Skeletal fluorosis from instant tea

Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research
M P WhyteGary M Whitford

Abstract

Skeletal fluorosis (SF) can result from prolonged consumption of well water with >4 ppm fluoride ion (F(-); i.e., >4 mg/liter). Black and green teas can contain significant amounts of F(-). In 2005, SF caused by drinking 1-2 gallons of double-strength instant tea daily throughout adult life was reported in a 52-yr-old woman. A 49-yr-old woman developed widespread musculoskeletal pains, considered fibromyalgia, in her mid-30s. Additionally, she had unexplained, increasing, axial osteosclerosis. She reported drinking 2 gallons of instant tea each day since 12 yr of age. Fluoxetine had been taken intermittently for 5 yr. Ion-selective electrode methodology quantitated F(-) in her blood, urine, fingernail and toenail clippings, tap water, and beverage. Radiographs showed marked uniform osteosclerosis involving the axial skeleton without calcification of the paraspinal, intraspinal, sacrotuberous, or iliolumbar ligaments. Minimal bone excrescences affected ligamentous attachments in her forearms and tibias. DXA Z-scores were +10.3 in the lumbar spine and +2.8 in the total hip. Her serum F(-) level was 120 microg/liter (reference range, 20-80 microg/liter), and a 24-h urine collection contained 18 mg F(-)/g creatinine (reference valu...Continue Reading

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