Tibet and Brick Tea Fluorosis

Aged Tibetan Brick Tea

There is something particularly terrible about a centuries-old tradition within a culture leading to suffering among its people. One particularly poignant example of this is the rampant fluorosis among the Tibetan people resulting from the consumption of traditional Tibetan brick tea, also called “churned tea” or “butter tea.” The traditional Tibetan drink uses tea that has been formed into compact blocks using older, lower quality leaves and stems. With longer growing times before cultivation, these parts of the tea plant absorb a considerably higher amount of fluoride (and aluminum) from the soil. Traditional preparation involves boiling and combination with yak butter and salt in a churn, a method that allows for more of the fluoride to be released into the tea liquor. Not only does the particular tea consumed by the Tibetans contain much more fluoride, the 40-50 cups of tea per day that constitute average daily consumption ensure that intake of the toxins is going to be staggeringly high. Even children consume large quantities of tea, often mixed into tsampa, the traditional roasted flour porridge, a key staple of the Tibetan diet.

The milder, earlier manifestation of fluorine poisoning is dental fluorosis, seen as streaks and pits in the teeth. A remarkably high percentage of Tibetan children exhibit the symptoms of this disease. Ongoing exposure leads to skeletal fluorosis in adulthood, characterized by crippling bone degeneration.

The students love this thick, off-whitish, butter-laced tea. They drink it every day, and as a result nearly 90 percent of them suffer from dental fluorosis. You can tell by looking at their teeth: white but dull, as if stalks of chalk had been implanted in their mouths–results of incomplete calcification of the enamel. Some of their symptoms might progress to permanent brown or black discoloration, chipping, pitting or decay.

High levels of fluoride in Tibetan brick tea were identified in the ’80s, which led to a Chinese research study of the tea and tea drinking habits among the minority populations in Tibet, Mongolia, Sichuan, Qinghai, Gansu and Xinjiang. The cause and effect were clearly identified, leading to efforts at amelioration, including the launch of a program by the Tzu Chi Foundation, the Taiwanese Buddhist relief organization, aimed at bringing safer tea to Tibet. Led by the heroic efforts of Professor Cao Jin of Central South University in Hunan Province, the program has met with a measure of success. The strategy was both reasonable and effective – The organization did not attempt to excise the tea drinking tradition from Tibetan daily life, but researched and found ways of manufacturing lower fluoride content brick tea without a tremendous increase in cost. This new type of brick tea, which was then introduced into select parts of the region, included a binder which helped minimize absorption of the fluoride into the body. Results have been quite promising, with exposure levels among test subjects down to acceptable levels. Despite marked successes among the test populations, the challenge is in convincing the major producers of the brick tea consumed by the Tibetans to alter their growing and production methods to produce a safer product. Currently there are no regulations or incentives to convince them that this needs to happen. The tragedy of the situation is illuminated in this article extract:

Tibet is a Buddhist country. Monks spend long hours chanting sutras, and therefore they drink more tea than ordinary Tibetans. These spiritual cultivators thus have a higher than average rate of severe skeletal fluorosis.

This disease is common outside of temples among secular Tibetans, too. Armar is 72 years old. She wanted to welcome and thank us visitors from afar. She greeted us with a bottle of highland barley wine in her hand. As she tottered towards us, I thought that she already had had too much to drink. Professor Cao examined her and thought that she was probably crippled by a severe case of skeletal fluorosis. Now she couldn’t even do her own hair, much less fetch a pail of water from the courtyard.

But what bothered Armar most of all was that for the last five years she had not been able to prostrate herself in front of statues of the Buddha to show her piety. She, and many others like her suffering from skeletal fluorosis, might be wondering if they were therefore unworthy of the Buddha’s blessings now and after death. Now she doesn’t even go into a temple. “If I can’t prostrate myself to show my respect for the Buddha, what’s the point of visiting a temple?” she thinks.

There are two excellent articles about the noble efforts of Professor Cao and Tzu Chi. The first was written near the beginning of the program in 2002 and the other, quoted above, was written in December of 2007, near the conclusion of the program.

There are a lot of additional sources for further reading:

Possibly Related Posts:


  1. Great post — this is one of those problems I had absolutely no awareness of… who would have thought flurosis in Tibet because of tea would be an issue?

    And, woa — 40-50 cups a day?!

  2. Thank you. I was quite surprised by the fluorosis issue when I first found out about it. And I drink quite a bit of tea, but I sure can’t imagine drinking 40-50 cups either!

  3. Is there a way to donate to a charity that will help Tibetans get better quality tea?

    • Thank you for your inquiry about contributions. I’m investigating whether there is still a program in place and I will post anything that I find out.

  4. hey there,
    its nice to read a tea article stating the brick tea type fluorosis.

    the fluorosis issue is terrible as its prevalence is conerned.

    may i know how many dentist are there in Tibet?