I’ve had chronic acid reflux for > 7 years now, and it has become increasingly more debilitating. Recently, I have been meeting with a surgeon to discuss the Nissen Fundoplication procedure as a next step. Over this seven year period, I've tried seemingly every remedy that others have mentioned. I've tried PPIs, apple cider vinegar, eliminated gluten for a month, baking soda, probiotics, dairy free diet, etc. etc. etc.. I just can't figure it out - my diet is so controlled and I've cross eliminated everything. As the people around me also suffer (mother with RA, aunt with ulcerative colitis, sister with general IBS), I often find myself wondering why the incidence of these issues is on the rise in the USA and in some other places.
Randomly, I wondered about
fluoride addition to drinking water - I think it was because I saw an article the other day mentioning how Israel had banned fluoridation of its drinking water and how most nations have similar bans. As some may already be aware, there are many controversies surrounding water fluoridation - some as simple as what I'm about
to say and other more 'conspiracy-theorish' ones mentioning how its used as a form of mind control by the government. I started doing some independent research on it and its potential relatedness to GERD and autoimmune disorders. I tried to pull together as much reputable information as possible and the results seem somewhat alarming. As a personal disclaimer, one issue with having symptoms for so long is that you jump at possible answers a little bit too readily. As a result, I'm trying to be objective about
this and would like others' input. Anyways, here it goes:
In areas of the United States that add fluoride to drinking water, concentrations are usually between 0.8-1.2mg of fluoride per liter of water (also referred as 0.8-1.2ppm), and can be higher in certain areas where fluorine from the environment can contaminate the drinking water. By doing some simple math, its easy to see how many of us could consume 2-3mg of fluoride every day. This amount is in addition to fluoride you are getting from other sources. For example, brewed coffee or black tea, which are unusually high in F content, can typically add 3-4mg/L of fluoride to the water. Smoking and chewing tobacco also greatly increases your fluoride exposure in the short term. Certain cereals and juices (such as prune juice) are also enriched in F content. Also, inadvertent swallowing of toothpaste and mouthwash increases F intake. Apparently, those who drink water from a natural river/stream/spring usually would only be consuming 0.05mg/L of F, or 0.05ppm, about
20 times less than artificially fluoridated water.
Most of the below information is taken directly from a very large, comprehensive review published by the National Research Council of the USA in 2006. From what I understand, this is an extremely reputable source that comprehensively evaluates several studies from other reputable sources. This governmental agency points out many frightening things about
F consumption and gaps of knowledge. It is freely available for all of you to read here:
http://www.nap.edu/catalog.php?record_id=11571
Apparently, there are several studies that link high (50+mg/L), moderate(20-50mg/L), or even mild (1-5mg/L) fluoride consumption to acute and chronic digestive illnesses. Because scientists cannot administer high doses of fluoride as a test, many of these studies involve data from an accidental 'over-fluoridation' in some area. In one case where too much fluoride was added to the tap water and it peaked at 51mg/L (again, US fluoridated tap water is usually ~1mg/L), out of 160 people sampled, 52% of individuals had acute gastric upset and only 2% of the control group had gastric upset (page 271 of National Research Council source, originally from Peterson et al. 1988). In a similar case, 34 individuals who had eaten at a restaurant (so maybe only a cup or so of water or some ice cubes) where F concentrations were 40mg/L reported acute gastric upset in the 24-hour period (page 271, Penman et al. 1997). Much of the text of this section, starting on page 268, identifies several studies showing that people might have gastrointestinal issues from the current levels of fluoride added to drinking water alone (the 0.8-1.2mg/L amount). A few of the outlined studies indicate that more than 1% of the general population are likely experiencing digestive issues, including GERD, simply from drinking fluoridated water. Apparently, there are no thorough studies examining the effects of regular fluoride consumption on a large scale over a long period of time.
For gastritis specifically, one mechanism seems to be that when F- anions enter the stomach with extremely low pH, it forms the acid HF. HF can dissolve through the gastric membranes to areas that immediately surround this acidic area (going from low pH to high pH) and this causes the H+ and F- ions to dissociate, which is harmful for our cells. Here is a source from the Center of Disease Control showing how HF can cause harm in a variety of ways (including ingestion):
http://www.atsdr.cdc.gov/mmg/mmg.asp?id=1142&tid=250
The source I mentioned earlier from the National Research Council mentions F becoming HF (the harmful toxin) in the low pH of the stomach on page 268. This destructive chemical process seems like it would occur proportionally to the amount of F you intake given a certain pH level. So even if you had a small amount, if the pH of your stomach was low, you would still have some degree of this damage occurring. One could also reason that PPIs can help reduce this process by making the stomach less acidic.
