Fluoride and diabetes

Diabetes is the fastest growing chronic health condition in Australia, costing the nation around $15 billion each year. So with numerous research studies suggesting fluoride can cause or increase the likelihood of diabetes, it is astonishing that our health authorities are not prepared at least to investigate this possible link further.
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“Segments of the population are unusually susceptible to the toxic effects of fluoride. They include postmenopausal women and elderly men, pregnant woman and their fetuses, people with deficiencies of calcium, magnesium and/or vitamin C, and people with cardiovascular and kidney problems."
United States Public Health Service Report (1993)

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Diabetes in Australia

By the time you’ve finished reading this article, another two Australians will develop diabetes. In fact 280 Australians develop or are diagnosed with this life-changing, life-threatening disease every single day.

According to Diabetes Australia, around 1.7 million Australians have diabetes. This includes 1.2 million known and registered diabetics and an estimated 500,000 silent, undiagnosed type-2 diabetics.

Here are a few more facts from Diabetes Australia:

  • Diabetes is the fastest growing chronic condition in Australia; increasing at a faster rate than other chronic diseases such as heart disease and cancer. All types of diabetes are increasing in prevalence;
  • Diabetes is the leading cause of preventable blindness in Australia;
  • There are more than 4,400 amputations every year in Australia as a result of diabetes;
  • People with diabetes are between two and four times more likely to develop heart disease;
  • Cardiovascular disease is the leading cause of death in Australia. It kills one Australian every 12 minutes;
  • In one year, the total cost of diabetes in Australia is currently estimated at $14.6 billion.

So it’s undeniable, diabetes is a growing epidemic in this country.

Diabetes is the fastest growing chronic condition in Australia; increasing at a faster rate than other chronic diseases such as heart disease and cancer. All types of diabetes are increasing in prevalence;
What is diabetes?

Diabetes is due to either the pancreas not producing enough insulin, or the cells of the body not responding properly to the insulin produced. Insulin plays a crucial role in allowing the body to utilise carbohydrates, especially glucose. Type 1 diabetes is an auto-immune condition in which the immune system destroys the cells in the pancreas which produce insulin. The pancreas therefore fails to produce adequate insulin. Type 2 diabetes begins with insulin resistance, a condition in which cells fail to respond to insulin properly. As the disease progresses, a lack of insulin may also develop. Gestational diabetes occurs during pregnancy and is the fastest growing type of diabetes in Australia with 12 to 14 per cent of pregnant women currently developing this condition.

Fluoride and diabetes

In 2006, after conducting an extensive 3-year review on fluoride, the US National Research Council (NRC) stated:

“The conclusion from the available studies is that sufficient fluoride exposure appears to bring about increases in blood glucose or impaired glucose tolerance in some individuals and to increase the severity of some types of diabetes. In general, impaired glucose metabolism appears to be associated with serum or plasma fluoride concentrations of about 0.1 mg/L or greater in both animals and humans.”

The ramifications of this statement alone are of major significance. In Australia our drinking water is “optimally fluoridated” (a term often used by fluoride proponents) at a concentration of around 1mg of “fluoride” per litre of water. This rate is sufficient for many people to have a resulting plasma (blood) fluoride concentration of 0.1mg/L. According to the NRC, this is enough to cause or exacerbate a diabetic condition.

The NRC went on to say; “any role of fluoride exposure in the development of impaired glucose metabolism or diabetes is potentially significant.”

Studies on both animals and humans have revealed a temporary decline in insulin production following fluoride ingestion, resulting in hyperglycaemia or elevated blood sugar levels. This simply means there is not enough insulin to facilitate the metabolism of glucose and therefore glucose levels rise.  Several other studies have revealed that fluoride may also lead to increased insulin resistance, or decreased insulin sensitivity, thereby contributing to glucose intolerance. Studies demonstrating both of these phenomenon are listed here.

