This is a tale of a Missouri woman, a mysterious bone disease, and too much of a good thing.
Skeletal fluorosis happens when people are exposed to high levels of fluoride for long periods, causing the chemical to creep into bones and replace calcium.
In countries where the disease is endemic, water drawn from wells is often contaminated with fluoride from surrounding rocks.
Whyte set out to find the source of the fluoride in his patient's painful bones.
The unfiltered well water at the woman's suburban home contained 2.8 parts of fluoride per million parts of water, higher than recommended, and probably enough to cause mild disease over decades.
But the level was not high enough to account for the excessive amount of fluoride in the woman's urine, Whyte said.
She drank one to two gallons of double-strength instant tea every day of her adult life, she told the doctor.
Studies of people in Tibet and other areas where people drink large amounts of "brick tea" have shown that the beverage can be a significant source of fluoride, even leading to skeletal fluorosis.
Whyte tested the woman's tea and found that her beverage of choice added 26 milligrams to 52 milligrams of fluoride to her diet each day.
The Environmental Protection Agency allows up to 4 parts of fluoride per million parts of drinking water, based on the calculation that it takes at least 20 milligrams of fluoride per day every day for 20 years to produce crippling skeletal fluorosis.
The World Health Organization sets the optimal level of fluoride in drinking water at 1 part of fluoride per million parts of drinking water (equal to 1 milligram per liter of water), to 1.2 parts of fluoride per million parts of water.