What Is the Deal with Alkalinized Water?

Alkalinized water comes in many sizes. Ranging from $1.00 for 16.9 ounces, $13.00 for five gallons of basic alkaline water, to nearly $60.00 for a four pack of 3-Liter bottles of more premium alkaline water that promises “Himalayan minerals and electrolytes, smooth taste, 8.8 pH bottled water, BPA-free.” Alkalinized water is being marketed as having health benefits. But what are they? Should you drink it? Is it worth it?

In chemistry, pH (potential of hydrogen) measures the relative amount of free hydrogen and hydroxyl ions in a liquid; it reflects the basicity or acidity of a liquid on a scale of 0-14. The higher the concentration of hydrogen ions, the more acidic and closer the pH is to 0; the less the concentration of hydrogen ions, the more basic and closer the pH is to 14. To help remember, A (acid) comes before B (base); 0 comes before 14. Neutral pH is 7.0. The pH of blood is 7.4, which means we are all a little basic.

The pH of alkaline water ranges from slightly greater than 7.0 to 9.5, with most falling between 8.0 to 9.0. Although there is water that is naturally more alkaline—for example, some spring water that passes through rocks and certain minerals results in a loss of hydrogen ions—commercially produced alkaline water is intentionally made that way through a process called ionization, which involves using an electromagnet and a salt acid called carbonate.

There are a number of ways to make alkalinized water at home. Some approaches include:

1. Thinly slice 1 cucumber into 2 quarts of water and refrigerate for 2-3 hours;

2. Squeeze 1/2 a lemon into 8 ounces of water;

3. Thinly slice 2 lemons into 2 quarts of water and refrigerate for 2-3 hours;

4. Add 1/2 to 1 teaspoon of baking soda to 8 ounces of water (maximum intake is 8 ounces daily; since baking soda is high in sodium, do not do this if you are on a low-sodium diet);

5. Filter water through an ionizing, or alkaline, filter; or

6. Attach a water-ionizing machine to your faucet.

Why drink it? The theory is that alkaline water can neutralize acid in the body, making it more alkaline and thereby decrease the damage that acids do at the cellular level. There are purported immune system benefits. Some proponents of an alkaline diet trumpet it extensively for improving fertility, increasing energy, regulating your internal pH, preventing diabetes, and even decreasing cancer risks. All that sounds good and hopeful. However, other than hydration benefits, similar to that of regular water, no studies have demonstrated any of those benefits from drinking alkalinized water. There may be potential benefits for acid reflux with pH 8.8 water. Until proven, it is just expensive water leading to expensive urine.

Lack of marked benefit in studies is likely because alkalinized water is ingested into the acidic environment of the stomach (pH 1-2) which acts quickly to acidify it.

Drinking alkalinized water is generally considered safe. Digestive side effects such as bloating, nausea, belching, and upset stomach can occur with high levels of consumption, especially with higher intake of higher alkalinized waters—those with pH greater than 9.0.

In most cities within the USA, tap water is safe, already paid for via taxes, and prevents unnecessary use of plastic. The U.S. has high quality tap water largely due to regulations set by Congress in the 1974 Safe Water Drinking Act (amended in 1986 and 1996). Enforced by the Environmental Protection Agency (EPA), it requires tap water to have a pH of 6.5 to 8.5, which means some places already have alkalinized water.

According to thetravel.com, these cities are top 10 for best-tasting water in the USA:

10. Chicago, IL

9. Denver, CO

8. Manchester, NH

7. Fort Collins, CO

6. Greenville, SC

5. Silverdale, WA

4. Oklahoma, City, OK

3. Louisville, KY

2. Macon, GA

1. Memphis, TN

Unless you favor the taste of alkalinized water or your water supply is from a non-EPA regulated source (e.g. well water), water is water, and alkalinizing it does not seem to make it more (or less) healthy, for now.

Dr. Stephen A. Wilson, MD, MPH, FAAFP, is Chair of Family Medicine at Boston University Chobanian and Avedisian School of Medicine and Chief of Family Medicine for Boston Medical Center.