How Fluoride Affects Your Bones + What To Do About It

Updated: July 26, 2023

Fluoride and Bone Health

Fluorides are present throughout the world in the earth’s crust. That’s why they’re naturally found in everything — including the soil, rocks, plants and water all over the earth.

But did you know fluoride may hurt your health, including your bones? While still a controversial topic, especially when it comes to fluoride preventing tooth decay, I’m going to dive into the research so you can make an informed decision about fluoride.

But first, let’s differentiate between fluoride and fluorine – as you may have seen both terms used before.


Fluoride vs. Fluorine

Are you confused about the difference between fluoride and fluorine? You’re not the only one.

To answer this common chemistry question simply…

Fluorides are compounds that contain the element fluorine (F-). Fluorine is an ion (a molecule with a net electric charge due to the loss or gain of one or more electrons). In fluorine’s case, the net electric charge is a negative one, which makes fluorine an anion (a molecule with a negative charge). Bear with me as I get to how this is important for you…

Just like all other elements (which are also ions with either a negative charge, in which case they are called anions, or a positive charge, in which case, they’re called cations), fluorine is unstable by itself and does not appear alone. It combines with a stabilizing partner, which for fluorine will be a compound with a positive charge or cation. So, when we are talking about fluoride, we are actually talking about the chemical element fluorine in one of its stable fluoride forms.  

Water fluoridation for instance, occurs when a fluorine-containing compound is added to drinking water. Common sources are sodium fluoride, sodium fluorosilicate or fluorosilicic acid,  which are added to the water and dissociates, releasing its F- ion.

Fluorides used in toothpaste and other dental treatments are typically sodium fluoride or stannous fluoride.

In addition, fluorides are used in numerous industrial processes:

  • Coal burning
  • Oil refining
  • Steel production
  • Brick-making
  • Phosphate fertilizer production (Yup, the fertilizers used in conventional farming. Another reason to eat organically grown foods!)

But what do fluorides mean for your health? And in particular…your bones?

Let’s find out…


Ever Present Fluoride: In Your Tap Water, Toothpaste and Harming Your Bones?

The primary sources of exposure to fluorides are our food and water, and fluoride-containing dental products, such as toothpaste.

Fluoride is found in higher concentrations in the southern United States and in all areas where the waters are soft, alkaline, and calcium-deficient.

Fluoride compounds that occur naturally in drinking water are almost totally bioavailable – at about 90%! That is, the fluorine they contain is virtually all absorbed from the gastrointestinal tract and enters our circulatory system.

The addition of extra fluoride to community drinking water, via its fluoridation in an effort to prevent cavities, has resulted in a significant increase in dental fluorosis– a disturbance in the production of dental enamel.

This is caused by exposure to high concentrations of fluoride when teeth are developing (between the ages of 3 months and 8 years).

Signs of Fluoride Exposure

In its mild forms, fluorosis appears as tiny white streaks or specks in the tooth enamel. In its severe form, permanent pitting and brown discolorations can darken over time and disfigure the teeth.

As of 2005, 23% of persons in the United States aged 6 to 39 years had mild or more severe forms of dental fluorosis!

Apologies for the picture below – but this is what it looks like…

signs of fluorosis

How Fluoride Causes Bone Loss

Fluorine activates both osteoblasts (bone-building cells) and osteoclasts (bone-resorbing cells). While fluoride may increase bone mass, the newly formed bone lacks normal structure and strength.

Under a microscope, the “crystallization pattern” of bone from fluoride-treated animals and humans proves abnormal.

In trabecular bone, the spongy interior portion of our bones, fluorine increases bone volume and thickness, but does not increase connectivity. This lack of trabecular connectivity reduces bone quality despite the increase in bone mass.

At very low and localized concentrations in dental implants, fluoride encourages osteoblast production and new bone formation. But at higher concentrations, fluoride blocks new bone formation.

In fact, high levels of fluorine in the body can cause skeletal fluorosis, a serious condition in which bones become hard and brittle, along with ligaments that can calcify, bone pain – and bone loss.

After ingestion, fluoride goes to the stomach where it reacts with stomach acid to form hydrogen fluoride. Hydrogen fluoride is absorbed from the gastrointestinal tract and sent into the portal vein, which delivers it to the liver.

