AMA #15：氟化物的益处与风险及迷走神经刺激

欢迎来到休伯曼实验室播客，在这里我们讨论科学以及基于科学的日常生活的工具。

Welcome to the Huberman Lab Podcast where we discuss science and science based tools for everyday life.

我是安德鲁·休伯曼，斯坦福大学医学院神经生物学和眼科学教授。

I'm Andrew Huberman and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.

今天是一期问答环节，也就是AMA。

Today is an Ask Me Anything episode or AMA.

这是我们的高级订阅者频道的一部分。

This is part of our premium subscriber channel.

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Our premium subscriber channel was started in order to provide support for the standard Huberman Lab Podcast, which comes out every Monday and is available at zero cost to everybody on all standard feeds, YouTube, Apple, Spotify, and elsewhere.

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We also started the premium channel as a way to generate support for exciting research being done at Stanford and elsewhere.

针对人类的研究，旨在带来重要发现，以促进心理健康、身体健康和表现提升。

Research on human beings that leads to important discoveries that assist mental health, physical health, and performance.

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I'm also pleased to inform you that for every dollar the Huberman Lab Premium Channel generates for research studies, the Tiny Foundation has agreed to match that amount.

因此，我们现在能够将用于心理健康、身体健康和人类表现研究的资金总额翻倍。

So now we are able to double the total amount of funding given to studies of mental health, physical health, and human performance.

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那么，不多说了，我们开始回答大家的问题。

So without further ado, let's get to answering your questions.

第一个问题是关于氟化物的，具体问题是：为什么我们的饮用水中会添加氟化物？它对我们的伤害有多大？

The first question is about fluoride and the specific question is why is fluoride in our water and how much is it harming us?

好吧，这个问题看起来可能很简单，但实际上包含很多内容。

Okay, well, that might seem like a short question, but there's actually a lot to that question.

我想明确一点，提问‘它对我们的伤害有多大’，

And I want to be very clear by posing the question, how much is it harming us?

这暗示了氟化物正在伤害我们。

It implies that fluoride is harming us.

但我要明确说明：氟化物是否对你有害，或有害到什么程度，取决于你摄入的水中、牙膏中或其他来源中的氟化物含量，明白吗？

And I want to be very clear, the degree to which fluoride can harm you or not harm you depends on how much of it happens to be in the water or toothpaste or some other thing that you're consuming, okay?

这一点非常重要。

So this is very important.

我不希望这个问题看起来像是在引导大家认为氟化物必然有害，因为接下来我会告诉你们，氟化物对增强牙齿强度和预防蛀牙有明确的好处。

I don't want the question to seem like a leading question to imply that fluoride is necessarily harming us because as I'm about to tell you, there are clear benefits of fluoride for tooth strength and for warding off cavities.

但如果你体内摄入了过多的氟化物，那就非常危险。

But if you get too much fluoride into your system, it is dangerous.

在某些剂量下，它是一种毒物。

It is a poison at certain levels.

所以，正如你可能以前听过的一样，剂量决定它是否成为毒物。

So as you've probably heard before, the dose makes the poison.

让我们把这个看似简单的问题拆分成两个部分来分析。

So let's take this seemingly simple question and dissect it in two.

这个问题的第一部分是：为什么我们的饮用水中会添加氟化物？

The first part of the question was, why is fluoride in our water?

你可能难以置信，但就连这个问题在2024年也很难直接回答。

And believe it or not, even that is hard to answer directly because here's what's happening right now in 2024.

目前，加利福尼亚州正有一起重大诉讼，试图将氟化物从饮用水中移除。

There is a major lawsuit in the state of California to try and get fluoride removed from the drinking water.

这个案件的判决结果尚未确定，但提起诉讼的是一个坚信饮用水中任何浓度的氟化物都有害的群体。

The outcome of that case is still yet to be determined, but the case was filed by a group of individuals who strongly believe that fluoride at any concentration in the drinking water is bad.

他们为什么会这么说？他们的证据是什么？这些证据有多强？

Why would they say that and what is their evidence and how strong is that evidence?

有一些证据表明，如果饮用水中的氟化物水平超过某个阈值，可能会对甲状腺激素功能甚至大脑的某些功能造成影响。

Well, there is some evidence that if levels of fluoride in drinking water exceed a certain threshold, it can cause problems with thyroid hormone function and perhaps even certain aspects of brain function.

同样，前提是氟化物水平超过了某个阈值。

Again, if the levels exceed a certain threshold.

因此，在加利福尼亚州，有一场重大诉讼试图将氟化物从饮用水中去除。

So in the state of California, there is a major lawsuit to try and get fluoride removed from the drinking water.

与此同时，也就是现在，美国还有一场重大的诉讼。

Now, at the same time, meaning right now, there is also a major lawsuit in The United States.

这场诉讼发生在纽约州布法罗市，市民们起诉市政府，坚称饮用水中的氟化物含量不足，并以他们孩子因饮用水中氟化物不足而导致的口腔健康问题为由，要求赔偿。

This one taking place in Buffalo, New York, whereby citizens are suing the city because they insist that there is not enough fluoride in the water and they are suing for damages based on the dental health needs of their children that did not, in their opinion, get enough fluoride in the drinking water.

我之所以告诉你这些，是因为问题再次回到：为什么我们的饮用水中要有氟化物？

So I'm telling you about all of this because the question again was why is fluoride in our drinking water?

你可能难以置信，美国某些州、某些地区饮用水中的氟化物含量很低，甚至为零，这正是布法罗诉讼所涉及的问题。

And believe it or not, there are certain states in The United States, certain areas of The United States where the fluoride levels in the drinking water are low, are zero, perhaps, that's what the lawsuit in Buffalo is about.

顺便说一句，布法罗市可能已经调整了饮用水中的氟化物含量，从零提升到了某个数值——至于是否真的曾为零，仍有争议，但我想你已经开始明白，人们对饮用水中添加氟化物的安全性有着极大的分歧。

And by the way, the city of Buffalo may have now corrected the amount of fluoride in the water, taking it from zero to something, whether or not it was actually zero is still debatable, but I think you're starting to get the point that there is a wide, wide divergence in terms of how safe people feel about having fluoride in drinking water.

