The truth about hydration hacks like IV therapies, alkaline water, and more

Plain old water doesn't get enough credit.
a glass of water with a slice of lemon and mint inside on a pink and yellow background
The most hydrating water is whatever water you'll drink. Unsplash

In 1766, English philosopher and scientist Henry Cavendish discovered the molecular makeup of water by burning hydrogen in oxygen and finding that the chemical reaction resulted in liquid droplets. Ever since, people have attempted to tweak the vital substance to make it even “healthier.” Their aims have been many, depending on the trends at the time: adding radium for impotence, acids for waifish thinness, and many other iffy chemical boosters that Cavendish couldn’t have dreamed of. 

Most of those fads failed to inspire products that actually worked, and the same holds true today. Some buzzy alt-waters can even be dangerous. Take raw water, which advertisers claim is superior for one’s health because it’s “untouched and untreated.” But that lack of filtration means it’s an excellent way to get diarrhea. Without protection from animal poop and other sources of harmful bacteria, you could be setting yourself up for some unpleasant health problems. “I certainly drink raw apple cider in the fall from an orchard,” says Carolyn Newberry, physician at Weill Cornell Medical Center and the director of nutritional services of the Innovative Center for Health and Nutrition in Gastroenterology at Cornell. “But it’s really something you have to be more careful of, particularly if you have any health conditions that suppress your immune system, or you take any medications that suppress your immune system.”

Most water fads are less risky, but still tend to be ineffective at best—and can cost a pretty penny, too. 

You can’t fault folks for trying to improve the efficiency of something as ubiquitous and important as water. The average human needs more than half a gallon of the substance a day to survive. It makes up the majority of our bodies, and since so many vital nutrients dissolve in water, it forms the superhighways of the body. No other molecule could ship around oxygen, calcium, sugars, and proteins while lubricating our eyeballs and mouth. It follows, therefore, that people would try to make drinking water even more efficient. We try to supercharge oxygen by blasting it into facials and attempt to boost our exercise efforts with high-intensity interval training—why wouldn’t we try to make water even wetter, too? 

This begs the question: Is there anything better than plain old H2O?

Technically, there are ways to hack water to our advantage. Adding flavor, for instance, might make some of us drink more of it. But many so-called enhanced waters aren’t any more hydrating than the original stuff. 

The supposed benefits of most specialty waters are hard to prove at best. Take mineral water. One such product claims “​​A liter covers a third of the daily requirements of calcium and magnesium.” That’s probably not nonsense. The FDA defines mineral water as “250 parts per million total dissolved solids, coming from a source tapped at one or more bore holes or springs, originating from a geologically and physically protected underground water source.” That definition is broad; it doesn’t specify what dissolved solids are in there. That makes it hard to nail down the effects on the human body. Calcium is good for you, but only in small quantities. Sodium, another popular add-in, might not be, depending on your current blood pressure. Most of us already eat more than the recommended amount of sodium through salt, but it’s true that there’s still some advantages of taking in more salt before and after an intense, sweaty workout. You don’t necessarily need a special drink for that, though. Some pretzels would work just fine.  

[Related: Don’t punish yourself for eating ‘unhealthy’ foods]

Packets of electrolytes are similar. They usually contain sodium and potassium, which helps your blood pressure stay normal. You can certainly perspire your way into needing an infusion of these substances. But that would take more than the average person’s jog on the treadmill, according to Newberry. “Those types of things may be helpful in extreme athletes or people that are running marathons,” she notes.

Activated charcoal is another confusing one. Emergency room doctors use it to bind to poisons in the stomach. Adding it to water, as some companies do, doesn’t seem like a terrible idea, but there’s little research to support the idea that it does any good. There are enough studies on activated charcoal relieving intestinal gas that the European Food Safety Authority has approved it for that purpose, but the pledge to cleanse your system is much more dubious. And you should be cautious: activated charcoal might soak up substances you don’t want in your body, but it can also mess with medications you’re taking on purpose

There’s a slang phrase that’s relevant to the hydration hacking industry: “Inject it straight into my veins.” There are clinics that offer IV water therapy that do exactly that. Of course, doctors and nurses in hospitals often give water and even electrolytes intravenously to keep people hydrated when there’s a lot going on—surgery, for example. But it’s usually not necessary for healthy people who are able to consume water through their oral cavity. And any sort of needle contains at least a slight risk of infection

Newberry says that people who suffer from heartburn often ask her about water with different pHs. That alkaline water could neutralize overactive stomach acid makes intuitive sense, after all. But there’s no evidence to support it, at least in formal research. “Right now, there’s really no data to support that drinking alkaline water is going to neutralize stomach acid enough that it would actually affect gastroesophageal reflux disease.” But on the other hand, she says, it doesn’t seem harmful, and “anecdotally, patients have told me they feel better.”

There’s one more fad to address here: water that manufacturers have added extra oxygen to during the bottling or canning process. But Cavendish’s original formula stands the test of time. There have only been a few studies on the subject, but one pointed out that “a single breath of air contains more O2 than a bottle of oxygenated water.” 

[Related: The best (and worst) beverages to sip when you’re dehydrated]

You might be noticing a pattern here: drinking gimmicky water is probably not going to kill you, but it probably won’t fix all your problems. Still, even if these products don’t work the way their marketers promise, they might improve your health or performance—if you believe they will. The placebo effect is very real, and advertisements can make us more susceptible to it. In a 2005 study, 106 undergraduate students drank either a caffeinated energy drink, an uncaffeinated diet drink, or water—all of which were presented to them as “energy drinks.” Beforehand, the researchers asked them how likely they thought it was that the “energy drink” would raise their athletic performance and blood pressure. For the people who answered “very likely,” the placebos raised blood pressure, made reflexes faster, and enhanced mental alertness.

Also, drinking fancy waters can sometimes be worth trying just because they’re fun. Fruit-infused water, for example, is not going to double our hydration, as some advertisers claim. (Even if fruits like watermelon are made of mostly water, they still don’t have any more hydration power than H2O itself.) But personally, when I have the rare opportunity to imbibe fancy water with fruit in it, I find myself drinking more than I’d sip from a boring container of unadorned tap. The CDC agrees: They recommend adding a slice of lemon to your glass to make it taste better, so that you chug more water overall. 

It might even help that “enhanced” waters are generally expensive—this makes drinkers even more susceptible to the placebo effect. People usually believe that costly items are more effective, according to a 2008 study that found that a $2.50 pill eased pain more than a $0.10 pill, even though they were both placebos

On the other hand, though, you could donate that money to people who don’t have access to clean water at all. In most of the US, potable H2O flows from the tap. But not everywhere: 435 million people get water from unprotected wells and springs according to the World Health Organization. Even within the US, at least half a million people lack access to clean water. Donating money to those in need is altruistic, which studies suggest contribute to your own well-being and health. In other words, slice a lemon into your water bottle, drink fluids that make you want to keep drinking, and explore the health and wellness benefits of making sure other humans have the ability to do the same. Just be sure to choose a reputable charity, preferably with a good score on Charity Navigator