Fluoride and Neurodegeneration

Research presented here documents fluoride's causative role in
several major pathological pathways involved in Alzheimer's
and other neurodegenerative and vascular diseases.

94 references are cited. 28 of the studies
were published in 2017 & 2018.
(See
2019 & 2020 research.)

John D. MacArthur

Mental Fluorosis
(text in graphic links to its section)

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Endoplasmic Reticulum Stress

Within a cell, the endoplasmic reticulum (ER) is the site where proteins are
synthesized and folded. ER function is highly sensitive to toxins that
can overwhelm the cell's folding capacity and cause misfolded
proteins to accumulate – a condition known as ER stress.

Fluoride and ER Stress

Dental Fluorosis: Researchers at the Forsyth Institute in Massachusetts, a fluoride research center for the past century, found that fluoride initiates an ER stress response in ameloblasts that interferes with protein synthesis and secretion – culminating in dental fluorosis. Beginning with the lowest dose tested, they observed an increase in the magnitude of ER stress with increasing doses of fluoride. [Sharma R, et al. 2008]

Ameloblasts are cells present during tooth development that secrete large amounts of proteins that later mineralize to form tooth enamel.

Skeletal Fluorosis: Fluoride causes ER stress during osteoblast maturation. [Zhou et al. 2013] Osteoblasts are cells that secrete the protein matrix for bone formation.

• The severity of osteofluorosis is associated with accumulation of fluoride in bone, in a dose-dependent manner. [Liu L, et al. 2015]

Pineal Fluorosis: Because it is not protected by the blood-brain barrier, the pineal gland is exposed to fluoride in the bloodstream. Its fluoride concentrations are positively related to calcium concentrations. By old age, the fluoride/calcium ratio in the human pineal gland is higher than in bone. [National Research Council (1) 2006; Luke 2001] (See MacArthur 2013)

• Animal research has found fluoride concentrations four times higher in the pineal gland than in the skull or the brain. [Kalisinska et al. 2014]

Soft Tissue Fluorosis: Fluoride exposure induced excessive ER stress and associated apoptosis (cell death) in the hippocampus of rats, resulting in histological and ultrastructural abnormalities that impaired learning and memory capabilities. [Niu et al. 2018]

• Fluoride has also been shown to induce ER stress that causes cell death in spleen lymphocytes [Deng et al. 2016] and in immature sperm cells. [Yang Y, et al. 2015]

Placental Fluorosis: Women who drank water fluoridated at 1.0-1.2 ppm (parts per million) averaged 2 ppm fluoride in their placentas – nearly three times higher than in women who drank unfluoridated water. [Gardner et al. 1952] (See MacArthur 2015)

ER Stress and Neurodegeneration

The endoplasmic reticulum is the main compartment involved in protein folding and secretion and is drastically affected in Alzheimer's disease neurons. [Gerakis et al. 2018]

• Accumulating evidence indicates that chronic ER stress is of paramount significance in development and progression of many neurodegenerative diseases whose pathology includes accumulation of misfolded proteins in the brain. [Mahdi et al. 2016]

• In stroke and Lou Gehrig's disease, chronic activation of ER stress is considered as main pathogeny. [Zhang et al. 2015]

• ER stress and accumulation of several types of misfolded proteins (β-amyloid, Tau, alpha-synuclein, etc.) are associated with most of the brain pathology processes observed in the development of Alzheimer's disease. [Li JQ, et al. 2015]


Pineal gland calcification is significantly higher in patients with Alzheimer's disease. [Mahlberg et al. 2008]

ER stress also mediates the pathogenesis of psychiatric diseases, such as depression, schizophrenia, sleep fragmentation, and post-traumatic stress disorder. Inhibiting specific causes of ER stress may help prevent neurodegeneration. [Xiang et al. 2017]











Low lymphocyte levels (lymphopenia) is associated with reduced survival due to heart disease, cancer and respiratory infections, including influenza and pneumonia. [Zidar et al. 2019]

Note: ER stress is a central mechanism in the pathogenesis of preeclampsia, the life-threatening pregnancy complication caused by the abnormal placenta. [Burton et al. 2011]

ER Stress References Cited

Deng H, Kuang P, Cui H, et al. Sodium fluoride (NaF) induces the splenic apoptosis via endoplasmic reticulum (ER) stress pathway in vivo and in vitro. Aging (Albany NY). 2016 Dec 27;8(12):3552-3567.

Gardner DE, Smith FA, Hodge HC, Overton DE, Feltman R. The fluoride concentration of placental tissue as related to fluoride content in drinking water. Science. 1952;115(2982):208-209.

Kalisinska E, Bosiacka-Baranowska I, Lanocha N, et al. Fluoride concentrations in the pineal gland, brain and bone of goosander... Environ Geochem Health. 2014; 36:1063-1077. Table 1.

