The Great Fluoride Heckoning

Catherine Ebeling, RN, MSN, Contributor, The MAHA Report

“Science is always evolving, and our policies should too. A growing body of evidence indicates that ingesting fluoride can cause neurological harm, and other adverse effects. Most of Europe has already moved away from water fluoridation…and it may well be time for the U.S. to follow suit.

— Robert F. Kennedy Jr., HHS Secretary, January 2026

On January 22, 2026, Lee Zeldin’s Environmental Protection Agency (EPA) announced an accelerated review of fluoride in drinking water under the Safe Drinking Water Act, the first assessment in over 40 years. The move, backed by the Trump White House and HHS Secretary Robert F. Kennedy Jr., comes after decades of scientific evidence linking fluoride to neurological, hormonal, and developmental harm.

What’s Really in Our Drinking Water?

The fluoride added to our drinking water is not the naturally occurring mineral, calcium fluoride. It is fluorosilicic acid (H₂SiF₆), a toxic byproduct of phosphate fertilizer production, captured from industrial smokestacks and sold to municipal water systems.

The supposed benefit of fluoride comes from topical contact with enamel, not from swallowing it. That’s why fluoride in toothpaste works, while fluoride in water provides no added benefit once teeth are formed.

Ingested fluoride is also known to cause dental fluorosis, visible as white spots or pitting on teeth. Interestingly, many European countries do not fluoridate water, and have lower cavity rates due to better diets and oral hygiene.

Neurotoxic to Young Brains

In a landmark 2019 NIH-funded study, researchers found that higher maternal fluoride exposure during pregnancy was linked to lower IQ in children. The National Toxicology Program has since concluded that fluoride is considered neurotoxic at normal exposure levels.

These findings have prompted renewed scrutiny of decades-old assumptions. Researchers note that no safe threshold exists for fluoride exposure during brain development.

Thyroid Dysfunction

Fluoride interferes with iodine uptake, an essential mineral for thyroid hormone production. Studies have shown a correlation between fluoridated water and increased rates of hypothyroidism, especially in areas with lowered iodine intake, including many areas of the U.S.

Thyroid dysfunction can lead to widespread issues like depression, fatigue, nutrient malabsorption, infertility, and weight gain.

Fluoride in Bones

Fluoride accumulates in the skeletal system over time. While it may technically increase bone density, it makes bones more brittle and increases risk of fractures. Chronic exposure can lead to skeletal fluorosis, and may be tied to the higher rates of osteoporosis in women.

Clogged Pineal Gland

Besides fluoride’s neurotoxic effect, research from the University of Surrey revealed that fluoride accumulates in the pineal gland, the small structure in the brain that regulates sleep and circadian rhythms. This buildup may contribute to insomnia, mood disorders, depression, early puberty, and even dementia.

The EPA’s 2026 Action Plan

The EPA’s Preliminary Assessment Plan, released this January 22, 2026, outlines a transparent process to re-evaluate fluoride’s health effects, particularly for infants and vulnerable populations. The agency pledged to use gold-standard science, public comment, and interagency collaboration focused on fluoride’s impact on children, pregnant women, and developing brains.

“Making America Healthy Again is a top priority, especially when it comes to concerns about what is in our water. Every American should be able to count on safe, healthy drinking water when they pour a glass to drink or use it to cook a meal, especially for a child. The Trump EPA is working in lockstep with Secretary Kennedy and following gold standard science to guide our next steps to protect drinking water under the Safe Drinking Water Act.”
— EPA Administrator Lee Zeldin

The Preliminary Assessment Plan details the science-based approach in evaluating fluoride’s health risks. The agency has pledged to “draw on expertise across the federal government,” and release the assessment for public comment and external peer review.

Rather than conducting a fluoride risk evaluation under the Toxic Substances Control Act (TSCA), the agency determined that a review under the Safe Drinking Water Act (SDWA), led by the Office of Water, is the most appropriate regulatory pathway for addressing fluoride as a drinking water contaminant.

The federal regulatory standards set by EPA apply regardless of whether fluoride is naturally occurring in source water or is intentionally added. EPA’s responsibility is to ensure that overall fluoride levels remain within health-protective limits; however, the agency does not make policy recommendations to state or local systems on fluoride.

The EPA previously set the maximum contaminant level (MCL) for fluoride at 4.0 mg/L, a limit unchanged since 1986. Under Zeldin, the agency today acknowledges this standard may no longer reflect the latest science and has accelerated the process to review and potentially revise it years ahead of schedule.

The EPA’s new plan will be available for public comment for 30 days once it is published in the Federal Register. The EPA will host a public webinar on January 28, 2026, to discuss the assessment plan as well as next steps. To register for this webinar visit the EPA, here.

This is the first government effort in four decades to reexamine fluoride’s risks. It reflects a welcome shift to protect our children and our country’s health — to serve the people not protect outdated assumptions or industry profits.