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FLUORIDE & ARTHRITIS


Excerpt from:

Hileman B. (1988). Fluoridation of water.Questions about health risks and benefits remain after more than 40 years. Chemical and Engineering News. August 1, 1988, 26-42. (See article )

"Although skeletal fluorosis has been studied intensely in other countries for more than 40 years, virtually no research has been done in the U.S. to determine how many people are afflicted with the earlier stages of the disease, particularly the preclinical stages. Because some of the clinical symptoms mimic arthritis, the first two clinical phases of skeletal fluorosis could be easily misdiagnosed. Skeletal fluorosis is not even discussed in most medical texts under the effects of fluoride; indeed, a number of texts say the condition is almost nonexistent in the U.S. Even if a doctor is aware of the disease, the early stages are difficult to diagnose. "


Excerpt from:

Kilborn LG, et al. (1950). Fluorosis with report of an advanced case. Canadian Medical Association Journal. 62: 135-141.

"Apparently [skeletal fluorosis] is rare on the North American continent, but a few cases have been reported... It is quite possible that endemic centres [of skeletal fluorosis] exist but that the cause of the disabling spondylitis or other joint affections has not been determined, and a diagnosis of chronic arthritis has resulted. Few cases in Canada or the United States will be found to be as dramatic as that recorded here from Southwest China, but by calling attention to the advanced stage of this condition help may be afforded to the diagnosis of early cases."


Excerpt from:

Singh A, et al. (1963). Endemic fluorosis. Epidemiological, clinical and biochemical study of chronic fluoride intoxication in Punjab. Medicine. 42: 229-246.

In the early stages of skeletal fluorosis, the "only complaints are vague pains noted most frequently in the small joints of hands and feet, the knee joints and those of the spine. Such cases are frequent in the endemic area and may be misdiagnosed as rheumatoid or osteoarthritis. Such symptoms may be present prior to the development of definite radiological signs."


Excerpt from:

Kumar SP, Harper RA. (1963). Fluorosis in Aden. British Journal of Radiology. 36: 497-502.

"The ligamentous calcification [of skeletal fluorosis] is often periarticular and shows as osteoarthritis of the spine and hip joints as well as of the sacro-iliac joints."


Excerpt from:

Latham MC, Grech P. (1967). The effects of excessive fluoride intake. American Journal of Public Health. 57: 651-660.

"Another frequent finding was the calcification of ligaments and muscle attachments... During the survey, those being x-rayed were asked whether they had body pains. Approximately three quarters of those later found to have radiological evidence of skeletal involvement did complain of pains mainly in the back, chest, and legs."


Excerpt from:

Jolly SS. (1968). An epidemiological, clinical and biochemical study of endemic, dental and skeletal fluorosis in Punjab. Fluoride. 1(2): 65-75.

"Whereas dental fluorosis is easily recognized, the incipient skeletal involvement is not clinically obvious until the disease has advanced to the state of crippling...[The early cases of the disease] are usually young adults whose only complaints are vague pains most frequently in the small joints of the hands and feet, the joints of knee and spine. Such cases are common in an endemic area. They are misdiagnosed as rheumatoid arthritis or ankylosing spondylitis. In the more advanced stages, there is obvious stiffness of the spine with limitation of its movements followed by kyphosis. Patients experience difficulty in walking, partly because of stiffness and limitation of movements of various joints and partly because of neurological defects in the advanced cases."


Excerpt from:

World Health Organization. (1970). Fluorides and Human Health. pp 32, 239-240.

"At higher levels of ingestion - from 2 to 8 mg daily, skeletal fluorosis may arise ... Whereas dental fluorosis is easily recognized, the skeletal involvement is not clinically obvious until the advanced stage of crippling fluorosis ... early cases may be misdiagnosed as rheumatoid or osteo arthritis."


Excerpt from:

Franke J, et al. (1975). Industrial fluorosis. Fluoride. 8(2): 61-83.

