Is Alkaline Water the Next Great Miracle Cure?

In late August, Good Morning America ran a story about the health benefits of alkaline water. The story claims a multitude health benefits from drinking water that has an alkaline pH. Alkaline water is slightly less acidic than tap water, and remarkable effects have been promised by those who promote it. Promoters claim this water this will provide better hydration and protect against a variety of diseases. Skeptoid is all about looking into potential health benefits. Let’s turn our skeptical eye on these claims and see if they do in fact hold any water.

What is alkaline water?

Alkaline pH Solution Via Wikimedia

There is no clear answer. A “consumers guide to alkaline water,” posted online by an alkaline-water retailer, really gave no indication as to what pH qualifies as properly alkaline. From a scientific standpoint, alkaline water is any water with a pH greater than 7. pH 7 is considered neutral, below 7 is considered acidic. Alkalinity has a precise definition. It is a measure of the capacity of the water to resist a change in pH that would tend to make the water more acidic. Most tap water is considered drinkable if you have a pH from 6 to 8.5. Although both ends of the spectrum are usually acceptable, drinking water is typically treated to get to as close to 7 as possible. This is mostly due to the mechanics of plumbing and for taste.

Most of the marketing for alkaline water is focused on the method by which it’s produced. There is plenty written about the benefits of alkaline water, but little about standards. Here are a few highlights from some of the more notable self-help gurus:

“Alkalize your body and live a healthier, more energized, and ultimately more fulfilling life. Our acid-alkaline balance is a baseline determinant of our physical health. When you break your old eating patterns, you will find yourself getting back to the real you, filled with the vitality and energy that you desire and deserve.” –Anthony Robbins

“Getting liberal amounts of alkaline water (having a pH between 9 and 10) neutralizes stored acid wastes and if consumed everyday in conjunction with a good diet, gently removes the acids from the body.” –Dr. Robert Young

“Drinking alkaline water is a great way to neutralize and flush out the toxins and acids that drain from the tissues and bodily fluids, and to quickly rehydrate the body and keep your body slightly alkaline.” –Daniel Reid

You can look up their names on your own. I have no desire to uplink their page traffic by linking to their webpages.

Of course there is always a book, a video, or water ionizer intended to be sold with these claims. I am sure that monetary gain has no effect on their ability to impartially assess the effectiveness of alkaline water. Promotion of alkaline water is not just relegated to the buy-yourself-healthy gurus. Like many types of marginal health advice there’s no shortage of notable celebrities promoting the use of alkaline water, including Elton John, Beyoncé, and Mark Wahlberg. Some sites even claim President Obama uses it for hydration, though I couldn’t find any direct evidence or quotes proving the validity to that claim.

Regular Skeptoid readers may have noticed that the pseudoscience red flags are piling up here. Fantastic health claims, sciencey-sounding reasons, and celebrity endorsements are the harbingers of bad science. Still, having red flags doesn’t invalidate the concept. So are the claims plausible?

Right out of the gates I find the concept stretches physiologic plausibility. Simply put, can something you drink affect your bodies pH? The short answer is no. Mildly alkaline water is not very likely to change your internal chemistry.

Even ingestion of massively alkaline substances, with a pH of 10 to 12 (e.g. drain cleaner), has no systemic effect beyond mechanical burns to the mouth and esophagus. There are rare cases of eosinophilia—a reaction of white blood cells produced by the injury. There is no change in the systemic pH due to accidental or purposeful ingestion of very alkaline substances. So how can a modest change to water produce the type of tissue and blood changes claimed by the proponents? They offer no plausible mechanism or reason why alkaline water might possibly have an effect that massive doses do not. In fact there are no well-controlled studies indicating any systemic response from alkaline water, even though many websites claim to have science that proves alkaline water’s benefits. The only medical research I can find about alkaline water is in gastro-reflux disease. That research does not show a systemic effect. Rather it shows a gastric antacid effect: the alkaline water slightly neutralizes our very strong stomach acid. Like all antacids, alkaline water might help your heartburn but it won’t change your blood or body tissue pH. Our body is physiologically set up to resist that change. And for good reason: rapid or persistent changes to our body’s pH results in pathology, not benefit.