“In general, impaired glucose metabolism appears to be associated with serum or plasma fluoride concentrations of about 0.1 mg/L or greater in both animals and humans.” (NRC review “Fluoride and drinking water” 2006)

Diabetics are more sensitive to fluoride

There are several interrelated reasons why diabetics are more susceptible to fluoride-related toxicity;

1. Diabetics tend to drink more water, because the kidneys require more fluid to process the higher than normal blood sugar levels. Therefore they generally consume substantially more fluoride from water and other sources. The 2006 NRC fluoride review stated:

“In addition, diabetic individuals will often have higher than normal water intake, and consequently, will have higher than normal fluoride intake for a given concentration of fluoride in drinking water.”

2. Diabetes is often associated with kidney damage or impaired kidney function. The high blood sugar levels can damage the blood vessels in the kidneys and high blood pressure – often associated with diabetes – can also damage the kidneys. The problem is the kidneys play a major role in removing fluoride from our system because this chemical substance is quickly recognised as a xenobiotic or toxic foreign substance. This means diabetics are generally less capable of processing and removing the fluoride.

3. Fluoride is a  persistent bioaccumulator. In a healthy person around 40 to 50 per cent accumulates in the body and continues to do so over a lifetime, while the balance is normally expelled via the kidneys and urine. But for a diabetic, in addition to the kidneys not immediately expelling as much fluoride, the fluoride may cause further damage to the kidneys and accumulate in various other parts of the body. For more details see our article: The bioaccumulation of fluoride.

Diabetics are therefore particularly susceptible to fluoride and may suffer disproportionately from fluoride’s adverse effects.

Australian scientist Dr. Geoff Pain, PhD, begins his comprehensive review Fluoride causes diabetes (2018 update) as follows:

“Experts in endocrinology have shown that fluoride causes diabetes and obesity. This review assembles the wealth of science that shows how fluoride damages the organs that generate or use Insulin to control glucose metabolism and the crucial involvement of other hormone systems.

More on fluoride and the kidneys

According to Diabetes Australia, kidney failure is three times more common in people with diabetes.

Fluoride is a known nephrotoxin, that is a toxic agent or substance that inhibits, damages or destroys the cells and/or tissues of the kidneys. Fluoride induced nephrotoxicity is dose dependent, i.e. the more fluoride consumed from water and other sources, the more damage to the kidneys.

The Australian Kidney Foundation states: “There is consistent evidence that impairment of kidney function results in changes to the way in which 

Diagram from "Fluoride is a developmental neurotoxin" (Pain G. 2017)

fluoride is metabolised and eliminated from the body resulting in an increased burden of fluoride” and warns that “Monitoring of fluoride intake and avoidance of fluoride-rich substances would be prudent for people with stage 4 or 5 CKD, in addition to regular investigations for possible signs of fluorosis”.

In his 2018 review, Dr Geoff Pain highlights the impact of fluoride on the kidneys: “Diabetics have a higher incidence of chronic kidney disease which leads to impaired renal clearance of fluoride, the “vicious cycle” that too often results in death or the need for transplant.”

In another review, Fluoride is a developmental Nephrotoxin (2017), Dr Geoff Pain highlights several relevant studies:

“The link between fluoride and kidney disease has been known and confirmed in animal and human studies since the 1890s (Hewelke 1890, Shortt 1937, Linsman 1943, Isaacson 1997) and has even been admitted by early fluoridation proponents (Heyroth 1952).”

“[A] fairly substantial body of research indicates that patients with chronic renal insufficiency are at an increased risk of chronic fluoride toxicity. Patients with reduced glomerular filtration rates have a decreased ability to excrete fluoride in the urine. These patients may develop skeletal fluorosis even at 1 ppm fluoride in the drinking water.” Schiffl H. (2008).

Schiffl (2008) also noted that the side effects of fluoride can easily be overlooked by physicians.

“The safety margin for exposure to fluoride by renal patients is unknown, measurements of fluoride levels are not routine, the onset of skeletal fluorosis is slow and insidious, clinical symptoms of this skeletal disorder are vague, progression of renal functional decline is multifactorial and physicians are unaware of side effects of fluoride on kidneys or bone.”

