Fluoride exposure and thyroid function among adults living in Canada: Effect modification by iodine status

Background: Fluoride exposure has the potential to disrupt thyroid functioning, though adequate iodine intake may mitigate this effect. This is the first population-based study to examine the impact of chronic low-level fluoride exposure on thyroid function, while considering iodine status. The obje...

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Main Authors: Ashley J. Malin, Julia Riddell, Hugh McCague, Christine Till
Format: Article
Language:English
Published: Elsevier 2018-12-01
Series:Environment International
Online Access:http://www.sciencedirect.com/science/article/pii/S016041201830833X
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author Ashley J. Malin
Julia Riddell
Hugh McCague
Christine Till
author_facet Ashley J. Malin
Julia Riddell
Hugh McCague
Christine Till
author_sort Ashley J. Malin
collection DOAJ
description Background: Fluoride exposure has the potential to disrupt thyroid functioning, though adequate iodine intake may mitigate this effect. This is the first population-based study to examine the impact of chronic low-level fluoride exposure on thyroid function, while considering iodine status. The objective of this study was to determine whether urinary iodine status modifies the effect of fluoride exposure on thyroid stimulating hormone (TSH) levels. Methods: This cross-sectional study utilized weighted population-based data from Cycle 3 (2012−2013) of the Canadian Health Measures Survey (CHMS). Information was collected via a home interview and a visit to a mobile examination centre. The weighted sample represented 6,914,124 adults in Canada aged 18–79 who were not taking any thyroid-related medication. Urinary fluoride concentrations were measured in spot samples using an ion selective electrode and adjusted for specific gravity (UFSG). Serum TSH levels provided a measure of thyroid function. Multivariable regression analyses examined the relationship between UFSG and TSH, controlling for covariates. Results: Approximately 17.8% of participants fell in the moderately-to-severely iodine deficient range. The mean (SD) age of the sample was 46.5 (15.6) years and the median UFSG concentration was 0.74 mg/L. Among iodine deficient adults, a 1 mg/L increase in UFSG was associated with a 0.35 mIU/L increase in TSH [95% CI: 0.06, 0.64; p = 0.01, one-tailed]. Conclusions: Adults living in Canada who have moderate-to-severe iodine deficiencies and higher levels of urinary fluoride may be at an increased risk for underactive thyroid gland activity. Keywords: Fluoride, Thyroid, Iodine status, Thyroid stimulating hormone
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spelling doaj.art-9f0bc9b2d2b44fca92c5b7de0432af8b2022-12-21T17:49:56ZengElsevierEnvironment International0160-41202018-12-01121667674Fluoride exposure and thyroid function among adults living in Canada: Effect modification by iodine statusAshley J. Malin0Julia Riddell1Hugh McCague2Christine Till3Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York 10029, NY, USA; Psychology Department, Faculty of Health, York University, 4700 Keele St, Toronto M3J 1P3, ON, Canada; Corresponding author at: Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA.Psychology Department, Faculty of Health, York University, 4700 Keele St, Toronto M3J 1P3, ON, CanadaInstitute for Social Research, York University, 242A-4700 Keele St, Toronto, ON, Canada, M3J 1P3Psychology Department, Faculty of Health, York University, 4700 Keele St, Toronto M3J 1P3, ON, CanadaBackground: Fluoride exposure has the potential to disrupt thyroid functioning, though adequate iodine intake may mitigate this effect. This is the first population-based study to examine the impact of chronic low-level fluoride exposure on thyroid function, while considering iodine status. The objective of this study was to determine whether urinary iodine status modifies the effect of fluoride exposure on thyroid stimulating hormone (TSH) levels. Methods: This cross-sectional study utilized weighted population-based data from Cycle 3 (2012−2013) of the Canadian Health Measures Survey (CHMS). Information was collected via a home interview and a visit to a mobile examination centre. The weighted sample represented 6,914,124 adults in Canada aged 18–79 who were not taking any thyroid-related medication. Urinary fluoride concentrations were measured in spot samples using an ion selective electrode and adjusted for specific gravity (UFSG). Serum TSH levels provided a measure of thyroid function. Multivariable regression analyses examined the relationship between UFSG and TSH, controlling for covariates. Results: Approximately 17.8% of participants fell in the moderately-to-severely iodine deficient range. The mean (SD) age of the sample was 46.5 (15.6) years and the median UFSG concentration was 0.74 mg/L. Among iodine deficient adults, a 1 mg/L increase in UFSG was associated with a 0.35 mIU/L increase in TSH [95% CI: 0.06, 0.64; p = 0.01, one-tailed]. Conclusions: Adults living in Canada who have moderate-to-severe iodine deficiencies and higher levels of urinary fluoride may be at an increased risk for underactive thyroid gland activity. Keywords: Fluoride, Thyroid, Iodine status, Thyroid stimulating hormonehttp://www.sciencedirect.com/science/article/pii/S016041201830833X
spellingShingle Ashley J. Malin
Julia Riddell
Hugh McCague
Christine Till
Fluoride exposure and thyroid function among adults living in Canada: Effect modification by iodine status
Environment International
title Fluoride exposure and thyroid function among adults living in Canada: Effect modification by iodine status
title_full Fluoride exposure and thyroid function among adults living in Canada: Effect modification by iodine status
title_fullStr Fluoride exposure and thyroid function among adults living in Canada: Effect modification by iodine status
title_full_unstemmed Fluoride exposure and thyroid function among adults living in Canada: Effect modification by iodine status
title_short Fluoride exposure and thyroid function among adults living in Canada: Effect modification by iodine status
title_sort fluoride exposure and thyroid function among adults living in canada effect modification by iodine status
url http://www.sciencedirect.com/science/article/pii/S016041201830833X
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