Pain in the Gut: Fluoride Damage to the Gastrointestinal Tract
By Geoff N Pain
Acute and chronic poisoning of the gastrointestinal tract by ingested Fluoride has been studied for over 130 years with the measurable damage documented from the oral cavity through to the intestines.
Anaphylaxis, Anorexia, Aphthous Stomatitis, Apoptosis, Asthma, Bowel, Cancer, Chemical Hypersensitivity, Chronic Fatigue Syndrome, Constipation, Diarrhea, Dyspepsia, Flatulence, Gastrin, Gastritis, Ghrelin, Haemorrhage, Heliobacter Pylori, Hydroxyapatite Disease, Hypertension, Irritable Bowel Syndrome, Multiple Chemical Sensitivity, Myalgic Encephalopathy, Nausea, Obesity, Oesophagus, Proteomics, Sialorrhea, Stomach, Stomatitis, Ulcer, Vomiting.
Many of those involved in disposal of Fluoride industrial waste via public drinking water, in the process known as Fluoridation, deny the existence of research demonstrating harm to the gastrointestinal tract.
This brief review provides a guide to the extensive literature available. Damage to the gastrointestinal tract caused by low level exposure to Fluoride has been studied for a very long time [Roholm 1937] and has prompted numerous national governments to ban or prevent the practice of Fluoridation [Quebec 1979]. It is recognized as a problem by numerous governments to ban or prevent the practice of Fluoridation [Quebec 1979].
It is recognized as a problem by numerous organizations involved in public health protection [UNICEF 1999, NRC 2006, WHO 2014].
Much of the research into the effects of Fluoride on the alimentary tract has been funded by companies who profit from sale of Fluoride toothpaste, acid gels, varnishes and rinses [Ekstrand 1980, Lecompte 1987, Muller 1992, Spak 1989, Spak 1990].
Less published research appears to have been done by the Phosphate Fertilizer industrial waste Fluoride industry. In Australia, and a few remaining countries, governments that purchase the waste for disposal through drinking water supplies have been reluctant to fund scientific research into the known harms of the toxin.
Fatalities through accident or self-harm arising from Fluoride products have provided useful autopsy data [Shulman 1997, Lech 2011]. The probable lethal dose of Fluoride is less than 5mg/kg [Gosselin 1984, Akinawa 1997].
Chronic stomach pain, often with ulcers, is widely reported in 80% of patients in areas with natural Fluoride groundwater pollution [Gupta 1992, Dasarathy 1996, Waldblott 1998, Sharma 2009, Namkaew 2012].
Governments dispensing the Fluoride industrial waste have been temporarily exposed and embarrassed by “overdosing” accidents caused by negligence. As an example people in Brisbane Queensland suffered spontaneous stomach cramps, nausea and vomiting when a slug of high concentration Fluoridated water was introduced. Such Fluoridation negligence has occurred in numerous countries [Hoffman 1980, Vogt 1982, Sidhu 2002].
Modes of action
An extensive review of the effects of Fluoride on the gastrointestinal tract, completely and deliberately ignored by Australia’s National Health and Medical Research Council (NHMRC), appeared in 2006 as the result of over 3 years work by a team of ethical scientists on behalf of the US National Research Council. [NRC 2006]. This built on an earlier report [NRC 1993] and has been extended [Connett 2010].
Damage to the stomach mucosa resembles that done by acetylsalicylic acid. “Fluoride acts as a barrier-breaking agent, inducing ultrafiltration of fluid from the interstitium into the gastric lumen accompanied by an increased acid back-diffusion, an outpouring of glycoproteins and a reduction of adherent mucus. The rapid penetration of fluoride in the mucosa as hydrofluoric acid molecules may play an amplifying role where once fluoride has induced local vascular stasis, intramucosal acidity increases and ultimately leads to a pronounced mucosal damage”. [Gharzouli 2000].
Early experiments showed that Fluoride alters acid, water, Potassium and Sodium secretion in the stomach [Bowie 1953, Bond 1956]. Fluoride might affect the gastric enzyme H+, K+- ATPase, the proton pump, in the acid environment of the intracellular canaliculi within the parietal cell. Reduced acid secretion can allow stomach bacteria profile to be altered with the risk of developing ulcers and affect nutrition, e.g. leading to hypocalcemia [Nakano 1990]. In contrast, NRC stated that Fluoride can stimulate secretion of acid in the stomach [Assem 1982, Shayiq 1984], reduce blood flow away from the stomach lining, dilate blood vessels, increase redness of the stomach lining [Fujii 1989, Whitford 1997] and cause cell death and desquamation of the GI tract epithelium [Easmann 1984. Pashley 1984, Susheela1988, Kertesz 1989, NTP 1990, Shashi 2002].
