Fluoride toxicity and new-onset diabetes in Finland: a hypothesis -

The incidence of type 1 diabetes (T1D) has increased substantially in Finland, but the exact trigger for the onset of T1D is still unknown. We know that use of amoxicillin and anti-cariogenic fluoride tablets is a common practice for children in Finland. It seems that beta-cell destruction is initiated by modification of the proinsulin by combined effects of fluoride (F2) and amoxicillin. Amoxicillin especially when used together with clavulanic acid results in an acid environment around the beta-cells that promotes the conversion of F2 to hydrogen fluoride (HF). Unlike F2, HF can diffuse easily into the beta-cell cytosol. Because the cytosol has a neutral pH, virtually all HF reverts to F2 in the cytosol and F2 cannot easily diffuse out of the cell. Exposure to excess F2 promotes proinsulin covalent dimerization and simultaneously hyperexpression of MHC Class I molecules. Proinsulin dimers then migrate to the cell membrane with MHC class I molecules, accumulate at the beta-cell membrane and produces a powerful immunogenic stimulus for the cytotoxic T-cells. Production of cytotoxic cytokines from the infiltrating T-cells initiates the destruction of beta-cells. In Finnish children, this might be helped along by a higher beta-cell activity and by a reactive thymus-dependent immune system induced by higher levels of thyroid hormones and calcitonin respectively. After repeated similar attacks, more and more effector T-cells are raised and more and more beta-cells are destroyed, and clinical diabetes occurs.