有些人希望水中含有氟化物，因此起诉城市，认为他们饮用水中的氟化物不足；而另一些人则完全不希望饮用水中含有氟化物，也因同样的原因起诉城市，明白吗？

Some people want it and are suing cities because they feel there wasn't enough of it in their drinking water, and others don't want any fluoride in their drinking water and they're suing cities because of that, okay?

所以这就像一片带刺的铁丝网，正如我常说的，无论你从哪个角度接近它，都难免会被扎到。

So this is a really barbed wire topic as I like to say, it's one that no matter how close you get to it, whatever angle you look at it, you're likely to get stuck a little bit.

这会有点痛苦。

It's gonna be a little bit painful.

那么，为什么有些饮用水中会含有氟化物呢？

Okay, why is fluoride in some drinking water at all?

好吧，我们先不管浓度，直接回答这个问题。

Okay, let's set aside the levels and just answer that question.

在即将播出的《休伯曼实验室播客》关于口腔健康的一集中，我会更详细地探讨这一点，但氟化物在口腔健康方面确实非常特别，原因如下。

Well, in an upcoming episode of the Huberman Lab Podcast about oral health, I'll get into this in a lot more detail, but fluoride is a really interesting compound with respect to oral health and here's why.

你的牙齿，你可能想不到，始终处于脱矿化或再矿化的状态。

Your teeth, believe it or not, are always in a state of either demineralization or remineralization.

这两个词说起来有点拗口。

Those are tricky words to say.

来，试着说一遍。

Go ahead and try and say it.

脱矿化，再矿化。

Demineralization, remineralization.

所以我会用‘脱矿’代表脱矿化，用‘再矿’代表再矿化。

So I'm gonna refer to them as a demin for demineralization and remin for remineralization.

你的牙齿总处于其中一种状态，或者其中一种状态占主导。

Okay, your teeth are always in one state or the other, or one state predominates versus the other.

现在，口腔中的蛀牙是由细菌——特别是变形链球菌，有时也叫链球菌突变株——以口腔中的糖分为食造成的。

Now a cavity in your mouth occurs when bacteria in particular streptococcus mutans, sometimes called strep mutans feeds on sugars in your mouth.

这些细菌在摄取糖分后会产生酸性物质，进而腐蚀牙齿的牙釉质及更深层结构。

And then as a byproduct of that feeding creates acids that then erode the enamel and deeper layers of your teeth.

换句话说，它会导致牙齿脱矿。

In other words, it demineralizes the tooth.

我刚才告诉你，你的牙齿随时都可能处于脱矿或再矿状态。

Now I just told you that your teeth can be in a state of demin or remin at any moment.

牙齿再矿化的方式，也就是它们能够填补尚未深入牙齿深层的小蛀洞，是通过一个涉及矿物质结晶构建的过程实现的，明白吗？这就是为什么它被称为再矿化。而且你听好了，这真的很惊人。

The way that your teeth remin, the way they remineralize and can potentially fill in little cavities that have not yet made it to the deeper layers of your teeth is through a process that involves the construction of crystals from minerals, okay, that's why it's called remineralization and get this, this is really wild.

这些矿物质实际上会以非常有序的微小序列堆叠在一起，有点像乐高积木。

These minerals actually stack together in very organized little sequences, kind of like Lego blocks.

这些积木中的关键成分是一种叫做羟基磷灰石的物质。

And the critical element within those blocks is something called hydroxyapatite.

我喜欢它里面包含'食欲'这个词，因为我们正在讨论口腔健康。

I love that it has the word appetite in it because we're talking about oral health.

这是正常的流程。

That's the normal process.

氟化物的发现并不是因为它是维生素，也不是因为它是必需营养素。

Fluoride was discovered not because it's a vitamin, not because it's an essential nutrient.

事实上，在高浓度下，它实际上是一种毒物。

In fact, at high concentrations, it's actually a poison.

我稍后会告诉你一个故事，关于我小时候在牙医那里因为自己的失误而被大量氟化物中毒的经历。

I'll tell you a story about that in a moment where I was actually poisoned by fluoride at the dentist when I was a kid in large part due to my own error.

氟化物被发现可以进入这些类似乐高积木的晶体结构中，并在它们之间形成比通常羟基磷灰石键更强的化学键。

Fluoride, it was discovered can actually get inside of those Lego chain like crystals, the building of those and form bonds between them that are actually stronger than the hydroxyapatite bonds that would normally form.

换句话说，如果你饮用含氟水或使用含氟牙膏，尤其是在儿童时期，牙齿的晶体和矿化结构会变得极其坚固，即具有超生理强度，从而限制了变形链球菌及其食用糖后产生的酸侵蚀牙釉质的能力，而这种侵蚀就是我们所说的蛀牙。

In other words, if you consume fluoridated water or use toothpaste with fluoride, especially if you do this when you're a kid, what ends up happening is that the crystals and the mineralization structure of the teeth becomes ultra strong, meaning super physiologically strong, which then limits the ability for that strep mutans and the acid strep mutans produces when it eats sugar to erode the enamel of your teeth causing what we refer to as cavities.

于是，我询问了几位牙医和牙周病专家，为什么饮用水中要添加氟化物？

Okay, so I went and asked several dentists and a periodontist about why is fluoride in drinking water?

为什么牙膏中要添加氟化物？

Why is fluoride in toothpaste?

他们当然给了我刚才所说的解释，这是一种化学和机械层面的原理或理由。

And they of course gave me the explanation that I just gave you, which is a chemical mechanical explanation or rationale.

然而，我们健康相关的大多数事情，比如我们吃的食物、锻炼的量，并不会自然地被添加到我们的环境中，对吧？

However, most of the things for our health, such as the foods we eat, the amount of exercise that we do are not naturally put into our environment, right?