Liu L, Zhang Y, Gu H, Zhang K, Ma L. Fluorosis induces endoplasmic reticulum stress and apoptosis in osteoblasts in vivo. Biol Trace Elem Res. 2015 Mar;164(1):64-71.

Luke J. Fluoride deposition in the aged human pineal gland. Caries Res. 2001 Mar-Apr;35(2):125-128.

MacArthur JD. Overdosed: Fluoride, copper, and Alzheimer's disease. Townsend Letter. 2013;363:63-70.

MacArthur JD. Placental fluorosis: Fluoride and preeclampsia. Townsend Letter. 2015;382:74-79.

National Research Council (1). Pineal Gland Calcification. Fluoride in drinking water: a scientific review of EPA's standards. The National Academies Press, 2006. Page 253.

Niu Q, Chen J, Xia T, et al. Excessive ER stress and the resulting autophagic flux dysfunction contribute to fluoride-induced neurotoxicity. Environ Pollut. 2018 Feb;233:889-899.

Sharma R, Tsuchiya M, Bartlett JD. Fluoride induces endoplasmic reticulum stress and inhibits protein synthesis and secretion. Environ Health Perspect. 2008 Sep;116(9):1142-1146.

Yang Y, Lin X, Huang H, et al. Sodium fluoride induces apoptosis through reactive oxygen species-mediated endoplasmic reticulum stress pathway in Sertoli cells. J Environ Sci (China). 2015 Apr 1;30:81-89.

Zhou YL, Shi HY, Li XN, et al. Role of endoplasmic reticulum stress in aberrant activation of fluoride-treated osteoblasts. Biol Trace Elem Res. 2013 Sep;154(3):448-456.

Burton GJ, Yung HW. Endoplasmic reticulum stress in the pathogenesis of early-onset preeclampsia. Pregnancy Hypertens. 2011 Jan;1(1-2):72-78.

Gerakis Y, Hetz C. Emerging roles of ER stress in the etiology and pathogenesis of Alzheimer's disease. FEBS J. 2018 Mar;285(6):995-1011.

Li JQ, Yu JT, Jiang T, Tan L. Endoplasmic reticulum dysfunction in Alzheimer's disease. Mol Neurobiol. 2015 Feb;51(1):383-395.

Mahdi AA, Rizvi SHM, Parveen A. Role of endoplasmic reticulum stress and unfolded protein responses in health and diseases. Indian J Clin Biochem. 2016 Apr; 31(2): 127-137.

Mahlberg R, Walther S, Kalus P, et al. Pineal calcification in Alzheimer's disease: an in vivo study using computed tomography. Neurobiol Aging. 2008 Feb;29(2):203-209.

Xiang C, Wang Y, Zhang H, Han F. The role of endoplasmic reticulum stress in neurodegenerative disease. Apoptosis. 2017 Jan;22(1):1-26.

Zhang HY, Wang ZG, Lu XH, et al. Endoplasmic reticulum stress: relevance and therapeutics in central nervous system diseases. Mol Neurobiol. 2015;51(3):1343-1352.

Zidar DA, Al-Kindi, SG, Liu Y, et al. Association of lymphopenia with risk of mortality among adults in the US general population. JAMA Netw Open. 2019;2(12):e1916526;  Cleveland Clinic, December 2, 2019.

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Endothelial Dysfunction

Endothelial cells line the inside of blood vessels from the aorta to microvessels,
and form a selective blood-tissue barrier that protects every organ system.
Endothelial dysfunction plays an early pathogenic role in many diseases.

Fluoride and Endothelial Dysfunction

Sodium fluoride causes dramatic endothelial cell barrier dysfunction. [Wang P, et al. 2001]

Sevoflurane, a Fluorinated Anesthetic
After exposure to Sevoflurane, a general anesthetic that significantly increases blood fluoride levels, the blood-brain barrier (BBB) is compromised due to "flattening of endothelial cell surfaces." [Goldberg et al. 1996; Acharya et al. 2015]

• Sevoflurane is associated with high rates of post-operative delirium, a common and often fatal disorder affecting as many as 50% of older people during surgery or hospitalization. The severity of post-operative delirium correlates directly to the severity of later cognitive impairment and decline. [Institute for Aging Research 2017]

• Inhibiting ER stress during sevoflurane anesthesia will be a potential method to prevent later learning and memory deficits in adulthood. [Zhu G, et al. 2017]

• Another drug that increases blood fluoride levels is 5-fluorouracil, which also causes endothelial cell dysfunction. [Hull et al. 1988; Altieri et al. 2017]

• Fluoroquinolone antibiotics induce cytotoxicity to endothelial cells, depending on drug concentration and duration of exposure. [Bezwada et al. 2008]

• Fluoride and/or arsenic induced significant increase in endothelial cell death and inflammation, mechanisms of vascular toxicity. [Ma et al. 2017]

Note: Amniotic tissue cultures treated with sodium fluoride have significantly higher expression levels of soluble Endoglin. [Tskitishvili et al. 2010]

Endothelial Dysfunction and Neurodegeneration

Microvascular endothelial cells play a critical role in brain development, maturation, and homeostasis. Acute or chronic insults cause brain endothelial cell dysfunction and damage.

