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BFA Statement on Thyroid

BRITISH   FLUORIDATION SOCIETY STATEMENT (January 2006) on the   absence of an association between water fluoridation   and thyroid disorders.

   This statement has   been reviewed and endorsed by   the British Thyroid   Association (BTA); however, the BTA would recommend that appropriate monitoring of thyroid status should be considered in areas where fluoridation is introduced to enable an ongoing epidemiological evidence base for thyroid status with fluoridation to be created. 

The   available medical and scientific evidence suggests an absence of an association   between water fluoridation and thyroid disorders.

Many major reviews of the   relevant scientific literature around the world support this conclusion. Of   particular importance are:

  • an exhaustive review   conducted in 1976 by an expert scientific committee of the Royal College of   Physicians of England; 
  • a  systematic review in 2000 by the NHS Centre for Reviews and Dissemination at the   University of  York; and, 
  • a   2002 review by an international group of experts for the International Programme   on Chemical Safety (IPCS), under the joint sponsorship of the World Health   Organisation (WHO), the United Nations Environment Programme (UNEP), and the   International Labour Organisation (ILO). 

None has found any credible   evidence of an association between water fluoridation and any disorder of the  thyroid.

Report of Royal College of  Physicians

A   scientific committee was established by the Royal College of Physicians to   review whether, and to what extent, water fluoridation benefited people’s teeth   and whether there were any harmful effects to general human health.  As well as confirming that water fluoridation   reduces levels of tooth decay, the review also found that it was safe.  

Specifically, the report   concluded that “there is no evidence that   fluoride is responsible for any disorder of the thyroid”.  It also confirmed that iodine deficiency was   the root cause of goitre, and that fluoride does not significantly influence the   thyroid’s uptake of iodine.

The University of York Review 

Published in 2000, the York   Systematic review identified over three thousand references in total. However, they found no scientific studies of an   acceptable scientific standard that would support suggestions of an association   between water fluoridation and thyroid disorders, including goitre, in the   populations drinking fluoridated water.

When the Medical Research Council subsequently   used the York   report as a basis for determining whether further research on any aspect of   water fluoridation was needed, it concluded on the basis of the evidence already   available that new research on fluoride and thyroid disorders should be regarded   as a low priority.

Review by the International   Programme on Chemical Safety (IPCS) 

The   IPCS review of fluoride was one of several published by the World Health   Organisation intended to “provide   critical reviews on the effects on human health and the environment of chemicals   and of combinations of chemicals …” , and to “assist national and international   authorities in making risk assessments and subsequent risk management   decisions.”  As such, it examined   evidence on fluoride relevant to all aspects of human   health.

The   review, which included 788 original studies from the worldwide scientific   literature – both published and unpublished –   identified no evidence of an association between fluoride and thyroid   dysfunction in humans.

Experience in the UK’s   most extensively fluoridated region

The   conclusions of these authoritative reviews are mirrored by the experience of   specialist doctors diagnosing and treating thyroid disorders in hospitals in the   West Midlands, which has had fluoridation schemes in operation since the   mid-1960s and which is today the most extensively fluoridated region of the   United   Kingdom.    Around seven out of ten people in the West Midlands now drink water whose   natural fluoride content has been topped up to the optimum for dental health of   one part of fluoride per million parts of water.

Dr   Andy Toogood, a consultant endocrinologist in the   Department of Medicine at the Queen   Elizabeth Hospital in Birmingham, says that he and his colleagues   have seen nothing to suggest a rise in thyroid disorder cases resulting from   water fluoridation.   

Nor   have public health officials who monitor trends in disease across the West   Midlands detected any impact on the health of local populations drinking   fluoridated water – other than a reduction in tooth decay levels which puts   children living in the West Midlands among the   best in the country for dental health.



Sources of   fluoride

All drinking water and virtually all foodstuffs contain measurable amounts of   fluoride; tea leaves are particularly rich in fluoride, as is fish.  We are all, therefore, exposed to fluoride   from natural sources on a daily basis. 

Furthermore, around 400   million people worldwide drink fluoridated water – including 150 million in the   US.    Water supplies for many communities have been fluoridated for over 60   years.  If fluoridation caused any adverse effects – including thyroid   disorders – it is inconceivable that the reviews to date would have missed   them.

Water fluoridation

Fluoride occurs naturally in   all water supplies. In many parts of the world – for example Hartlepool in the   North East of England, and many parts of   East Anglia and Essex – the level is around the optimal for dental health   (one part of fluoride per million parts of water – 1ppm). However many   communities lack sufficient natural fluoride in their drinking water to prevent   tooth decay, and because of the significant health benefits of the right amount   of fluoride, the World Health Organisation recommends water   fluoridation.

Water fluoridation takes   place at the water treatment works.  It   is the controlled adjustment of the naturally occurring fluoride in the water to   a level known to be safe, and to benefit dental health (1ppm).  


* McDonagh,   M., et al. (2000): A systematic review of public water   fluoridation. York, The University of York NHS Centre for Reviews and   Dissemination. Report 18.

* Medical Research Council (2002): Working   Group Report: Water fluoridation and health. London, MRC.

* Royal College of   Physicians (1976): Fluoride Teeth and Health. London, Pitman Medical: 83.

* International Programme on Chemical   Safety (2002): Environmental Health Criteria 227   FLUORIDES. Geneva, World Health   Organisation.

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