THE WATER ISSUE

Over the course of the past year, I've spent a lot of time thinking about and researching all things water. My interest probably was first kindled when I did my personal research several years ago for my best-selling book, The Self-Care Solution (buy it on Amazon!), in which I challenged myself with a new health/wellness goal every month for a year. For June, it was hydration—drinking more water. I just started paying more attention to water, generally (I even tried cold plunges…which I love!). And I’ve learned a lot.

In this issue of TODAY’S AJENDA, I am sharing some of what I learned with all of you. Water is vital to all living things; human, animal, or plant, we can’t survive long without it. Read on for facts about H₂O—the good, the bad, and the pretty ugly too—and how we can make our necessary use and consumption of it the healthiest it can be.

TODAY’S DOSE OF HONESTY

Why I got my water tested.

Remember when the headline about microplastics in bottled water ripped across our feeds and media outlets? I do, because I helped to cover that story when I was the Chief Medical Correspondent for ABC News. Did you know you consume (on average) a credit card’s worth of plastic every week? This problem has become so pervasive that microplastics have been found in Antarctic snow and newborn babies. As a doctor and medical journalist, my first thought was, “Finding microplastics in our water doesn’t sound great, but how much of an actual problem or risk is this, really?” As a water consumer, my initial reaction was, “Ugh, I don’t drink enough water as it is—NOW what do I do?”

Well, as a person of science, my response was to launch into experiment/testing mode. My first step was to get my tap water analyzed; because I am bicoastal, I decided to do this in both New York City and Los Angeles. After all, our adult bodies consist of around 60% water, and our brains are 80-85%. A newborn’s body is fully 90% water. You can go a long time without food, but you cannot survive more than 3 days without water.

Did you know the CDC recommends that people with well water periodically get their home tap water tested? I was not aware of this until I did it, though I don’t have well water. According to CDC guidelines, it’s recommended that you test your well water at LEAST once a year to check for total coliform bacteria, nitrates, total dissolved solids, and pH level. Where you live is important, so check with your local health department to find out if there are other chemicals or organisms that should be included in a test. If you use a non-commercial company to process the specimen, make sure you use a state-certified lab to test your water. Your health department should be able to help you interpret your testing results and answer any further questions you may have on your report.

The Environmental Protection Agency (EPA) regulates public drinking water (tap water), while the Food and Drug Administration (FDA) regulates bottled drinking water. In the U.S., the Clean Water Act (1972) and the Safe Drinking Water Act (1974) are the main governing laws. In 1976 and 1986, the EPA published the Quality Criteria for Water—known as the “Red Book” and the “Gold Book,” respectively. The criteria in these documents are still current. There have been some recent recommendations, but absolutely no new laws. Click here for more details.

Testing your tap water has its pros and cons. On the potentially positive side: Testing can identify harmful contaminants like lead, bacteria, pesticides, or heavy metals that may be associated with health risks. It can ensure that your water meets basic safety standards and provide information that might make you more confident about the quality of the water you and your family consume. If you notice an unusual smell, taste, or color in your water, testing can help identify the problem. Periodic testing of older plumbing systems or private wells can also uncover contamination issues early and help you avoid more extensive repairs and health problems later.

And the cons? The cost, for one. Here are estimated price ranges (though depending on where you live, they may be higher):

• $100 – $500 average well water testing cost

• $250 – $550 average well inspection cost

• $400 – $650 average well & septic inspection cost

Cost may be an issue, yes, but the environmental health of your home should be a financial priority. In my opinion, it’s worth budgeting for.

Anyway, I did it; I ordered the kits, collected the samples, and sent them off. The results really shocked me. Spoiler alert: NYC water was much “cleaner” than my LA water. The LA water analysis came back with 8—EIGHT!—flagged health concerns, one taste concern, and one concern about my plumbing. 

Let’s cut to the chase and get to the health concerns. There were 8 substances found in significantly higher levels than the guidance level standard for health and safety (which is the most protective human health benchmark used among public health agencies for a contaminant); they included arsenic, bromodichloromethane, chloroform, dibromochloromethane, fluoride, lead, lithium, and uranium. Most of these are used as part of the disinfection process, but the EPA sets a maximum level above which the risks outweigh the benefits. 

This is what my testing company, GoSimplelab, noted about chloroform: “Chloroform is a member of a group of disinfection byproducts called trihalomethanes (THMs) that form in water treated with chlorine and is generally the most abundant THM formed in drinking water. It is produced naturally by marine algae and soil processes in significant quantities and is also used as a laboratory solvent and found in small amounts in many common products. Chloroform is readily volatile; thus, all routes of exposure (ingestion, inhalation, and transdermal [absorption]) are relevant if one is exposed via drinking water. Known health effects of elevated chloroform exposure include kidney, liver, immune system, and developmental toxicity and increased risk of cancer.” Wow.

