Passionate claims are made that drinking distilled water is harmful and will 'lead to early death'.  Others make equally fervent claims that drinking distilled water is the best way to become and stay healthy.  However, There is no compelling evidence that drinking distilled water is more harmful than drinking regular water* for most people.  There is also no good evidence that drinking distilled water is better for your health than drinking regular water*.  We obtain most mineral nutrients from our food not water.
	Distilled water does not selectively leach minerals from the body^ (neither does regular water).  Water naturally transports minerals and other nutrients throughout the body as needed.
	There is no evidence that drinking distilled water selectively flushes toxins out of your body^ (neither does regular water).  Detoxification, as used to promote various health products and treatments, is a vague term with no precise definition of what is meant by 'toxins' or any evidence that demonstrates effectiveness.  The natural processes responsible for transporting nutrients into cells and waste products out are not significantly influenced by drinking distilled or regular water.  Another skeptical article.
	Distilled water is not "dead" nor does it have (nor has it lost) some "vital force".  These  ideas are scientifically meaningless statements.  All water molecules, whether from a distiller, a water tap, a rain cloud, a pristine natural spring or in a sewer are exactly the same physically and chemically - there are just differences in the amount of contaminants the water might contain.  All water molecules (from any source and with any treatment) behave the same way in the body.  Water is absorbed into the body and into cells as individual molecules - whether or not they were originally accompanied by mineral contaminants does not matter.
Obviously though, everyone is different. If you experience problems after drinking distilled water regularly - stop and consult a physician!  If you experience health problems after drinking regular water, consult a physician!

In the following discussion I cover a frequently asked question: 

Is drinking Distilled Water either better or worse for health than drinking water that still contains minerals.

The question takes several forms, but the essence boils down to  whether very pure water (treated with Reverse osmosis, Distillation, or Deionization � Deminerialized water) is either bad or good for the body because of the complete lack of mineral ions.

* In this context, I define regular water as just water that is free of harmful contaminants.  Regular, non-demineralized water usually contains some beneficial minerals which would provide some nutrient value.  The majority of our nutrients, however, normally come from the food we eat � and many people also choose to take supplements.

^ Water plays an essential role in providing the environment for all chemical reactions of life.  Water also transports minerals and other nutrients to the body's cells and removes waste products, but there does not appear to be any reliable evidence that distilled water behaves any differently in the body than purified 'normal' water that contains some dissolved minerals.

If you are reading this page, you have probably read or heard statements like:

Distilled water is

bad for your health good for your health

because it is almost completely lacking in dissolved minerals.

Heads 'n Tails: Two recent distilled water questions: Heads:  ...Several years ago my kidneys almost shut down, I was drinking about 4-6 glasses of distilled water a day... Tails:  ...My dog who had shown elevated levels of calcium which signaled a parathyroid growth which can become very serious showed completely normal levels of calcium after two weeks on distilled water... (Read complete questions and response here)

The primary intent of this discussion is to dispel the myth that somehow distilled, RO or otherwise demineralized, highly purified water has some special properties that make it either beneficial or harmful to health for most people � compared with ordinary drinking water that is free of harmful contaminants yet contains some dissolved beneficial minerals.

My conclusions assume that individuals who regularly choose to drink demineralized water have a diet that supplies all mineral nutrient requirements.  As discussed below, evidence that hard water may protect against cardiovascular problems (while soft water doesn't) is not evidence that drinking distilled water in inherently bad for health - it simply means that any sources of calcium and magnesium are beneficial.

I frequently search for studies on distilled water, and have found that actual experimental evidence (in mainstream scientific journals) about the health effects of drinking demineralized water seems to be almost non-existent.  Discussions, opinions, and arguments about whether or not demineralized water is good or bad to drink, on the other hand, abound!

It is unfortunate there is so much miss-information about demineralized water.  Reverse osmosis and distillation are very effective water treatment methods, and are often the best water treatment options when the source water contains harmful mineral ions and salts � contaminants that are not easily removed by activated carbon filtration.