Mucus secretion increases followed by patchy or widespread loss of the mucus layer, hypaeremia, oedema, and haemorrhage [Pratusha 2011]. Rupture of the stomach lining can occur [Teotia 1973].
Fluoride causes tissue injury by coagulation necrosis, which causes desiccation or denaturation of superficial tissue proteins, often resulting in the formation of an eschar or coagulum [Kardon 2016].
Fluoride induces genetic damage through increased DNA strand breaks and sister chromatid exchange [Gadhia 1997].
Fluoride causes problems as soon as it enters the mouth, with a percentage of the population suffering Aphthous Stomatitis, more commonly known as mouth ulcers [Waldblott 1958, Feltman 1961, Grimbergen 1974, Ganter 1997]. Direct destruction of oral mucosal cells has been measured [He 2006, Tsai 2008]. Fluoride enters the bloodstream directly through the mouth tissues [Whitford 1982].
Fluoride is largely converted to the toxic gas Hydrogen Fluoride upon contact with the gastric juices. Some of this gas will travel back to the airways, possibly accounting for increased rates of cancer of the Trachea and asthma observed in Fluoridated communities. Gastric reflux is associated with hypopharyngeal cancer [Ward 1998] and asthma [Saadeh 2017]. Approximately 70-90% of ingested fluoride is absorbed in the alimentary tract and, for very soluble forms such as sodium fluoride, absorption is almost 100% [NRC 2006 as cited in NTP 2016]. The rate of Fluoride of absorption is determined by gastric acidity and velocity of gastric emptying.
Rats treated with Fluoride intraperitoneally showed increasing absorption of Fluoride from the stomach, small intestine, caecum to a maximum in the large intestine [Dost 1968]. Up to 40% of the total fluoride ingested is absorbed from the stomach, while the remainder is absorbed from the proximal small intestine [He 1998, Buzalaf 2011]. Drinking water containing 1ppm Fluoride has as much as 200-fold higher concentration than the ionic level normally present in the blood. It is absorbed into the blood from the stomach and upper intestines, where it can sometimes cause gastric irritation and pain. Direct clinical evidence of reversible  and irreversible toxic effects from 1 ppm fluoride in drinking water has been reported.
Symptoms and Hypersensitivity
Symptoms of Fluoride poisoning that have been demonstrated by double blind placebo human testing include unaccountable fatigue not relieved by extra sleep; excessive thirst resulting in polydipsia and polyuria; migraine headache; loss of appetite, muscular weakness; involuntary muscle spasms; joint and back pains and stiffness; urinary tract irritation; stomach distension, bloating sensation and pains; mouth sores; skin rashes and itching, and visual disturbances involving the retina [Feltman 1956, Feltman 1961, Chand 1999]. The Australian National Health and Medical Research Council called for these complaints to be studied in 1991. That call has been ignored.
These symptoms closely match those reported by doctors attending to sufferers of Multiple Chemical Sensitivity, otherwise known as Chemical Hypersensitivity. As stated by an official from the South Australian Health Department: “Symptoms reported by sufferers can include headaches, burning eyes, nose or throat, concentration or memory lapses, nausea, stomach problems, muscle pain, dizziness and fever, asthma or other breathing problems, fatigue, depression or mood swings, sleeping problems and eczema.” [Fitzgerald 2005;2008].
Other labels for such disease include Myalgic Encephalopathy/ Chronic Fatigue Syndrome (ME/CFS).
The symptoms experienced by those who are sensitive to Fluoride resemble those produced by anaphylaxis, including anxiety, tingling or warm feelings, itching, the taste of metal in the mouth, swelling of lips and tongue, hives or other skin rash, difficulty breathing, wheezing, vomiting, diarrhoea mimicking irritable bowel syndrome, stomach cramps, colitis, dizziness, light-headedness and chest pain [WA 2007, Melo 2017 ].