但自来水是供应给所有使用水龙头的人的资源，基本上是由政府或地方政府提供的。

But tap water, which goes out to everyone who consumes it from the tap is basically a government or local government supplied resource.

基本的出发点是——我相信这最早发生在20世纪50年代——既然氟化物有潜力让牙齿变得超生理强度，我们能做些什么来减少儿童和成人中的蛀牙和牙齿腐蚀呢？

And basically the rationale was, and I believe this took place first in the 1950s was, okay, given the potential for fluoride to make super physiologically strong teeth, what can we do to reduce the cavities and tooth decay that would occur in children and adult populations?

我们把氟化物加到饮用水里吧。

Let's put fluoride in the drinking water.

他们就这么做了。

So that's what they did.

我被告知，他们这么做并不是因为这是保护牙齿、预防蛀牙的最佳方式。

They did not do this, I was told, because it was necessarily the best way to take care of teeth and avoid cavities.

事实上，即使你不饮用含氟水或使用含氟牙膏，也有许多方法可以增强牙齿的矿化状态，甚至可以填补那些尚未深入到牙齿深层牙本质的蛀洞。

It turns out there are a bunch of other things that you can do, even if you consume no fluoridated water or toothpaste, there are things that you can do to enhance the mineralization state of your teeth, even fill in cavities provided those cavities haven't made it into the deeper so called dentine layers of the teeth.

我将在未来的节目中详细讲解这些内容，但美国和其他国家政府决定——当然，世界各地在饮用水中添加氟化物的程度各不相同——通过在饮用水中添加氟化物，可以大幅预防原本会发生的大规模蛀牙和牙齿腐蚀，明白吗？

I'll get into all of this in that future episode, but what The US and other governments decided, this of course varies across the world to the extent to which there's fluoride in the drinking water or not, was that by putting fluoride in the drinking water, they could prevent a large amount of tooth decay and cavities that would otherwise occur, okay?

这是一种成本相当低廉的方法，供这些城市在饮用水中添加氟化物。

It was a, and remains a fairly low cost approach for these cities to introduce fluoride to the drinking water.

这就是为什么饮用水中会含有氟化物。

And that's why fluoride is in drinking water.

目的是为了打造超生理强度的牙齿。

It is to try and create super physiologically strong teeth.

事实上，我所交谈过的每一位牙医，包括功能牙医、牙周病专家，以及从传统训练背景到所谓替代疗法背景的多位牙医，都同意这一点。

And indeed every single dentist I spoke to, including functional dentists, I spoke to periodontists, I spoke to several dentists ranging from, let's call them more traditionally trained dentists to more, let's call them alternative dentists.

他们都一致认为，在化学和机械层面，氟化物能制造出更坚固的牙齿。

All of them agree that at a chemical mechanical level, fluoride creates stronger teeth.

然而，他们每一位也都承认，我所指的那些矿化链中形成的键——我知道这不是专业术语——并不是通常会形成的羟基磷灰石键。

However, every single one of them also acknowledged that the bonds that are created in those mineralization chains as I'm referring to, I realize that's not the technical term, is not the normal hydroxyapatite bonds that would form.

这些键比正常情况下形成的键更强。

They are stronger than the bonds that would normally form.

它们在结构上是不同的。

They are structurally different.

如果你用电子显微镜观察，就会发现它们在结构上存在差异。

If you look at them down, what's called an electron microscope, you'll see that they're structurally different.

我所交谈过的部分牙医（并非全部）表示，最好通过再矿化来修复最初形成的蛀洞——当然，不是已经深入到深层的蛀洞，但可以通过自然构建羟基磷灰石键来实现自然填充。

And some, not all of the dentists I spoke to said, yeah, it would be best to remineralize the teeth to fill in any cavities that initially have formed, again, not down to the deep layers, but they could still be filled in naturally through the building up of those hydroxyapatite natural bonds.

但他们也承认，许多人，或许大多数人都没有对口腔和牙齿进行足够的护理。

But they acknowledged that many people, perhaps most people don't take adequate care of their mouths and their teeth.

因此，他们理解了在饮用水中添加氟化物的合理性。

So they understood the rationale of putting fluoride into drinking water.

当然，这也是为什么许多（但不是所有）牙膏中都含有氟化物的原因。

And of course, that's also why fluoride is in many, not all toothpaste.

好的，我希望这清楚地回答了你关于为什么我们的饮用水中会含有氟化物的问题——至少在美国大多数城市，饮用水中确实含有氟化物。

Okay, so I'm hoping that clearly answers for you the question of why there is fluoride in our drinking water at all, at least in most American cities, there is fluoride in the drinking water.

尽管布法罗的这起诉讼即将裁决，可能会告诉我们当地饮用水中是否完全或部分缺乏氟化物。

Although this lawsuit in Buffalo, I guess soon to be determined, probably tell us whether or not indeed there was a total lack or a partial lack of fluoride in the drinking water there.

我推测指控是真实的，但我并不确定这一点。

I'm presuming that the accusation is true, but I don't actually know that to be true.

我只是知道这起诉讼确实存在。

Just know that there's a lawsuit that exists.

如果你在谷歌上搜索，可以找到一些关于此事的YouTube视频。

If you Google that, you can see some YouTube videos about it.

有关这一情况的信息是存在的。

There's information about this happening.

有很多愤怒的家长，我敢肯定另一方也有愤怒的家长。

There are a bunch of angry parents and I'm sure there are angry parents on the other side.

我不知道孩子们怎么说，但希望不管他们怎么说，都能拥有健康的牙齿。

And I don't know what the kids are saying, but hopefully no matter what they're saying them through healthy teeth.

好的，问题的第二部分是：饮用水中的氟化物对我们有多大危害？

Okay, now the second half of the question was how much is the fluoride in drinking water harming us?

好吧，我会非常具体地回答这个问题。

Okay, I'm gonna answer this question very specifically.