• Loss of BBB integrity is a common pathological finding in many psychiatric disorders including autism and schizophrenia. BBB dysfunction leads to infiltration of peripheral material, culminating in neuroinflammation and oxidative stress. [Kealy et al. 2018]

• Endothelial cell dysfunction in the blood-brain barrier is the first pathological change in the development of small vessel disease, a major cause of vascular dementia in older people that triples the risk of stroke and contributes to Alzheimer's disease. [Rajani et al. 2018; Kelleher et al. 2013]

• A common mechanism in age-related diseases like dementia, cancer, and diabetes is the accumulation of dysfunctional endothelial cells that are not just an effect of aging. It's a reason why we age. [University of Exeter 2018]

• ER stress induces endothelial cell dysfunction in the brain and blood vessels. [Rizzo et al. 2010; Soejima et al. 2018]

• Chronic activation of ER stress in endothelial cells leads to increased oxidative stress and inflammation and often results in cell death. [Lenna et al. 2014]

Note: In the complex pathogenesis of preeclampsia, endothelial dysfunction remains the most agreed-upon central mechanism involved. [Meeme et al. 2017]

A marker of endothelial dysfunction is soluble Endoglin, whose levels are elevated in preeclampsia. [Al-Jameil 2014]

See also the page about endothelial cell dysfunction.

Endothelial Dysfunction References Cited

Acharya NK, Goldwaser EL, Forsberg MM, et al. Sevoflurane and isoflurane induce structural changes in brain vascular endothelial cells and increase blood-brain barrier permeability: Possible link to postoperative delirium and cognitive decline. Brain Res. 2015 Sep 16;1620:29-41.

Altieri P, Murialdo R, Barisione C, et al. 5-fluorouracil causes endothelial cell senescence: potential protective role of glucagon-like peptide 1. Br J Pharmacol. 2017 Nov;174(21):3713-3726.

Bezwada P, Clark LA, Schneider S. Intrinsic cytotoxic effects of fluoroquinolones on human corneal keratocytes and endothelial cells. Curr Med Res Opin. 2008 Feb;24(2):419-424.

Goldberg ME, Cantillo J, Larijani GE, et al. Sevoflurane versus isoflurane for maintenance of anesthesia: are serum inorganic fluoride ion concentrations of concern? Anesth Analg. 1996 Jun;82(6):1268-1272.

Hull WE, Port RE, Herrmann R, et al. Metabolites of 5-fluorouracil in plasma and urine... Cancer Res. 1988 Mar 15;48(6):1680-1688.

Institute for Aging Research. Severity of post-operative delirium relates to severity of cognitive decline. November 28, 2017.

Ma Y, Ma Z, Yin S. et al. Arsenic and fluoride induce apoptosis, inflammation and oxidative stress in cultured human umbilical vein endothelial cells. Chemosphere. 2017 Jan;167:454-461.

Tskitishvili E, Sharentuya N, Temma-Asano K, et al. Oxidative stress-induced S100B protein from placenta and amnion affects soluble endoglin release from endothelial cells. Mol Hum Reprod. 2010;16(3):188199.

Wang P, Verin AD, Birukova A, et al. Mechanisms of sodium fluoride-induced endothelial cell barrier dysfunction: role of MLC phosphorylation. Am J Physiol Lung Cell Mol Physiol. 2001 Dec;281(6):L1472-1483.

Zhu G, Tao L, Wang R, et al. Endoplasmic reticulum stress mediates distinct impacts of sevoflurane on different subfields of immature hippocampus. J Neurochem. 2017 Jul;142(2):272-285.

Al-Jameil N, Aziz Khan F, Fareed Khan M, Tabassum H. A brief overview of preeclampsia. J Clin Med Res. 2014 Feb;6(1):1-7.

Kealy J, Greene C, Campbell M. Blood-brain barrier regulation in psychiatric disorders. Neurosci Lett. 2018 Jun 30:133664.

Kelleher RJ, Soiza RL. Evidence of endothelial dysfunction in the development of Alzheimer's disease: Is Alzheimer's a vascular disorder? Am J Cardiovasc Dis. 2013 Nov 1;3(4):197-226.

Lenna S, Han R, Trojanowska M. Endoplasmic reticulum stress and endothelial dysfunction. IUBMB Life. 2014 Aug;66(8):530-537.

Meeme A, Buga GA, Mammen M, Namugowa A. Endothelial dysfunction and arterial stiffness in pre-eclampsia demonstrated by the EndoPAT method. Cardiovasc J Afr. 2017 Jan/Feb 23;28(1):23-29.

