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Fluoride Poisoning
Fluoride Poisonings

Fluoride poisoning is caused by excessive intake of fluorides.

Presentation

A case of fluoride poisong is presented which was manifested by severe hypocalcemia, ventricular arrhythmias, and respiratory failure. Treatment of this poisoning, including peritoneal dialysis, is discussed. [ncbi.nlm.nih.gov]

Fluoride is present in many commonly used products: Toothpaste Vitamin supplements Nutritional supplements Detergents Insecticides Rodenticides No antidote for fluoride poisoning is available. [symptoma.com]

Entire Body System

  • Fatigue

    We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: May 14, 2019 [patientslikeme.com]

    Calcifications of connective tissue on X-ray, especially with pain and reduced range of motion Chronic fatigue syndrome (CFS) – especially if it persists when you spend time in an unfluoridated city or switch to distilled water for drinking and cooking [slweb.org]

    Constant fatigue — Unusual and excessive sleepiness/fatigue. Vision disturbances — (High) sensitivity to bright light Occassional/frequent 'chills' — symptoms include body temperature disturbances and cold shivers. [icnr.com]

    The symptoms of hypothyroidism include depression, dizziness, fatigue, weight gain, muscle and joint pain, hair loss, headache, migraine, shortness of breath, GI problems, menstrual problems, unbalanced blood pressure, increased cholesterol levels, allergies [ener-chi.com]

Respiratoric

  • Cough

    Fluoride is found in rodenticides, insecticides, fertilisers, industrial chemicals, anaesthetics and in overconcentraions in the water supply (due to miscalculation), and adverse effects occur due to its: • Inhalation (coughing, choking, chills, fever [medical-dictionary.thefreedictionary.com]

    Your recognised location is United States (US) Chronic cough in a child This article is freely available only to users in the UK. [evidence.nhs.uk]

    Adverse health effects of acute poisoning usually include lacrimation, nasal or throat irritation, cough, dyspnea, paresthesias, electrolyte abnormalities, and possibly seizures (1-3). [emergency.cdc.gov]

Gastrointestinal

  • Nausea

    Acute fluoride poisoning produces a clinical syndrome characterized by nausea, vomiting, diarrhea, abdominal pain, and paresthesias. [ncbi.nlm.nih.gov]

    Symptoms of acute fluoride poisoning include nausea, vomiting, diarrhea, abdominal pain and paresthesias. [symptoma.com]

    Acute fluoride poisoning involves an immediate physiological reaction, with nausea, vomiting, hypersalivation, abdominal pain, and diarrhea. [medical-dictionary.thefreedictionary.com]

    In the case of fluoride, early symptoms of acute fluoride poisoning include gastric pain, nausea, vomiting, and headaches. [fluoridealert.org]

    Fluoride and hydrogen ions combine in the stomach to form hydrofluoric acid, which causes nausea, vomiting, diarrhea, and abdominal pain. [nejm.org]

  • Abdominal Pain

    Acute fluoride poisoning produces a clinical syndrome characterized by nausea, vomiting, diarrhea, abdominal pain, and paresthesias. [ncbi.nlm.nih.gov]

    Acute fluoride poisoning involves an immediate physiological reaction, with nausea, vomiting, hypersalivation, abdominal pain, and diarrhea. [medical-dictionary.thefreedictionary.com]

    Symptoms of acute fluoride poisoning include nausea, vomiting, diarrhea, abdominal pain and paresthesias. [symptoma.com]

    Fluoride and hydrogen ions combine in the stomach to form hydrofluoric acid, which causes nausea, vomiting, diarrhea, and abdominal pain. [nejm.org]

    Abdominal pain. Diarrhea. Muscle spasms. Muscle weakness. Headaches. Tremors. Arrhythmias. Joint stiffness. Shortness of breath ( dyspnea ). Low levels of calcium (hypocalcemia), magnesium (hypomagnesemia) and glucose (hypoglycemia) in the blood. [healthhype.com]

  • Dysphagia

    Difficulty swallowing ( dysphagia ). Abdominal pain. Diarrhea. Muscle spasms. Muscle weakness. Headaches. Tremors. Arrhythmias. Joint stiffness. Shortness of breath ( dyspnea ). [healthhype.com]

  • Choking

    Fluoride is found in rodenticides, insecticides, fertilisers, industrial chemicals, anaesthetics and in overconcentraions in the water supply (due to miscalculation), and adverse effects occur due to its: • Inhalation (coughing, choking, chills, fever [medical-dictionary.thefreedictionary.com]

Jaw & Teeth

  • Yellow-Brown Discoloration of the Teeth

    Signs and Symptoms of Fluoride Poisoning White specks or streak to yellow-brown discoloration of the teeth. Pitting of the teeth. Damage of tooth enamel – teeth are more prone to cavities. Increased salivation (hypersalivation). [healthhype.com]

Musculoskeletal

  • Back Pain

    Walbott discovered that low dose fluoride was causing allergic reactions in some of his patients who displayed a variety of symptoms such as headaches, back pain, gastric problems, muscle fatigue, etc. [chrisbeatcancer.com]

Face, Head & Neck

  • Facial Burn

    A fatality resulting from a severe facial burn, which produced acute systemic fluoride poisoning with profound hypocalcemia and hypomagnesemia, is presented. [ncbi.nlm.nih.gov]

