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.
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 al. Activity/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.