"In the initial stages [of skeletal fluorosis], the complaints of the patients are not remarkable. At first they experience vague rheumatic pains, then the pains become localized in the spine, especially in the lumbosacral region. Later, a sensation of stiffness in the lumbar and cervical spine develop. However, we also found patients with slight radiological changes (subtle signs or stage O-I) who complained of intense pains in the spine and in the large joints. On the other hand, some patients whose fluorosis was radiologically distinct were almost without complaints."


Excerpt from:

Teotia SPS, et al. (1976). Symposium on the Non-Skeletal Phase of Chronic Fluorosis: The Joints. Fluoride. 9(1): 19-24. (See paper)

"In early stages, fluorosis is usually associated only with stiffness, backache, and joint pains which may suggest the diagnosis of rheumatism, rheumatoid arthritis, ankylosing spondylitis and osteomalacia. At this stage the radiological findings of skeletal fluorosis may not be evident and therefore most of these cases are either misdiagnosed for other kinds of arthritis or the patients are treated symptomatically for pains of undetermined diagnosis (PUD). The majority of our patients had received treatment for rheumatoid arthritis and ankylosing spondylitis before they came under our observation."


Excerpt from:

Czerwinski E, Lankosz W. (1977). Fluoride-induced changes in 60 retired aluminum workers. Fluoride. 10(3): 125-136.

"In our material we noted degenerative changes in the lumbar spine in 95% of cases, which suggests that fluoride accelerates these changes. In addition to pain in the lower spine which is associated with radiological changes, patients with negative x-ray findings also complain of pain in the lumbar-sacral area, an indication that symptoms precede changes demonstrable by x-ray."


Excerpt from:

Czerwinski E, Lankosz W. (1978). Skeletal changes in industrial and endemic fluorosis. Fluoride. 11(1): 29-32.

"In the aluminum workers, the most frequent changes in the spine were exostoses and ossification of the ligaments. These changes did not differ in appearance from those seen in spondylarthritis or vertebral ankylosing hyperostosis."


Excerpt from:

Waldbott GL, et al. (1977). Skeletal fluorosis near fluoride-emitting factories. Fluoride. 10: 45-47.

"During litigation of this case, muscular pains, general fatigue, and arthritis in conjunction with liver and kidney damage and with hypothyroidism were recorded. The court decision found a definite relationship between the disease and fluoride ingested from food grown in the contaminated area."


Excerpt from:

Waldbott GL, Burgstahler AW, and McKinney HL. (1978). Fluoridation: The Great Dilemma. Coronado Press, Inc., Lawrence, Kansas.

"[E]xtensive research from India has revealed severe arthritic changes and crippling neurological complications even where the fluoride concentration in water naturally is as low as 1.5 ppm...Even though extensive bone deformities may not be found on a large scale from fluoride in water at the 1 ppm concentration, some of the early signs of the disease, such as calcifications of ligaments, joint capsules, and muscle attachments, are likely to occur. Indeed these conditions are characteristic of osteoarthritis, in which the formation of microcrystals of apatite (known to be promoted by fluoride) has now been clearly demonstrated. Among the elderly, arthritis of the spine is an especially common ailment that is customarily attributed to "aging." Since fluoride retention in bones increases as a person grows older, how can we disregard the possibility that this "old age" disease might be linked with fluoride intake? For example, Pinet and Pinet described in detail X-ray changes encountered in skeletal fluorosis in North Africa that are in every respect identical with those present in the arthritic spine of the elderly elsewhere."


Excerpt from:

Grandjean P. (1982). Occupational fluorosis through 50 years: clinical and epidemiological experiences. American Journal of Industrial Medicine. 3(2):227-36. (See abstract)

"In light cases of fluorosis, the bone changes are often associated with nonspecific joint and muscle pains..."


Excerpt from:

Smith GE. (1985). Repetitive Strain Injury, or Incipient Skeletal Fluorosis? (Letter.) New Zealand Medical Journal 98:328. (See letter)

"Early bone fluorosis is not clinically obvious; often the only complaints of young adults are vague pains in the small joints of the hands, feet, and lower back. Such cases may be misdiagnosed as rheumatoid arthritis or ankylosing spondylitis."


Excerpt from:

Zhiliang Y, et al. (1987). Industrial fluoride pollution in the metallurgical industry in China. Fluoride. 20(3): 118-125.