In the liver, harmful compounds are usually transformed into something we can send out of the body in urine or bile. This biotransformation occurs through the activity of liver enzymes that first oxidize the harmful compound and then bind it to a carrier that deposits it in urine or bile for excretion.

Fluorine, however, is itself such a strong oxidizer– the strongest oxidizer currently known— that it easily blocks the liver’s attempts to prepare it for excretion and passes into the bloodstream, where it is rapidly distributed to all tissues, including our bones.

Once inside bones, fluorine attacks them through several mechanisms:

First, fluorine overwhelms bone cells’ ability to produce their most important antioxidant defender, glutathione. Once defenses have been eliminated, fluorine is free to wreak havoc, shut down osteoblasts and cause inflammation that increases osteoclast production and activity.

Next, fluorine accumulates in bone, binding to and shutting down alkaline phosphatase, an enzyme involved in the production of osteoblasts. Fluorine exposure also reduces levels of copper, zinc, manganese and other trace minerals required for bone building. The end result is that osteoblast production stops.

Our bones are largely composed of calcium compounds, up to 50% of which are hydroxyapatite. Fluorine converts hydroxyapatite to fluorapatite, which changes bones’ crystalline structure, delaying mineralization with calcium. This causes a reduction in bones’ mechanical strength properties.

Hydrogen fluoride reacts with calcium to form an insoluble salt, CaF2. This salt has to be cleared by the body, and as it goes, takes out some calcium from the bone matrix.

Fluorine also induces secretion of parathyroid hormone, which triggers the production of osteoclasts. Increased fluoride intake has been repeatedly shown to increase levels of parathyroid hormone circulating in the bloodstream and to cause hyperparathyroidism.

Parathyroid hormone signals osteoblast cells to secrete a signaling molecule called RANKL.

RANKL then summons the production of osteoclasts. For this reason, when our parathyroid hormone levels are chronically elevated, so is our production of osteoclasts – and we therefore lose bone.

The thing is, you may not realize the foods and beverages you’re consuming regularly contain significant amounts of fluoride. To discover common dietary sources and protect your health and bones, check out the table below.

honey, coffee, granola

Foods and Beverages with Highest Fluoride Content

Want to know which foods and beverages consumed in the U.S. have the highest fluoride content? Then check out the following table to see a brief list!

Food Micrograms of Fluoride in 100 grams (3 oz)
Wine, red 105
Wine, white 202
Carbonated water, fruit flavored 105
Coffee 91
Fruit juice drink, apple 104
Grape juice blend, (apple & grape) Juicy Juice 102
Grape juice, white 204
Tea, brewed, microwave 322
Tea, instant, powder, prepared with tap water 335
Tea, brewed, decaffeinated 269
Water, tap (Mid-west), municipal 99
Water, tap (Mid-west), well 53
Water, tap (Northeast), municipal 74
Water, tap (Northeast), well 9
Water, tap (South), municipal 93
Water, tap (South), well 10
Water, tap (West), municipal 51
Water, tap (West), well 24
Oatmeal, cooked 72
French fries, McDonald’s 115
Crab, canned 210
Shrimp, canned 201
Shrimp, fried 166
Fish sticks, baked 134

The full listing of 400 foods across 23 food groups can be freely accessed at the National Fluoride Database.

Were you aware of all of the food and beverages that contain high fluoride levels listed above? Let me know in the comments below.


Protecting Your Bones From Fluoride

How can we protect ourselves from fluoride’s nasty effects in our bones?

Include calcium and magnesium-rich foods in your diet!  Calcium and magnesium ions form insoluble complexes with fluoride, reducing its absorption and increasing its elimination in stools.

Eat plenty of fruits and vegetables. A high intake of plant foods increases the pH of your urine (makes it more alkaline), which increases the kidneys’ ability to excrete fluoride.

And take AlgaeCal Plus, which delivers both plant-based calcium and magnesium, further lessening fluorine’s bioavailability.

Avoid fluoride-containing toothpaste by checking the ingredient list on your tube. It’s not always clear that toothpaste contain fluoride.