有人问，我们饮用水中的氟化物对我们有多大危害？

The person asked how much is the fluoride in our drinking water harming us?

好吧，我已经告诉过你氟化物是如何增强牙齿强度的，对吧？

Well, I already told you ways in which it is helping the strength of your teeth, okay?

这一点是没有争议的，对吧？

That's not debated, okay?

当然，可能有些牙医会说，氟化物形成的键合与没有氟化物时自然形成的键合不同。

Again, there might be some dentists that say, oh, you know the bonds that are formed by fluoride are different than the ones that are naturally created with no fluoride.

因此，关于这一点可能存在一些争议，但所有人都承认，氟化物形成的键合和牙齿的矿化作用更强。

And so there might be some debate about that, but all of them acknowledge that those bonds and the mineralization of the teeth is stronger with fluoride.

他们理解并认同这一理论依据，即使他们不一定认为这种做法是最优实践。

They understand and agree with the rationale, even if they don't necessarily agree with the practice as the best practice.

饮用水中的氟化物对你的伤害有多大？

How much is fluoride in drinking water harming you?

你需要问两个问题。

Well, there are two things you need to ask.

第一个是你实际摄入了多少氟化物？

One is how much fluoride are you actually drinking?

因为事实是，不同城市的自来水中的氟化物浓度差异极大。

Because it turns out there's a tremendous range of fluoride concentrations in tap water depending on what city you live in.

我曾在《休曼纳实验室播客》中专门做了一期关于水的节目。

Now, I did an entire episode of the Huberman Lab Podcast about water.

我们讨论了蒸馏水和泉水的区别。

We talked about distilled water versus spring water.

我们谈到了氢化水。

We talked about hydrogenated water.

我们谈到了碱性水。

We talked about alkaline water.

我们谈到了所有这些内容。

We talked about all of those things.

而且我们确实谈到了氟化物。

And we did talk about fluoride.

当你考虑饮用水中的氟化物时，一个关键要点是：如果饮用水中的氟化物浓度过高，或者——这一点非常重要——你摄入了大量含有即使低水平氟化物的水，那么就可能存在风险。

And one of the key takeaways when you're thinking about fluoride in drinking water is to know that if fluoride concentrations in drinking water are too high, or, and this is a very important or, or you're consuming a lot of a particular water that contains even low levels of fluoride, well, there's the potential.

而且我要再次强调‘潜在’这个词。

And again, I wanna highlight the word potential here.

我不希望引起恐慌，认为氟化物会干扰甲状腺激素的分泌或受体端，换句话说，干扰甲状腺激素在体内的代谢和利用。

I don't wanna cause alarm that the fluoride is causing disruptions to thyroid hormone output or on the receptor end, in other words, disruptions to thyroid hormone metabolism and usage in the body.

好吧，我想在这里说得非常清楚。

Okay, I wanna be really clear here.

我不希望人们以为氟化物会破坏你的甲状腺激素。

I don't want people to think, oh, fluoride destroys your thyroid hormone.

剂量决定毒性。

It's the dose that makes the poison.

这取决于摄入量。

It depends on how much.

现在，美国疾病控制与预防中心建议饮用水中氟化物的浓度为每升0.7毫克，这个水平有助于预防蛀牙、促进口腔健康，并且被认为是安全的——这里我是在转述他们的说法。

Now, the Center for Disease Control have set a recommended level of zero seven milligrams per liter, zero point seven milligrams per liter of fluoride in drinking water as the level, and here I'm paraphrasing, that can help prevent tooth decay and promote good oral health and that they have deemed safe.

但如果你想了解你饮用水中的氟化物含量是否高于、等于或低于这个标准，就需要对你的自来水进行检测。

But if you want to know how much fluoride is in your drinking water, whether or not it is above, at, or below that value, you need to get your tap water tested.

幸运的是，有一些网站可以告诉你饮用水中的氟化物含量。

Now, fortunately, there are websites that can tell you how much fluoride is in your drinking water.

如果你信任这些网站的数据，只需输入你所在的城市名称，就能获得相关信息。

And if you trust the data on those websites, you can simply put the city you live in into one of those websites and you'll get the information back.

我会在本集的节目说明中提供几个这些网站的链接。

I'll provide a few links to those different websites in the show note captions for this episode.

我们也在关于水的那期节目笔记中提供了这些链接。

We also provided those links in the show note captions for the episode on water.

然后你可以看到，你所饮用的饮用水中的氟化物含量是高于、等于还是低于这个安全值？

And then you can see, are you adjusting the level of fluoride in your drinking water that's deemed safe, less than that value, or more than that value?

但请记住，无论你饮用少量、中等量还是大量含氟饮用水，你摄入的氟化物总量都会相应增多或减少。

But keep in mind that if you drink a little bit, a moderate amount, or a lot of fluoridated drinking water, you're going to be consuming either more or less fluoride.

即使疾病控制中心认定的浓度是安全的，这并不能告诉你，你每天饮用半加仑、一加仑还是仅几杯自来水时，是否真的处于安全范围内。

Just because there's a concentration that's been deemed safe by the Center for Disease Control does not actually tell you whether or not, okay, you're drinking half a gallon of tap water a day versus a gallon versus just a couple cups, whether or not you are in that safe zone.

当然，这还会因体重而异，对吧？

And of course, this is going to vary by body weight, right?

如果你是个小孩子，那些较低的氟化物浓度相对于你的身体体积来说，实际上会对应更多的氟化物摄入量，对吧？

If you're a small child, those lower levels of fluoride are going to equate to a larger total amount of fluoride as seen by the volume of the body, right?

你想想看，对吧？

If you think about this, right?

所有这些都与体重体积有关，这就是为什么药物剂量通常根据体重的磅数或公斤数来计算，对吧？

Everything's by body weight volume, this is why drug dosages are most typically calculated as a function of pounds or kilograms of body weight, right?

不是每个人都会得到相同剂量的每种药物。

Not everybody gets the same dose of every drug.