Rajani RM, Quick S, Ruigrok SR, et al. Reversal of endothelial dysfunction reduces white matter vulnerability in cerebral small vessel disease in rats. Sci Transl Med. 2018 Jul 4;10(448);   Middleton J. Stabilizing endothelial cells could help tackle vascular dementia. American Association for the Advancement of Science. July 4, 2018.

Rizzo MT, Leaver HA. Brain endothelial cell death: modes, signaling pathways, and relevance to neural development, homeostasis, and disease. Mol Neurobiol. 2010 Aug;42(1):52-63.

Soejima E, Ohki T, Kurita Y, et al. Protective effect of 3-hydroxybutyrate against endoplasmic reticulum stress-associated vascular endothelial cell damage induced by low glucose exposure. PLoS One. 2018;13(3):e0191147.

University of Exeter. Key aspects of human cell aging reversed by new compounds. August 7, 2018.

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Microglial Activation and Neuroinflammation

Microglia are a type of immune cell that account for 10-15% of all brain cells.
An essential function of microglia is to defend the brain against toxins.
When activated, microglia produce neuroinflammation
that can damage and kill neurons.

Fluoride Activates Microglia and Neuroinflammation

Fluoride can cause fluorosis and irreversible brain damage. The neuroinflammation process is meditated by microglia: activated microglia release pro-inflammatory cytokines and neurotoxic molecules. [Chen et al. 2017]

• Fluorine affects oxidative stress, glial activation and inflammation in the central nervous system, which leads to neurodegeneration. [Dec et al. 2017]

• Fluoride induced neuron apoptosis and inflammatory factors by activating microglia in rat brain. [Yan N, et al. 2016]

• When rats were treated for 30 days with fluoride in their drinking water, it caused an increase in microglial activation and neuroinflammation. [Akinrinade et al. 2015]

• In the central nervous system, inflammatory cytokines are released from activated microglial cells induced by fluoride. [Yan L, et al. 2013]

Fluoride exposure activated microglia and promoted neuroinflammation in the hippocampus of rats sub-chronically exposed to fluoride in their drinking water, which affected synaptic plasticity by decreasing levels of PSD-95. [Yang L, et al. 2018]

• In rats that drank water with added fluoride for several months, the fluidity of brain synaptic membranes and the expression level of PSD-95 decreased in a dose-dependent manner. [Qian et al. 2013; Zhu W, et al. 2011]

• Rats anesthetized for 4 hours with 2.5% Sevoflurane – a general anesthetic that significantly increases blood fluoride levels – showed longterm deficits in hippocampal function and decreased hippocampal PSD-95 expression. Seven weeks after exposure, they had significant spatial learning and memory impairment. [Wang SQ, et al. 2013] (Sevoflurane studies cited above in Fluoride and ER Stress.)

Microglial Activation, Neuroinflammation and Neurodegeneration

Growing evidence links microglial activation to the development and progression of a variety of neurodegenerative disorders, including Alzheimer's, Parkinson's, Huntington's, and Lou Gehrig's diseases. A common hallmark in the pathogenesis is neuroinflammation. [Hickman et al. 2018]

"Microglia are the linchpin of the neurodegenerative process" – an appealing target of efforts to prevent cognitive decline in neurodegenerative diseases. [Washington Univ. School of Medicine 2019]

• Inflammatory cues trigger microglial cells to release the protein ASC. Specks of ASC promote aggregation and deposition of β-amyloid protein, a hallmark of Alzheimer's disease. [Ranshoff 2017]

• This review looked at the role of ER stress signaling in brain-associated immune cells and the implications to neuroinflammation and development of neurodegenerative diseases. [Garcia-Gonzalez et al. 2018]

• Chronic neuroinflammation is sustained by persistent and aberrant microglial activation in the brain. [McKenzie et al. 2017]


PSD-95 (postsynaptic density protein-95) is concentrated at synapses, the tens of trillions of tiny yet complex structures that link neurons so they can communicate with each other. Research demonstrates that PSD-95 orchestrates synaptic development and plays an important role in synaptic plasticity, the basis of learning and memory. [Wang SQ, et al. 2013] Neuronal synapses with less PSD-95 are likely to be weakened or lost. [Thomas Jefferson Univ. 2015]


Note: Autism spectrum disorder is related to ER stress, and PSD-95 is involved. [Fujita et al. 2010 and 2015] (See MacArthur 2016)

Microglia and Neuroinflammation References Cited

Akinrinade ID, Memudu AE, Ogundele OM, et al. Interplay of glia activation and oxidative stress formation in fluoride and aluminium exposure. Pathophysiology. 2015 Mar;22(1):39-48.

Chen R, Zhao LD, Liu H, et al. Fluoride induces neuroinflammation and alters Wnt signaling pathway in BV2 microglial cells. Inflammation. 2017 Aug;40(4):1123-1130.