In fact, fluoride may be listed as:

  • Sodium fluoride (NaF)
  • Stannous fluoride (SnF2)
  • Olaflur (an organic salt of fluoride)
  • Sodium monofluorophosphate (Na2PO3F)

Most toothpaste sold in the United States contains 1,000 to 1,100 parts per million (ppm) fluoride. In the UK, the fluoride content is often higher; a 1,450 ppm fluoride is not uncommon.

According to the Institute of Medicine (IOM) guidelines in 1997, fluoride intakes of 0.01 mg/day for infants through 6 months, 0.05 mg/kg/day (meaning milligram per kilogram of body weight per day) beyond 6 months of age, and 3 mg/day and 4 mg/day for adult women and men (respectively), are adequate to prevent cavities.

IOM set upper limits for fluoride at 0.10 mg/kg/day in children less than 8 years and 10 mg/day for those older than 8 years.

But consumption of even the lowest amount of fluoride recommended by the IOM to prevent cavities is unnecessary.

Why? Xylitol – a natural sugar found in trace amounts in berries and vegetables- is a great, safe alternative to fluoride. In fact, AlgaeCal chose to use xylitol as its natural sweetener for Triple Power Omega 3 Fish Oil because of its beneficial properties and safety.

Xylitol not only prevents plaque formation and cavities, but is shown to even reverse developing cavities and restore healthy tooth enamel — safely.

Our bodies already produce xylitol in tiny amounts, but can benefit from more.¹

Studies demonstrate that 4 to 12 grams of xylitol per day is safe and effective.

The easiest and best way to deliver xylitol to your teeth?

Xylitol-containing chewing gums, which keep the xylitol in contact with teeth far longer than toothpaste or mouthwash. If a piece of gum contains 1 gram of xylitol, then cavity protection, and minty fresh breath, can be easily achieved by chewing 4 or more pieces throughout the day.


The Bottom Line on Fluoride

Chronic exposure to too much fluoride is harmful to your bones.

And when you realize that chronic exposure to too much fluoride is the status quo in our everyday lives, minimizing your exposure becomes an obvious part of your healthy bones’ game plan.

Avoiding fluoride altogether is impractical. Hey, I’m not giving up a glass of Merlot with dinner several times a week! But I am suggesting that you:

  • Choose a fluoride-free toothpaste
  • Consider your water source
  • Brew your tea for the shortest amount of time you find delivers the taste you prefer (the longer tea sits, the more fluoride will appear in your cup)
  • Make foods rich in calcium and magnesium staples in your diet and take your AlgaeCal Plus to reduce fluoride’s effects.
  • And don’t forget about xylitol– a natural, healthy alternative to fluoride that will protect your teeth without harming your bones!

What changes are you going to make – or have already – to reduce your fluoride intake? I’m curious to hear your thoughts!


Book Source:

  1. Wright JV. Fight tooth decay and dramatically slash or even eliminate dental cavities for a lifetime! Nutrition & Healing. Vol. 19, Issue 3, May 2012.

Article Comments

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  1. Laura Ricci

    August 19, 2017 , 6:52 am

    The link to the food list has been removed. Is there another source? I have no idea where fluoride might come from from this article.

  2. Monica

    August 19, 2017 , 7:22 am

    Hi Laura,

    Thanks for letting us know. I’ve found and updated the link here: https://www.ars.usda.gov/ARSUserFiles/80400525/Data/Fluoride/F02.pdf

    – Monica @ AlgaeCal

  3. KSpencer

    March 4, 2024 , 7:19 am

    As far as IOM fluoride recommendations, I suggest reading this: https://fluoridealert.org/wp-content/uploads/brockovich-iom.april-27.2015.pdf

    As to food sources of fluoride, rule of thumb is avoid black & green teas (stick to herbal), shellfish and canned fish (salmon & sardines), any grape products (use f-pesticides, so no raisins or wines, either), and mechanically deboned poultry. I avoid sorbet ice cream because it is made with water that is likely fluoridated (found that out the hard way.)

    See: https://tools.myfooddata.com/nutrient-ranking-tool/Fluoride/All/Highest/Common/Simple/No

  4. Garry Montgomery

    August 19, 2017 , 7:17 am

    From the list you provided, is the fluoride content of each, “added” or “naturally occurring”?
    As a child I was told that the fluoride added to the water supply was derived from aluminium dust tailings. I have believed that up until today. Is there any truth to that?

