This episode is sponsored by Raycon.
A 47 year old woman went in for X-Rays at
Henry Ford Hospital in Detroit complaining
of pain in her lower back, legs, and hips.
Over the last few years, her teeth had grown more and more
brittle, and started chipping off at the slightest impact.
Eventually, all of her teeth had to be removed.
When doctors asked about her lifestyle habits,
she noted that for the last 17 years she had
been consuming a single pitcher of black tea made
using between 100-150 tea bags every single day.
That’s a strong brew.
Y’know I’m almost jealous.
What was the cause behind her back pain?
Could it be connected to her insane tea drinking habits?
Could the secret behind this drama
be the very water she was drinking?
Or could it be something even more sinister?
Let’s get into it!
I like a stiff drink, but over 100 tea bags
for a single pitcher of tea is excessive, but
could it be behind her hellish hospital visit?
After X-Rays were taken, doctors noted that her spine and
legs showed calcification in the membranes between her bones.
Meaning that the soft outside parts
of her bones hardened unnaturally.
They also wrote that she showed signs of a condition
called “rugger jersey spine”, which, as the name
suggests, makes your spine look like a striped jersey.
On the x-rays, her bones appeared to have dense
sections, which the doctors feared was cancer.
She was referred to Dr. Rao, an endocrinologist specializing in bone health,
in order to confirm or deny this cancer diagnosis.
After studying the x-rays,
Dr. Rao “was able to recognize it immediately,"
as an acute case of skeletal fluorosis.
Whoa, what’s skeletal fluorosis?
Great question!
Fluorosis, skeletal or dental, are conditions characterized
by high fluoride levels building up in the body.
Dental fluorosis can be diagnosed by staining
and pitting of the teeth, and in severe
cases, your enamel can become damaged.
In skeletal fluorosis, fluoride builds up in the bones over
many years leading to stiffness and pain in your joints.
In bad cases, your bone structure may change, and your
ligaments may calcify resulting in paralysis or brittle bones.
In very severe cases, skeletal fluorosis can spread to the
skull, and a brittle skull is never a good thing especially
if you want to keep your soft, squishy brain intact.
In fact, in Jharkhand, a northeastern region
in India, as many as 36 people have died
from skull fluorosis in the past decade!
Skeletal fluorosis occurs when one consumes low levels
of fluoride over a very long time, so in terms of our
case, how did so much fluoride get into her system?
Y’know what I don’t mind having too much in my system?
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What is fluoride and why is The Man making me drink it?
Ok, so some of you may already be aware that there
is fluoride in drinking water, but do you know why?
To find this out, we need to go back to an ancient and bygone era…
The late 1970s.
At that time, the majority of middle class
Americans above 60 years old were expected to
lose their teeth and need a full set of dentures.
Today, most middle class Americans keep their teeth well
into their 80s, and according to dentists, this is because
of mass fluoridation, or in other words, the practice
of putting fluoride into community drinking water.
Journalist Charles Mann, in an article for The Atlantic,
notes that upon mentioning fluoridation on social media,
“People I did not know troubled themselves to tell me
that I was an idiot, and that fluoridation was terrible.”
which prompted him to ask, “How much fluoride is in my
water, and how did public-health officials set the dose?”
Dosage is super important for all things
medical, and mass fluoridation is no different.
Children are particularly susceptible to fluoride poisoning.
Which is consuming too much fluoride too quickly,
characterised by immediate abdominal pain, excessive
salivation, vomiting, seizures, and muscle spasms.
Children’s bodies are generally smaller than
adults, which puts them at risk of higher
concentrations of any given substance.
Health officials in North America, where most of us
drink tap water, must take into account the child who
drinks a lot of it, and lower the dose accordingly, but
if they lower the dose, does it still help full grown
adults who can tolerate a much higher concentration?
To find the answer, we need to know how we found out
that fluoride aided dental health in the first place.
It all begins with the increased availability of sugar
in the early 20th century with increased global trade.
In the first few decades, dentists would regularly
create full sets of dentures for teenagers so they could
look nice in pictures at their high school graduations.
American soldiers even had to pass a dental exam proving that
they had at least 6 teeth on the top and bottom of their jaws.
This is where dentist Frederick McKay comes in.
In 1901, while he was practicing in Colorado
Springs, McKay noticed that many of his
patients' teeth were dotted with brown stains.
He collaborated with another dentist and they found that
students at Colorado College in Colorado Springs had
discolored teeth, where students from other regions did not.
Nearly 30 years later, McKay finally
identified what was staining people’s teeth.
It was naturally occurring fluoride in water
supplies leaching out of calcium deposits
into aquifers—yes, fluoride is natural.
What really blew their minds was that people who
had fluoride stains also had fewer dental issues.
And by “fewer dental issues” I mean, they had more teeth.
If you’re still a little skeptical about fluoridation,
wait until you hear that commercial fluoride is
a compound of a substance called Fluorine, which
is lethal in small doses, and immensely reactive.
Fluorides are a waste product of certain industrial
processes including the production of glass,
fertilizers, aluminum, and pesticides among other things.