For arsenic, the GoSimplelab results summarizes this way: “The EPA drinking water limits for arsenic are based on adverse effects to the skin and circulatory systems as well as an increased risk of cancer. Long-term exposures to low levels of arsenic concentrations in drinking water are associated with an increased risk for several types of cancer including bladder, GI tract, kidney, liver, lung, pancreas, and skin. Other noncancerous health effects of long-term exposure to arsenic found in epidemiological studies include developmental effects, cardiovascular disease, pulmonary disease, ocular effects, impaired immune response, neurotoxicity, and diabetes. High doses of arsenic can be lethal, and lower (yet still elevated) levels of arsenic exposure can result in acute health effects. The first signs of arsenic exposure may include a metallic taste in the mouth or a garlicky odor on the breath. This is followed by symptoms that include abdominal pain, nausea, vomiting, diarrhea, muscle cramps, weakness, tingling, and numbness. These acute impacts are unlikely at concentrations found in drinking water.” Double wow.

Obviously, I was not pleased with the results of my LA tap water test. But the testing was/is the easy part. There are a number of ways to test your drinking water. Some towns/cities offer free testing at the local health department, and numerous companies offer testing at a variety of price points. What to do AFTER you get results (if the results are bad) is really the question. I decided to switch to glass-bottled water (more expensive but much safer) and am looking into getting a filter under my sink in LA. More expensive is not necessarily better when it comes to these filters, so make sure you do your research. I am still doing mine—and will keep you posted!

Also, as scary as these kinds of reports can be, remember that most risks associated with elevated levels of chemical contaminants are due to lifetime exposure to said chemical, and that the general principles of toxicology center largely on duration of exposure, dose of the toxin, and one’s individual susceptibility to this exposure. That’s another way of saying that just because high levels are detected does not automatically mean that adverse health effects should be expected.

My NYC water fared better, and testing revealed nothing terribly scary. But the results in LA really made me nervous. I started thinking about how much we were using that tap water: to cook, to make coffee or tea, to give to our dog, Mason. I’ll admit it: At this point, I may have ventured down the proverbial rabbit hole a bit. I don’t generally drink enough water as it is; now I had to be concerned about my tap water (as many people already are), and I felt slightly panicked about WHATEVER I was doing with water.

So, your dose of honesty for today is twofold: When you test anything, make sure you are prepared if that test doesn’t turn out as you expected or hoped it would! But if the test involves something as vital to your health as the quality of—or potential harm that may be caused by—the water you drink, do the research, consult the experts, and spend the money if necessary to make it safe.

Water quality testing: How to get started.

Want to learn what’s in YOUR water? The best place to start is with some research. And in doing mine, I found some really helpful information on the Consumer Reports website. From what these tests should be evaluating to which actually work the way they should, the editors have provided a good, basic guide to starting the process. The link will also take you to other resources—about bottled water, PFAs, and an extensive water filter buying guide. Click here to learn more.

To find out how safe your water is, check this out: Learn more.

MY 6-MONTH WELLNESS EXPERIMENT

My re-upped commitment to hydration!

I confess: Despite my good hydration efforts for my book, I’m generally pretty bad about drinking enough water. There are a few reasons for this. I only like ice-cold water, so once it warms up, I have a hard time continuing to drink it. I’m busy and find the “inconvenience” of having to pee a lot an annoyance during my hectic days. I’m also not in the habit of having a water bottle, pitcher, or glass of water around me at all times, so if it’s not there, I don’t think about it. It’s a rather pathetic list of excuses (unacceptable, really) for someone like me, who has had THREE kidney stones caused by dehydration. I know better, but I finally vowed to DO better. This happened during Month 3 of my 6-month experiment.  

I was telling my trainer, Korey Rowe, that I felt swollen and puffy, which is unusual for me. I noticed it in my ankles and occasionally in my eyes first thing in the morning. I had never really experienced this before, especially in my eyes—which would have been a major problem waking up at 4-5 a.m. to go on air for “Good Morning America”). Korey's answer: Drink more water.  Physiologically speaking, Korey was right. I remembered enough from the complex study of the renal system in medical school to know that there is some truth and accuracy to this: When you’re dehydrated, your body sends signals to the kidneys to retain both salt and water, which can lead to edema or swelling. So, I started drinking. My target was 2.5-3 liters a day.  