如果你是个体型很大的人，也许你能耐受更多的氟化物。

And if you're a very large person, maybe you can tolerate more fluoride.

正如我之前提到的，高剂量的氟化物已被证明会干扰甲状腺代谢。

As I mentioned before, high levels of fluoride have been shown to disrupt thyroid metabolism.

此外，有人提出假设——这仍然存在很大争议——认为在某些条件下氟化物具有神经毒性，即对神经元有毒，能在特定浓度下杀死神经元，但这些浓度未必存在于你的饮用水中。

It has also been hypothesized, again, this is still highly debated, hypothesized to be neurotoxic under certain conditions, that is toxic to neurons, it can kill neurons at certain concentrations, not necessarily the concentrations present in your drinking water.

证明氟化物具有神经毒性的大量证据来自所谓的体外研究。

A lot of the evidence that fluoride is neurotoxic is from so called in vitro studies.

也就是说，这些研究主要在培养皿中进行，尽管也有一些体内研究证据表明它可能引起神经毒性，即神经退行性变化。

So studies done effectively in a dish, although there is some in vivo evidence that it can cause a neuro neurotoxicity AKA neurodegeneration.

所以我认为，谈到氟化物这个话题时，人们往往会分成几类：一类是完全不担心，只想让氟化物强化牙齿；另一类是轻微担忧，会留意这些事，觉得氟化物对我不太好，但只要浓度不高就没问题，就像有些人会说：我一辈子都在喝自来水，感觉很好，牙齿坚固，大脑正常，甲状腺也没问题；

So I think when it comes to the topic of fluoride, people tend to bin out into not concerned and simply want fluoride to strengthen their teeth, mildly concerned, kind of keeping an eye on this stuff, okay, fluoride doesn't sound great for me, but as long as the concentrations aren't too high, as people will say, I've been drinking tap water my whole life and I feel great, my teeth are strong and my brain works and my thyroid seems fine, okay.

还有一类人对饮用水中任何浓度的氟化物都极度担忧，因此才有了加利福尼亚州及其他地区的一系列诉讼。

And then people who are very, very concerned about fluoride at any concentration in their drinking water, hence the lawsuit in California and other lawsuits around the country.

所以我认为，当我们讨论氟化物时，你必须认真考虑剂量，并问自己属于上述三个类别中的哪一个。

So I believe that when we're talking about fluoride, you really need to think about the dosages and you need to ask yourself which one of those three categories you fall into.

如果你对氟化物感到担忧，并不意味着你不能喝自来水。

Now, if you are concerned about fluoride, it does not necessarily mean that you can't drink tap water.

建议仅仅是将自来水进行过滤。

The suggestion simply would be to filter that tap water.

在我关于水的那期节目中，我谈到了几种不同的过滤方法。

And during the episode I did on water, I talked about a number of different filtration approaches.

许多这些过滤器都能去除氟化物，你可以直接查找能消除或减少氟化物的净水器。

Many of those filters will filter out fluoride and you can simply look up water filters that eliminate or reduce fluoride.

有些人有足够的可支配收入，或者对饮用水中的氟化物足够担忧，因此会购买或搭建非常全面、彻底的过滤系统，以完全去除饮用水中的氟化物，明白吗？

And then some people have enough disposable income and or are concerned enough about fluoride in their drinking water that they will purchase or create very extensive, very thorough filtration systems to completely eliminate fluoride from their drinking water, okay?

所以你会看到不同层次的担忧程度。

So you'll find different ranges of concern.

再次强调，除了高浓度氟化物可能干扰甲状腺激素通路并具有潜在神经毒性之外，我个人在饮用自来水前都会进行过滤，除非是用它来煮沸制作散装 yerba mate 茶——这是我最爱的饮品之一，不过最近我更常喝冷泡的 Mattina Yerba Mate，这款产品用的是纯净水，不含氟化物，等等。

Again, aside from the data of high fluoride levels being disruptive to thyroid hormone pathways and possibly neurotoxic, I personally am somebody who filters the drinking water I consume out of the tap, unless that is I'm going to boil water with it for making things like loose leaf yerba mate, which is one of my favorite drinks, although lately I drink this cold brew, Mattina Yerba Mate, which by the way is made with purified water, no fluoride, and so on and so forth.

但如果我煮饭、煮意大利面或做燕麦片，需要用到自来水，我并不会担心去除水中的氟化物。

But if I'm making rice or I'm making pasta or I'm making oatmeal and I need to use tap water, I don't worry about removing the fluoride from that water.

然而，如果我要直接喝水，或者要混合电解质粉，或者只是喝一杯水，或者出去徒步时带水，我就会使用净水器，比如那种从顶部注水、缓慢渗下的过滤器，或者放在冰箱里的过滤器；最近我还为家里的饮水水龙头安装了全屋过滤系统，这样可以彻底去除氟化物和其他一些污染物。

However, if I'm gonna drink water, if I'm gonna mix, you know, an element electrolyte pack in or just drinks a glass of water or go out on a hike and take some water with me, I do use a water filter, either a filter that fills from the top and then seeps down and the ones you put in the refrigerator or, and I recently purchased a whole house filter for the drinking water taps in my house so that it does remove all the fluoride and remove some other contaminants as well.

所以这取决于你的关注程度，也取决于你的可支配收入以及其他各种因素。

So it's going to depend on your level of concern and it's going to depend on your disposable income and any number of other things.

我必须说，偶尔我也会直接从水龙头喝一点自来水，完全不担心氟化物的问题。

And I must say that every once in a while, I'll drink a little bit of tap water out of the tap without any concern about filtering the fluoride.

我不是那种会对这些事情过度担忧的人，但我理解为什么有些人会如此担忧，尤其是那些研究过氟化物以及过量摄入氟化物可能带来的健康风险的人。

I'm not somebody who gets hyper concerned about these things, but I do understand why some people do get hyper concerned about these things, especially people who've read up on fluoride and some of the health concerns of consuming too much fluoride.

