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That's what I read here: http://www.merckmanuals.com/professional/nutritional_disorders/mineral_deficiency_and_toxicity/fluorine.html

No tests to diagnose toxicity are available.

jimjim
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Skeptical
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2 Answers2

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The scary implication here is that you or your children could be dying of fluoride poisoning, and there is no way your doctor could ever know, because there isn't a single blood test that will report on the fact. The truth is that the medical profession can diagnose fluoride poisoning.

In the paragraph above the line you cite:

The earliest signs are chalky-white, irregularly distributed patches on the surface of the enamel; these patches become stained yellow or brown, producing a characteristic mottled appearance. Severe toxicity weakens the enamel, pitting its surface.

So, long-term fluoride poisoning has a distinct medical sign, especially in children.

Diagnoses of Fluoride Toxicity is documented by Medscape

It discusses patient presentation, and differential diagnoses, so other poisonings are not confused with it.

It suggests the following tests when fluoride poisoning is suspected:

  • Serum electrolytes
    • Hyperkalemia
    • Hypocalcemia
    • Hypomagnesemia
    • Hypoglycemia
  • Electrocardiogram and cardiac monitoring
    • Effects of hyperkalemia (peaked T waves, widened QRS, bradycardia, atrioventricular [AV] nodal blockade)
    • Effects of hypocalcemia (prolonged corrected QT interval [QTc])
  • Serum and urine fluoride levels are not available for ED evaluation.
  • Perform a Dextrostix evaluation (fingerstick) on all patients with seizure and altered mental status because of the risk for hypoglycemia with systemic fluoride toxicity.

Note that fluoride levels can also be measured in water.

Oddthinking
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  • the chalky-white patches on the enamel is known as "dental fluorosis". 40% of the US population has dental fluorosis, so it's hardly a sign of fluoride poisoning. (Or is it?) – Kenshin Dec 28 '12 at 02:35
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    @Chris: That probably depends on how one defines "poisoning." The dictionary defines poisoning as "the condition produced by a poison or by a toxic substance"--according to that definition, dental fluorisis is clearly the result of "poisoning." Is it particularly dangerous? In its mildest forms, no. But any poison is not particularly dangerous in sufficiently mild doses. – Flimzy Dec 28 '12 at 02:46
  • @Oddthinking: See PubMed.gov--http://www.ncbi.nlm.nih.gov/pubmed/2099108--"Fluoride level in human nails and its significance"--The nails furnish a readily accessible material for studying fluorine saturation in the organism.-- It looks like this technique may be used in Poland where they don't add fluoride to their water. I wonder if its a reliable test? I've heard pro & con on it. But it seems likely that a dentist could accomplish this to help prevent dental fluorosis in his pediatric patients. – Skeptical Dec 28 '12 at 03:38
  • @Skeptical: Is that nails test part of the question? You could always look at the cites on that page to see how people have reacted to it. [This response article](http://www.ncbi.nlm.nih.gov/pubmed/7993565) discusses some of the problems with using hair and nails, in being sure of the source of the fluorine. [This review article](http://www.ncbi.nlm.nih.gov/pubmed/2179310) the reliability of other techniques for determining fluorine levels in biological substances. – Oddthinking Dec 28 '12 at 05:07
  • @Oddthinking it would be good to know the levels of fluoride that result in those symptoms to put the exposure required in context. – matt_black Dec 28 '12 at 12:32
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Are there currently no tests available to diagnose fluoride [...] toxicity?

Susheela, A.K. and Das, T.K. 1988 Fluoride toxicity and fluorosis: diagnostic test for early detection and preventive medicines adopted in India. [Abstract], International Symposium on Environmental Life Elements and Health, Beijing, 89.

World health organisation - Fluoride in drinking water

... or fluorine toxicity?

Fluorine is a pale yellow gas. It is highly reactive (e.g. water burns with a bright flame in fluorine). Consequently people generally don't come into contact with fluorine.

RedGrittyBrick
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