That on its own is somewhat noteworthy, but what follows makes it more interesting. Later in the review (starting on page 293), it goes on and on about
the relationship between F intake and immune system hypersensitivity, including increased prevalence of mouth ulcers, colitis, and epigastric distress! The source postulates that after several years of high F intake, much F has accumulated in a person's skeletal structure over time. Given that immune cells originate from bone marrow, this issue could cause immune hypersensitivity for all/many parts of the body indefinitely once the F concentration has reached a certain point. Even though such a relationship between immune hypersensitivity disorders and F accumulation in bone tissue has been postulated, there are no studies examining the two over long-term F consumption.
This prompted me to look into geographic trends to see if there was a link between fluoridation and GERD/GORD/acid-reflux symptoms. It seems like in many cases where data is available on both GERD and fluoridation rates, countries that fluoridate their water (or have used fluoridation practices in the past few decades) have higher incidence of GERD or other gastrointestinal illnesses. Keep in mind that certain places have naturally fluoridated water (not added by the municipal wastewater plant). For example, In China, where F is not added, certain small regions do have fluoridated water simply because the source water naturally has that much fluoride. The numbers that these sources give seem to vary wildly, so I am not going to list any in particular - I suggest you look into it yourself. However, I will list some stats that I found - USA, UK, and Australia all have GERD rates (experienced heartburn at least once in the past week) of 15-25% and all have fluoridation practices to some degree. Spain's GERD rate is ~9% and only ~10% of the population drinks fluoridated water. Water is not fluoridated in Italy, and ~7.7% of the population there experiences GERD related symptoms. The Nordic countries are mixed, probably because most were fluoridating up until recent decades. China, Japan, Koreas, etc. all have GERD rates less than 5% and do not fluoridate their water. On the other hand, in nearby Malaysia, where >75% of the population has fluoridated water (one of the highest rates I've seen), as many as 30% of the population suffer from GERD and as many as 50% from some form of GI illness! Its a huge issue there and no one seems to have a good answer for this observation. Why would Malaysia be so different from other nearby Asian countries? While the obesity there is slightly more than China and Japan, it is still much less than USA/UK and is even less than Italy, where GERD rates are much lower. If Malaysia is one of the only asian countries that fluoridates their drinking water and also has a strikingly higher rate of digestive disorders, even greater than in the USA, doesn’t that present strong evidence of a causal relationship?
One of the strongest points made by the National Research Council in this review is that these relationships between GI upset, immune hypersensitivity, organ failure, child brain development, bladder issues, thyroid issues, etc. do exist. When these relationships were more evident, a high concentration of F was used. When a smaller amount of F was used, there was either no relationship or the results were inconclusive. However, there have been very few tests, if any, that examine this in the long term (i.e. F intake in an individual over the course of years or
decades).
All the below information is taken from a potentially non-dependable anti-fluoridation source:
http://fluoridealert
.org/content/bfs-2012/
Most countries do not fluoridate their water. Of the 25 that do, 11 of them only do it in less than 20% of the country. Only 11 countries have fluoridation rates above 50%, they are Australia (80%), Brunei (95%); Chile (70%), Guyana (62%), Hong Kong (100%), the Irish Republic (73%), Israel (70%), Malaysia (75%), New Zealand (62%), Singapore (100%), and the United States (64%). It seems to me that most other countries recognize the potential for negative health effects from fluoridation - this is why most don’t practice it and many that used to have stopped in recent decades.
Anyways... it seems to me like these issues are more worthy of further examination than they've been given. Surely there is more evidence for a connection between digestive disorders and fluoridation than something like… high fructose corn syrup or gluten intake (except an individual with Celiac's), and all sorts of other potential causes that we commonly hear.
I wanted to share these thoughts with the community and get feedback. Has anyone here personally tried to cut fluoride out of their diet for a long period of time and noticed a change (or no change)? To those that suffer GERD after cutting out bad things like caffeine, fatty foods, smoking, etc., do you consume fluoridated drinking water?
Post Edited (EJohn) : 8/31/2014 2:29:00 PM (GMT-6)