Fluoride and Fluorosis Interaction, Symptoms, Prevalence and Mitigation



Ever since the pioneering research in fluorosis has been undertaken at ICMRNational Institute of Nutrition, Hyderabad in the year 1937, the first case of fluorosis was identified in cattle in Kanagiri, Prakasam district, Andhra Pradesh. Since then, the fluoride and fluorosis research is being continued at ICMRNational Institute of Nutrition. Fluorosis is a disease that is caused due to excess fluoride in drinking and cooking water which can be easily prevented by safe drinking water. The nonavailability of a book in layman‘s language consisting of various research papers/articles on fluorosis and related areas inspired the author to compile his 25 years of research findings in a simple language that can easily be understood by the common people.

The book has covered 20 chapters in various thematic areas like epidemiological studies, basic research (animals), applied research in humans, mechanistic studies, fluorosis mitigation, education and training, and dissemination of knowledge. The epidemiological studies, studies were conducted in 5 districts of Tamil Nadu, Nellore and Prakasam district of Andhra Pradesh, Nalgonda district of Telangana, Doda district of Jammu, and Kashmir, Nawada district of Bihar, and KarbiAnglong of Assam.

These studies were conducted to understand the prevalence and severity of disease, its etiology, and various dietary factors including environmental factors which enhance or reduce the burden of fluoride toxicity in the study areas.

The basic studies have been conducted in animal models/species (dog, guinea pig, rabbit, and rat) to understand organ toxicity, various biomarkers, and toxicokinetics of fluoride toxicity and its mitigation by tamarind. The efficacy of mitigation of fluoride toxicity by tamarind pulp was evaluated in humans in the field set up. Whereas, the mechanistic studies related to the enhanced excretion of fluoride through urine and reduced deposition in bone by tamarind intervention were assessed in laboratory conditions in rats, which has been also supported by the insilico studies.


Arjun Laxmanrao Khandare Scientist G, Director grade Scientist and HOD Food Safety Department, ICMRNational Institute of Nutrition, Hyderabad. His current project is ―Prevalence of fluorosis in the community of selected districts of India and development of an appropriate Intervention model for prevention and control of fluorosis.

Dr. Arjun L. Khandare joined NIN on the permanent post of Research Officer in 1995 after completion of his Ph.D. in Biochemistry from Dr. B.R. Ambedkar Marathwada University, Aurangabad (1985), prior to join NIN,he was Biochemist at Kalawati Saran Children Hospital, Leady Harding Medical College,GOI, New Delhi and Assistant Technical Advisor under M/O HRD, Department WCD,GOI.

Due to his expertise in fluoride and fluorosis research, he is a part of the ICMR TaskForce Group and presently dealing with the ICMR Taskforce project in Prakasam District, Andhra Pradesh. Member of the expert committee and trainer for the National Program for Prevention and Control of Fluorosis, M/O Health, and Family Welfare GOI. Elected as the President of International Society for Fluoride Research in 2016. The most significant findings with crucial public health significance have been

1) Ameliorative effect of tamarind.

2) Ameliorative effect of tamarind fruit extract supplementationon glucose intoleranceand insulin resistance induced by fluoride.

3)Health risk assessment of heavy metals and strontium in ground water.

4)Limited consumption of grass pea (64 g/Cu/day) causes no neurolathyrism