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Minerals, trace elements, Vit. D and bone health

The association of fluoride in drinking water with serum calcium, vitamin D and parathyroid hormone in pregnant women and newborn infants



Chronic exposure to fluoride in drinking water causes an increase in plasma fluoride levels that is related to a reduction in calcium transport across the renal tubule endoplasmic reticulum and plasma membrane. In the present study, it was hypothesised that varying levels of fluoride present in drinking water are associated with serum levels of calcium and the related hormones vitamin D and parathyroid hormone in pregnant women and newborn infants.


This cross-sectional study included two groups based on the fluoride concentration in drinking water. One group was considered low/optimum in which the fluoride concentration in drinking water was <1 ppm, and the other group was considered a high fluoride group with ≥1 ppm fluoride in drinking water. In each group, 90 pregnant women were recruited at the hospital during delivery. The participants were given a questionnaire regarding their medical history, sunshine exposure duration, and supplement use and a food frequency questionnaire (FFQ). Fluoride was measured in drinking water, urine, maternal serum and cord blood. Serum calcium, vitamin D, and parathyroid hormone were measured in a fully automated analyser.


In pregnant women, drinking water that contained fluoride was significantly positively correlated with urine and blood serum. Low mean concentrations of vitamin D and deficient (<10 ng/ml) vitamin D were more prevalent among the high fluoride group irrespective of diet, sunshine exposure and supplementation. Serum calcium and parathyroid hormone (PTH) levels were significantly lower in the high fluoride group than in the low/optimum fluoride group in both pregnant mothers’ blood and cord blood.


Drinking water with high fluoride levels was significantly associated with calcium and the related hormones vitamin D and parathyroid hormone.

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This research was funded by Indian Council of Medical Research (ICMR), India.

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HMT was responsible for project conception, development of overall research plan and study oversight. DD was responsible for study oversight and data collection. MNK was responsible for primary responsibility for final content. MMW and SNP were responsible for hands-on conduct of the experiments and data collection.

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Correspondence to M. Nanditha Kumar.

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Thippeswamy, H.M., Devananda, D., Nanditha Kumar, M. et al. The association of fluoride in drinking water with serum calcium, vitamin D and parathyroid hormone in pregnant women and newborn infants. Eur J Clin Nutr 75, 151–159 (2021).

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