If your body loses hydrogen ions (acid) for any reason—including ingestion of alkaline water—you have an automatic system that puts your blood and tissue right back to normal. Your blood and tissues contain bicarbonate. Bicarbonate is slightly alkaline and it is your body’s pH buffer system. The body keeps bicarbonate to elevate low pH and excretes it to balance high pH. When you alkalize your blood or tissues your body gets rid of bicarbonate through the kidneys to balance the pH back to normal. Your body has a much quicker response to even tiny changes in pH. There is an immediate effect on a cellular level. As the pH rises there is a contraction of the extracellular volume around a relatively constant quantity of extracellular bicarbonate. The degree to which this occurs is offset by intracellular buffering, which results in the release of hydrogen ions from cell buffers to lower the plasma bicarbonate concentration toward the baseline value. Your body is much quicker and more skilled at balancing pH than drinking a specialized water ever could be. And, since you don’t know the precise effect of the amount of water you’re drinking, if it did have a systemic effect and brought your pH too low, your body would correct it. If it had a systemic effect and you didn’t drink enough, raising your body’s acidity, your body would automatically correct that, too. But, as far as the science has shown, it has no systemic effect and your body serves this need anyway.

Your body keeps the pH stable for a very good reason. All of our enzymes, proteins, DNA, etc., function best at the body’s normal pH. Changing it doesn’t make things run better, it makes them run worse. In the case of some diseases and medications, which can exhaust the pH balancing system, there are severe consequences. Although it is possible to change the blood pH, it is not desirable to do so. In cases of metabolic alkalosis—elevated pH—you can have uncontrolled muscle spasm, tetany and heart arrhythmia.

The promoters of alkaline water are betting that you have a poor understanding of how your body works, or maybe they don’t understand it themselves. If they did they would never make the claim that alkaline water is a better hydrator. This is an obvious house of cards. If you ingest water and it is alkaline enough to get past your stomach acid it will burn you. If its pH is low enough then it’s neutralized by your stomach acid and your body contributes hydrogen ions to re-acidify the stomach acid. This results in your body having too much bicarbonate, which in turn it gets rid of by urinating. That’s right: the “superior hydrating water” makes you pee. It’s not a plausible mechanism for improved hydration; more probably it has no appreciable difference with regular tap water at best.

All this leaves little chance your are doing anything but consuming regular old water. Any other effect is frankly improbable.

Making the water, however, is not so benign. The most common way to produce alkaline water is to use a water deioinzer.

A commercial water deionizer. Via Wikimedia.

Deionization is a process by which ion-exchange resins are used to remove ionic contaminants from water by exchanging hydrogen ions for cations (cationic resins) and hydroxyl ions for anions (anionic resins). Mixed-bed deionizers contain both cationic and anionic resins; the exchanged hydrogen and hydroxyl ions combine to form water. Although mixed-bed deionizers effectively remove ionic contaminants, they do not remove bacteria and endotoxins. Furthermore, the resins provide a good environment for bacterial proliferation and often worsen the microbiologic quality of water passing through them, increasing the requirement for bacterial control after the deionizer to ensure that the product water meets the appropriate microbiologic quality.

If you google “alkaline water” you will find many ionic water systems promoting alkaline water and it purported health benefits. You will also find a host of amateur chemists telling you how to make it—some incorrectly, I might add. My personal favorite is adding lemon juice to alkalinize your tap water. Lemon juice has a pH of—it’s acidic. Acidifying your water will not make it alkaline, it will make it the opposite of alkaline. I would call that chemical homeopathy, treating like with like, and equally useless as homeopathy for its expressed purpose.

So overall what does this all mean? You can throw out the claims and testimonials—they are meaningless. Humans, including you and me, are exceptionally poor at figuring out what works without scientific structure. Like many marginal health claims alkaline water uses pseudoscience to make a plausible narrative. What they are selling you is an idea—an idea that there is something magical about slightly changing the pH of water.

Be thankful that your body doesn’t care one little bit about ideas. It keeps right on going keeping your pH steady. Be glad your body’s buffer system isn’t susceptible to marketing or compelling celebrity stories. Your body knows that changing your pH is bad and it fights it every step of the way. Fortunately it protects the drinkers of alkaline water like anyone else.

A MagicWater fuel saver device. Alkalinized water does as little for your car as it does for your body. Via Wikimedia.