因为我也觉得，当人们越来越了解某种物质可能对大脑或身体健康造成危害时，他们对摄入这种物质的担忧增加，这是非常合乎逻辑且可以理解的。

Because I also find it very logical and understandable that as people learn more about how a particular substance might be harming their brain or bodily health, that they would become more concerned about consuming that substance.

这再正常不过了。

That just stands to reason.

那么，我到底在建议什么呢？

So what am I suggesting?

我建议你弄清楚你家自来水中的氟化物含量。

I suggest that you figure out how much fluoride is in your tap water.

然后根据情况决定是否在饮用前对水进行过滤。

I suggest that you then make a decision as to whether or not to filter that water or not before drinking it.

当然，你还需要决定愿意为过滤这些水投入多少资金。

And then of course, you have to make a decision about what sort of financial investment you're willing to make to filter that water.

你可以在节目笔记的水专题部分找到不同价格范围的净水器列表。

You can find a list of different price ranges of water filters in the show note captions in the water episode.

你也可以观看那一集，并跳转到相应的时间戳。

You may also wanna watch that episode and go to that timestamp.

那里的价格范围非常广。

And there's an enormous range there.

我想说得非常清楚。

I wanna be very clear.

我和这些过滤设备没有任何经济利益关系。

I don't have a financial relationship to any of those filtration mechanisms.

再次强调，有些人根本没有钱用于去除饮用水中的氟化物和其他污染物。

Again, some people have $0 to devote to that process of taking the fluoride out of their water and other contaminants.

有些人则拥有数万美元的可支配收入，因此这完全取决于你的可支配收入和关注程度。

Some people have many, many tens of thousands of dollars, so it really just depends on your disposable income and your level of concern.

但如果你问我，我会说，是的，我认为既然大多数能去除大部分氟化物的过滤器价格低廉，而且摄入过多氟化物确实存在健康风险，为什么不干脆把饮用水中的氟化物去除掉呢？

But if you were to ask me, I would say, yeah, I think, you know, given that the cost of most of the filters that can remove most of the fluoride is low and given that there is some health concern of consuming too much fluoride, why not just remove fluoride from the drinking water?

如果你说：‘那不会削弱我的牙齿吗？’

And then if you say, well, won't that weaken my teeth?

那我会说：‘等等，即将播出的关于口腔健康的那一集会详细介绍多种方法，包括含氟牙膏，也包括不含氟的牙膏，以及其他专业牙医普遍认可、能有效改善牙齿矿化状态、甚至能修复尚未深入牙层的早期蛀牙的方法，等等。’

Then I would say, well, watch the episode that's soon to come out on oral health because it's going to explain a lot of approaches, including fluoride containing toothpaste, but some other non fluoride containing toothpaste and other things that one can do that the community of professionally trained dentists all agree can really help improve the mineralization state of your teeth and indeed can fill in cavities that have begun to form, but haven't yet made it to the deeper layers of your teeth and on and on.

现在，我有个关于氟化物的小故事，如果不讲的话就太遗憾了，这个故事清楚地表明，氟化物的设计初衷是强化牙齿，但它确实也是一种毒物。

Now, I do have a brief story about fluoride that I'd be remiss if I didn't tell you, which essentially shows that fluoride is designed to strengthen teeth, but is also indeed a poison.

小时候，我的牙齿问题很多。

So when I was a kid, I had a lot of dental issues.

但我并不吃多少糖。

I didn't consume much sugar.

幸运的是，我母亲很注意不让我们摄入太多糖，但不知什么原因，我的口腔状况一团糟。

My mother fortunately was good about not letting us consume too much sugar, but for whatever reason, my mouth was kind of a mess.

我每天刷牙、用牙线，做了所有该做的事，但我的恒牙却在乳牙后面长出来，没有把乳牙顶掉。

I'd brush, I'd floss, I would do all these things, but I actually had my adult teeth come in behind my baby teeth, so it didn't push out my baby teeth.

所以我不但没从牙仙子那里收到钱——我最近才意识到牙仙子根本不存在，但那时候我怎么知道呢？

So not only did I not collect from the Tooth Fairy, which I only recently discovered isn't real, but how would I know?

因为牙仙子从没来过，我的所有恒牙都在乳牙后面长出来，所以我不得不把上排所有的乳牙都拔掉。

Because the Tooth Fairy never showed up because all of my adult teeth came in behind my baby teeth, so I had to have all of my baby teeth pulled on the top.

因此，我对牙医这个场所或牙医这个人并没有好的印象。

So I did not have a good relationship to the dentist as a location or a person.

事实上，他们还得提醒我别咬牙医。

In fact, they had to tell me not to bite the dentist.

顺便说一句，我已经很久没咬过牙医了，所以希望正在看这个视频的我的牙医不要太担心。

By the way, I haven't bitten a dentist in a long time, so hopefully my dentist, if watching this is not too concerned.

我每年都会做两次洁牙，所有牙医都认为这是件好事。

I do get twice a year cleanings, every dentist agrees that's a good thing to do.

有些人可能需要少一些，有些人可能需要多一些，但你怎么知道呢？

Some people may need less, some people may need more, but how do you know?

你需要去看牙医才能知道。

You need to go to a dentist to find out.

回到氟化物的故事，因为我小时候有这么多牙齿问题，我开始频繁看牙医。他们以前的做法是，我不知道现在还做不做，就是给你一些小托盘，有点像拳击或曲棍球用的护齿器，用来防止牙齿被打掉。

Back to the story about fluoride, I started going to the dentist quite a bit because of all these dental issues that I had as a kid and what they used to do, I don't know if they do this anymore, but what they used to do is they give you these little trays, which are kind of like mouth guards that you would use for boxing or hockey so your teeth don't get knocked out.

他们会把这些托盘填满一种果冻状的物质，里面含有氟化物，然后放在上下排牙齿上，那些物质会一点点渗入你的舌头和喉咙，味道特别酸，简直糟糕透顶。

And they would fill those trays with this jelly like stuff that contained fluoride and they put it on the top and on the bottom and the stuff just, little bits of it would seep into your tongue and your throat and it was so sour, was so awful.

