VIDEO - WHAT’S THE DEAL WITH ALKALINE WATER?

25 minute video

Your advice today is coming from Zubin Damania, MD. ZDoggMD is a UCSF/Stanford trained internal medicine physician and founder of Turntable Health, an innovative primary care clinic and model for Health 3.0 that was part of an ambitious urban revitalization movement in Las Vegas spearheaded by Zappos CEO Tony Hsieh. During a decade-long career as a hospitalist at Stanford, he led a shadow life performing stand-up comedy for medical audiences worldwide as a way to address my own burnout. Our videos and live shows have since gone epidemically viral with nearly a half a billion views on Facebook and YouTube, educating patients and providers while mercilessly satirizing our dysfunctional healthcare system.

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The Transcript of the video/podcast is below!

What’s up, Z pack? I just alkalized the hell out of my body with Icelandic glacial water. Only five dollars at Whole Foods and I can feel it already transforming everything in my body. I can fell the toxins starting to chealte out and flush out of my body. I can feel all the bicarbonate taking a break and my organs getting a holiday and so I liked it so much because I read about it on Goop and so I bought all the waters that are alkaline because of something like pH and stuff. Tom Hinueber.

– Actually, I bought them, and you owe me $37.50, ’cause those waters are expensive as fuck.

– I told you get me some tap water and Tom disappears for 20 minutes, comes back with this, and I’m like Tom, I don’t know, why are you buying me this? And he says, ZDogg, because I want you to live. I want you to live a long time because you’re my cash cow. And I said, Tom Hinueber, I don’t pay you, and then he had to do math and he realized this was a disastrous investment. Actually, Tom pointed out to me, and I already knew, that many, many, many, many, many people in the public somehow believe that alkaline water is somehow better for you than regular tap water.

– The argument goes something like this. Do you know that cancer can only grow in an acidic environment? So if your body is alkaline and is at the perfect pH, you can basically live forever. Unless you get shot.

-Ponce de Leon was looking for the fountain of youth. All he had to do was take some baking soda and put it in some Florida tap water, and he went boom, fountain of youth, according to the proponents of alkaline water. What’s the deal? First of all, let’s define some terms, Tom. Do you even know what, you guys know what alkaline means?

– No.

– It means you basic.

– Have no idea.

-Logan, you so basic.

– I know.

– [Zubin] Your pH is way higher than seven.

– I know.

– Let’s talk about that real quick because I think a lot of people like to drop scientific words without really knowing what they mean. Alkaline —

– Like this one. Antioxidant, because it says here alkaline water is a power antioxidant. Suck it, Z.

– Yeah, okay, let’s backtrack for a second. What is alkaline, what is acidic, what does all this mean? It all comes back down to the concept of pH. Little p, big h. What’s the pH? Most people don’t understand this I think in the lay community. It is the negative log of the active hydrogen ion concentration, okay professor. That’s what pH is. Shorthand, it’s how much active hydrogen ion is floating around in your liquid, and hydrogen ions can react with things, so a very strong acid means a very low pH which means a very high hydrogen ion concentration, which means it can eat through your table because of the reactivity of the active hydrogen ion. Has a little positive charge, it’s a little proton. It can do stuff. That’s the simplest explanation. In water, for example, pure water, which is distilled water, is very close to a pH of seven. We define kinda seven based on water neutral. Anything below seven is considered acidic and anything above seven, which means less hydrogen ions because of the negative part of the negative law of the hydrogen ion concentration is alkaline, or more basic, like your basic chick who just goes to Starbucks and wears Uggs. The question is, what does this have to do with anything with the body? Well, it turns out the human body operates, especially blood, organ systems, brain, et cetera, operate within a very narrow pH window. Generally somewhere in the 7.4 range. A little bit more alkaline than pure distilled water, and the reason that it has to be in that range is that many of our metabolic processes, they work based on proteins and enzymes, and those enzymes become unraveled or denatured or less functional when the pH is out of that range because those hydrogen ions interfere with the function of the proteins. That’s the simplest explanation. That being said, the body over millions and billions of years has evolved elaborate mechanisms to keep the blood pH within a very narrow range. Generally 7.35 to 7.45, and things that are out of that parameter, depending on your lab, are considered abnormal. You can check the blood acidity with a lab test, either from Venus blood or arterial blood, often, we’ll check from an artery like the radial artery, and that’s called a blood gas. You’ll get a pH, you’ll get a CO2 concentration, et cetera. Now the question is, how does the body maintain its acid/base balance, and what does that have to do with this snake oil? Everything. The body has many mechanisms to keep pH imbalance. The biggest are the kidneys and the lungs. It turns out the kidneys can actually excrete extra acid and hold on to bicarbonate which is a molecule that acts as a base, as a more alkaline component. If your pH starts to drop you get more acidic, your kidneys will handle business by holding on to bicarbonate. You can measure this in the blood in a functional kidney. If you start to get too acidic in the blood, the lungs can compensate by causing you to hyperventilate and blow off, excrete more of that carbon dioxide. It turns out carbon dioxide when dissolved in the blood forms something called carbonic acid, which is an acid. By getting rid of some of it, you shift the acid/base balance towards the basic. Now, the body has, again, evolved over millions of years to pull this off in a beautifully, elegant way. It fails in certain disease processes. For example, emphysema, chronic obstructive lung disease, you don’t get to blow off enough CO2, you retain it and your body starts to get more acidic. So, what ends up happening? The kidneys step in and they’re like, I’m gonna hold on to more bicarbonate, son, to keep the pH normal. Now, acutely, if you decompensate, you can’t breathe or you have an asthma attack or COPD exacerbation, your pH can actually drop, your blood can get very acidic, and your kidneys don’t have time to keep up and you can get very sick. The same happens with diabetes. You can get a metabolic production of acid, that’s called diabetic ketoacidosis from these keto acids. So, there’s lots of ways this can go out of balance, but in the normal person, we have ways to treat those. In the normal person, it’s kept pretty tight. Second, the stomach has a huge amount of acid that keeps its pH close to two, which is a lot of hydrogen ion. Here’s the proposal. Why do people say that drinking slightly alkaline water, that means a pH higher than seven, ’cause neutral water is seven. Why, Tom, do people think this helps?