Stop looking for magic in a water bottle. It’s just water, only more expensive. Evolution and physiology have figured out how to deal with the wide variations in fresh water and still use it. If you drink from a reputable public water supply, you’re getting the same health benefit of any water. No matter how many wiz bang marketing terms or celebrity endorsements they hang on alkaline water, there is just no plausible or proven benefit. So drink up, and enjoy your tap water, but keep your money in your pocket.

About Stephen Propatier

Stephen Propatier is a board certified acute care nurse practitioner specializing in spine and sports medicine. He is a member of the Society for Science Based Medicine.
This entry was posted in Health, Pseudoscience, Science, TV & Media and tagged , , , , , , , , , . Bookmark the permalink.

23 Responses to Is Alkaline Water the Next Great Miracle Cure?

  1. Steve Rogers says:

    Thanks for continuing to teach about our bodies’ amazing structures and their resilience to the daft things we try to put into them.

  2. Castiel says:

    Been drinking this at home for years….it’s called Hard Water, and means we get next to no bubbles from shampoo!

    Thanks for a well researched and well reasoned take down of another bizarre fad! THIS is what we come here for! =)

  3. I agree with the article and the points about physiology, but this whole thing isn’t even original or educated. It is just another weary scam to parasitise suckers. Remember reverse osmosis and the banishing electrolytes from your water? Scamming the chemical illiterates by introducing ferrous ions from the electrodes of the conductivity meter? I actually have had elderly friends calling me out to advise them whether they should spend their savings on the overpriced device because they were terrified of the dark precipitate, and not well enough familiar with Chem 101 to do a control experiment to see whether plain tap water, “untested” would precipitate like that.
    Never mind how good such waters are for the pockets of the vendors, but they have a bad effect on my sense of personal nausea.
    Now, personally we use a water filter of the carbon-and-brass variety at home, but that is not for our health; it simply is because our tap water tends to have tastes from time to time that are unpleasant and spoil our tea etc. But for other purposes we take no precautions and come to no harm. Silly us! Bottled water left us speechless… Wellll, almost speechless; say speech-a-little-less… It will be interesting to see what the next scam will be: oxygenated water? De-oxygenated? Decarbonated? Hypercarbonated?, Nitrogen-free…? The mind boggles, but I bet that I am already behind the times on this.
    In sum, I think that the whole article is well summed up by the closing paragraph:
    “Stop looking for magic in a water bottle. It’s just water, only more expensive….”

  4. And Castiel, dead right. While reading the article I kept thinking “Lime water? If the pH is the issue, when are we getting to lime water?”

    Oh wellll…!

  5. Nelson says:

    To point out that lemon juice: “Lemon juice has a pH of—it’s acidic”, shows a complete lack of understanding about the function of ingested substances and their affect on alkalinity. What the PH measurement is of the food or liquid before the process of metabolism has virtually no bearing on the effect of said substance after the process. Some substances that measure acidic will form alkaline ash when processed and some alkaline substances will form acidic ash when processed. The only way to determine the ultimate PH of any substance ingested is to measure the ash formed after the process. It is the alkaline or acid FORMING quality of the substance that is important not the measure of the PH in its raw form. Now we are NOT talking about extreme acids like Hydrochloric acid or bases like Lye. The effect of ingestion of these extreme substances would probably be a quick and very painful death. The body does have mechanisms to bring the blood back to a very narrow range of PH of between 7.35 – 7.45, where the alkaline minerals of calcium, magnesium, potassium or sodium are cannibalized from body that contain them (except sodium which is generally found in the diet), sometimes causing problems such as osteoporosis (too much calcium cannibalized from the bones) among other problems. There isn’t any process however that the human metabolism can readily change the extra cellular fluids that bath all body cells if that becomes too acidic. Drinking high PH water will not on it’s own bring back the body PH to a neutral level if the person continues to eat excessive amounts of acid forming foods. Plus you are always at a deficit as many bodily functions including digestion throws off many acids as a end product. That’s why you mother was right when she told you to eat your (alkaline forming) greens.

    • @ Nelson
      Please define alkaline ash and what that means to you it is a nonsense word physiologically. The statements I am sure you found somewhere show a profound lack of knowledge about human physiology.
      “There isn’t any process however that the human metabolism can readily change the extra cellular fluids that bath all body cells if that becomes too acidic.”