Dec K, Lukomska A, Maciejewska D, et al. The influence of fluorine on the disturbances of homeostasis in the central nervous system. Biol Trace Elem Res. 2017 Jun;177(2):224-234.

Qian W, Miao K, Li T, Zhang Z. Effect of selenium on fluoride-induced changes in synaptic plasticity in rat hippocampus. Biol Trace Elem Res. 2013 Nov;155(2):253-260.

Wang SQ, Fang F, Xue ZG, et al. Neonatal sevoflurane anesthesia induces long-term memory impairment and decreases hippocampal PSD-95 expression without neuronal loss. Eur Rev Med Pharmacol Sci. 2013 Apr;17(7):941-950.

Yan L, Liu S, Wang C, et al. JNK and NADPH oxidase involved in fluoride-induced oxidative stress in BV-2 microglia cells. Mediators Inflammation. 2013; 2013: 895975.

Yan N, Liu Y, Liu S, et al. Fluoride-induced neuron apoptosis and expressions of inflammatory factors by activating microglia in rat brain. Mol Neurobiol. 2016 Sep;53(7):4449-4460.

Yang L, Jin P, Wang X, et al. Fluoride activates microglia, secretes inflammatory factors and influences synaptic neuron plasticity in the hippocampus of rats. Neurotoxicology. 2018 Dec;69:108-120.

Zhu W, Zhang J, Zhang Z. Effects of fluoride on synaptic membrane fluidity and PSD-95 expression level in rat hippocampus. Biol Trace Elem Res. 2011 Feb;139(2):197-203.

Fujita E, Dai H, Tanabe Y, et al. Autism spectrum disorder is related to endoplasmic reticulum stress induced by mutations in the synaptic cell adhesion molecule, CADM1. Cell Death Dis. 2010 Jun;1(6):e47.

Fujita-Jimbo E, Tanabe Y, Yu Z, et al. The association of GPR85 with PSD-95-neuroligin complex and autism spectrum disorder: a molecular analysis. Mol Autism. 2015;6:17.

Garcia-Gonzalez P, Cabral-Miranda F, Hetz C, Osorio F. Interplay between the unfolded protein response and immune function in the development of neurodegenerative diseases. Front Immunol. 2018 Nov 2;9:2541.

Hickman S, Izzy S, Sen P, et al. Microglia in neurodegeneration. Nat Neurosci. 2018 Oct;21(10):1359-1369.

MacArthur JD. Prenatal Fluoride and Autism. Townsend Letter. 2016;393:49-55.

McKenzie JA, Spielman LJ, Pointer CB, et al. Neuroinflammation as a common mechanism associated with the modifiable risk factors for Alzheimer's and Parkinson's diseases. Curr Aging Sci. 2017;10(3):158-176.

Ranshoff RM. Specks of insight into Alzheimer's disease. Nature. 2017 Dec 21;552(7685):342-343;   German Center for Neurodegenerative Diseases. Inflammation drives progression of Alzheimer's. December 20, 2017.

Thomas Jefferson University. Building and breaking synapses. October 19, 2015.

Wang SQ, Fang F, Xue ZG, et al. Neonatal sevoflurane anesthesia induces long-term memory impairment and decreases hippocampal PSD-95 expression without neuronal loss. Eur Rev Med Pharmacol Sci. 2013 Apr;17(7):941-950.

Washington University School of Medicine. Targeting immune cells may be potential therapy for Alzheimer's. October 10, 2019.

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Arterial Stiffness

The biological aging process is always associated with arterial stiffness,
which is accelerated by arterial hypertension.

Fluoride and Arterial Stiffness

Fluoride accelerates arterial calcification and stiffening that lead to hypertension. In people with fluorosis, the elastic properties of the ascending aorta are impaired. [Varol et al. 2010; Machoy-Mokrzynska 2004]

Hypertension prevalence increased 22% when fluoride levels in drinking water increased from 0.84 to 1.55 mg/l. [Sun et al. 2013]

• PET/CT scans show a significant correlation between fluoride uptake and calcification in most of arterial walls. The coronary fluoride uptake value in patients with cardiovascular events was significantly higher. [Li Y, et al. 2012]

Fluoride is readily incorporated into the crystalline structure of bone and will accumulate over time, resulting in arthritic symptoms of "joint stiffness and pain." [National Research Council (2) 2006]



Fluoroquinolone antibiotics can increase the occurrence of an aortic aneurysm that can lead to dangerous bleeding. [FDA 2018]

Data from nearly 8,000 medical practices in England showed that hypothyroidism was positively associated with fluoride levels in patients' drinking water. Those in a fluoridated area had twice the hypothyroidism prevalence of a nonfluoridated area. [BMJ 2015]

