Hyperparathyroidism

   Hyperparathyroidism is commonly observed in fluorosis patients.

   Past reviews have stated:

• "Fluorine is known to bind calcium in the body, causing ionic calcium to decrease; this, in turn, causes secondary hyperparathyroidism." [Trace Elements in Human and Animal Nutrition - Fifth Edition, Edited by Walter Mertz, U. S. Dept. of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Beltsville, Maryland, p. 375 (1987)]

   However, more recent investigations have revealed that a new mechanism of action: hyperparathyroidism is caused by chronically elevated TSH levels (Paloyan et al, 1997). (Fluoride is the TSH clone].

   Elevated TSH levels are usually seen in hypothyroidism, and therefore explain why hyperparathyroidism is so closely associated with hypothyroidism (Paloyan et al,1997).

   Hyperparathyroidism is ten times more frequent in thyroid patients than expected in a general medical population and is especially prevalent in patients with goiter (Stoffer, 1982).

   When thyroid and parathyroid glands are removed in subjects, same mineral effects occur as can be observed in dental fluorosis patients (Avecedo, 1996; Chardin et al, 1998).

2001 - 2002 - Gupta et al. (India) and Suketa (Japan) show again that in cases of fluorosis there is hyperparathyroidism, as seen in elevated parathyroid hormone (PTH) levels.

References:

Acevedo AC, Chardin H, Staub JF, Septier D, Goldberg M - "Morphological study of amelogenesis in the rat lower incisor after thyro-parathyroidectomy, parathyroidectomy and thyroidectomy." Cell Tissue Res 283(1):151-7 (1996)

Chardin H, Acevedo AC, Risnes S - "Scanning electron microscopy and energy-dispersive X-ray analysis of defects in mature rat incisor enamel after thyroparathyroidectomy." Arch Oral Biol 43(4):317-27 (1998)

Gupta SK, Khan TI, Gupta RC, Gupta AB, Gupta KC, Jain P, Gupta A - “Compensatory hyperparathyroidism following high fluoride ingestion - a clinico - biochemical correlation“ Indian Pediatr 38(2):139-46 (2001)

Paloyan Walker R, Kazuko E, Gopalsami C, Bassali J, Lawrence AM, Paloyan E - "Hyperparathyroidism associated with a chronic hypothyroid state" Laryngoscope 107(7):903-9 (1997)

Spira L - “Fluorosis - toxicity: incidence of dystrophies in organs regulated by parathyroid glands”J Hyg 43(Sept):402-408 (1944)

Stamp TC, Saphier PW, Loveridge N, Kelsey CR, Goldstein AJ, Katakity M, Jenkins MV, Rose GA - “Fluoride therapy and parathyroid hormone activity in osteoporosis” Clin Sci (Lond) 79(3):233-8 (1990)

• “Results show that long-term fluoride and calcium therapy increase biologically active parathyroid hormone in osteoporosis and that excessive parathyroid hormone activity may account for certain features of the refractory state.”

Stamp TC, Jenkins MV, Loveridge N, Saphier PW, Katakity M, MacArthur SE - “Fluoride therapy in osteoporosis: acute effects on parathyroid and mineral homoeostasis” Clin Sci (Lond) 75(2):143-6 (1988)

• “...sodium fluoride acutely stimulates bio-PTH activity and must also enhance mineral uptake from circulation into tissue(s).”

Stamp TC, Jenkins MV, Katakity M, Stainthorpe E, Loveridge N, Saphier PW - “Acute and long term metabolic and parathyroid effects of fluoride in osteoporosis” Bone  9:251 (1988)

Stoffer SS, Szpunar WE, Block M - "Hyperparathyroidism and thyroid disease. A study of their association" Postgrad Med 71(6):91-4 (1982)

Suketa Y - “Fundamental and applied studies on transport and metabolism of electrolytes and glucose--aim to contact with molecular biology” Yakugaku Zasshi 122(8):507-25 (2002)

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Review of Fluoride Benefits and Risks, Department of Health &  Human Services, February p.45 (1991):

• "Bone changes observed in human skeletal fluorosis are structural and functional, with a combination of osteosclerosis, osteomalacia, osteoporosis and exostosis formation,  and secondary hyperparathyroidism in a proportion of patients."

Review of Fluoride Benefits and Risks, Department of Health & Human Services, February p. 47 (1991):

• "In India, Tanzania, and South Africa, crippling forms of skeletal fluorosis have been reported in pediatric age groups. Endemic bent knee is observed primarily in young and adolescent boys and is characterized by: simultaneous osteomalacia; osteosclerosis; and osteoporosis with secondary hyperparathyroidism."

Trace Elements in Human and Animal Nutrition - Fifth Edition, Edited by Walter Mertz, U. S. Dept. of Agriculture, Agricultural Research  Service, Beltsville Human Nutrition Research Center, Beltsville, Maryland, p. 375 (1987)

• "Fluorine is known to bind calcium in the body, causing ionic calcium to decrease; this, in turn, causes secondary hyperparathyroidism."

Trace Elements In Human and Animal Nutrition, U.S. Dept. of Agriculture (1987) p. 380:

• "It is thus clear that the clinical picture of fluorosis includes softening of the bones and osteoporosis as well as secondary hyperparathyroidism on a global basis."