NO SAFE THRESHOLD OF FLUORIDE IN WATER
The US Government’s National Toxicological Program (NTP) has released the final version of its eight year review of fluoride and IQ. The NTP found “with moderate confidence, that higher estimated fluoride exposures (e.g., as in approximations of exposure such as drinking water fluoride concentrations that exceed the World Health Organization Guidelines for Drinking-water Quality of 1.5 mg/L of fluoride) are consistently associated with lower IQ in children.”
The NTP report looked at total exposure, whereas the WHO guidelines, set in 1984, are based only on drinking water consumption. Today, people are exposed to fluoride from many sources other than just the water e.g. toothpaste, mouthwash, pesticide residue, various medications and foods such as fish and tea.
NOTE: Fluoridated water in New Zealand is carried out at a level of around 0.85ppm. This is higher than the US and Canada that have a maximum level of 0.7ppm.
Results of the NTP Systematic Review
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- The final version was released in August 2024.
- NTP Monograph on the State of the Science Concerning Fluoride Exposure and Neurodevelopment and Cognition: A Systematic Review
- A draft review had been released in May 2024 and included the peer reviewers comments and the NTP response to those comments. The Draft was issued in two parts:
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- The meta-analysis reported that 52 of 55 studies found lower IQ with higher fluoride exposures, 95% consistency. 7 IQ point reduction (SMD-0.46 (-0.55, -0.37)). Page 499 has the 55 Human IQ studies. 1 SMD = standardized weighted mean difference is equivalent to 15 IQ Points. Therefore, -0.46 means 15 x -0.46 = 7 IQ Points. Page 502 has a breakdown of the 55 Human IQ studies with the -0.46 SMD.
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- Of the 19 studies rated higher quality, 18 found a lowering of IQ. Page 1,107 – 1,161.
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- The NTP recognised that of the high quality studies the Canadian and Mexican cohort data were the strongest. Those studies included Bashash 2017, Bashash 2018, Green 2019, Till 2020, Farmus 2021. Those studies found an IQ reduction range between 3 – 9 IQ points. On average, a 1ppm increase caused a 5 IQ point reduction. Note, in New Zealand we fluoridate at a range of between 0.7ppm – 1ppm which is why it can be said that we maybe lowering IQ in New Zealand between 3 – 5 IQ points on average.
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- Concluded that prenatal and early life exposures can reduce IQ.
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- The meta-analysis could not detect a safe level of exposure.
- First draft of NTP in 2019 concluded “that fluoride is presumed to be a cognitive neurodevelopmental hazard to humans.”

Who is the NTP?
The NTP, (est. 1978), is an interagency collaboration within the U.S. Department of Health and Human Services. Is in partnership with:
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- National Institute for Occupational Safety and Health (part of Centers for Disease Control CDC)
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- Food and Drug Administration (FDA)
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- National Institute of Environmental Health Sciences (part of National Institutes of Health NIH)
The NTP is the Go-To agency when the US Government want to review any “agents of concern”. It does the most serious scientific analysis to identify if there are any toxic or biological effects caused by that agent.
The NTP provide an overview of the topic, including links to the Board of Scientific Counselors meetings and a timeline.
Ministry of Health have not reviewed the NTP Review since the 2020 Draft.
The Chief Science Advisor’s report of 2021 quotes from the 1st Draft of the NTP which says “…when considering all the evidence, including studies with exposures to fluoride levels higher than 1.5 mg/L in water, NTP concludes that fluoride is presumed to be a cognitive neurodevelopmental hazard to humans. This conclusion is based on a moderate level of evidence that shows a consistent and robust pattern of findings in human studies across several different populations demonstrating that higher fluoride exposure (e.g., >1.5 mg/L in drinking water) is associated with lower IQ and other cognitive effects in children.”
The Chief Science Advisor follows with the comment that “This determination is very clearly dose dependent” which should actually mean we don’t have fluoridation since there is no way of knowing what dose anyone is getting, or more importantly what dosage (mg/kg/day) anyone is getting.
1.5 mg/L in water is very close to the target the MoH promotes of 0.85 mg/L, there is no margin of safety of a known neurotoxin.
But it gets worse. In the 2nd Draft of the NTP Report the scientists reject the claim that neurotoxicity occurs only 1.5 mg/L. On page 318 they say “Several of the highest quality studies showing lower IQs in children were done in optimally fluoridated (0.7 mg/L) areas…many urinary fluoride measurements exceed those that would be expected from consuming water that contains fluoride at 1.5 mg/L.” On page 652 the NTP say “there is no obvious threshold”.
Fluoride Action Network USA (FAN) Summaries
NTP report finds “large body” of evidence that fluoride exposure is “consistently associated with lower IQ in children” – August 21 2024 | Fluoride Action Network
Fluoride is the New Lead – May 3rd, 2023 | Chris Neurath, Science Director, Fluoride Action Network
Government Report Finds No Safe Level of Fluoride in Water; Fluoridation Policy Threatened – March 16th, 2023 | Fluoride Action Network
Suppressed Government Report Finding Fluoride Can Reduce Children’s IQ Made Public Under EPA Lawsuit – March 15th, 2023 | Fluoride Action Network.
Mainstream Media Articles
By MIKE STOBBE Associated Press Aug 22, 2024
NEW YORK — A U.S. government report expected to stir debate concluded that fluoride in drinking water at twice the recommended limit is linked with lower IQ in children…..
