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Fluoride-related bone disease associated with habitual tea consumption.
Julie E Hallanger Johnson1, Ann E Kearns, Patric M Doran
1Division of Endocrinology, Diabetes, Metabolism, and Nutrition, College of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Mayo Clinic Proceedings
|June 7, 2007
Summary
Excessive tea consumption can lead to acquired osteosclerosis, a rare bone disorder caused by chronic fluoride exposure. This condition presents with dense bones and gastrointestinal issues, especially in those with kidney problems.
Area of Science:
- Endocrinology
- Toxicology
- Bone Metabolism
Background:
- Acquired osteosclerosis is a rare bone disorder characterized by increased bone density.
- Differential diagnoses for sclerotic bones include malignancy, hepatitis C, and fluorosis.
Observation:
- Four patients with bone disorders from chronic fluoride exposure due to excessive tea intake were evaluated.
- Three patients presented with toxic serum fluoride levels (> 15 micromol/L).
- All patients exhibited disproportionately higher spine bone mineral density compared to hip bone mineral density.
Findings:
- Clinical features included gastrointestinal distress (nausea, vomiting, weight loss), lower extremity pain with stress fractures, renal insufficiency, and elevated alkaline phosphatase.
- Chronic excessive tea consumption, particularly with obsessive-compulsive drinking behaviors or renal insufficiency, can lead to fluoride accumulation.
- Fluoride-related bone disease is an important consideration in patients with dense bones or gastrointestinal symptoms and a history of excessive tea consumption.
Implications:
- Fluoride excess should be considered in patients with a history of excessive tea consumption due to its insidious nature and nonspecific presentation.
- This highlights the importance of dietary history in diagnosing bone disorders.
- Early identification and management of fluoride toxicity are crucial for preventing severe bone complications.
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