Sodium Fluoride

Safetychecker Summary for Sodium Fluoride
(for details about the summarized interactions, read the full article)

May be Beneficial: Depletion or interference—The medication may deplete or interfere with the absorption or function of the nutrient. Taking these nutrients may help replenish them.	Zinc
May be Beneficial: Supportive interaction—Taking these supplements may support or otherwise help your medication work better.	Vitamin D Vitamin E
Check: Other—Before taking any of these supplements or eating any of these foods with your medication, read this article in full for details.	Calcium
Side effect reduction/prevention	None known
Reduced drug absorption/bioavailability	None known
Adverse interaction	None known

Interactions with Dietary Supplements

Calcium
Research shows that calcium from leg bones may be transferred to bones in the spine causing stress fractures when fluoride is taken alone. However, supplementing with 1,500 mg of calcium each day together with slow-release forms of fluoride increases the bone density of the lumbar spine without causing fractures.¹ Therefore, people taking sodium fluoride to treat osteoporosis should probably supplement with calcium to prevent this adverse effect. However, taking fluoride and calcium at the same time significantly reduces the absorption of fluoride;² consequently, they should be taken at least an hour apart.

Vitamin D
Collagen is a protein that is used in many areas of the body for structural support. One test tube study showed that the active form of vitamin D, 1,25 dihydroxycholecalciferol, increased the production of a certain type of collagen when it was combined with fluoride.³ Controlled research is needed to determine whether taking 1,25 dihydroxycholecalciferol with sodium fluoride might promote beneficial collagen growth.

Zinc
Individuals who are bedridden for long periods may become deficient in zinc, which can affect the strength of bone that is formed. In a controlled study of healthy adults who were confined to bed, fluoride supplementation prevented zinc loss from the body.⁴ Bedridden individuals should consult a qualified healthcare practitioner for guidance in using fluoride to prevent zinc deficiency.

Vitamin E
Vitamin E increases the resistance of tooth enamel to acids that cause cavities, and test tube studies show that fluoride, when added to vitamin E, enhances this effect.⁵ Controlled research is needed to determine whether people might develop fewer cavities when taking vitamin E and fluoride together.

Interactions with Foods and Other Compounds

Food
Taking sodium fluoride with food⁶ or dairy products⁷ reduces the absorption of the mineral. Therefore, sodium fluoride should be taken an hour before or two hours after a meal, or any snack containing milk, ice cream, yogurt, or cheese.

Tea
Many compounds in tea, such as tannin, catechin, and caffeine, can increase the resistance of tooth enamel to acids that cause cavities, and test tube studies show that fluoride, when added to these compounds, enhances this effect.⁸ Controlled research is needed to determine whether drinking tea might further reduce the number of cavities in people taking fluoride.

References:

1. Deal CL. Osteoporosis: prevention, diagnosis, and management. Am J Med 1997;102:35s–9s.

2. Ekstrand J, Spak CJ. Fluoride pharmacokinetics: its implication in the fluoride treatment of osteoporosis. J Bone Miner Res 1990;5 Suppl 1:s53–61.

3. Kassem M, Mosekilde L, Eriksen EF. 1,25-dihydroxy-vitamin D3 potentiates fluoride-stimulated collagen Type I production in cultures of human bone marrow stromal osteoblast-like cells. J Bone Miner Res 1993;8:1453–8.

4. Krebs JM, Schneider VS, LeBlanc AD. Zinc, copper and nitrogen balance during bed rest and fluoride supplementation in healthy adult males. Am J Clin Nutr 1998;47:509–14.

5. Yu H, Oho T, Xu LX. Effects of several tea components on acid resistance of human tooth enamel. J Dent 1995;23:101–5.

6. Ekstrand J, Spak CJ. Fluoride pharmacokinetics: its implication in the fluoride treatment of osteoporosis. J Bone Miner Res 1990;5 Suppl 1:s53–61.

7. Ekstrand J, Ehrnebo M. Influence of milk products on fluoride bioavailability in man. Eur J Clin Pharmacol 1979;16:211–5.

8. Yu H, Oho T, Xu LX. Effects of several tea components on acid resistance of human tooth enamel. J Dent 1995;23:101–5.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2003.