The United States Navy has used distillation and reverse osmosis for decades as one source to provide a source of water.  In chapter 6,  Water Supply Afloat, of the Manual of Naval Preventive Medicine, both distillation and triple pass reverse osmosis that produce water with Total Dissolved Solids (TDS) levels of 1 - 2 parts per million.  The only concerns mentioned are, "Distilled water tends to be mineral free and can be highly corrosive to metal piping and storage tanks."  There is no mention of any health risks associated with drinking demineralized water or any required treatment to restore minerals.

The origin of the current "distilled water is harmful" claim can be traced to just two sources, near as I can determine.

Nearly everyone who reaches this site will have read a paper by Zoltan P. Rona with the alarming title "Early Death Comes With Regular Drinking Of Distilled Water". 

This paper has been quoted or published in books and on hundreds of web pages (usually with the original title "Early Death Comes From Drinking Distilled Water").  While Dr. Rona cites some anecdotal evidence from his practice, he provides no experimental evidence or references to good studies that would support various statements in the paper.

Other statements in Dr. Rona's paper also reveal what appear to be fundamental misunderstandings of how the body regulates inter/intra-cellular pH and the differences between soft water (water lacking calcium, magnesium and other �hardness minerals�) and distilled water (water lacking all minerals and other contaminants).  I finally wrote to Dr. Rona (spring 2009) requesting some evidence to back up his statements.  He did not responded to the initial request or a follow-up e-mail several weeks later.  My questions to Dr. Rona can be found here.  Perhaps if enough people contact him requesting evidence for his statements he will provide some to somebody!  His e-mail address is here.  I discuss the specific claims I disagree with (and which I can find no supporting evidence) in the next section, Health Effects of Distilled Water

The other primary source of the "Distilled Water is Harmful" myth is chapter 12 of a report, Nutrients in drinking water, published by the World Health Organization (WHO).  A rebuttal to the article to an earlier WHO study that reached similar conclusions was published by the Canadian Water Quality Association, and I discuss some other aspects of the paper here.

One of the websites where Dr. Rona's paper has been republished along with an editorial, "Why I Now Say No to Distilled Water Only"  is chetday.com.  Those articles are currently listed on the first page of a Google search on "Distilled Water and Health".  I recently wrote to chetday.com asking if they had any additional evidence to support the claims about harm from drinking distilled water.  It tuned out that the article was prompted by experiences with a vegan group that drank only distilled water.  "Essentially, our opinion and experience is that anyone following a strict vegan � especially primarily RAW foods � diet long term should not be drinking distilled or R/O or D/I water, but, as said above, that water is most likely the smallest thing to worry about due to other deficiencies." And on another occasion "Honestly, hard-line vegan diets are so terribly deficient in protein, B-12, calcium, and a host of other nutrients that distilled water ingestion I suspect would be the least of their worries, though it absolutely would not be helping them and certainly would be contributing to deficiencies (in my opinion at at least)." (Josh Day).  An article I wrote, Drinking Water: Facts, Scams, and Treatment Methods, was published on chetday.com.

March 2014 update: I recently received communications from several visitors who have obsessive opinions on the physical harm they believe will result from drinking distilled water.  I also received a communication from another visitor engaged in a passionate mission to expose pseudoscience as a travesty of logic and real science who has had similar communications - only with fanatical distilled water proponents who believe drinking distilled water can cure any disease.  That experience of "delving into the swirling vortex of pseudoscience" is detailed here.

It is interesting that those who promote the idea that "water without mineral ions is bad" are often the groups that sell filters which do not remove beneficial minerals like calcium, magnesium, phosphorus, etc. from the water.

Those who claim that "demineralized water is beneficial" ("and actually better than drinking water that contains minerals") are � no surprise � often the ones who sell systems that remove minerals (typically distillation and reverse osmosis).

Many "health-related sites" fall in between � if one of their diets or "cleanses" requires some sort of body "purification" they may suggest drinking demineralized water to help "leach harmful contaminants out of the body".  As discussed elsewhere, water participates in virtually all biochemical reactions in addition to transporting nutrients into the body and waste products out.  Water (distilled or otherwise) can't be directed to leach specific contaminants out of the body.  