Neurologic

  • Headache

    In the case of fluoride, early symptoms of acute fluoride poisoning include gastric pain, nausea, vomiting, and headaches. [fluoridealert.org]

    Headaches. Tremors. Arrhythmias. Joint stiffness. Shortness of breath ( dyspnea ). Low levels of calcium (hypocalcemia), magnesium (hypomagnesemia) and glucose (hypoglycemia) in the blood. High levels of potassium in the blood (hyperkalemia). [healthhype.com]

    Cramps in muscles Headache Muscle weakness Tremor Stiffness of joints Palpitation Shortness of breath Rise of potassium level in body. Convulsion in case of acute poisoning. Increased risk of fractures. [tandurust.com]

    The symptoms of hypothyroidism include depression, dizziness, fatigue, weight gain, muscle and joint pain, hair loss, headache, migraine, shortness of breath, GI problems, menstrual problems, unbalanced blood pressure, increased cholesterol levels, allergies [ener-chi.com]

    […] known authority on environmental diseases Physician, Warren, Michigan CAVEAT: The following list contains symptoms that can have other origins even in someone suffering from chronic fluoride poisoning: Chronic fatigue not relieved by extra sleep or rest Headaches [nofluoride.com]

Treatment

Health department investigators and town water department officials inspected the fluoridation system at the town's main water treatment plant. [ncbi.nlm.nih.gov]

Medical Toxicology – Diagnosis and Treatment of Human Poisoning. [farmwars.info]

In majority of cases after treatment there is no permanent damage observed in the patient. One of the major deciding factors is the speed at which the patient receives treatment after acute poisoning. [tandurust.com]

Prognosis

The prognosis of patients who suffered fluoride toxicity is dependent on the amount of fluoride that was ingested and how soon medical intervention was started. [overdoseinfo.com]

Additional washing of stomach with lime water IV fluid replacement + calcium gluconate : blood calcium level + sodium bicarbonate : urine flow rate & urinary pH Other monitoring and supportive therapies Generally, if death has not occurred in 1-2 days the prognosis [slideshare.net]

Prognosis Death may result from ingesting as little as 2 g of fluoride in an adult and 16 mg/kg in children. Symptoms may appear with 3-5 mg/kg of fluoride. Estimated toxic dose for fluoride ingestion is 5-10 mg/kg. [emedicine.medscape.com]

If the poisoned patient can be supported for 24 hours, the prognosis improves markedly, although delayed toxicity can occur. [link.springer.com]

Etiology

The case can be confirmed if laboratory testing was not performed because either a predominant amount of clinical and nonspecific laboratory evidence of a particular chemical is present or a 100% certainty of the etiology of the agent is known. [emergency.cdc.gov]

[…] bone mineral density and increase skeletal fragility, leading to increased fracture risk. [5] In addition to effects on bone, a decrease in insulin sensitivity and insulin signaling has been reported in an animal model of chronic fluoride toxicity. [6] Etiology [emedicine.medscape.com]

Epidemiology

Author Affiliations From the Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta (B.D.G.); the Section of Epidemiology, Alaska Division of Public Health, Anchorage (M.B., J.P.M.); and the Department [nejm.org]

Probable : A clinically compatible case in which a high index of suspicion (credible threat or patient history regarding location and time) exists for a sulfuryl fluoride exposure, or an epidemiologic link exists between this case and a laboratory-confirmed [emergency.cdc.gov]

Nevertheless, epidemiological studies about fluoride toxicity have established that such oligoelement may be safely used at odontoiatric dosages. [ncbi.nlm.nih.gov]

Although there are no epidemiological studies that demonstrate a causative link between professionally applied fluoride or fluoride-containing products and any of the above disorders (or any other disorders for that matter), this is the tack the anti-fluoridationists [sciencebasedmedicine.org]

“In support of this concern are results from two epidemiology studies from China that show decreases in I.Q. in children who get more fluoride than the control groups of children in each study. [vaccinationinformationnetwork.com]

Pathophysiology

Pathophysiology and Management Review Article Poisoning Management First Online: 04 October 2012 63 Downloads 28 Citations Summary Acute intoxication with inorganic fluoride disrupts numerous physiological systems. [link.springer.com]

Pathophysiology Fluoride has several mechanisms of toxicity. Upon ingestion, the GI tract is the earliest and most commonly affected organ system. [emedicine.medscape.com]

Prevention

The bitter, salty taste of the water deterred consumption of large amounts and prevented serious intoxication. [ncbi.nlm.nih.gov]

It is probably best known for playing an important role in dental health by preventing dental caries and assisting with tooth strength. Effects of Fluoride Fluoride in water and toothpaste works in two ways for maintaining strong and healthy teeth. [healthhype.com]

There are a few things that a grower can do to prevent fluoride toxicity. First, if possible, only use well-water or rainwater to irrigate susceptible crops. [msue.anr.msu.edu]

Summary

Fluoride poisoning is caused by excessive intake of fluorides which may be acute or chronic. Symptoms of acute fluoride poisoning include nausea, vomiting, diarrhea, abdominal pain and paresthesias.

Fluoride is present in many commonly used products:

  • Toothpaste 
  • Vitamin supplements 
  • Nutritional supplements 
  • Detergents 
  • Insecticides 
  • Rodenticides

No antidote for fluoride poisoning is available. Management includes gastric aspiration and lavage and correction of electrolyte imbalance.

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