Keen promoters of Fluoridation had no problem admitting over 70 years ago that a significant portion of the population will suffer more than the rest from the disposal of industrial waste through drinking water, some describing it as “low-grade chronic poisoning” [Kaminski 1990].
Dogs as the preferred test animal
Dogs have been used in studies of Fluoride toxicity for over 130 years. In long-term Fluoride toxicity studies, signs of hyperkeratosis and acanthosis of the stomach mucosa have been observed [Maurer 1990].
In rats, which have a higher tolerance to Fluoride than dogs or humans, chronic exposure to Sodium Fluoride at 4, 10, or 25 mg/kg in the diet resulted in dose-dependent chronic gastritis and glandular stomach acanthosis.
Colic and stomach ulcers linked to Fluoride have been reported in horses [Sauerheber 2013].
Human exposure to chronic industrial Fluoride pollution
Workers occupationally exposed to Fluoride have reported a variety of gastrointestinal effects including chronic gastritis with or without accompanying skeletal fluorosis, duodenal ulcers, and erosion of the gastric mucosa [Roholm 1937, Czerwinski 1977, Medvedeva 1983, Desai 1986, NRC 1993]. Fluoride is known to aggravate existing ulcers, with warnings to this effect on material safety data sheets. Workers in hot environments drink large volumes of water and are at greater risk [Sridharan 1999].
Human volunteers undergo deliberate damage
Scientists have found that a single dose of just 3 mg fluoride is sufficient to damage the gastric mucosa, and that tissue damage can occur in the absence of gastric symptoms [Spak 1990]. Human volunteers suffered terrible damage to their stomach on ingestion of a single dose of Fluoride with the lesions taking weeks to heal [Spak 1989]. Symptoms from similar experiments using 2 to 10 mg of Fluoride were not reported [Trautner 1986;1989].
Upper gastrointestinal endoscopy and punch biopsy material examined under scanning electron microscope revealed loss of microvilli on the cell surfaces, loss of mucus in the mucosa and “cracked clay” appearance of the cell surfaces of the mucosa compared to normal, healthy mucosa [Susheela 1988].
Case studies, such as those deliberately ignored by the NHMRC, are of course essential to properly understand the effects of low doses of Fluoride on humans. Eliminating Fluoride from drinking water has repeatedly shown full recovery from weight loss, dyspepsia, and gastric ulcer [Spittle 2008]. Tea contains high concentrations of Fluoride and many people suffer upset stomach and gastric pain if drinking this source.
Fluoride impact on Ghrelin
Ghrelin is an acylated peptide hormone mainly produced in the stomach. It activates the growth hormone (GH) secretagogue-receptor (Ghrelin receptor). Ghrelin functions as an orexigen and a GH-releasing hormone with other physiological roles, including modulation of energy metabolism, regulation of the autonomic nervous system, cardiovascular system and an antihypertensive effect. Destruction of the Ghrelin system results in hypertension, obesity and Diabetes [Hamada 2012]. Certain cancers, including stomach cancers, have been found to express Ghrelin [Papotti 2001]. Fluoride interference with Ghrelin requires further research.
Fluoride Impact on Melatonin
An inverse relationship between melatonin and the incidence of stomach ulcers has been observed in the stomach tissue and plasma of pigs [Bubenik 1998]. Exacerbation of duodenal ulcers in human patients is correlated with low urinary melatonin levels [Malinovskaya 2001]. Fluoride is known to suppress Melatonin.
Fluoride impact on the Enteric Nervous System (ENS)
Fluoride was found to alter the expression of hundreds of proteins in the gastrointestinal system of rats given drinking water containing 10 ppm Fluoride as analysed by mass spectrometric proteomics [Melo 2017]. In particular, ribosomal proteins involved in protein translation and other multiple extraribosomal activities, such as DNA repair, cell death, inflammation, tumorigenesis, ribosome assembly and transcriptional regulation were affected.
Hydroxyapatite deposits have been found in the gastric mucosa of dogs [Woodard 1982]. Fluoride doped Hydroxyapatite exhibits many similarities to asbestos which is known to cause cancer in the stomach and other tissues [Pain 2015].
Recently in Australia a famous manufacturer of infant formula was forced to withdraw product from the market due to discovery of nanocrystals of Fluoride doped Hydroxyapatite in its product.