I tried to get my first liter in before 9 a.m. My second liter I notched by noon, and then I nursed the third liter over the course of the afternoon/rest of the day. I discovered that not only did my swelling go down, but my energy went up, my skin looked better, I ate slightly less, and my kidneys were happier (well, not sure about that last point, but you get the picture!). Sometimes I’ll drop a flavored powder into my water (like amino acids or collagen for my skin), but other times, I drink just plain, ice-cold water. The standard guidelines suggest that waking up ONCE per night to urinate is a measure of adequate hydration (waking up more than that is NOT ideal and may indicate another issue like bladder problems or insomnia).  

Personally, I found that using a bottle that allows me to keep track of volume really helps. Examining the color of your urine is another way to assess hydration: Your pee should be pale yellow, like straw. And yes, there is such a thing as drinking too much water. It’s called water intoxication and can result in a life-threatening low level of sodium in your blood, so don’t think that more is naturally better; 2.5-3 liters of water a day is a safe and healthy goal for the average healthy woman. Drink up, and cheers to you!

SYMPTOM SOLUTIONS

Get CLEAN when you shower!

As I started thinking more and more about water, I saw the increasing popularity of shower water filters. There are several great brands on the market now, but when I started researching them, my first question was, “Is this something I really need?” Here’s what I learned.  

Everyone’s water supply is slightly different, which is why learning about the quality of the water where you live is key. As I mentioned earlier, I had my water in NYC and LA tested by a commercial company, but there are free reports available widely. (It’s usually a good idea NOT to have a water treatment company perform your testing as there may be an incentive for them to find “something wrong.”)

Regardless of where you live or how you get your water tested, there are often chemical additives in water that may present issues for your skin and/or hair. Two of the biggest potential aggravators are chlorine and chloramine. In small amounts, these are added to water to kill bacteria—in other words, to do good. Problems may crop up, however, when either the concentration is slightly high OR if someone is extremely sensitive to these chemicals. According to the dermatology literature, chlorine has the potential to reduce the lipid (fat) or natural oils in skin and hair, and to break down the amino acids in hair, which can lead to weakening, dullness, or even a change in hair color. Chlorine can also be an irritant, potentially causing or contributing to various skin conditions such as rashes, hives, or eczema.

And here’s the deal: Though there are several heavy metals or chemicals that are theoretically important to remove or filter out of our water, the primary focus of a shower filter is chlorine and so-called “hard” water. Although there are many companies that claim to filter out 99% of chlorine, most science suggests that 90% is the maximum amount that can be filtered, as long as you have a KDF filter.  

KDF is short for kinetic degradation fluxion. A KDF shower filter utilizes granules made from high-purity copper-zinc, which are designed to greatly reduce common water impurities. In the KDF process, which is certified by NSF (an independent public health and safety organization that does product testing, inspection, and certification), impurities are changed into harmless substances that can be effectively removed by backwashing. KDF filter systems contain no chemical additives, making them safe to be used in home filter systems to treat drinking water as well.

My experience: After 3 months of using a showerhead filter, it was time to replace the filter; when I did, I was shocked to see how dirty and brown the old one looked. Without the filter, that “unclean” water would have been hitting my hair and skin—suboptimal to be sure, and overall high on the “ick” scale. The bottom line for me and shower filters is this: It’s a low-risk action that may have a benefit for hair and skin. So, I’m in!

Speaking of showerhead filters: The Jolie Skin Company offers a really slick-looking showerhead that comes with a 90-day filter; click the link below to learn more about what it can do for your shower experience!

COMMUNITY

One company dedicated to (sensibly) bottling some of the purest water on Earth.

Now let me (re)turn my attention to drinking bottled water. My husband has always been a big consumer of bottled water, but those bottles were plastic, and as I mentioned earlier, I was well aware of the recent microplastics concern. I was caught in the dilemma of “Should I drink bottled water or tap water or NO water?” As luck would have it, right at that same point in time, by chance, I met someone who changed my thinking on this in a huge way.

Elisabeth explained how when plastic water bottles are made, the plastic is “blown out” of a balloon-like machine in the shape of the bottle and then is cooled immediately to form its rigid shape. Guess what cools the liquid plastic? THE WATER THAT FILLS THE BOTTLE! Yes, the water we drink. That’s part of the reason why high concentrations of microplastics end up in those bottled beverages. The other way microplastics come into contact with even the purest water is when it’s transported from the ground source to the bottles. Many plastic-bottled water brands use pipes made of PVC or other inexpensive, durable plastic; Hallstein uses stainless steel pipes to carry water from the artesian well to their bottles. To ensure purity, the company tests its water regularly for contaminants and annually for both PFAS and microplastics.** Hallstein water is consistently 100% microplastic- and nanoplastic-free—not only in their recycled white glass bottles but also in their 5-gallon BPA-free bottles. Read more about BPA here.