• A Canadian study published in December 2018 found that the risk of hypothyroidism increases in adults who have iodine deficiencies and higher urinary fluoride levels. [Malin et al. 2018] Another 2018 Canadian study found that urinary fluoride levels are almost two times higher for pregnant women living in fluoridated regions compared with nonfluoridated regions. [Till et al. 2018]

Racial Susceptibility to Fluorosis
African American children are more vulnerable to fluoride's toxicity. They have significantly higher rates and more severe forms of dental fluorosis than either White or Hispanic children. A study of African American and White 7-14 years olds found that even though both groups had the same fluoride concentrations in their drinking water and saliva, dental fluorosis was 28% higher in African American children. [Connett 2012; Martinez-Mier et al. 2010]

Arterial Stiffness and Neurodegeneration

Arterial stiffness correlates with the pathogenesis of a large spectrum of vascular disorders including hypertension, kidney dysfunction, cerebral small vessel disease, and decreased cognitive function, such as Alzheimer's disease. Worldwide, it's estimated that 9.4 million deaths per year are related to arterial hypertension. [Mikael et al. 2017; Singer et al. 2014]

• Hypertension causes stiffening and loss of elasticity in blood vessels, which affects the movement of interstitial fluid out of brain cells. This hinders clearance of the Alzheimer's pathology protein β-amyloid from the brain. [McMurray 2019]

• Aortic stiffness reduces the buffering of pulsatile blood flow, exposing cerebral small arteries to microvascular damage. [Kennedy et al. 2018]

• Arterial stiffness is determined by pulse wave velocity (PWV), a noninvasive measure of the speed at which the blood pressure pulse travels through the arteries. Older adults with high PWV readings were 60% more likely to develop dementia. Even after adjusting for age, sex, race, education, BMI, and anti-hypertensive medication, arterial stiffness was significantly associated with increased risk of dementia. [Cui et al. 2018]

Aortic stiffening is an early trigger of abdominal aortic aneurysm. [Raaz et al. 2015]

Impaired elasticity of the ascending aorta is associated with subclinical hypothyroidism. Higher TSH levels, a measure of hypothyroidism, are positively correlated with aortic stiffness. [Yurtdas et al. 2013]

Subclinical hypothyroidism in pregnant women is associated with decreased IQ of their offspring. The decline in iodine intake in the US could contribute to increased toxicity of fluoride for some individuals. [National Research Council (3) 2006]

Racial Susceptibility to Cardiovascular Disease
Black Americans suffer from a disproportionate burden of cardiovascular disease (CVD) compared with Whites. Blacks had greater arterial stiffness, even after adjustment for traditional CVD risk factors. Importantly, these differences were present even in the subgroup of participants who were completely free of conventional CVD risk factors. [Morris et al. 2013]

• Stiffness of the placenta is significantly higher in preeclampsia, which is characterized by increased arterial stiffness. [Kilic et al. 2015; Kaihura et al. 2009] Patients with mild preeclampsia had impaired aortic elasticity. [Ciftci et al, 2014]

Arterial Stiffness References Cited

BMJ. Water fluoridation in England linked to higher rates of underactive thyroid. February 23, 2015;   Peckham S, Lowery D, Spencer S. Are fluoride levels in drinking water associated with hypothyroidism prevalence in England? A large observational study of GP practice data and fluoride levels in drinking water. J Epidemiol Community Health. 2015;0:1-6.

Connett M. Racial disparities in dental fluorosis. Fluoride Action Network. June 2012.

FDA. Increased risk of ruptures or tears in the aorta blood vessel with fluoroquinolone antibiotics. December 20, 2018.

Li Y, Berenji GR, Shaba WF, et al. Association of vascular fluoride uptake with vascular calcification and coronary artery disease. Nucl Med Commun. 2012 Jan;33(1):14-20.

Machoy-Mokrzynska A. Fluorine as a factor in premature aging. Ann Acad Med Stetin. 2004;50 Suppl 1:9-13.

Malin AJ, Riddell J, McCague H, Till C. Fluoride exposure and thyroid function among adults living in Canada: Effect modification by iodine status. Environment International. Volume 121, Part 1, December 2018, Pages 667-674.

Martinez-Mier EA, Soto-Rojas AE. Differences in exposure and biological markers of fluoride among White and African American children. J Public Health Dent. 2010 Summer;70(3):234-240.

National Research Council (2). Skeletal Fluorosis. Fluoride in drinking water: A scientific review of EPA's standards. The National Academies Press, 2006. Page 5.

Sun L, Gao Y, Liu H, et al. An assessment of the relationship between excess fluoride intake from drinking water and essential hypertension in adults residing in fluoride endemic areas. Total Environ. 2013 Jan 15;443:864-869.

Till C, Green R, Grundy JG, et al. Community water fluoridation and urinary fluoride concentrations in a national sample of pregnant women in Canada. Environ Health Perspect. 2018 Oct;126(10):107001.

