Abstract
Pain and swelling of the large joints of the lower limbs occur in about 33% of patients receiving sodium fluoride, calcium, and vitamin D therapy. In a previous study we described radiographic and scintigraphic features suggesting that these symptoms are due to juxtaarticular stress fractures. We now report the histologic features of one such lesion in a calcaneum of a patient receiving fluoride, calcium, and 1 alpha-vitamin D therapy for postmenopausal osteoporosis. Bone biopsy after tetracycline double labeling showed a trabecular fissure fracture and large intratrabecular resorption cavities surrounded by microcallus. Comparison of the static and dynamic histomorphometric parameters in the calcaneum with those in the simultaneously taken iliac bone biopsy showed a marked regional acceleratory phenomenon in the calcaneum that we ascribe to the microfractures. It cannot be said with certainty whether the microfractures resulted from the osteoporosis, the vitamin D, or the sodium fluoride therapy.
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Increased incidence of hip fracture in osteoporotic women treated with sodium fluoride
There has been controversy as to whether fluoride therapy increases the risk of fracture in the appendicular skeleton. In the present study we compared the incidence of hip fracture in four groups of osteoporotic women: 22 treated with placebo, 17 with fluoride and calcium, 18 treated with fluoride and calcitriol,
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Effects of sodium fluoride and alendronate on the bone mineral in minipigs: a small-angle X-ray scattering and backscattered electron imaging study
Sodium fluoride (NaF), which stimulates bone formation, and bisphosphonates, which reduce bone resorption, are both used in the treatment of osteoporosis, and are binding to bone mineral. In this study, using small-angle X-ray scattering and backscattered electron imaging, we analyzed the bone mineral in the vertebrae of minipigs treated with
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Review of the Bartlett-Cameron survey: a ten year fluoride study.
Analysis of the data produced the following conclusions: 1. As was expected, dental fluorosis was significantly greater in Bartlett than in Cameron (all of the participants born and in continuous residence in Bartlett during the tooth formative period exhibited positive evidence of dental fluorosis). 2. The incidence of cardiovascular disease was higher
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The relationship of bone mass and fracture history to fluoride and calcium intake: a study of three communities
Stimulated by the suggestion that water fluoride greater than 1 mg/L may protect against osteoporosis, we studied bone mass of women in three rural communities with differing mineral content of the water supply. Mean fluoride and calcium of community drinking waters were 4 mg/L and 16 mg/L, respectively, high fluoride
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Long-term fluoride therapy of postmenopausal osteoporosis
The benefit of sodium fluoride (NaF) in the therapy of osteoporosis is still controversial. For 3 years we monitored patients with postmenopausal osteoporosis subjected to a continuous treatment with 80 mg NaF/day and patients without fluoride treatment. Every 3 months peripheral total and trabecular bone densities were evaluated with high-precision
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Fluoride in Water & Bone Fracture
Current epidemiological evidence indicates that the margin of safety between the level of fluoride in water that does, and does not, increase the risk of fracture is insufficiently large to protect all members of society from fluoride-induced damage to bone.
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Fluoride & Osteoarthritis
While the osteoarthritic effects that occurred from fluoride exposure were once considered to be limited to those with skeletal fluorosis, recent research shows that fluoride can cause osteoarthritis in the absence of traditionally defined fluorosis. Conventional methods used for detecting skeletal fluorosis, therefore, will fail to detect the full range of people suffering from fluoride-induced osteoarthritis.
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"Pre-Skeletal" Fluorosis
As demonstrated by the studies below, skeletal fluorosis may produce adverse symptoms, including arthritic pains, clinical osteoarthritis, gastrointestinal disturbances, and bone fragility, before the classic bone change of fluorosis (i.e., osteosclerosis in the spine and pelvis) is detectable by x-ray. Relying on x-rays, therefore, to diagnosis skeletal fluorosis will invariably fail to protect those individuals who are suffering from the pre-skeletal phase of the disease. Moreover, some individuals with clinical skeletal fluorosis will not develop an increase in bone density, let alone osteosclerosis, of the spine. Thus, relying on unusual increases in spinal bone density will under-detect the rate of skeletal fluoride poisoning in a population.
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Fluoride Reduces Bone Strength in Animals
Most animal studies investigating how fluoride effects bone strength have found either a detrimental effect, or no effect. Few animal studies have found a beneficial effect. In fact, one of the few studies that found a beneficial effect was unable to be repeated by the same authors in a later
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Skeletal Fluorosis: The Misdiagnosis Problem
It is a virtual certainty that there are individuals in the general population unknowingly suffering from some form of skeletal fluorosis as a result of a doctor's failure to consider fluoride as a cause of their symptoms. Proof that this is the case can be found in the following case reports of skeletal fluorosis written by doctors in the U.S. and other western countries. As can be seen, a consistent feature of these reports is that fluorosis patients--even those with crippling skeletal fluorosis--are misdiagnosed for years by multiple teams of doctors who routinely fail to consider fluoride as a possible cause of their disease.
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