– Because people are dumb, Z. Because when I just heard you go on that whole scientific explanation, the only thing I go out of it was that when diabetics go on the ketogenic diet, they get acidic, and then they need alkaline water.

– That’s true.

– You know, the end of Western civilization, I pegged at certain political events, I’m thinking it’s just that conversation we just had. That’s what I think.

– Hey, did you know that alkaline can cure psoriasis? Or cirrhosis? How do you say this word?

– [Zubin] Ps?

– Yeah.

– [Zubin] That’d be psoriasis.

– Psorasis.

– It’s like pterodactyl, the S is silent.

– I love it because it says alkaline water can help cure psoriasis. And then it says psoriasis is a skin disease that has no cure.

– This is the thing. Many people who sells this stuff will proport that drinking a more alkaline water is good for the body for these following kind of vague reasons. One is that toxins, which is always a trigger word for anyone doing science because it’s usually made up, toxins produced by the body tend to be acidic in nature, so the body is always trying to de-acidify via the kidneys and potentially via the lungs slowing down your respiration, and via the buffer systems of the blood, and so by drinking alkaline water, you’re giving your body’s detoxification systems a boost by taking some of the stress off this highly evolved and naturally designed system over millions of years by drinking this stuff. What they fail to tell you is that stomach acid at a pH of two pretty much destroys any alkalinity that is in this water. Now some have actually backed up and said yeah, yeah, exactly, but by doing that, man, the stomach needs to secrete like less acid, and that takes some of the stress off the stomach and allows more bicarbonate into the blood which puts a break on the bicarbonate buffer system. Okay, all that is made up. When you look at actual data around this stuff, does it actually do any of the things they say? Help you live longer, reduce oxidative stress, reduce load on the kidneys and damaged organs and basically anything that Gwyneth Paltrow says that it does, which is all made up stuff. You look at the data, there are tiny little case studies usually in alternative medicine journals that have looked at them. They’re poorly designed, they’re small, and they’re correlation and not causation. There’s no real good evidence that this stuff does anything.

– That’s not true, Z. That’s not true, Z, ’cause alkalinewatermachinereviews.com says and I quote, alkaline water benefits can help fight cancer.

– It’s true.

– [Tommy T Bones] So, you know.

– [Logan] I read it on the internet.

– [Tommy T Bones] Yeah.