他们让我坐在一张小藤椅上，面对电视播放卡通片，好像这样就能让我忘记整个过程有多难受。

And they'd seat me in this little wicker chair in front of a television and turn on cartoons as if that was supposed to make me forget how awful the whole experience was.

恰恰相反，这可能反而让我对卡通产生了条件反射般的厌恶，虽然这似乎没成功，因为我当时喜欢看卡通，现在却不看了。

If anything, it probably just created a Pavlovian condition response to hate cartoons, which I suppose did not work because I liked cartoons then, I don't watch them now.

真的，我现在一点都不看卡通了。

Truly, I don't watch them now.

所以我坐在那张藤椅上，嘴里含着两个装满氟化物的托盘，整个人都在痛恨这个过程。

So I sit down in this wicker chair, I've got the fluoride in my teeth with these two trays, and I'm just hating this whole process.

我想那时候我大概是五六岁。

I think it must've been about five or six years old.

于是，我以我那无穷的智慧决定把所有氟化物牙膏吞下去。

So I decide in my infinite wisdom to swallow all the fluoride paste.

于是我开始通过牙托把氟化物往喉咙里咽，能感觉到它往回流，又酸又刺痛，太难受了，但我心想：好吧，我就这么干了，我坐在这儿，我 basically 要赢过这次测试。

So I start shuckering it down through these mouth guards, I can feel it going back into my throat and sour and it's stinging, it's awful, but I'm thinking, okay, I'm just going to like do this and I'm going to sit there, I'm basically going to, I'm going to beat the test.

于是我喝下了所有的氟化物牙膏。

And so I drink all this fluoride paste.

当然，大约三分钟后我就严重恶心了。

And then of course I got immensely sick within about three minutes.

我站起来，转过身，把胃里东西全吐在了藤椅上。

I stood up, I turned around and puked all over the wicker chair.

现在回想起来，我觉得那是故意的。

I think that was deliberate, actually looking back, it was deliberate.

然后把呕吐物全吐在了藤椅上。

And puke all over the wicker chair.

我妈妈冲进来，问：出什么事了？

My mom comes running in, what happened?

你对他做了什么？

What'd you do to him?

她非常保护我。

She was very protective of me.

谢谢妈妈。

Thanks mom.

你对他做了什么？

What'd you do to him?

然后我说，我只是把那东西吞下去了。

And then I said, I just swallowed the stuff.

他们想再做一次。

They wanted to do it again.

从那以后，我就不再做氟化物治疗了。

And I stopped doing the fluoride treatment at that point.

我为什么呕吐？

Why did I vomit?

我呕吐是因为氟化物在高浓度下确实是一种毒物。

Well, I vomited because fluoride is indeed a poison at high concentrations.

现在，我讲这个故事是为了让你不敢给孩子用含氟牙膏或含氟水吗？

Now, do I tell you that story to make you afraid of giving your kids fluoride toothpaste or fluoride water?

不，无论如何，做你觉得对你和孩子最好的选择。

No, by all means, do what you think is best for you and for your children.

不过，我确实努力避免使用含氟牙膏。

For me, however, I've made some effort to avoid fluoride toothpaste.

我每年都会去看牙医，正如我提到的，我承认在疫情期间，因为牙医忙、预约困难等原因，去看的次数可能更少。

I do go to the dentist, as I mentioned about once a year, I confess during the pandemic, it was probably less as they were busy and it was hard to schedule, etcetera.

我成年后长的蛀牙非常少，几乎都没有。

I've had very, very few cavities in my adult life, hardly any.

我的牙龈健康非常好，等等，这很大程度上得益于我将在口腔健康那一集里介绍的护理方法。

And my gum health is very strong, etcetera, etcetera, largely through taking on protocols that I'm going to describe in the oral health episode.

这些都是一些既是牙医又是牙周病专家的朋友推荐给我的。

And that were recommended to me by friends who are both dentists and other friends who are periodontists.

因为同样地，我们可以通过增强羟基磷灰石键来以自然方式强化牙齿，而羟基磷灰石键正是牙齿天然形成的结构。

Because again, there are a lot of things that we can do to strengthen our teeth in natural ways by building up those hydroxyapatite bonds, which are the natural bonds that teeth form.

而且，你可能难以置信，只要蛀牙还没有深入牙齿内部，是有可能逆转一些早期形成的蛀牙的。

And yes, believe it or not, being able to reverse some early formed cavities, as long as they haven't made it deep into the tooth.

此外，使用软毛牙刷也很重要，因为如果你刷牙太用力，虽然能刷得非常干净，

Also things like using a soft toothbrush, because if you brush too hard, if you take that approach, you're going to brush your teeth really hard, get them really, really clean.

是的，你能刮掉所有生物膜，避免牙结石堆积，但可能会严重损伤牙龈组织，导致牙龈退缩。

Yes, you'll scrape off all the biofilm, you'll avoid tartar buildup, but you can really cause some tenting of the gum tissue above the teeth.

而那些牙龈后方的小凹陷正是细菌藏身之处。

And those little recesses back in there are where bacteria get in.

现在有大量强有力的证据表明，这些细菌可能引发心脏病、代谢疾病，甚至可能与某些神经系统疾病有关。

And there's now a lot of really strong evidence showing that some of that bacteria can translate into cardiac disease, can translate into metabolic disease and maybe even into some neurologic disease.

所以，这可不是小事。

So it's serious stuff.

口腔健康是健康中最重要但也被最忽视的领域之一。

Oral health is one of the most important areas of health and it's one of the most overlooked areas of oral health.

我认为人们通常可以分为两类。

And I think people generally fall into two categories.

我会用这两类人来框架即将推出的关于口腔健康的那期内容。

And I'll use these two categories to frame up the episode on oral health that's coming.

一类人对自己的口腔健康非常乐观。

One category of person seems really bullish on their oral health.