Another study (Hanhijarvi, 1975), recorded blood/fluoride concentrations of 2,200 people, including 501 living in a low fluoride area (less than 0.2mg/L natural fluoride) and 1,083 living in an area with artificially fluoridated water (1mg/L). The study found that fluoride concentrations; i) increased with age; and ii) were higher in individuals living in areas with water fluoridation. “Decreased renal clearance of fluoride was observed in persons with renal insufficiency or diabetes mellitus.”

Other studies have also shown decreased fluoride clearance in both adults and children with impaired renal function (Kono et al, 1984; Spak et al 1985).

Fluoridated water is also acknowledged to be potentially harmful to patients on dialysis machines. There are cases where dialysis patients have died or were fluoride-poisoned when filtration systems on the machines allowed fluoride into the bodies of the patients. In July 1993, the Chicago Tribune reported the death of three dialysis patients. “Because dialysis patients are exposed to high volumes of water, these patients can accumulate potentially harmful amounts of fluoride if the water is left untreated.”

 
A diabetic patient on dialysis is susceptible to fluoride poisoning
Fluoride and the endocrine system

Another potential issue for diabetics is the influence that fluoride can have on the endocrine system, which handles body functions such as the growth of cells, organs and metabolism; keeping the body’s hormone and secretion levels in balance. Since there is a whole series of organs and glands that must work in tandem to maintain healthy hormone and secretion levels, when one of them doesn’t function the way it’s supposed to function, it puts a heavy strain on the rest of the body.

The pancreas has both endocrine and exocrine functions within the one organ. The exocrine function of the pancreas produces enzymes to help with the digestion of food, while the endocrine function is composed of small islands of cells, called the islets of Langerhans. These endocrine cells release hormones, such as insulin and glucagon, into the blood stream, and these hormones in turn help control blood sugar (glucose) levels. The functioning of the pancreas can be significantly reduced in patients with hypothyroidism (under active thyroid), compared with healthy subjects. Patients with autoimmune pancreatitis have a high prevalence of hypothyroidism.

Various studies have shown the increased likelihood of hypothyroidism in areas where fluoridated water is consumed, especially when combined with low iodine levels. For more details see our article: Fluoride and the endocrine system.

As Dr Geoff Pain points out in his 2018 review, according to one study (Takahashi 2001), there are higher pancreatic incidence and death rates in fluoridated areas compared to non-fluoridated areas in the United States. In fact this study showed the pancreatic cancer rate is 34 per cent higher in fluoridated communities.

The functioning of the pancreas can be significantly reduced in patients with hypothyroidism (under active thyroid), compared with healthy subjects.
Various studies have shown the increased likelihood of hypothyroidism in areas where fluoridated water is consumed, especially when combined with low iodine levels.
Fluoridated water, diabetes and dental fluorosis

It has long been acknowledged that fluoridated water causes a defect of the tooth enamel known as dental fluorosis. See our article on Dental fluorosis.

Children with diabetes have a particularly high risk of developing severe fluorosis due to the increased volume of water consumed.

Several studies have highlighted the issue of dental fluorosis among diabetics:

In 1965, Sauerbrunn et al concluded, “Prolonged polydipsia (excessive thirst) may be hazardous to persons who live in areas where the levels of fluoride in drinking water are not those usually associated with significant fluorosis.”

In 1974, Greenberg LW et al call for a portion of the water ingested by children with Diabetes Insipidus to be supplied from a non-fluoridated source.

In 1975, Klein, H concluded; “Extremely heavy intake of water with a fluoride content of about 0.5 ppm during the early years of tooth development has produced severe to mild fluorosis of the teeth in the family members affected by hereditary pituitary diabetes insipidus.” This study is of particular relevance to Australia because our “optimal” fluoridation rate of 1mg/L is double the rate in this study.

