Effect of Sodium Fluoride Therapy on Calcium Metabolism in Multiple Myeloma

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Abstract
A patient with multiple myeloma and generalized osteoporosis whose disease was stable over a 2-yr. period afforded an opportunity to study the effects of sodium fluoride on bone mineral metabolism. After 4 mo. of fluoride (27 mg/day), Ca balance became progressively positive and this effect was even more marked after 1 yr. of therapy. Studies with radioactive Ca47 suggested that fluoride exerted its effect by stabilizing bone crystal, thus slowing bone resorption. The observed reductions in urinary and fecal Ca were secondary to this effect. Balance studies showed that 80% of the ingested fluoride was retained. Serial bone biopsies revealed that most of this fluoride was deposited in the skeleton. These results confirm a previous report on the efficacy of fluoride therapy in this disease, and provide a testable hypothesis for the mechanism of action.