Fluoride may diminish kidney and liver function in adolescents, study suggests

(New York, NY - August 8, 2019) -- Fluoride exposure may lead to a reduction in kidney and liver function among adolescents, according to a study published by Mount Sinai researchers in Environment International in August.

The study examined the relationship between fluoride levels in drinking water and blood with kidney and liver health among adolescents participating in the National Health and Nutrition Examination Survey, a group of studies that assess health and nutritional well-being in the United States. The findings showed that exposure to fluoride may contribute to complex changes in kidney and liver function among youth in the United States, where 74 percent of public water systems add fluoride for dental health benefits. Fluoridated water is the main source of fluoride exposure in the U.S.. The findings also suggest that adolescents with poorer kidney or liver function may absorb more fluoride in their bodies.

While fluoride exposure in animals and adults has been associated with kidney and liver toxicity, this study examined potential effects of chronic low-level exposure among youth. This is important to study because a child's body excretes only 45 percent of fluoride in urine via the kidneys, while an adult's body clears it at a rate of 60 percent, and the kidneys accumulate more fluoride than any other organ in the body.

"While the dental benefits of fluoride are widely established, recent concerns have been raised regarding the appropriateness of its widespread addition to drinking water or salt in North America," said the study's first author Ashley J. Malin, PhD, postdoctoral fellow in the Department of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai. "This study's findings suggest that there may be potential kidney and liver health concerns to consider when evaluating fluoride use and appropriate levels in public health interventions. Prospective studies are needed to examine the impact of chronic low-level fluoride exposure on kidney and liver function in the U.S. population."

The study analyzed fluoride measured in blood samples of 1,983 adolescents and the fluoride content of the tap water in the homes of 1,742 adolescents. Although the tap water fluoride concentrations were generally low, there are several mechanisms by which even low levels of fluoride exposure may contribute to kidney or liver dysfunction.

This study's findings, combined with previous studies of childhood exposure to higher fluoride levels, show there is a dose-dependent relationship between fluoride and indicators of kidney and liver function. The findings, if confirmed in other studies, suggest it may be important to consider children's kidney and liver function in drafting public health guidelines and recommendations.

Potential health side effects include renal system damage, liver damage, thyroid dysfunction, bone and tooth disease, and impaired protein metabolism.

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Study co-authors included Corina Lesseur, MD, PhD, Stefanie A. Busgang, MPH, Paul Curtin, PhD, Robert O. Wright, MD, MPH, and Alison P. Sanders, PhD. This study was supported in part by funding from the Mount Sinai Children's Center Foundation and grants from the National Institutes of Health's National Institute of Environmental Health Sciences (R00ES027508, R01ES014930, R01ES013744, R24ES028522, P30ES023515).

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The Mount Sinai Health System is New York City's largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 18 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Gastroenterology/GI Surgery, Geriatrics, Nephrology, and Neurology/Neurosurgery, and in the top 50 in six other specialties in the 2018-2019 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 11th nationally for Ophthalmology and 44th for Ear, Nose, and Throat. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West, and South Nassau Communities Hospital are ranked regionally.

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