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Notes -
So, what's the deal with Fluoride in the water anyway?
According to this tweet by Marc Andreesen, a U.S. government review has concluded that Fluoride in the drinking water lowers IQ's in kids. The literature reviewed suggests that high levels of exposure reduce IQ's by 2 to 5 points.
If so, this would absolutely dominate any conceivable benefit from putting the stuff in the drinking water.
And it also seems largely unnecessary given that fluoridated toothpastes and mouthwash exist. Drinking the stuff is an incredibly poor intervention compared to, you know, actually applying it directly to our teeth.
Assuming Anddreesen's tweet is true (which I assume by default given his status as a top venture fund leader), this is absolutely scandalous.
I did a deep dive a few weeks ago and thought about making an effort post of “Everything you wanted to know about Flouride”
But alas, I didn’t. Instead I’ll just drop this low effort summary:
Reasonable (according to me) responses:
Don’t panic about your current consumption. It’s probably fine.
IF YOU ARE PREGNANT, current evidence suggests it would be VERY WORTHWHILE TO TRY TO ELIMINATE FLUORIDE from your diet. Buy an appropriate water filter/purifier (not all remove it). Maybe even consider removing it from your toothpaste. 2a. If you have small children consider limiting their exposure.
The magnitude of the effect is insanely large if true. National healthcare systems should be urgently prioritizing studies on it. This should be the number one priority study. ( the most compelling reason is that this would be an easy intervention. It’s not like we would have to tear out our entire infrastructure like with lead pipes. It’s about as close to flipping a switch as any intervention could ever be)
Since your post didn’t mention it: even more concerning than the IQ drop is the effect on rates of severe emotional/mental illness. That LA (?) study had some insane rates (if true).
*posting from phone so probably lots of typos. Sorry.
Edited summary #3 to add "Even at relatively normal levels." The interesting question is not: "can extreme levels of fluoride cause issues?" The interesting question is "Are current levels extreme?"
Let's do the math on this. Toothpaste is about 0.1% fluoride. Typically you'll put about 1g of toothpaste on your toothbrush, so that's 1 mg of fluoride. If you ingest 10%, that's 0.1 mg. Fluoridated water is typically around 1 mg/L, so by using fluoridated toothpaste twice a day, you're probably ingesting about 10% of what you would get from two liters of fluoridated tap water. Not insignificant, but probably not a major concern.
On the other hand, if it's available in the US, hydroxyapatite toothpaste is a perfectly acceptable substitute, if a bit more expensive.
Agreed. Thanks for the note.
My inclusion of that line was intended to be more of a rhetorical flair to highlight how fluoride consumption is probably only relevant for the pregnant (and small children). Upon rereading I don't think I was successful at conveying that. The risk of using fluoridated toothpaste is likely to be zero or close to it.
My personal read of the evidence is something like:
If you are an adult in a 1st world country, don't sweat fluoride. If you are pregnant or have small children, maybe try to limit exposure when it's convenient. Don't freak out if your child drinks tap water at a friends house.
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