Further studies have documented the occurrence of severe fluorosis among children with diabetes in areas of “optimally” fluoridated water concentrations (Seow WK, Thomsett MJ (1994)).

Several studies have highlighted the issue of dental fluorosis among diabetics
Diabetes and kidney disease amongst our indigenous population

According to Diabetes Australia, Aboriginal and Torres Strait Islander people are almost four times more likely than non-Indigenous Australians to have diabetes or pre-diabetes.

Almost one in five (18 per cent) of our indigenous population aged over 18 had indicators of chronic kidney disease.1

Indigenous people are more than twice as likely as non-Indigenous people to have indicators of chronic kidney disease; three times as likely to have indicators of Stage 1 chronic kidney disease, and more than four times as likely to have indicators of Stages 4 and 5 kidney disease.1

The incidence of end stage kidney disease for indigenous people is especially high in remote and very remote areas of Australia, with rates up to 20 times those of comparable non-Indigenous.2

With such high rates of diabetes and kidney disease, our indigenous population may therefore be particularly susceptible to the potential damaging effects of fluoride. And yet our health authorities completely ignore or dismiss the scientific evidence linking fluoride with diabetes and impaired kidney functioning and still want to fluoridate as much of our indigenous communities as possible.

Improving the lives of people especially at risk among indigenous communities should therefore be a priority for our health authorities.

Age-specific hospitalisation rates for diabetes, by Indigenous status, July 2011–June 2012 (Source: AIHW)
Indigenous people are more than twice as likely as non-Indigenous people to have indicators of chronic kidney disease; three times as likely to have indicators of Stage 1 chronic kidney disease, and more than four times as likely to have indicators of Stages 4 and 5 kidney disease.1
Diabetics and the risk of death

In 2015, there were 16,400 deaths in Australia due to diabetes, with 55 per cent due to type 2 diabetes (ABS). By 2030, the The World Health Organisation predicts diabetes will be the seventh leading cause of death.

In 2001, The Institute of Public Health in Ireland published a study titled “Inequalities in Mortality: a report on all-Ireland mortality data 1988 – 1998”. This report found the mortality from diabetes during the study period was 372 per cent higher in fluoridated Republic of Ireland than it was in non-fluoridated Northern Ireland.

It is worth noting there is no real difference genetically between the two populations and the only obvious environmental toxin exclusively in the south is fluoride. Most of Northern Ireland has never been fluoridated while 70 per cent of the population of the Republic of Ireland receives fluoridated water. Like Australia, Ireland’s fluoridation program began around 50 years ago.

 

Conclusion

Apart from the enormous suffering caused by diabetes in Australia, the sharply increasing prevalence of this condition and the massive and expanding cost to our society should be of great concern to our health authorities.

With the substantial amount of research showing links between fluoride and diabetes, impaired kidney functioning and damage to the endocrine system, plus the increased susceptibility of diabetics to fluoride, it is remarkable that our governments and our National Health and Medical Research Council continue to ignore or dismiss the risks of fluoridation and refuse to undertake any clinical studies to examine the link between fluoride and diabetes.

As Paul Connett, PhD, co-author of The Case Against Fluoride, states, “When an entire population is exposed to a toxic substance, simply setting regulatory levels to protect the average person is not enough; those levels must be set to protect the most vulnerable citizens, such as people with diabetes and those susceptible to it.”

When an entire population is exposed to a toxic substance, simply setting regulatory levels to protect the average person is not enough; those levels must be set to protect the most vulnerable citizens, such as people with diabetes and those susceptible to it.”

Paul Connett, PhD, co-author of "The Case Against Fluoride"

Notes

  1. Australian Bureau of Statistics. 2014. Australian Aboriginal and Torres Strait Islander Health Survey: Biomedical Results, 2012-13. Report No: 4727.0.55.003, Canberra.
  2. Stumpers S, Thomson N. Review of kidney disease among Indigenous people. Australian Indigenous Health Bulletin 2013;13(2).