  5. Earline Merritt

    August 19, 2017 , 9:29 am

    Thanks for information very helpful and informative this will help me be more aware of the proper foods I have already started purchasing Organic food.

  6. Monica

    August 19, 2017 , 9:46 am

    Hi Earline,

    You’re welcome! Glad this article has been helpful and informative for you.

    – Monica @ AlgaeCal

  7. Earline Merritt

    August 19, 2017 , 9:31 am

    Thanks again for the information.

  8. jerry hampton

    August 19, 2017 , 9:56 am

    You do not mention using a reverse osmosis system for drinking water in your home. I have one that is a six stage system that returns the minerals back into the water after taking out the harmful chemical such as fluoride and others.

    Do you not find this helpful?

  9. Lara Pizzorno

    August 21, 2017 , 10:26 am

    Hi Jerry, WOW, this is very sophisticated technology! We have a state of the art system in our home, but it does not add back healthful minerals. Could you please share more information on the system you are using? What company makes it?

  10. KSpencer

    March 4, 2024 , 7:10 am

    In my experience, and the experience of friends, most if not all RO systems do not deliver as promised. They may be effective for a few weeks, but they never last as long as guaranteed.

    A friend, a chemist retired from the Corps of Engineers, hooked up a RO system for her shower, but she has to change the filter frequently.

    A friend with an adult autistic son who gets horrible migraines from even showering in fluoridated water, has a system that supposedly removes the F. Her son has to use a timer and be out in less than 4 minutes and she has to change the filters every 3 months instead of 6 in order to avoid his headaches. Her son has no artifice.

  11. Leta C.

    August 19, 2017 , 10:12 am

    wowWOW!…….SEEMS THERE IS A DANGER TO OUR HEALTH AT EVERY CORNER WE TURN…….THANKS DEAN NEUL FOR THE INFO ON FLOURIDE. MY DENTIST PUSHES FLUORIDE VIA RX PREVIDENT…….GONNA DISCONTINUE……..LC

  12. Yvonne

    June 5, 2021 , 8:40 pm

    There is a huge danger. They should have appropriate poisoning labels on everything with the fluoride. Take if feom sosmome eho knows and loves other it.

  13. Laura Milligan

    August 20, 2017 , 8:03 am

    I can’t decide if the levels in toothpaste and food are worth considering or not, since the units of flouride limits in the IOM guidelines are in milligrams (mg), but the flouride levels in toothpaste was listed in parts per million (ppm), and the flouride levels in the foods you listed was in MICROgrams (mcg), which seems scare-inducing. For reference, 1 mg = 0.001 mcg. I think it would have been beneficial to the readers had Ms. Pizzorno simply translated her flouride amounts in toothpaste and the food chart to mcg so that people could get a better picture of what they are actually consuming. Having to force readers to make the ppm to mcg and mg conversions is simply a bit much.

  14. Lara Pizzorno

    August 21, 2017 , 10:26 am

    Laura, of course it’s up to you whether or not you choose to lessen your exposure to fluoride, but I hope you will decide to avoid it when possible.

    Re toothpaste: A pea size amount of toothpaste contains 0.3 mg (300 mcg) of fluoride. A large stripe of toothpaste delivers 2.25 mg (2,250 mcg) of fluoride. In one liter of fluoridated water, you’ll find 1 mg (1,000 mcg) of fluoride.

    Given the incidence of fluorosis in the US, the amount of fluoride being ingested by many Americans is excessive. In addition to harming our bones and teeth, fluoride is a neurotoxin that should not be in our water supply. Since it is, we have 2 ways to minimize exposure: water purification systems in our homes and avoidance of known sources of fluoride, e.g., toothpastes that contain fluoride, foods with the highest concentrations of fluoride.