      Increased respiration of Co2 reduces serum hydrogen, and bicarbonate present in the blood neutralized acidosis as well as extracellular bicarbonate released.
      I am not going to post all the biochemical pathways here.
      That is just one false part of the statements you have gotten.
      You body constantly maintians and balances hydrogen ion balance. if it didn’t you would be dead.
      People can and do live for days and even months with diabetes metabolic acidosis until it becomes deadly diabetic ketoacidosis overwhelming the body’s defenses. If your body didn’t do that juvenile onset diabetes would kill children before you even realized they had a problem. It is a terrible medical issue but once recognized it is treated.
      Those statements you have repeated make sense to people who lack the proper knowledge of physiology but understand basic high school chemistry. It is meant to be deceptive on purpose. Don’t be fooled by them it is marketing not science.

  6. Vere Nekoninda says:

    Thanks for your well researched and detailed description of pH and the body’s mechanisms for regulating it. Unfortunately, this is irrelevant to the alkaline health question. I know, because I offered similar arguments to several of my friends, when they advocated the health benefits of alkalinity. They kindly explained to me that my objections were on the wrong track, because the miracle of alkaline health does not change the pH of the stomach, blood, or cells. It just makes the body itself more alkaline, which is a good thing. The body, not the parts of the body. Keep that in mind.

    Furthermore, they educated me that lemon juice, and various other acid and neutral foods, will make the body more alkaline. You can’t tell this by measuring the pH of the blood or cellular fluid, only by the improvements in good health that will result. Holistic alkalinity will come into being when you consume the right products. Apparently, there is a common source for this information, since my disparate friends all offered the same information.

    My puny science was unable to deal with this flood of new education.

    • Tell them “Show me the data.” And when they point to anecdotes and testimonials, say “Data has numbers.Like accounting does.Show me the ‘books’ .”

    • Vere
      I know you are a smart commenter we have had several really thoughtful conversations. What they are really saying is that physiology and chemistry don’t matter. That there is a property of alkalinzation that supersedes physiology getting around the reality of the human digestive system and basic chemistry. To produce an undesirable condition in the human body because they believe that it is somehow desirable.
      IE- Magic water.

    • Daniel says:

      Vere,

      What your acquaintances have described is clearly the principles of body chi and some eastern medicine thousands of years of wisdom and knowledge. Clearly it’s not the water they are drinking. It’s the balance of the yin and yang that one achieve when one drinks the water.
      The consumption of water (any water) to treat the body “heatiness” has helped in promoting good health. Alkaline water is a new term given to traditional eastern water to help west’s general acceptance. Alkaline is not the alkaline we talked about in science class and the critics are on the wrong track. Take that skeptoid!
      Remind them to mediate 3 times a week to achieve maximum holistic healing.

      #sarcasm Please don’t burn me. Just a weekend joke. 😉

    • Melissa K says:

      My head hurts thinking about your experience! My condolences that your puny science was also unable to help in this case. I’ve been there.

  7. Stephen Connell says:

    The problem is shows such as Good Morning America backing these shyster products and giving them a Halo of respectability via their perceived integrity which is nonsense because they are nothing but shills making a buck at ever opportunity out of their audience which is what they were set up for .
    Go after the makers of these products but also go after shows such as Good Morning America who provide a conduit for this garbage time and time again.

  8. DrRandy says:

    I would expand upon your excellent article by reminding readers that the body is far more tolerant of acid conditions than alkaline – you can live for years with a serum pH of 7.2, but probably only for days with a pH of 7.5, and only hours at 7.6 or more. Why? Because acid conditions reduce hemoglobin’s affinity for oxygen, while alkalinity increases it. In alkaline conditions, you can’t get oxygen off the hemoglobin to use it in cells (we say “the oxyhemoglobin dissociation curve shifts to the right”). Your cells must have oxygen to produce energy, so despite the abundance of oxygen circulating in the blood stream, they starve, because they can’t access it.

    Because of the very potent hydrochloric acid produced in the stomach, any alkaline substances ingested will simply be neutralized. About the only potential effect I can see would be reduced digestion of proteins if this silly stuff is drunk with a meal, since you need the acid to allow pepsin (the major digestive enzyme in the stomach) to work. If you drink it on an empty stomach, it won’t do a thing.