– The internet is usually my final source of truth for everything and now since April Fools is over I can trust the internet again to be 100% accurate. This is the thing. It doesn’t help cure cancer, it doesn’t cure cancer, it doesn’t do any of that. It’s very expensive water. Let’s go back. The machine that you’re talking about that they’re selling costs minimum $900. It alkalinizes water through ionization. You can do the same thing by putting a sprinkle of baking soda in your water, by adding minerals to your water. How does water get alkalinic anyways when distilled water has got a pH of about seven, Dasani is somewhere between five and seven, it’s slightly acidic, mineral water, with like calcium and silica, potassium tends to drive the pH up and it’s a little more basic. Heavily mineralized waters actually are naturally a little more alkaline. The question is, even if you did a study that showed that alkaline water helped people, you would have to ask was it the alkaline nature of the water that helped, which makes no sense scientifically, or was it something in the mineral content of the water that’s, you know, maybe repleting some trace deficiency people have, something else? Because there’s some argument over reverse osmosis water, which has a very small amount of dissolved solutes, it’s closer to a pH of seven, whether that’s really healthy versus drinking mineral water, and the jury, nobody knows. The thing is, this idea that you can raise the pH. Look at this, look at this. Look at some of this stuff. Okay, this one here, okay 365, so this is a Whole Foods brand. By the way, how many people agree that Whole Foods has gone completely to crap since Amazon bought them?

– I agree, it sucks.

– It totally sucks. Like, what happened, Amazon’s awesome. Whole Foods used to be kind of fun to go to and go oh my God, this is how rich people live. Now it’s just a complete, it’s just grim.

– Basically, it turned into expensive Trader Joe’s, and I’m not a fan.

– No, ’cause I like trader Trader Joe’s, which is affordable for me. Anyway, so look at this stuff, 365, ionized to a pH of 9.5.

– [Tommy T Bones] Plus, Z. Don’t forget about that plus.

– You know, the plus is what takes it from stupid to ultra stupid. That’s what I like. Let’s look at the back of this thing. They give us a pH scale. Zero, which is, let’s just not even talk about zero because we can go right to two, which is lemon juice, three is vinegar, five is black coffee, seven is pure water, and 9.5 is 365 everyday value alkaline water. And then on the back it says, this is my favorite, why can’t I use pH strips to accurately test alkaline water? Because we don’t want you finding out that it’s entirely a placebo. I mean, what do they say? PH strips, which are commonly used to test the pH of some liquids, cannot accurately test purified waters including purified alkaline water. In order to accurately test the pH level of any purified water, a calibrated pH meter must be used. In other words, don’t you bother your pretty little head about it. Let’s just say this is 9.5, which is placebo enough for you to believe that it’s gonna cure or prevent cancer. No evidence to show that that’s the case.

– Facts, facts, Z. Everybody who has drank regular water has died. What say you, science man?

– I say that it’s very hard to refute that honest truth, Tom Hinueber, and that’s what separates me from Goop. They speak the truth, like that, and I have to talk about the negative log of the hydrogen ion compensation. And people, this who we, focus Logan. This is why science never seem to win over pseudo-science because it’s very easy to use words like I alkalinized my toxins away and everyone who drinks regular water ultimately dies.

– Pick up the Core bottle. It has a perfect pH on it. That’s the one all the way on the right.

– No, I’m sorry, this says core. This says core.

– [Tommy T Bones] That says cure.

– Oh sorry. Is it this one?

– [Tommy T Bones] With a Q, it’s a Q, or —

– This one.

– [Tommy T Bones] At Core, yeah.

– Okay, Core.

– [Tommy T Bones] What’s a perfect pH according to their marketing, Z?

– Okay, so this is the best part. The marketing, you’re paying $5 plus a bottle for this free tap water with a little mineral added, or ionized by their machine that costs $900. The pH that naturally occurs in your body happens to be perfect, so it should come as no surprise that we mirrored our water after it. Core hydration is ultra purified, clean, crisp taste and has just the right amount of electrolytes and minerals to match your body’s natural pH of 7.4, or simply put, the perfect pH. So, no matter what you do to get thirsty, hydrate with Core and feel the benefits of perfect pH water, #truetothecore. Okay, let’s talk about this. Your perfect 7.4 pH water is gonna fall into a stomach with a pH of two. It is then going to obtain a pH that is something north of three or four before it’s absorbed. The fact that it’s 7.4 means Jack crap to the blood that you’re proporting to match. First of all, humans evolved drinking whatever crappy water was available, so the body pH buffer systems are designed to tolerate whatever water we were drinking in the savanna Having to perfectly tailor make a 7.4 pH makes absolutely no, and this is using the natural toxin people’s own language against them. Well, what’s more natural than fricking water out of a tap? Sure, it’s been chloridated and has some flouride in it, that’s it. And it depends on your water. Or taking a Brita filter and running it through that. That’s pretty natural. If you’re gonna start doing stuff like this, first of all, you have to cart it around in plastic, which is a massive fossil fuel load, and second of all, it costs five bucks. So, it’s fine if snake oil was free. This snake oil is costing money and making someone rich.

