Effect of fluoride on postmenopausal osteoporosis

To the Editor: The risks and benefits of fluoride treatment for osteoporosis have been the subject of much controversy, fueled by a lack of adequately controlled, prospective, randomized, blinded studies. Although such shortcomings cannot be attributed to the study recently reported by Riggs et al. (March 22 issue),¹ there are several aspects of its design that suggest that the risks of fluoride therapy may have been magnified and the potential benefits minimized. The risks appear to fall into three major categories — namely, gastrointestinal intolerance, osteoarticular pain, particularly of the lower extremities, and appendicular fractures. The first two appear to.