Those individuals who are vehemently opposed to drinking distilled (or RO filtered) water are of interest to me.  They don't just believe there are no benefits to drinking pure water, they are convinced it will seriously harm people, and are on a mission to prevent people from drinking distilled water - even at the cost of denying the value of SlingShot, a new water purification technology developed by Dean Kamen (Segway inventor) that will potentially bring low cost, clean, safe water to the developing world.  This comment was left in response to a short documentary on SlingShot a "Pure water without minerals is just as bad as dirty water. Purified water can be dangerous because of the rapid loss of electrolytes (sodium, potassium, chloride) and trace minerals like magnesium, deficiencies of which can cause heart beat irregularities and high blood pressure.  ...What you are doing is pure and simple irresponsible. Distilled water is corrosive and no good for human consumption. I bet you would not do this in America because eventually you would get your backside sued. But as usual, experimenting on African children IS OK, who gives a damn about african kids developing health problems, hell they already have health problems. Hats off to some of your inventions but in water you are way out of your depth." This is a perfect example of where strongly held yet faulty beliefs and a distrust of science can lead to seriously harmful consequences.  I added "distrust of science" to my statement, because even though the person who made the allocations appears to use science to support the claims of harm, it is obvious that the person has no real understanding of chemistry or physiology and has hijacked scientific terminology to make the claims sound authoritative.  This person would apparently rather allow continuing deaths from water that's contaminated by real, measurable, harmful contaminants than support production and distribution of a real solution that provides safe water that will reduce diseases and deaths caused by contaminated water.  Even if the claim that "Pure water without minerals is just as bad as dirty water." were true (all evidence I am aware of indicates it is completely false) it is a trivial matter to add some calcium and magnesium to the distilled water.  I discuss the consequences of this dangerous combination of beliefs that are fundamentally driven by a deep suspicion of science yet justified by a selective and faulty understanding and interpretation of basic scientific principles and processes on this page.
 

Obviously, the discussion below will focus only on the presence or absence of the "good/beneficial" ions (like calcium, magnesium, and potassium) that are removed by demineralization processes.  It is a given that it is good to remove all harmful ions like lead, mercury, etc. (as well as other harmful contaminants) by distillation, reverse osmosis or by any other process. 

There are four threads that make up the fabric of the "distilled or demineralized water is harmful to health" argument, and they all unravel when you try and find scientific evidence to support the claims:  
1) Essential minerals are removed from the water - and that's bad.
2) Demineralized water 'leaches' minerals from your body - and that's bad.
3) Distilled water is more acidic than regular water - and that's bad.
4) Distilled water is dead (or has lost its vital force) - and that's bad.

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Argument 1:  All the calcium and magnesium ions (and other trace minerals) are removed from the water by demineralization processes, and, because calcium, magnesium and trace minerals are essential nutrients and necessary for life, the removal of those mineral ions from the water is harmful to health.  

Response 1:  It is true that demineralization removes the "good" minerals along with the harmful contaminants, but it is by no means true that drinking water is the only source (or even the primary source) of these minerals.  The recommended daily requirements for calcium and magnesium are about 1,000 - 1,200 mg and 300 - 400 mg respectively (with specific requirements that vary by age, gender, etc.).

According to one table the hardness scale provides information about the amount of calcium in various levels of hard water.  The presence of magnesium  in addition to calcium will also increase the hardness levels.

Classification grains/gal mg/l or ppm  CaCO3 equivalent mg/l or ppm  Calcium Soft 0 - 1 0 - 17.1 0 - 7 Slightly hard 1 - 3.5 17.1 - 60 7 - 24 Moderately hard 3.5 - 7.0 60 - 120 24 - 48 Hard 7.0 - 10.5 120 - 180 48 - 72 Very Hard 10.5 & over 180 & over 72 and over NOTE: Other organizations may use slightly different classifications.

