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It's not just about the dose of fluoride...

Genetic and Other Factors Affect One's Susceptibility to
Fluoride's Adverse Systemic Effects

Dental fluorosis

Dental fluorosis is the visible evidence of an individual's susceptibility to fluoride's adverse systemic effects. Dental fluorosis has mild to severe consequences, but this does not just depend on the amount of fluoride an individual consumes – or the concentration of fluoride in drinking water.

"Dental fluorosis, no matter how slight, is an irreversible pathological condition recognized by authorities around the world as the first readily detectable clinical symptom of previous chronic fluoride poisoning. To suggest we should ignore such a sign is as irrational as saying that the blue-black line which appears on the gums due to chronic lead poisoning is of no significance because it doesn't cause any pain or discomfort." – New Scientist (1983)

Genetic Susceptibility to Fluoride

"The role that an individual's genetic background plays in modulating fluoride's actions is becoming more evident." – Journal of Dental Research (2011)

"Severity of dental fluorosis varies individually at the same level of intake." – European Food Safety Authority (2013)

Genetic sensitivity to fluoride's adverse neurological effects was confirmed by researchers who found that children with a variation of the COMT gene, which is associated with cognitive performance, had steeper cognitive decline from exposure to fluoride. – Toxicological Sciences (2015)

"Efflux genes that confer resistance to environmental fluoride may select for inflammatory bowel disease associated gut microbiota and therefore be involved in the pathogenesis." – Scandinavian Journal of Gastroenterology (2016)

Journal of Neurochemistry International – October 2016

"Autism genes are selectively targeted by environmental pollutants
including pesticides, heavy metals, bisphenol A, phthalates and
many others in food, cosmetics or household products"

"The increasing incidence of autism suggests a major environmental influence. Epidemiology has implicated many candidates and genetics many susceptibility genes... Research is warranted to determine the relevance of large number of suspect candidates whose addition to the environment, household, food and cosmetics might be fueling the autism epidemic in a gene-dependent manner."

The suspect compounds researchers identified include fluoride and other substances on the EPA's list of "developmental neurotoxicants."

Lower pH Enhances Cellular Sensitivity
to a Given Dose of Fluoride (F-)

pH affects fluoride toxicity
The acid test of fluoride: how pH modulates toxicity. PLoS One (2010)

"Lower pH aggravates fluoride stress." – Eukaryotic resistance to fluoride toxicity mediated by a widespread family of fluoride export proteins. Proceedings of the National Academy of Sciences USA (2013)

Subsets of the Population Susceptible to Fluoride Toxicity

"Some existing data indicate that subsets of the population may be unusually susceptible to the toxic effects of fluoride and its compounds. These populations include the elderly, people with osteoporosis, people with deficiencies of calcium, magnesium, vitamin C, and/or protein, and people with kidney problems." – Toxicological profile for fluorides, hydrogen fluoride, and fluorine. US Public Health Service (2003)

Based on the government's own research and recommendations, women who are pregnant (or intend to be) should avoid consumption of fluoride in tap water, bottled water, and supplements – especially if they have dental fluorosis, the visible evidence of their genetic susceptibility to fluoride's toxicity. Also avoid beverages made in fluoridated cities, as well as exposure to fluoride from dental products and procedures.