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February 20, 2022

Is Alkaline Water Safe?

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At-A-Glance

  • There are no health risks associated with drinking alkaline water; and as far as its benefits go, the only thing that alkaline water is proven to be good for—for certain—is acid reflux, both GERD and LPR … especially for LPR (i.e., respiratory reflux).
  • Alkaline water used for treating reflux is not for neutralizing acid that is in the stomach; it’s purpose is to kill pepsin in and on the tissues of the esophagus and airway, that is, the “reflux-sickened” tissue above the stomach (LES).
  • A search of PubMed for the risks, side effects or complications of use/overuse of alkaline water, revealed nothing; there was not a single citation. I also examined most of the Internet Pros and Cons of Alkaline Water articles, and while many cited potential problems, none provided any credible data. The alkaline water “cons” cited were conjectural and theoretical, with no scientific support.
  • Inside your body (in blood), the acid/base balance is maintained at a constant pH 7.4, regardless of the pH of what you imbibe or ingest. No significant internal pH shift has ever been reported from alkaline water (pH 8-10) or even from drinking acid, i.e., soft drinks (pH 2.5-4).

What Does “Alkaline” Mean?

Acid and alkaline are measured by the pH-scale (0-14). In Latin, the term “pH” ponderous Hydrogenium, means “the weight of hydrogen.” Water contains hydrogen ions (H+) and hydroxide ions (OH‒). They are present in equal amounts at pH 7. Below pH 7 (more H+) is acid, and above pH 7 (more OH‒) is alkaline, also called basic. At the extremes of the pH scale, hydrochloric acid is pH 0, and sodium hydroxide, a corrosive chemical, is pH 14. Stomach acid is typically pH <4, which is the same for most soft drinks, energy drinks, fruit juices and seltzer. In my three-week Reflux Detox Diet, I recommend consumption of nothing below pH 5.

The acid-base balance inside your body remains at a constant pH 7.4 — regardless of the pH of what you imbibe or ingest. If you are worried about alkaline water at pH 8-10, consider the case of heavy soda drinkers. Millions of people consume two-liters of soda a day — most are in the acidity range as stomach acid (pH 2-4) — and if there is no pH shift in the “soda people,” one would hardly expect any potential negative impacts of alkaline water. 

Is Drinking Alkaline Water Safe? Are There Any Serious Side-Effects?

A poorly-researched recent article — without a shred of supporting evidence — suggested that “overuse” of alkaline water can cause: (1) gastrointestinal issues (2) skin irritations (3) nausea/vomiting (4) muscle twitching (5) tingling sensation on your face and (6) confusion. These are NOT real things! All those “cons” are erroneous, nonfactual, nonmedical nonsense … NOT caused by alkaline water!

There are other fallacies, too. “Alkaline water can dilute your stomach acid too much, leading to indigestion and digestive system issues.” Wrong! You cannot drink enough water to knock out all your stomach acid and impair digestion; and “If you have a kidney condition, or are on any medication that could alter the function of your kidney in any way, drinking alkaline water could cause the minerals to accumulate in your body.” This is not true either, not a shed of evidence. Again, this “con” is only theoretical, with no credible data to support it. Minor caveat: We are talking about unadulterated, natural alkaline waters here. Some manmade waters, like Essentia, contain phosphates; I have had some patients complain that it (presumably the phosphates) irritated their throats.

If you have any data, that reports any risks, side-effects or complications of alkaline water, send them to me, and I will review them. But please, don’t send me a personal anecdote … like my friend’s cousin’s balls got real swollen from Covid vaccine.

When it comes to the “Pros and Cons of Drinking Alkaline water,” There Are No Cons. Alkaline water is safe and does NOT cause any side effects or symptoms, even when consumed every day in large quantities. Incidentally, millions of Americans drink public-sourced (that comes out of the ground) alkaline water without any reported problems or repercussions.

Is Alkaline Water Good for Acid Reflux, GERD and LPR? 

Yes. Alkaline water pH >9 is really good for people with reflux (LPR and GERD); see previous alkaline water post. Not only can you drink it, you can use it as a topical spray (in any kind of spray bottle) to get it into your nose and throat to treat your nose or vocal cords, for example, directly. Pepsin, the bad stomach enzyme, is washed out, dies, at pH >9; so the alkaline water spray can really help. Many of my professional singer patients carry around a spray bottle of alkaline water for their voices, and they tell me that it feels good and helps a lot.

References

Koufman J. Low-Acid Diet for Recalcitrant Laryngopharyngeal Reflux: Therapeutic Benefits and Their Implications. Ann Otol Rhinol Laryngol 120:281-287, 2011.

Johnston N, et alActivity/stability of human pepsin: implications for reflux attributed laryngeal disease. Laryngoscope. 117:1036-9, 2007.

Koufman J, Johnston N. Potential benefits of pH 8.8 alkaline drinking water as an adjunct in the treatment of reflux disease. Ann Otol Rhinol Laryngol (2012) 121:431-4.  

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