– Did you know, though, Z, that alkaline water prevents the development of diabetes? Dr. Theodore Barry released a study about alkaline water where he says there’s an important relationship between sugar intake and alkaline water. In his book, Alkalize Or Die, Dr. Barry stated, and I quote, the pancreas is highly dependent on a correct alkaline diet. In return, it produces alkaline digestive enzymes and sodium bicarbonate, blah blah blah. The pancreas also regulates blood sugar balance which creates energy in the body, thus to have proper blood sugar balance, maintain a primarily alkaline forming diet. Now, check it out, Z. I am borderline developmentally delayed. I don’t know what any of these science words mean. You know what I do know? There’s no cure for cancer, 100%. Why, ’cause rich people die of cancer, and rich people would totally want to live forever if they could.

– You pretty much nailed it. When Bill Gates dies of cancer, you guys are gonna be like, man, if he wasn’t one of the illuminati, I don’t know who was. They should have cured this. First of all, whatever you just said about the alkaline diet guy, so the main guy who was a proponent of the alkaline diet just got arrested for practicing medicine without a license. These guys are highly quackademic. The pancreas thing that you just said is actually one of the explanations these guys give. By alkanizing the stomach, you need less acid produced and less bicarbonate to neutralize it by the pancreas and when the pancreas neutralizes it in the time and the duodenum, it has to work less hard which means you don’t break your pancreas which means you don’t get diabetes and you don’t get cancer. There’s no, just because you make up a chain of events like that, and you have no evidence that it actually happens, you can then go market it to people who are looking for a quick answer and are basically the only thing you’re gonna be thirsty for is cash money when they’re broke.

– [Tommy T Bones] By the way, Dr., Dr. Barry is a ND, DC, PhD.

– Like I said, he’s not, ND stands for not a doctor. And he was practicing without a proper license. I forget what the actual details are. I don’t wanna slander the guy.

– Sarah Chalk says aqua hydrate doesn’t make me incredibly nauseous the way that tap or regular bottled water does. Why, I don’t know, but I like not being super nauseous all the time. I think that can actually be easily explained by the fact that you’re trippin’, girl, that’s retarded.

– No.

– Sorry, that’s borderline development delayed.

– [Zubin] Developmentally delayed.

– That’s what I’m supposed to say, aren’t I?

– We don’t use the R word on this show.

– [Tommy T Bones] That’s right, we don’t.

– Except accidentally.

– We would never do that. Logan’s retarded.

– Damnit. We had such a good show going, so perfect, and then you know, when we go live, ah. Here’s the thing, actually. If it makes you feel good, and some people put baking soda in their water to treat acid reflux and things like that. Look, if it makes you feel good, great. If you’re willing to spend more for water, great. It’s probably not going to cause harm although there’s some debate as to whether it can cause de-calcification and other things like that. Is it better than drinking a soda that has a pH of two? Probably, because it’s not a soda. It doesn’t has phospHoric acid that’s gonna interfere with nutrient absorption, calcium, et cetera. So, yeah, that’s great, but is tap water just as good? Probably. In fact, I would say definitely. And is it free? Uh, yeah, I mean, relatively free compared to this. The other thing is let’s just do a quick little bit of science, guys. If alkaline water means that, this pancreas explanation bit, the pancreas has to work less to neutralize the stuff so that you can absorb it. Then that would mean that proton pump inhibitors, which are drugs that block acid secretion in the stomach, would be like one of these on crack and that people who took proton pump inhibitors would never get cancer, would never get diabetes, and would live forever based on the marketing of these drinks. Uh, no. What we find with proton pump inhibitors is what we find with any drug. They have side effects and benefits and the side effects include osteoporosis potentially, infections like C. diff because killing stomach acid, the stomach acid is there to actually de-nature bacteria, destroy viruses, and keep us relatively safe from ingested pathogens and other things like that, and so as a result, we see with proton pump inhibitors, we don’t see any of the benefits that they’re calling for alkaline water. It makes no even logical sense that this stuff would help. Using even just a little bit of brain power on this, you can come from first principles and say I’m just gonna stick with the kind of water that I like. And look, if you like the taste of this stuff, great. Distilled water tastes terrible. It’s not really potable, it’s not something you drink. Reverse osmosis water has a little more solute in it. Some people like it, some people don’t, and then just tap water, with or without one of those carbon filters, great. Raw water, you’re gonna die. This stuff, you’re gonna die of poverty. So, either way.