Varol E, Akcay S, Ersoy IH, et al. Aortic elasticity is impaired in patients with endemic fluorosis. Biol Trace Elem Res. 2010 Feb;133(2):121-127.

Ciftci FC, Ciftci O, Gullu H, et al. Does mild preeclampsia cause arterial stiffness and ventricular remodeling through inflammation?. Ginekol Pol. 2014 Dec;85(12):900-907.

Cui C, Sekikawa A, Kuller LH, et al. Aortic stiffness is associated with increased risk of incident dementia in older adults. J Alzheimers Dis. 2018;66(1):297-306.

Kaihura C, Savvidou MD, Anderson JM, et al. Maternal arterial stiffness in pregnancies affected by preeclampsia. Am J Physiol Heart Circ Physiol. 2009;297:H759-H764.

Kennedy et al. Physical fitness and aortic stiffness explain the reduced cognitive performance associated with increasing age in older people. J Alzheimers Dis. 2018;63(4):1307-1316.

Kilic F, Kayadibi Y, Yuksel MA. Shear wave elastography of placenta: in vivo quantitation of placental elasticity in preeclampsia. Diagn Interv Radiol. 2015 May-Jun;21(3):202-207.

McMurray C. Healthy blood vessels may delay cognitive decline. Society for Neuroscience. June 17, 2019.

Mikael LR, Paiva AMG, Gomes MM, et al. Vascular aging and arterial stiffness. Arq Bras Cardiol. 2017 Sep;109(3):253-258.

Morris AA, Patel RS, Binongo JN, et al. Racial differences in arterial stiffness and microcirculatory function between Black and White Americans. J Am Heart Assoc. 2013 Apr 8;2(2):e002154.

National Research Council (3). Effects of Thyroid Function. Fluoride in drinking water: A scientific review of EPA's standards. The National Academies Press, 2006. Page 236.

Raaz U, Zollner AM, Schellinger IN, et al. Segmental aortic stiffening contributes to experimental abdominal aortic aneurysm development. Circulation. 2015 May 19;131(20):1783-1795.

Singer J, Trollor JN, Baune BT, et al. Arterial stiffness, the brain and cognition: a systematic review. Ageing Res Rev. 2014 May;15:16-27.

Yurtdas M, Gen R, Ozcan T, Aydin MK. Assessment of the elasticity properties of the ascending aorta in patients with subclinical hypothyroidism by tissue Doppler imaging. Arq Bras Endocrinol Metabol. 2013 Mar;57(2):132-138.

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Oxidative Stress

Oxidative stress is essentially an imbalance between cellular
levels of harmful reactive oxygen species (ROS) and the
protective antioxidants that neutralization them.

Fluoride and Oxidative Stress

It's long been recognized that fluoride increases ROS and causes oxidative stress. A PubMed Title/Abstract search for fluoride and oxidative stress lists over 300 studies published since 1990. For example:

"Over uptake of fluoride for a long term could cause potential increase in the level of oxidative stress in the brain tissue." [Shao et al. 2000]

"Fluoride at a dose encountered in drinking water in contaminated areas exerts an adverse effect on the male reproductive system and this effect is associated with indicators of oxidative stress." [Ghosh et al. 2002]

Flash Forward

A major review described the impact of fluoride-induced oxidative stress and inflammation in the pathogenesis of Alzheimer's disease, as well as a mechanism for its initiation by fluoride. [Goschorska et al. 2018 Dec 9]

Fluoride Decreases Glutathione Levels
Glutathione was decreased in mice given chronic doses of fluoride compatible with human consumption. [Miranda et al. 2018]

• The neurotoxicity of fluoride is associated with oxidative stress due to imbalance between production and removal of ROS, including reduction of total glutathione content. [Wu J, et al. 2015]

• Increased levels of fluoride in drinking water are associated with reduced levels of glutathione and with an increased prevalence of carotid artery atherosclerosis in adults. [Liu H, et al. 2014]

• Glutathione content decreased markedly in fluoride-treated groups. [Shuhua et al. 2012]

Fluoride Decreases Acetylcholine Levels
Fluoridated water was found to decrease acetylcholine levels. [Reddy et al. 2014]

• A study published in December 2018 explores how fluoride reduces acetylcholine levels in the brain by suppressing antioxidant activity. [Goschorska et al. 2018 Dec 20]

Oxidative Stress and Neurodegeneration

It's also well known that oxidative stress is involved in neurodegeneration. A PubMed Title/Abstract search for oxidative stress and neurodegeneration lists over 3,900 studies published since 1990. For example:

"Because of the scavenging activity of glutathione against accumulation of oxygen radicals, its decrease in the brains of parkinsonian patients has been interpreted as a sign of oxidative stress." [DiMonte et al. 1992]

"Oxidative stress and excessive activation of glutamate receptors... provide a final common pathway for cell vulnerability in the brain." [Coyle et al. 1993]