"According to our survey, clinical manifestations of fluoride injury were systemic. A wide variety of vague, subtle symptoms (i.e. backache, restricted joint movement, abdominal pain) occurred either prior to or simultaneously with the development of bone changes similar to those reported previously. Nonskeletal symptoms, therefore, are important for early diagnosis."


Excerpt from:

Anand JK, Roberts JT. (1990). Chronic fluorine poisoning in man: a review of literature in English (1946-1989) and indications for research. Biomedicine & Pharmacotherapy. 44: 417-420.

"Symptoms of pain, stiffness and diffuse aches may be dismissed as functional, but may in fact be early signs of fluoride damage to tendinous insertions and ligaments as well as joint capsules... It is notable that the symptoms and radiological changes occur first in areas of greater muscular activity. Siddiqui describes the effects on the wrists, shoulders and the neck in women engaged in household work and on the lumbar spine and lower limbs of men working in the fields. Both Siddiqui and Singh et al noted... the selective effect of this halide on the joints which are most used."


Results from Clinical Trials


Excerpt from:

Rich C. (1966). Osteoporosis and fluoride therapy. JAMA. 196: 149.

"Sodium fluoride in the dose used (50 to 150 mg/day) often causes anorexia or epigastric pain... Symptoms of osteoarthritis are often made worse during treatment."


Excerpt from:

Inkovaara J, et al. (1975). Phophylactic fluoride treatment and aged bones. British Medical Journal. 3: 73-74.

"Fractures and exacerbation of arthrosis were more frequent in the fluoride group."


Excerpt from:

Dambacher MA, et al. (1978). Long term effects of sodium fluoride in osteoporosis. In: Fluoride and Bone; Proceedings of the Second Symposium CEMO, Nyon, Switzerland, Oct. 9-12, 1977. Bern Switzerland, Hans Huber Publishers.

"Osteoarticular pains in the lower extremities often combined with ankle swelling represent the major problem of NaF treatment."


Excerpt from:

Riggs BL. (1983). Treatment of osteoporosis with sodium fluoride: An appraisal. Bone and Mineral Research. 2: 366-393.

"Results from several large (fluoride clinical trials) indicate that significant side effects attributable to treatment occur in about one-third to one-half of patients. Symptoms have been of two types--periarticular and gastrointestinal. Periarticular symptoms have consisted of periarticular pain, and occasionally, tenderness about the large joints of the lower extremities and a painful plantar syndrome."


Excerpt from:

Dambacher MA, et al. (1986). Long-term fluoride therapy of postmenopausal osteoporosis. Bone. 7: 199-205.

"In 47% of the treated patients, osteoarticular side effects were observed."


Excerpt from:

Hodsman AB, Drost DJ. (1989). The response of vertebral bone mineral density during the treatment of osteoporosis with sodium fluoride. Journal of Clinical Endocrinology and Metabolism. 69(5):932-8.

In osteoporosis treatment "there have been serious concerns raised about the safety of sodium fluoride, which has a tendency to cause significant upper gastrointestinal side-effects, arthritis, fascitis, and a more recently described acute lower extremity pain syndrome."


Excerpt from:

Duell PB, Chestnut CH. (1991). Exacerbation of rheumatoid arthritis by sodium fluoride treatment of osteoporosis. Archives of Internal Medicine. 151(4):783-4.

"This report documents the repeated exacerbation of rheumatoid arthritis on three occasions after the initiation of sodium fluoride therapy...We suggest that sodium fluoride should be used cautiously in patients with rheumatoid arthritis."


Excerpt from:

Inkovaara JA. (1991). Is fluoride treatment justified today? Calcified Tissue International. 49 Suppl:S68-9.

"The use of fluoride in the prophylaxis or treatment of osteoporosis seems highly questionable for the following reasons: (a) the therapeutic window is very narrow, (b) 15%-37% of patients do not respond to fluoride, (c) there are frequent gastrointestinal disturbances and arthralgias, and especially because (d) patients receiving fluoride have experienced more fractures, especially nonvertebral and hip fractures, than control patients."


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