– I like to drink my water out of a box ’cause it shows that I’m just a little bit better than everyone else.

– This is, show them this. This is 100% naturally alkaline spring water with a pH of 8.1 at the source, so it comes out with a pH of 8.1. Tom, how much did you pay for this?

– That particular water was $4.75, I believe.

– Not that you’re counting.

– [Tommy T Bones] Yeah.

– And it comes in a box that you then have to open. Now, let’s see what this water tastes like, because if it tastes amazing, it might be worth it just as a drink.

– Mmm It actually tastes like shitty water. I actually don’t even like the taste of this. Now, that’s just me. I like my water acidic like my coffee and Hasidic like my Jewish friends. I have no idea what that means. This is probably a waste of money.

– Wait, Z, do you put your lemons in the lemon water?

– Yeah, do you know that, Z, that when you put lemons in an alkaline water, and then you put them in your body, lemon’s acidic, but it actually turns, it’s like the acid and the acid in your stomach like they melt together and two wrongs make a right, and like —

– Double.

– Yeah, it becomes alkaline, bro. Do you know that?

– Did someone actually say that to you?

– This is all over the internet. Lots of idiots believe this.

– Okay, so this is the thing, guys. Tom is sort of my Muggle sensor. I send him as a probe into the universe and he reports back on the idiocy of the world. It turns out that this actually is, people believe that actually somehow lemon juice becomes alkaline when it’s absorbed in the body and …

– You know why, because they can’t square their two crazy beliefs, that lemons are good for you and alkalinity is good for you. So, they’re having a, they’re colliding. And they’re like, well, magic, and this one now goes over here in this camp. That’s what they’re doing.

– And that’s exactly right. That’s why in one breath they’ll tell you that lemons cure cancer and are a replacement for chemotherapy, and in the second they’ll tell you we’re way too acidic and we need to alkalinize our diet. So, listen, here’s the bottom line. Drink water. As opposed to other beverages, it’s pretty good for you, generally. Don’t spend a lot of money on quack water, okay? On this basically glorified toilet water with a high pH. Think scientifically, get scientifically literate and critically look at literature whenever you can and if you can’t, come to us, and we’ll try to do it with you and for you. Because we’re probably going to be better at it than Gwyneth Paltrow, who’s trying to sell you something. I ain’t trying to sell you anything ’cause I got nothing. I got nothing. I got nothing to sell.

– Listen, guys. If you ever think that you’re too stupid to make it in America, or that your idea won’t work, don’t get down on yourself. There’s a thousand different brands of water in the grocery store. You can do this. I believe in you.

– I believe in Michael Chooley’s comment, dihydrogen monoxide is dangerous. Thousands of overdoses on it every year. It’s found in tumors. It’s used as a cleaning agent in industries. It’s more acidic than Drano. Michael, that’s brilliant. I’m gonna break that down for a second. So, dihydrogen monoxide is, in fact, water. Thousands have overdosed on it every year, they drown. It’s found in tumors. Tumors are 75% water just like humans. It’s used as a cleaning agent in industries, and it’s more acidic than Drano because Drano is a pure base and has a pH of like 12 or something. This is brilliant, it’s true on every point, it sounds scientifically accurate because it is and people will be like, oh my God, I need to avoid dihydrogen monoxide. I don’t know Tom, I think we’re out, what do you think?

– You know, one more theory about water is that you know how the moon pulls on the tides and like our bodies are made of water, Z, so like when the moon is pulling on the tides, it’s also pulling on our body water and that causes some stuff, I don’t know. I haven’t looked into it. But, it’s probably real.

– Does that explain morning erections?

– No, but it explains moonitis. I have nothing. Let’s end the show

– We are abject failures at everything. Tom Hinueber, I hate you so much, so let’s take it out. I got moonitis of my prostate once.

– Seriously, you owe me for those waters, ’cause that shit was —

– [Zubin] I’m not paying for this.

– Super expensive.

– [Zubin] Listen, Jeff Bezos is rich enough.

Bryce FinckComment