    Many highly respected scientists agree that IOM’s recommendations regarding fluoride consumption are unacceptable. In fact, IOM’s recommendations have been challenged. A lawsuit has been brought against IOM for its failure to correct these recommendations. https://www.aaemonline.org/pdf/LetterIOM_2015.04.27.pdf

    The mcg amounts of fluoride present in the Food Sources of Fluoride table can easily quickly add up a milligram or more (1,000 mcg = 1 milligram) of fluoride consumption per day. Add to that consumption of fluoridated water and the use of fluoridated toothpaste, and you will find yourself consuming more than the IOM’s DRI for adults of 2 mg/d. It is my educated opinion that consumption of even 1 mg/d of fluoride is potentially harmful for our bones, so I, personally, will do what I can to minimize my exposure.

  15. Judy Filipich

    August 21, 2017 , 1:42 pm

    My dentist has me on 1.1% sodium fluoride tooth paste. Now I don’t know what to do since he is adamant about me using it.

  16. Yvonne

    June 5, 2021 , 8:38 pm

    I was using that toothpaste also and it made my teeth very dark and I think it can lead to fluoride poisoning. The sodium fluoride sticks to anything calcium which is bones anything that has calcium. Stop usage immediately! Strap watching consumption of things with fluoride. Look up skeletal fluorosis.

  17. Linda

    September 5, 2017 , 7:40 pm

    we drink only purified water with reverse osmosis. How is this different than tap water? Say as in coffee or tea?

  18. Monica

    September 6, 2017 , 8:14 am

    Hi Linda,

    Reverse osmosis is a water purification system that is devoid of minerals – unless you have a system like Jerry’s (see comment below). It differs from tap water as tap water can contain chemicals, heavy metals, fluoride, allergens etc.

    – Monica

  19. Frank

    September 26, 2020 , 5:28 pm

    Hi Lara,

    You mentioned fluoride ion in dental implant. I hope you can help me understand how the fluoride ion interact with the body after implant placement. How long does the fluoride ion stays on the implant before it’s completely absorbed by the jaw bone and does the fluoride eventually get absorbed by the human body. If so, how does does the absorbtion process takes?

  20. Lara Pizzorno

    October 5, 2020 , 8:06 am

    Hi Frank,

    Fluoride is released into saliva and absorbed via the mucosal membranes in the mouth and also via the digestive tract when saliva is swallowed. The answer to your question about how long the fluoride is present in the implant before it will all have been released and has been fully absorbed depends upon the amount of fluoride that was used in the dental implant. I could find no research reporting a timeline. Fluoride applications to teeth are typically recommended every 4 to 6 months, so I would expect a similar timeline for its release from a dental implant.

    What I did see is that at low local concentrations, such as those that typically used with fluoride modification of dental implants, fluoride enhances osteoblast differentiation and interfacial bone formation at the implant site. So, there is an increase in new bone formation when the percentage of fluoride is low (0.5% by weight); however, when the percentage fluoride is higher (2.23% by weight), enhanced new bone formation does not occur, and the effects are harmful. High systemic fluoride exposures can lead to skeletal fluorosis, a condition hallmarked by osteosclerosis, ligament calcifications, and often accompanying osteoporosis, osteomalacia, or osteopenia.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144112/

    The area around dental implants will contain microgaps that are highly susceptible areas for biofilm formation and fluoride retention. Along with biofilms, fluoride increases sliding wear that increases degradation of the implant. And because fluoride is corrosive to titanium, a potentially toxic metal, the release of titanium ions into the saliva is increased. The result is increased roughness of the implant surface, and that increases biofilm formation, further adding to the problem.

    https://link.springer.com/article/10.1007/s40735-015-0021-0

    https://pubmed.ncbi.nlm.nih.gov/30368813/

    Be well, Lara

  21. John

    April 23, 2021 , 3:01 am

    Could having too much fluoride in the body lead to shin splints/shin pain in high school athletes? I’m trying to figure out why even my top athletes get shin splints/shin pain.

  22. Megan AlgaeCal

    April 23, 2021 , 10:13 am

    Hi John, good question!

    This isn’t a correlation that has been studied in clinical research so we’re unable to comment on a possible cause and effect relationship.

    Wishing you the best in your research,

    -Megan @ AlgaeCal

  23. John Doe

    July 28, 2021 , 5:48 pm

    Are animal bones used to make bone broth such as cows high in fluoride if they drank fluoridated water?

  24. Megan AlgaeCal

    August 5, 2021 , 3:59 pm

    Good question!

