicine & Rehabilitation and Founder of the Yoga Injury Prevention Website.,
Prof. Didier Hans
PHD, MBA - Head of Research & Development Center of Bone Diseases, Lausanne University Hospital CHUV, Switzerland,