According to the table to the right, water that is slightly to moderately hard will contain up to about 50 mg/l of calcium.   Reports I have seen indicate that magnesium levels average often about 12 - 15% of the calcium levels (or about 7.5 mg/l).  One liter (about 1 quart or four 8-oz drinks) of hard to very hard water will contain around 72 mg/l of calcium and perhaps 11 mg/l of magnesium.  Extremely hard water, though, can contain over 1,000 mg/l calcium carbonate (CaCO₃₎, or over 400 mg of calcium per liter.

So, drinking eight {8} glasses (about 2 liters) of slightly to hard water a day will provide your body with about 14 - 144 mg of calcium. That translates to a maximum of about 1.2% to 12% of the daily 1,000 to 1,200 mg of calcium your body requires. In that same 8 glasses of water you will be supplying your body with about the same percentage of your daily requirement of magnesium.  One glass of milk, by comparison, contains about 300 - 350 mg of calcium � over twice as much as 8 glasses of hard water. 

Hard water that contains calcium and magnesium can realistically be a source of up to about 15% of the daily requirements for these minerals for the majority of people who do not drink 'very hard' water. It is reasonable to assume that non-demineralized water would provide similar proportions of trace minerals. 

However, your body does not care where the minerals come from, drinking water, diet, or supplement**.  So, as long as you get enough calcium and magnesium (and other essential minerals) from some source, there should be no health problems for most people even if they drink demineralized water and obtain none of their essential minerals from that source.  If a person's diet is so bad that they must depend on drinking water to meet the minimum daily requirements of certain minerals (mostly calcium and magnesium), they will probably be severely malnourished and have a variety of medical problems. 

**That said, there is some evidence that that points to reported health benefits from drinking hard water instead of soft water.  As most of the articles below point out, though, there is no strong consensus about the actual cause of the findings (it may be something in the soft water that is harmful rather than the calcium and magnesium ions in the hard water that are beneficial, for example) or even how real the effect is. 

Over the last decade as I have been following discussions on this topic, there seem to be better quality studies published, and a few continue to show a correlation between drinking hard water and cardiovascular health and even an experimental study that reports a cause and effect relationship.  Other studies continue to show no health effects of drinking hard or soft water.  These studies are interesting, and if ordinary people actually show increased health benefits from drinking hard water, than my assumption above that most people in developed countries obtain sufficient calcium and minerals from their food might be in error. 

Studies on the potential health benefit from drinking hard water.  Again, the few studies that report a positive health effect of drinking hard water don't demonstrate that drinking distilled water is bad, only that everyone needs to eat or drink sufficient calcium and magnesium every day from any source.

• Potential Health Impacts of Hard Water, Pallav Sengupta, Int J Prev Med. Aug 2013; 4(8): 866�875,  Conclusions - Although, there is some evidence from epidemiological studies for a protective effect of magnesium or hardness on cardiovascular mortality, the evidence is being debated and does not prove causality.
• More References...

There is a qualification to the statement above.  While the body does not care where the minerals ultimately come from � that is, calcium from water, milk, diet, or from supplements is used by the body the same as calcium obtained from water � the bioavailability of calcium (or other minerals) is affected by the form in which the calcium is delivered to the body.  Calcium citrate, for example has been shown to be 2.5 times more bioavailable (easier for your body to use) than calcium carbonate.  Some articles attribute that difference in absorption to the fact that organic forms of calcium (citrate, lactate, etc.) dissolve more easily in the stomach � releasing the calcium ions � than calcium carbonate (which is where much of the calcium in water comes from and which you might find in an inexpensive supplement).  Other studies I have read indicate there is little difference.  It must be noted, however,  that the calcium in drinking water is already dissolved.  I have not read the result of studies where the absorption of fully dissolved types of calcium supplements are compared, but I suspect that the bioavailability of any calcium ion that arrives in the stomach already dissolved may be similar.