他们认为只要保持牙齿洁白干净，每天早晚刷牙、使用牙齿增白产品和漱口水就够了。

They're like, keep my teeth white and clean and they floss and brush twice a day, every day, they use tooth whiteners and mouthwash and all those things.

而另一类人则对此漠不关心。

And the other category is kind of blase about it.

是的，早上刷牙只是为了不让口气影响和别人交流，如此而已。

Yeah, brush my teeth in the morning so that my breath doesn't kill every person I get into an interaction with and so on and so forth.

但实际上，那些为了保持牙齿洁白和口气清新而做大量事情的人，虽然确实在改善口腔健康，但也无疑在损害健康，尤其是对至关重要的口腔微生物组造成伤害。

But in reality, the group of people that are doing an immense number of things to try and keep their teeth white and their breath fresh are yes, doing things that are good for their oral health, but also no doubt damaging their health in particular, the oral microbiome, which is absolutely critical.

当然，另一类忽视口腔卫生、不使用漱口水等产品的人，也在以不同的方式损害他们的口腔健康。

And then of course the other category of people that are neglecting their oral hygiene and are not taking mouthwashes and things like that are also damaging their oral health, but in different ways.

因此，在关于口腔健康的这期节目中，我会详细说明你可以做的一切事情——其中大多数，顺便说一句，完全是零成本的。

So during the episode on oral health, I'll spell out all the things that you can do, most of which by the way, are completely zero cost.

其中许多方法实际上能帮你省钱，无论是短期还是长期，并能真正帮助你改善口腔微生物组、增强牙齿强度、减少蛀牙数量，甚至可能逆转那些刚刚形成但尚未深入牙体的蛀牙。

Many of them actually will save you money, both in the short and long term, and can really help you improve your oral microbiome, the strength of your teeth, and reduce the number of cavities, maybe even reverse cavities that have begun to form and are not too deep into the tooth yet.

而且，所有这些方法都与你对氟化物的立场无关，非常友好。

And in a really nice way, all of that independent of your stance on fluoride.

感谢你参与这期‘问我任何问题’节目的开端。

Thank you for joining for the beginning of this Ask Me Anything episode.

要收听完整节目、收听未来这些‘问我任何问题’系列节目，以及获取这些节目和Huberman Lab播客标准频道的文本稿，还有其他独家发布的高级工具，请访问 hubermanlab.com/premium。

To hear the full episode and to hear future episodes of these Ask Me Anything sessions plus to receive transcripts of them and transcripts of the Huberman Lab Podcast standard channel and premium tools not released anywhere else, please go to hubermanlab.com/premium.

只是为了提醒大家我们推出Huberman Lab播客高级频道的真正原因，其实有两个方面。

Just to remind you why we launched the Huberman Lab Podcast Premium Channel, it's really twofold.

首先，是为了支持标准的Huberman Lab播客频道，该频道当然仍会每周一完整发布。

First of all, it's to raise support for the standard Huberman Lab Podcast Channel, which of course will still be continued to be released every Monday in full length.

我们不会改变标准版《休曼纳实验室播客》的格式或任何内容，而是用这些资金来资助研究，特别是针对人类而非动物模型的研究——我相信我们都同意，人类是我们最感兴趣的物种。我们将专门资助旨在进一步开发心理健康、身体健康和表现提升方案的研究，这些方案将通过所有渠道分发，而不仅限于付费频道，包括《休曼纳实验室播客》和其他媒体渠道。

We are not going to change the format or anything about the Standard Huberman Lab Podcast and to fund research, in particular research done on human beings, so not animal models, but on human beings, which I think we all agree is a species that we are most interested in, and we are going to specifically fund research that is aimed toward developing further protocols for mental health, physical health, and performance, and those protocols will be distributed through all channels, not just the premium channel, but through all channels, Huberman Lab Podcast and other media channels.

因此，我们的理念是为您提供深入解答您最关心的问题，并让您有机会支持那些能提供这类答案的研究。

So the idea here is to give you information to your burning questions in-depth and allow you the opportunity to support the kind of research that provides those kinds of answers in the first place.

现在，付费频道一个特别令人兴奋的特色是，Tiny基金会已慷慨承诺对通过付费频道筹集的所有研究资金进行一比一匹配。

Now, an especially exciting feature of the premium channel is that the Tiny Foundation has generously offered to do a dollar for dollar match on all funds raised for research through the premium channel.

这使他们能够有效放大通过付费频道流入的资金，进一步支持心理健康、身体健康和表现提升相关的科学研究与工具开发。

So this is a terrific way that they're going to amplify whatever funds come in through the premium channel to further support research for science and science related tools for mental health, physical health, and performance.

如果您想订阅《休曼纳实验室》付费频道，每月费用为10美元，或者您也可以一次性支付100美元购买全年服务。

If you'd like to sign up for the Huberton Lab premium channel, again, there's a cost of $10 per month or you can pay $100 upfront for the entire year.

这将使您能够访问所有问答环节（AMA）。

That will give you access to all the AMAs.

您可以提出问题，并获得针对您问题的解答。

You can ask questions and get answers to your questions.

当然，您也将获得其他所有人所提问题的解答。

And you'll of course get answers to all the questions that other people ask as well.

此外，还有一些高级内容，比如AMA的文本稿以及在其他地方找不到的《休曼实验室播客》各期的文本稿和方案。

There will also be some premium content such as transcripts of the AMAs and various transcripts and protocols of Huberman Lab Podcast episodes not found elsewhere.

而且，您将支持心理健康、身体健康和表现提升方面的研究。

And again, you'll be supporting research for mental health, physical health, and performance.

您可以通过访问 hubermanlab.com/premium 来订阅高级频道。

You can sign up for the premium channel by going to hubermanlab.com/premium.

再次提醒，网址是 hubermanlab.com/premium。

Again, that's hubermanlab.com/premium.

一如既往，感谢您对科学的关注。

And as always, thank you for your interest in science.