Friday, June 08, 2007

Coffee, Tea or me?

For those who wanted to know, this was the topic of my presentation at the meeting, a case series of 4 patients with osteosclerosis from fluoride toxicity associated with tea consumption. The presentation was well-received, and I had numerous questions from the audience since this is extremely rare in the USA. However, fluorosis appears to be endemic in some parts of the world, probably related to high tea consumption and fluoride levels in drinking water. This generated an interesting discussion at the meeting because some amongst the audience came from these endemic areas and had some experience as well. We published this in a journal this month. I've included the abstract:
Acquired osteosclerosis is a rare disorder of bone formation but an important consideration in adults with sclerotic bones or elevated bone density results. In such patients, malignancy, hepatitis C, and fluorosis should all be considered when making a diagnosis. We describe 4 patients evaluated at our Metabolic Bone Disease Clinic from May 1, 1997, to July 1, 2006, whose bone disorders resulted from chronic fluoride exposure due to excessive tea intake.
Three of these patients had toxic serum fluoride levels (>15 ╬╝mol/L). Although the clinical presentation of the patients varied, all 4 had an unexpectedly elevated spine bone mineral density that was proportionately higher than the bone mineral density at the hip. Other clinical features included gastrointestinal symptoms such as nausea, vomiting, and weight loss; lower extremity pain sometimes associated with stress fractures of the lower extremities; renal insufficiency; and elevated alkaline phosphatase levels. Readily available, tea often contains high levels of fluoride. Obsessive-compulsive drinking behaviors and renal insufficiency may predispose to excessive fluoride consumption and accumulation. The current cases show that fluoride-related bone disease is an important clinical consideration in patients with dense bones or gastrointestinal symptoms and a history of excessive tea consumption. Furthermore, fluoride excess should be considered in all patients with a history of excessive tea consumption, especially due to its insidious nature and nonspecific clinical presentation.
Some interesting numbers:
Recommended adult intake: 3-4 mg fluoride/day
Fluoride content of regular tea: 2-6.5 mg per liter
Fluoride content in jasmine tea: >200 mg per liter
So, something to think about the next time you order that 3rd glass of teh tarik.

6 Comments:

Blogger fibrate said...

Oops...looks like I'm high risk!

10:43 PM  
Anonymous ront said...

what constitute 1liter of tea ? does it mean regular strength?...then again...what's regular??

5:55 AM  
Anonymous mumbler said...

oh man. how about green tea? and chinese tie guan yin? i love tea, and it sucks to hear this. heh, but thanks for your efforts. better to know it then not. =)

7:15 AM  
Anonymous Anonymous said...

very interesting - but are you sure that jasmine tea has such a very high concentration of fluoride? I've tried to find confirmation of high levels relative to other types of tea and have not been able to. Would be great to find out what you think - might the concentration you cite for jasmine tea be perhaps mistaken?

8:14 AM  
Anonymous Judah said...

Hello,
I am the owner of Dragon Pearl Tea, we have tested all our teas for Flouride to understand this potentially toxic relationship. Our findings from chemistry tests showed that our teas average .2-.3 mg of Flouride per 2 gram serving of tea. The Jasmine Pearl Green Tea was only slightly higher in Flouride than our White Tea, with the Black Tea testing slightly higher than the Jasmine.
Many servings and large portions can increase intake of course. Tea grown in polluted and industrialized areas can have much higher concentrations because Flouride is a by-product of chemical fertilizers and from Aluminum production. Dragon Pearl Tea comes from remote mountain sources with little development. As they always say...location, location, location.

11:58 AM  
Blogger vagus said...

we did not measure the fluoride content in the tea ourselves, just the instant tea from my patient. the numbers I quoted were published elsewhere in medical journals and should be listed in the references in my paper. if you want the citations you could find it there.
appreciate the comments. one thing however i should clarify: fluoride is a mineral and is found in soil. so many plants, polluted or not, will soak this up and concentrate it.
also tea DOES contain fluoride, but to get toxic like my patient did you would have to drink massive amounts of tea. so regular Joes should not be overly concerned.
thanks for stopping by. will have to try dragon pearl tea someday :)

12:08 PM  

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