Industrial executives were… what’s the word… elated when
they found out that the waste product they paid to dispose
of, that was believed to poison water supplies, could
be sold for profit by … putting it into water supplies?
Huh.
So large industries in America began spending
more money to fund research on the link
between fluoride and reduced cavities.
Then, in 1945, the cities of Grand Rapids, Michigan,
and Newburgh, New York, both added fluoride
to their water in a pilot project to see the
effects of mass fluoridation on city populations.
For both cities, a nearby city that did not add
fluoride to water supplies was chosen as a control.
The tests were intended to extend for a decade, so researchers
could examine the long term effects, but less than 10 years
into the experiment one of the control cities fluoridated
its water at the behest of its citizens who had heard
about the positive effects from tests in other cities.
And so mass fluoridation began in earnest,
and everything was good forever and no one
ever had to go to the dentist ever again.
Unfortunately not, but fluoridation did correlate
with a decrease in tooth decay among countries that
adopted mass fluoridation in the last 50 years.
Upon fluoridation, instances of tooth
decay decreased almost immediately.
However, instances of tooth decay in non-fluoridated
countries, like Belgium, Luxembourg, and Denmark,
have also been decreasing over the last 50 years.
Not to mention that they have better dental care than the US.
Part of this trend is thanks to the growing robustness
of government funded dental programs in some countries,
and the increased use of fluoridated toothpaste.
However these trends only appear in the last 50 years.
Fluoridation did improve dental health, but
there are other factors at play these days.
So now the argument in favor of fluoridation is basically
that fluoridation, in the smallest possible dosages,
will benefit those who do not have access to good dental
care with the least harm to the rest of the population.
Howard Pollick, an ADA spokesperson and dental
scientist at UC San Francisco School of Dentistry,
says that “water systems are operated by professionals.
With the new equipment, they can control the
fluoride level within a very narrow range” and
he believed that it is safe for public health.
That being said, it’s impossible to account for individual
sensitivity to fluoride, so as long as mass fluoridation is in
effect, there will always be some who are negatively affected.
So, is mass fluoridation the cause
behind our case’s skeletal fluorosis?
No, however skeletal fluorosis is more common in places around
the world with higher levels of naturally occurring fluoride.
They’re commonly called “fluoride belts”.
There is one that lingers from Syria through to Kenya,
and another that stretches from Turkey to China.
So what was behind our case of skeletal fluorosis?
What was pumping her full of fluoride,
weakening her bones and breaking her teeth?
Well, as it turns out, black tea is one of the
most common catalysts of skeletal fluorosis.
The woman’s blood serum concentrations of fluoride
came to 0.43 milligrams per litre, which is
more than 4 times higher than the normal levels.
After drinking a single pitcher of tea per
day, using over 100 tea bags each time, it’s
easy to see how quickly this got out of hand.
What’s more, the percentage of soluble fluoride that
the gastrointestinal tract can absorb is close to
100%, meaning that very little fluoride is removed
by your liver before it enters your bloodstream.
I have literally no clue why she drank her
tea like this, the case report doesn’t say.
According to Registered Dental Hygienist, Cathy
Hester Seckman, Camellia sinensis, the species of
plant that all teas come from—aside from herbal teas—
are fluoride hyperaccumulators, which means that
they absorb chemicals and heavy metals to a higher
concentration than they exist in the soil around them.
Tea plants will just keep sucking up all the
fluoride that they can until the concentration
in the plant itself is much higher.
Not only that, but the older the tea
plant, the more fluoride they can absorb.
Typically, the cheaper the tea, the older the leaves.
A study from the UK found that drinking teas
that used these older leaves could provide
up to 150% of one’s dietary fluoride intake.
Another study based in the Republic of Ireland
took 54 brands of tea commonly sold in the country,
and found that the levels of fluoride sat at
an average level of 3.3 milligrams per litre.
When you consider that not only is RoI the only European
country with mandatory water fluoridation, but also has
the highest per capita consumption of black tea on Earth.
So to return to our case, after drinking so much
fluoride in her tea for 17 whole years, losing all
of her teeth, and turning her spine into a striped
jersey, is there any way for her to get better?
Well the good news for you and my sanity is that after
speaking with medical professionals she stopped her
tea-drinking habits, and soon after, her symptoms improved.
It can take years for the body to remove skeletal
fluoride, so her doctors considered using teriparatide,
a hormone that aids in bone formation to help her recover
though the case report ends before she was discharged.
So is fluoride good for us?
That’s a hard question to answer, and is far more
complicated that we could sum up in one video.
While fluoride did improve dental health in the
20th century; dental care, education, and cleaning
products were less available to the public.
That being said, much of the scientific research
at the time when nations were considering mass
fluoridation were confounded by other factors,
like socio-economic class, sugar consumption, and
sample size, that researchers could not control.
Today many of us reap the benefits of a more robust
healthcare system, but in the words of University of
Manchester School of Dentistry researcher Anne-Marie Glenny,
“There’s no argument that fluoridation doesn’t work … The
question is whether it is still the right way forward.”
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When I find that one dentist that didn’t recommend my channel…