There are substances that interfere with the body's ability to absorb and use calcium including oxalate, protein, phytate, sodium and caffeine - and vitamin D is essential for the absorption and use of calcium.  A 2014 study, Digestibility and retention of zinc, copper, manganese, iron, calcium, and phosphorus in pigs fed diets containing inorganic or organic minerals, found that with some diets, organic minerals were less likely to form complexes that would interfere with absorption.

There is a debate you may encounter if you research mineral availability and absorption that is more or less related to the distilled water debate.  Organic vs. inorganic nutrients.  Like distilled water, you will encounter passionate statements that only organic minerals can be absorbed, for example "Only plants can transform inorganic minerals into organic minerals. "Animals must eat plants or plant-eating animals to obtain their organic minerals. "Inorganic minerals are useless and injurious to the animal organism. ...Like mineral supplements, mineral waters cannot provide any beneficial minerals to the body. reference"

Ultimately, minerals are absorbed as individual ions dissolved in the water-mix of chemicals that reach your intestines.  They are not absorbed if they are bound to other organic or inorganic molecules.  One of the roles of the digestive process is to break apart complex organic or inorganic molecules and release individual ions and smaller molecules that can be absorbed.  If you swallowed a chunk of limestone (calcium ions bound to carbonate ions) or a chunk of beef (with calcium ions bound to proteins and trapped in cells) neither the calcium nor other minerals or nutrients would be available for absorption until processed by the digestive process.  The digestive system is often more effective at releasing mineral ions from organic sources than inorganic - a piece of beef digests more easily, for example, than a piece of limestone. reference

Another point I have read is that cooking in water that is low in minerals (demineralized water) will extract more minerals from food than cooking with normal water thus lowering the amount of minerals in the diet.  This sounds like a reasonable critique of demineralized water, however I have not read results of actual experiments that measured and compared the calcium and other mineral levels in food prepared with normal and demineralized water. 

One 1981 study, however, examined minerals in food cooked with hard and soft water, Changes in the mineral composition of food as a result of cooking in "hard" and "soft" waters, Haring BS, Van Delft W., Arch Environ Health. 1981 Jan-Feb;36(1):33-5, The abstract concluded, "The most significant differences were found for calcium; the concentration of this element in potatoes and vegetables usually increased when cooking with hard-water types, while a decrease was noted when soft water was used for cooking."

A warning:  Do NOT believe the hype you may read about coral calcium providing any advantages over other sources of calcium, either in the diet or in supplements.  Coral calcium is simply calcium carbonate.  It is, however, unregulated and unpurified and (like calcium supplements from oyster shell, dolomite, and bone meal) may contain harmful levels of heavy metals like lead and mercury.  This type of scam is similar to the altered water scams discussed elsewhere on my site in that they are very expensive, and all evidence about the benefits of these products is self-generated and not supported by any legitimate scientific studies.  They differ in that the altered water scams are typically harmful only to your pocket book, while these unregulated supplements can be harmful to your health as well as your pocket book.

Demineralized water will also have all fluoride removed (natural and/or added).  Depending on your stance on the benefits or harm from fluoride in your drinking water (a whole different discussion that is far more contentious than the demineralized/non-demineralized issue), that may be an issue. In some locations, drinking water is a major source of fluoride.  So, if you are a believer in the benefits of fluoride in drinking water, you may wish to make certain you and your family obtain enough of that chemical from other sources.

Hard Water Hardness Calcium Magnesium Water Corrosion Mineral Scale
Linus Pauling Institute - Micronutrient Information Center - Calcium
Calcium Citrate vs. Calcium Carbonate - Some people's bodies may have problems making enough stomach acid, or may be taking medications that suppress acid production. For them, says J. Edward Puzas, MD, a calcium citrate supplement might be better because it "dissolves a little better than calcium carbonate for these people."
Coral Calcium � The answer to how do you spell HYPE?
Coral Calcium
Calcium Info - Supplements
The "Mother" of all magnesium and health sites

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Argument 2:  Demineralized water, since it is devoid of all substances (including ions), is "aggressive" and will deplete the minerals from your body causing serious harm over time.