In fact, a recent German study showed that quality of drinking water is as essential to health as quantity; Hallstein Water Company was asked to contribute their product to this research. The 182 participants were divided into 3 groups—one drinking ordinary tap water, one drinking presumed high-quality municipal water from a special area in Germany, and the last group drinking Hallstein water. The doctors and scientists wanted to see if there was a change in the amounts of free radicals or antioxidants present in the participants’ bodies after a period of drinking water; these two markers are essential to understand overall health and the potential to fight oncoming illnesses.

The results were stunning: After just 3 weeks, the people who drank Hallstein water increased their antioxidants by 14% (vs. 7% and 0%) and decreased their free radicals by 7% (vs. 2% and 0%). The study was published and was so well received that new, deeper clinical studies about water and health have been and continue to be conducted.

Elisabeth told me of the tremendous research with the world’s leading medical and nutritional experts, who identified which factors would together produce the “purest” water for bodily health. (One of those factors was that it be naturally perfect, which is a very important distinction—and hence Hallstein’s tagline: Perfected by Nature.) About 150 individual markers were determined to be necessary for the purest, healthiest, and best-tasting water. For the ease of understanding and comparing, the research team distilled these down to the 8 most important quantitative factors. Elisabeth shared those with me; here they are:

1. The best water comes from a very deep artesian well. Hallstein’s is 700 feet deep and the exit temperature is low (important!)—about 5 degrees Celsius (41 degrees Fahrenheit), a state where no bacteria can survive.

2. Pristine, natural, untreated water contains dissolved oxygen. Oxygen is either in there or not; once it’s gone, you can’t add it. Hallstein has 10.8 mg of O₂ per liter (mg/L) and therefore tastes silky, cleans your palate when you enjoy food and wine, cuts down your recovery time after exercise, and helps clean out the toxins in your cells.

3. Water should be naturally alkaline. On the pH scale of 1 to 14, 7 is neutral; all below is acidic and all above is alkaline. Natural alkalinity (and I stress natural, because many water companies “engineer” their product by adding sodium to make them alkaline) is important because it helps our body to function more easily and avoid inflammation. Hallstein is both naturally high-alkaline and naturally low-sodium.

4. Water should be naturally low in sodium. Here’s more: To be safe for infants as well as adults with high blood pressure, drinking water must be low or close to zero in sodium—ideally with levels of 1 mg/L or lower. Hallstein water has just 0.15 mg/L.

5. Another important number is TDS (totally dissolved solids). It indicates minerals and substances in the water. A moderate number is 170 mg/L, which Hallstein water has. Too many minerals produce a bad taste, which may mean you are ingesting substances you may not want in your body.

6. Some waters advertise that they are high in calcium or magnesium, but beware! Many water brands claim they supply you with minerals that are essential to your daily diet, but that’s not totally accurate. For example: If your daily calcium requirement averages between 1,000-1,200 mg, and your liter of water contains around 90 mg, you would have to drink 10-12 liters of water to meet that need! Same with magnesium: Waters have an average of 10 mg/L, but your magnesium intake should be at least 450–500 mg per day. Again, you would need to drink many liters of water to get enough of that mineral.

7. Let’s talk about nitrate levels. Nitrogen is mainly used as a chemical fertilizer and enters sources of drinking water from septic systems, animal feedlots, industrial waste, and food processing waste. It’s especially hazardous for pregnant women and small children. So, the allowed amount should be close to zero! Why the EPA allows up to 10 mg/L is not easily explained.

8. Finally, TOC (total organic carbon) should also be near zero in drinking water. It’s an indicator of the cleanliness of the water, or how much it was in contact with organic matter (which includes bacteria, sewage, soil, animals, plants, etc.). Hallstein water is a remarkable 0.09 mg/L.

** TWO SUBSTANCES WERE NOT TRACKED WHEN THE MUHR FAMILY COMMISSIONED THE RESEARCH 25 YEARS AGO: PFAS AND MICROPLASTICS, BOTH OF WHICH MAY BE CARCINOGENIC. MOST PEOPLE ARE AWARE OF THEM TODAY. SADLY, MOST WATERS CONTAIN ONE OR THE OTHER—OR BOTH. HALLSTEIN CONTAINS ZERO!

After meeting Elisabeth Muhr, learning about her company’s mission and products, and seeing my tap water analysis, I decided to sign up for Hallstein. Yes, it’s expensive, but I decided my health is worth it, and it’s better for the environment too. I’ll save money elsewhere. So far, I’ve definitely been drinking more water, and it’s wonderful—which is a good thing for me!

A special offer for TODAY’S AJENDA Subscribers!

ABOUT DR. JEN

In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time. And she has gone through menopause…

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