Flash Forward

Glutathione Depleted in Alzheimer's
In a breakthrough human study published in October 2018, the antioxidant glutathione, which protects the brain from oxidative stress, was significantly depleted in Alzheimer's patients compared to normal subjects. Lead researcher Dr. Pravat Mandal said:

"If routine non-invasive tests for lower levels of glutathione in the hippocampus regions are performed, we might be able to mitigate the advancement of Alzheimer's disease by providing glutathione supplements." [Mandal et al. 2018]

In a March 2019 editorial, Dr. Mandal highlighted the need for glutathione supplementation in mild cognitive impairment and Alzheimer's. [Mandal et al. 2019]

Maintaining glutathione levels may provide a therapeutic treatment for Parkinson's disease. [Smeyne & Smeyne 2013]

Acetylcholine Decreased in Alzheimer's
Another "neuropathological hallmark/pathway" of Alzheimer's disease is decreased levels of the neurotransmitter acetylcholine. [Sharma A, et al. 2018]

Oxidative Stress References Cited

Ghosh D, Das Sarkar S, Maiti R, et al. Testicular toxicity in sodium fluoride treated rats: Association with oxidative stress. Reprod Toxicol. 2002 Jul-Aug;16(4):385-390.

Goschorska M, Baranowska-Bosiacka I, Gutowska I, et al. Potential role of fluoride in the etiopathogenesis of Alzheimer's disease. Int J Mol Sci. 2018 Dec 9;19(12). pii: E3965.

Goschorska M, Gutowska I, Baranowska-Bosiacka I, et al. Influence of acetylcholinesterase inhibitors used in Alzheimer's disease treatment on the activity of antioxidant enzymes... under fluoride-induced oxidative stress. Int J Environ Res Public Health. 2018 Dec 20;16(1). pii: E10.

Liu H, Gao Y, Sun L, et al. Assessment of relationship on excess fluoride intake from drinking water and carotid atherosclerosis development in adults in fluoride endemic areas, China. Int J Hyg Environ Health. 2014 Mar;217(2-3):413-420.

Miranda GHN, Gomes BAQ, Bittencourt LO, et al. Chronic exposure to sodium fluoride triggers oxidative biochemistry misbalance in mice: Effects on peripheral blood circulation. Oxid Med Cell Longev. 2018 Aug 27;2018:8379123.

Reddy YP, Tiwari SK, Shaik AP, et al. Effect of sodium fluoride on neuroimmunological parameters, oxidative stress and antioxidative defenses. Toxicol Mech Methods. 2014 Jan;24(1):31-36.

Shao Q, Wang Y, Guan Z. Influence of free radical inducer on the level of oxidative stress in brain of rats with fluorosis. Zhonghua Yu Fang Yi Xue Za Zhi. 2000 Nov;34(6):330-332.

Shuhua X, Ziyou L, Ling Y, et al. A role of fluoride on free radical generation and oxidative stress in BV-2 microglia cells. Mediators of Inflammation. Volume 2012, Article ID 102954, 8 pages.

Wu J, Cheng M, Liu Q, et al. Protective role of tert-butylhydroquinone against sodium fluoride-induced oxidative stress and apoptosis in PC12 cells. Cell Mol Neurobiol. 2015 Oct;35(7):1017-1025.

Coyle et al.Oxidative stress, glutamate, and neurodegenerative disorders. Science. 1993 Oct 29;262(5134):689-695.

DiMonte et al. Glutathione in Parkinson's disease: a link between oxidative stress and mitochondrial damage?. Ann Neurol. 1992;32 Suppl:S111-5.

Mandal P. A new study indicates measuring the progression of Alzheimer's disease by monitoring major brain antioxidant levels using non-invasive techniques. J Alzheimers Dis. vol. 66, no. 2, pp. 517-532, 2018.

Mandal PK, Shukla D, Tripathi M, Ersland L. Cognitive improvement with glutathione supplement in Alzheimer's disease: A way forward. J Alzheimers Dis. 2019;68(2):531-535.

Sharma A, Pachauri V, Flora SJS. Advances in multi-functional ligands and the need for metal-melated pharmacology for the management of Alzheimer disease. Table 1. Front Pharmacol. 2018 Nov 15;9:1247.

Smeyne M, Smeyne RJ. Glutathione metabolism and Parkinson's disease. Free Radic Biol Med. 2013 Sep;62:13-25.

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Continuing to let the dental establishment dominate fluoride research with
their fixation on tooth decay is especially irrational now when fluoride's
causative connections to mental decay are supported by fluoridation's
ecological correlations to major diseases and disorders.

If ending fluoridation reduced life decay by just 10%,
this would be a tremendous humanitarian boon
and save $100 billion per year in the US.

October 2019:
Fluoride and Mental Decay
Published in the Townsend Letter: The Examiner of Alternative Medicine