The FDA Is Warning Against Drinking This Alkaline Water Brand

Real Water, an alkaline water brand, has been linked to a number of cases of hepatitis.

The Food and Drug Administration (FDA) has issued a warning about drinking a particular brand of alkaline water after it was linked to cases of hepatitis and liver failure.

The FDA said in a press release that it is investigating "a number of reports" of acute non-viral hepatitis in Nevada tied to people who have had Real Water brand alkaline water. To date, the FDA said it's aware of five people who developed acute non-viral hepatitis. All five were hospitalized with liver failure but have since recovered, according to the press release.

While the FDA said the investigation is ongoing, the available details on the case thus far suggest "that this alkaline water product may be the cause of the illnesses," according to the release.

ICYDK, hepatitis is an inflammation of the liver, according to the National Institute of Allergy and Infectious Diseases (NIAID). Viruses are the most common cause of hepatitis, but the NIAID says you can also develop non-viral hepatitis (as in the case of Real Water) from toxins, heavy alcohol use, certain medications, and autoimmune disease. (

Los Angeles County health officials are also warning residents not to drink Real Water. "Since 'Real Water' may be sold in Los Angeles County and surrounding jurisdictions, Public Health is advising consumers who have purchased the product not to consume the water," according to a news release.

Real Water has also issued a press release, saying that the company is "saddened" to hear of a "potential health issue" from the company's home delivery operation in Las Vegas. "While the potential problem arose in Las Vegas, we are taking proactive steps to stop selling and distributing Real Water products throughout the United States until the issue is resolved," the release says. "Real Water is asking that all retailers pull the product from the shelf, effective immediately, and hold it in the back rooms or return it to the distributors."

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It's understandable to have questions — a lot of questions — after reading all that, especially if you've had Real Water recently. Here's what you need to know.

What is Real Water, exactly?

Real Water is a form of alkaline water with a 9.0 pH. Alkaline water, in general, is different from tap water because it's less acidic and has a pH over seven. That means it has a lower concentration of hydrogen ions.

"All liquids have a measure of acidity, which is determined on the pH scale," Alyse Levine, R.D., founder of the Eating Reset Plan, previously explained to Shape. "The pH measures the concentration of hydrogen ions in the liquid, which is expressed on a scale of 0-14. Anything under seven (think black coffee, orange juice, and vinegar) is acidic, seven is neutral and above seven (like baking soda) is alkaline territory."

People make a lot of unsubstantiated health claims about alkaline water, including that it can (supposedly) improve energy and metabolism and has anti-aging properties. But, again, there's nothing to back up those claims, Levine told Shape. Real Water in particular says on its website that the company's product will help you "hydrate like never before" and "detoxify" your body. However, the company includes an asterisk with those claims, noting that those statements haven't been evaluated by the FDA. (Here are other, more legit ways to stay hydrated all day long.)

All that said, alkaline water may have at least one perk: It could help tame acid reflux. An older study published in the Annals of Otology, Rhinology & Laryngology found that alkaline water with a pH of 8.8 can help soothe acid reflux. Why? The higher pH level kills pepsin, an enzyme involved in breaking down food proteins that's also a main cause of acid reflux.

What should you do if you have Real Water at home?

The FDA recommends that you stop using it immediately. The agency urges against drinking, cooking with, or serving Real Water to anyone until the investigation turns up more information.

In case you're not sure if you have Real Water at home, it often comes in five-gallon containers that are sold through a home delivery service, bottles, and Real Water concentrate. It's also sold through the following companies at different locations:

  • Honolulu, HI through Aloha Water
  • Orange County, CA through Paradise Bottling Company
  • St. George, UT through Real Water Southern Utah
  • Tucson, AZ through Aqua Pure
  • Ventura and Santa Barbara, CA through Real Water Gold Coast

The FDA has photos of the company's packaging if you're still not sure.

What should you do if you recently drank Real Water?

Don't panic — but you should keep an eye out for possible symptoms of non-viral hepatitis, says Andrew Talal, M.D., a liver disease expert and professor of medicine at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. The FDA says those symptoms (which, BTW, are the same as those associated with other forms of hepatitis) include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay or gray-colored bowel movements, joint pain, yellow eyes, and jaundice.

If you do develop any of these symptoms, call your doctor ASAP. "You should consult with your doctor and have liver tests done," says Dr. Talal. "With acute toxicity, it causes an injury similar to what could occur with [an overdose of] drugs or some other medications."

Should you worry about other alkaline waters?

Worth noting: It's not clear at this point if Real Water directly caused the liver illnesses seen in these cases. As of now, the FDA has flagged that there seems to be a link between the two. (

So, should you take a pass on having any alkaline water? Not necessarily, says Dr. Talal. "The cause of the hepatitis still needs to be worked out," he explains. "Was there a problem with manufacturing? This lot of water? Or is there a problem with the whole category?" Dr. Talal says he suspects that it's "more likely related to manufacturing," but points out that the FDA's investigation is ongoing.

Basically, if you have Real Water at home, it's best to either toss it or put it someplace safe out of the reach of others. As of now, there are no other warnings on the safety of using other types of alkaline water.

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