The European Commission adopted a position on Hydroxyapatite in 2016 stating: “The available information indicates that nano-hydroxyapatite in needle-shaped form is of concern in relation to potential toxicity. Therefore, needle-shaped nano-hydroxyapatite should not be used in cosmetic products. It is of note that Material 2 of the submission also includes nanofibres of needle-like structure.” [EC 2016].
Colon and Rectum Cancer
Significantly higher rate of colon and rectum cancer was found in fluoridated communities [Yiamouyiannis 1975;1977, Burk 1976, Takahashi 2001]. The Republic of Ireland (fluoridated) has a higher incidence of colon cancer than Northern Ireland (not fluoridated) [Waugh 2014]. High tea consumption (i.e. high Fluoride intake) showed increased risk of colorectal cancer (RR 1.28 95% CI 1.02-1.61) [Zhang 2010].
Significantly higher rate of oesophagus cancer was found in fluoridated communities [Takahashi 2001]. The Republic of Ireland (fluoridated) has a higher incidence of oesophagus cancer than Northern Ireland (not fluoridated) [Waugh 2014]. Generation of HF gas in the stomach is a likely contributor to increased incidence of this cancer.
Stomach cancer is a major killer worldwide. Workers exposed to Fluoride in Phosphate Fertilizer manufacture experience a higher incidence of stomach cancer [Glasser 2001]. After examination of data it was considered impossible to rule out the possibility of fluoridation causing a 1.5% increase in total cancer rates or a 15% increase in specific cancer rates [Taves 1977]. Decreased gastric acidity due to any means including proton pump inhibitors increases gastric counts of bacteria normally present in the gastrointestinal tract. Fluorinated drugs
Various inorganic salts of Fluoride have been used in attempts to treat ailments such as osteoporosis, using dangerous doses, however its use has been virtually abandoned due to side effects, including those on the gastrointestinal tract: epigastric pain, anorexia, dyspepsia, severe nausea and vomiting, diarrhea, peptic ulcer, or blood-loss anemia [Rich 1966, Jowsey 1972, Inkovaara 1975, Riggs 1980, Riggs 1982, Riggs 1983, Hodsman 1989, Riggs 1990, Inkovaara 1991, Kleerekoper 1991, Sogaard 1994, Pak 1994, Khosla 1995, Grey 2013]. Attempts at amelioration of the side effects with Calcium supplements increased the risk of Hypercalcemia.
Acifluorfen has been classified as a Group B2 (probable human carcinogen) chemical by the OPP Cancer Peer Review Committee (CPRC), and produces a high incidence of uncommonly occurring stomach papillomas in male mice [USEPA 1997].
Fluorouracil has been identified as a major risk factor for oral mucositis [Burgess 2016]. Side-effect symptoms of Voriconazole, which is rapidly metabolized to free serum Fluoride ion, closely match those observed with inorganic Fluorides as expected. They have been listed thus: “Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); abnormal thoughts; black, tarry stools; bone pain; calf or leg pain, redness, swelling, or tenderness; change in the appearance of a mole; chest, jaw, or arm pain; confusion; decreased urination; fainting; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; flushing; hallucinations; mental or mood changes (e.g. depression); mouth sores; one-sided weakness; red, swollen, peeling, or blistered skin; seizures; severe or persistent dizziness or headache; shortness of breath; speech changes; sudden, severe nausea or vomiting; suicidal thoughts or actions; swelling of the arms or legs; symptoms of liver problems (e.g. yellowing of the skin or eyes; dark urine; pale stools; severe or persistent nausea, vomiting, or stomach pain; loss of appetite; itching); symptoms of pancreatitis (e.g. severe stomach or back pain, with or without nausea or vomiting); unusual bruising or bleeding; unusual skin change or skin growth; unusual sweating or weakness; unusual tiredness; unusual vaginal bleeding; vision changes (e.g. colour vision change, persistent or severe blurred vision or sensitivity to light). This is not a complete list of all side effects that may occur.”
Summary and Conclusion
Fluoride has been known for decades to damage the gastrointestinal organs. Recent use of the most advanced proteomics toxicological techniques identified hundreds of proteins and processes adversely affected by Fluoride in the gastrointestinal tract. It is time to implement a comprehensive global ban on water Fluoridation and force the generators of Fluoride industrial waste to permanently immobilize the toxin.
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