  9. Amorette says:

    I live in eastern Montana where we have VERY alkaline water. It can kill you. There are historical records of people dying from drinking the water. There are wells around here that bubble like Alka Seltzer and if you drink them, you will die a painful and unpleasant death. So we know NOT to drink highly alkaline water. Sheep, on the other hand, are notorious for drinking the stuff and falling over dead but sheep are sheep. And anyone who drinks highly alkaline water is even stupider than a sheep.

  10. Matthew E says:

    Interesting ad for 8.5 pH Essentia Ionized Alkaline water claims it is 88% more hydrating.
    What’s Interesting is that it says “Results of a double-blind, placebo controlled clinical study with Essentia Water vs the leading bottled water” proved this!

    Perhaps this http://www.nature.com/news/over-half-of-psychology-studies-fail-reproducibility-test-1.18248 makes the results easier to explain.

    • Noah Dillon says:

      And the standards used by the marketing team for Essentia, in terms of what they call “double-blind,” “placebo controlled” [sic], and “clinical study,” are probably totally dubious. Do you know if they link to their study or if they describe the methodology? I can’t even imagine how you would measure “more hydrating.”

    • mudguts says:

      Funny that nobody mentioned that the water goes into the stomach.

      ie.. after that million+ fold assault (wrt pH) it really doesnt matter.

      pH means (literally) the negative log of the hydrogen ion concentration.

      Alkaline water is bunk.

      Gullibility factor applies.

      Now if folk want to associate ions what are associated with general alkaline water (please check your food and (hopefully not) self administered supplements).. sure.. those ions will get through to your digestive tract and blood stream. But this isnt what this device promises and these will pop out from your general well rounded diet.

      No stupid arguments about serum pH are needed ..

  11. TorchWood says:

    Anthony Robbins is a behavioral specialist. Why would I take his advice on bio-chemistry? I’d rather go to Lady Gaga for fashion advice.

  12. Owen says:

    I read yesterday that it’s the hydrogen. That hydrogen is a byproduct of the electrolysis. I’ve never bought into the alkaline but cause your stomach a is balanced it out before it could even get into your body… But they have a bunch of studies where it actually has beneficial effects. When they tried duplicating those studies with bottles alkaline water they failed. If it sits too long the hydrogen dissipates.

  13. Shaji says:

    Alkaline water is not a buffer and has low alkalinity. As such, it cannot neutralize very much acid. Many people have seen that just a small amount of soda can easily lower the pH of a gallon of alkaline water. To help put this into perspective, consider that 1 tsp of baking soda (sodium bicarbonate) can neutralize the same amount of acid as 10,000 liters of alkaline water at a pH of 10. This is a primary reason why medical professionals have been skeptical about “alkaline ionized water”. It simply wasn’t known that the benefit of this water is attributed to the dissolved hydrogen gas until around 2007.

    Molecular hydrogen or H2 is the primary form in which hydrogen is found. In other words, two hydrogen atoms (H) are covalently bonded (a type of chemical bond) together as H-H. Because the hydrogen atoms are covalently bonded together they form a molecule; so H2 is also referred to as molecular hydrogen. We can also refer to it as dihydrogen. The hydrogen molecule contains two protons and two electrons making it a neutrally-charged molecule. It is a colorless, odorless, tasteless, non-metallic highly flammable gas, and very explosive above a 4.6% concentration by volume. It is this form of hydrogen that has been shown to exert the wide range of therapeutic effects. Some articles refer to this as “hydrogen-rich water”. It is the smallest molecule in the universe, and this extremely small size and its high lipid solubility allows it to easily diffuse into the subcellular compartments of the mitochondria and other locations.
    (Copied from an article)

    • Skypp says:

      Excellent reply. I LOVE my Hydrogen Water Machine. If anyone thinks the good results are just from a “placebo effect”, then pour some on your potted plants and watch them turn deep green, flowers get brighter, and literally grow before your eyes. VERY REAL.

  14. Owen says:

    Just now seeing that autocorrect slaughtered my comment lol

  15. Guillermo says:

    My PSA went from 16.4 to 4.1 in less than 2 weeks, I drinker 1 gallon of kangem water a day.

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