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Susheela

Excess fluoride ingestion and thyroid hormone derangements in children living in Delhi, India

Susheela, AK; Bhatnagar, M; Vig, K; Mondal, NK
Fluoride. Vol. 38, no. 2, pp. 98-108. May 2005.
 

"Ninety children with dental fluorosis, aged 7-18, living in fluoride endemic, non-iodine deficient areas of the National Capital Territory of Delhi, India, where iodized salt has been promoted for over a decade, were investigated, along with 21 children in two control groups without dental fluorosis living in non-endemic areas, to determine their levels of free T sub(4) (FT sub(4)), free T sub(3) (FT sub(3)), and thyroid stimulating hormone (TSH). The drinking water fluoride of the 90 children in the sample group ranged from 1.1 to 14.3 mg F super(-)/L (mean 4.37 mg F super(-)/L); their serum ranged from 0.02 to 0.41 mg F super(-)/L (mean 0.14 mg F super(-)/L); their urine ranged from 0.41 to 12.8 mg F super(-)/L (mean 3.96 mg F super(-)/L). The drinking water fluoride of the control I group (n = 10) ranged from 0.14 to 0.81 mg F super(-)/L (mean 0.23 mg F super(-)/L) and that of the control II group (n = 11) ranged from 0.14 to 0.73 mg F super(-)/L (mean 0.41 mg F super(-)/L). In control I, only 3 children had serum fluoride below the normal upper limit of 0.02 mg F super(-)/L. The remaining 7 children, even though they were consuming "safe" water, had elevated serum fluoride. In control II, only one child had serum fluoride below the normal upper limit. The remaining 8 children who were tested also had elevated serum fluoride. In control I, only 3 children had urine fluoride samples in the normal range (0.09-0.10 mg F super(-)/L); in the remaining 7 children they were above normal. In control II, only one child had urinary and serum fluoride within the normal range. In the remaining 8 children who were tested it was high, suggesting they had excess F super(-) exposure from sources other than drinking water. The hormonal status of the 90 sample children indicated that 49 (54.4%) had well-defined hormonal derangements. In the remaining 41 children the findings were borderline. The hormonal deviations among the affected 49 children fall into the following five categories: (1) high TSH with normal FT sub(4) and FT sub(3) (46.9%); (2) normal TSH and FT sub(4) with low FT sub(3) (32.7%); (3) high TSH and FT sub(3) with normal FT sub(4) (14.3%); (4) high TSH with normal FT sub(3) but low FT sub(4) (4.1%); and (5) high TSH with normal FT sub(4) but low FT sub(3) (2.0%). In control I and control II, similar hormonal deviations were detected in as many as 50% and 45.4% of the children, respectively.

These findings indicate that children with or even without dental fluorosis from exposure to excess fluoride, either through drinking water or through other sources, may have thyroid hormone derangements that may not be clinically overt until late stages. Determining free T sub(3), free T sub(4), and TSH is therefore important for a proper diagnosis of potential health problems. Withdrawal from fluoride sources along with measures to correct the thyroid hormonal status may be necessary to promote better health in such children living in fluoride endemic areas."

Reversal of fluoride induced cell injury through elimination of fluoride and consumption of diet rich in essential nutrients and antioxidants.

Susheela AK, Bhatnagar M.

Mol Cell Biochem. 2002 May-Jun;234-235(1-2):335-40.

"The objective of the present communication is to address the issues concerning reversal of fluoride induced cell injury and disease (i.e. fluorosis) through the elimination of fluoride and consumption of a diet containing essential nutrients and antioxidants. Humans afflicted with fluorosis, as a result of consuming fluoride contaminated water or food, have been investigated. Hospital based diagnostic procedure for early detection of fluorosis, through retrieval of history, clinical complaints, testing of blood, urine and drinking water for fluoride using ion selective electrode technology, along with X-ray of the forearm have been carried out. Confirmed cases of fluorosis were introduced to an intervention protocol consisting of (1) provision of safe drinking water with fluoride levels less than 1 mg/L and (2) counselling on nutritional supplementation with focus on adequate intake of calcium, vitamins C, E and antioxidants. The patients were monitored at frequent intervals up to one year and the results are reported. With a standardized early diagnosis, elimination of fluoride intake and supplementation of a diet rich in essential nutrients and antioxidants, we have shown that the fluorosis can be reversed."

FluorideAndFluorosis.com

Website for India’s Fluorosis Research and Rural Development Foundation.  Dr Susheela is Executive Director
 

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