    Unfortunately, yes, fluoride consumed by animals will appear in their bones as well. For this reason, you may want to enjoy bone broth only on an occasional basis.

    Hope this helps,

    Megan @ AlgaeCal

  25. Jackie T

    November 14, 2021 , 8:02 pm

    Please comment on the topical fluoride treatments that dentists recommend with teeth cleanings. They must have MANY mcg of fluoride in them…3 x year!

  26. Ishneet AlgaeCal

    November 15, 2021 , 1:17 am

    Hi Jackie!

    Thanks for reaching out! Here is some information shared on this topic by our bone health expert Lara Pizzorno –

    it’s up to you whether or not you choose to lessen your exposure to fluoride, but I hope you will decide to avoid it when possible.

    Re toothpaste: A pea size amount of toothpaste contains 0.3 mg (300 mcg) of fluoride. A large stripe of toothpaste delivers 2.25 mg (2,250 mcg) of fluoride. In one liter of fluoridated water, you’ll find 1 mg (1,000 mcg) of fluoride.

    Given the incidence of fluorosis in the US, the amount of fluoride being ingested by many Americans is excessive. In addition to harming our bones and teeth, fluoride is a neurotoxin that should not be in our water supply. Since it is, we have 2 ways to minimize exposure: water purification systems in our homes and avoidance of known sources of fluoride, e.g., toothpastes that contain fluoride, foods with the highest concentrations of fluoride.

    Many highly respected scientists agree that IOM’s recommendations regarding fluoride consumption are unacceptable. In fact, IOM’s recommendations have been challenged. A lawsuit has been brought against IOM for its failure to correct these recommendations. https://www.aaemonline.org/pdf/LetterIOM_2015.04.27.pdf

    The mcg amounts of fluoride present in the Food Sources of Fluoride table can easily quickly add up a milligram or more (1,000 mcg = 1 milligram) of fluoride consumption per day. Add to that consumption of fluoridated water and the use of fluoridated toothpaste, and you will find yourself consuming more than the IOM’s DRI for adults of 2 mg/d. It is my educated opinion that consumption of even 1 mg/d of fluoride is potentially harmful for our bones, so I, personally, will do what I can to minimize my exposure”

    Hope this information helps, Jackie! Please let us know if you have any questions!

    -Ishneet @ AlgaeCal

  27. Victor Negron

    March 9, 2023 , 3:24 am

    Your article on fluoride is very instructive. Thank you.

  28. Shelby AlgaeCal

    March 9, 2023 , 9:36 am

    Hi Victor!

    Thank you so much for reaching out and sharing your feedback with us – we’re thrilled to hear that you find our article instructive! 🙂

    – Shelby @ AlgaeCal

  29. KSpencer

    March 4, 2024 , 7:02 am

    Good article, but time to update it, again. See peer-reviewed studies published since 2015 and listed in PubMed on the damage to bones, bodies and brains caused by fluoride: https://www.fluoridelawsuit.com/science

    And the heavily hyperlinked article on the 2024 “Fluoride Trial” specific to developmental neurotoxicity: https://fluoridealert.org/news/the-fluoride-trial/

  30. Yoori AlgaeCal

    March 4, 2024 , 3:16 pm

    Thank you for sharing, K! We recognize the abundance of information and ongoing updates in various studies. We appreciate your time to share these articles with us, and I’d be happy to share this with our team :).

    – Yoori

This article features advice from our industry experts to give you the best possible info through cutting-edge research.

Lara Pizzorno
MDiv, MA, LMT - Best-selling author of Healthy Bones Healthy You! and Your Bones; Editor of Longevity Medicine Review, and Senior Medical Editor for Integrative Medicine Advisors.,
Dr. Liz Lipski
PhD, CNS, FACN, IFMP, BCHN, LDN - Professor and Director of Academic Development, Nutrition programs in Clinical Nutrition at Maryland University of Integrative Health.,
Dr. Loren Fishman
MD, B.Phil.,(oxon.) - Medical Director of Manhattan Physical Medicine & Rehabilitation and Founder of the Yoga Injury Prevention Website.,
Prof. Didier Hans
PHD, MBA - Head of Research & Development Center of Bone Diseases, Lausanne University Hospital CHUV, Switzerland,