The elevated fluoride from drinking water impacts on T 3 , T 4 and TSH hormones. The aim was study impacts of drinking water fluoride on T 3 , T 4 and TSH hormones inYGA (Yazd Greater Area). In this case-control study 198 cases and 213 controls were selected. Fluoride was determined by the SPADNS Colorimetric Method. T 3 , T 4 and TSH hormones tested in the Yazd central laboratory by RIA (Radio Immuno Assay) method. The average amount of TSH and T 3 hormones based on the levels of fluoride in two concentration levels 0-0.29 and 0.3-0.5 (mg/L) was statistically significant (P = 0.001 for controls and P = 0.001 for cases). In multivariate regression logistic analysis, independent variable associated with Hypothyroidism were: gender (odds ratio: 2.5, CI 95%: 1.6-3.9), family history of thyroid disease (odds ratio: 2.7, CI 95%: 1.6-4.6), exercise (odds ratio: 5.34, CI 95%: 3.2-9), Diabetes (odds ratio: 3.7, CI 95%: 1.7-8), Hypertension (odds ratio: 3.2, CI 95%: 1.3-8.2), water consumption (odds ratio: 4, CI 95%: 1.2-14). It was found that fluoride has impacts on TSH, T 3 hormones even in the standard concentration of less than 0.5 mg/L. Application of standard household water purification devices was recommended for hypothyroidism.Over the past decade, several studies have focused on the effects of environmental toxins on the human endocrine system, including the impact of fluoride on the thyroid gland 1,2 . Globally, millions of people suffer from thyroid-related problems. When the thyroid gland does not function properly, it can affect multiple aspects of our health [3][4][5] . The most important effect is thyroid complications in pregnant women. Uncontrolled hypothyroidism can raise the blood pressure during late pregnancy, increase the risk of miscarriage and preterm delivery, and affect brain development and growth rate 3-5 . The incidence of thyroid cancer has risen from 2% to 5% per decade. If this trend continues, thyroid cancer may become the fourth most common cancer in the United States by 2030 6 . The incidence rate of this type of cancer is two times more in high-income and middle-income countries as compared to low-income countries. It has a three to four time's higher probability of occurring in women than in men 6 . The adverse effects of fluoride on animal and human health are well documented in the literature 7,8 . The effects of high fluoride ingestion through drinking water, green tea, and ambient air pollution on thyroid hormones (T3, T4, TH, and TSH) were investigated in both humans and animals. Some studies reported a reduction in the T4 and T3 levels as well as an abnormal increase in the TSH levels 9-15 . said that even at 1 mg/L of fluoride in water, T3 levels reduced in teenagers living in Northern Mexico 16 . During the years 2007-2016, the Parents of Fluoride Poisoned Children (PFPC) has reported over 190 studies on the effects of fluoride on thyroid hormones, including studies on both animals and humans 17 . Some studies have discovered the relation between dental fluorosis and thyroid...