Response 2:  If you are talking about pipes and storage containers, demineralized water could be considered more "aggressive" than water containing dissolved substances.  Water without anything in it will tend to dissolve anything it comes in contact with (the copper or iron in a pipe, the lead from a solder joint or brass fixture, etc.) more 'aggressively' than water that already contains some dissolved substances.  Also, one of the "things" easily dissolved by demineralized water is carbon dioxide.  This forms a weak acidic solution (carbonic acid) which can cause further dissolving and corrosion of materials that it comes in contact with � that's one way caves get formed � soft, acidic rain water dissolves limestone (calcium carbonate) and becomes hard water in the process of forming the cave structure.  I have found no evidence, though, that demineralized water dissolves significantly more CO₂ than regular water.

The above is a valid argument for only storing demineralized water (or any water) in clean glass containers which are chemically inert.

Now, does this "aggressiveness" of demineralized water translate to actually leaching minerals out of the human body?  I have looked regularly in the scientific literature for good evidence of this alleged phenomenon without success.  I have not been able to find anything in the literature specifically about long term effects of drinking demineralized water on health � the only articles I can find are about he health effects of soft water and lead back to the hard vs. soft water health benefits discussed above.  I use the word 'contaminated' below to describe anything besides pure water.

** From my understanding of how digestion, food/water absorption, and the process of drinking demineralized water must work, however, I am very skeptical about the possibility that drinking demineralized water has any major negative impact on the human body (or positive impact either). Consider:

	Ideally demineralized water contains nothing except perhaps some dissolved CO2 picked up from the air.
	Adding anything to that pure water will 'contaminate' it.
	The alleged leaching of minerals from the body is said to take place in the small intestines because of the "pure, aggressive" water that comes in contact with the intestine lining � as opposed to hard water with a few milligrams of calcium or other ions which is claimed will not cause this leaching of minerals.
	Consider the contents of your stomach, particularly after a meal � a huge mix of every conceivable type of organic and inorganic compound plus a healthy dose of hydrochloric acid.  More 'stuff' gets pumped into the mix in the small intestine.
	It does not matter where pure water becomes 'contaminated' (in the ground, in the distribution system, on the kitchen counter, or in your body) � adding anything (from any source) to water will 'contaminate' it.
	Imagine two glasses of water on the counter � one containing clean, filtered tap water with a few milligrams of calcium and magnesium, and the other glass containing only pure, demineralized water with no ions.
	Imagine now the difference a few milligrams of ions will make when either glass of water hits the contents of your stomach! Since any alleged harmful effect of drinking demineralized water does not happen until several hours later when molecules from the glass of water eventually reach your intestines, it is very difficult to believe that the presence or absence of a few ions in the original water will make any difference at all.

Another way to look at it: Since it does not matter to the body where water becomes 'contaminated' (externally or in your stomach), consider this "thought experiment":

	Take a blender, throw in a cheeseburger meal with all the trimmings (fries, pickle, and a shake)**, turn the blender on and mix the together thoroughly.
	Fill two glasses of water 1/2 full, one with pure demineralized water, with no ions,  and one 'contaminated' with calcium and magnesium ions.
	Pour 1/2 of the burger mixture into each glass of water and mix.
	Now, which is the more 'contaminated' glass of water � is it really going to matter to your body which glass of water you drink � the glass of water that started with perhaps 2 - 18 mg of calcium ions or the glass of "pure" water that started with 0 mg.
	Drink the mixtures � Yuck!

** Using the nutrition guide at Colorado State University Cooperative Extension (since removed_ and adding together the calcium, sodium, and potassium levels of a hamburger patty, 1/2 oz cheese, bread, tomato slice, 20 chips, and a pickle, I found the total ion content of those three cations to be roughly 3,192 mg (nearly 3.2 grams).  That is several hundred times more than might be in ordinary, tap water.  Calcium levels would be around 178 mg, Sodium  around  1,740 mg, and Potassium about 1,274 mg.  And, that's the concentration of just 3 ions.  All of the other 'contaminants' (other ions, carbohydrates, fats, and proteins, etc.) would make the initial difference between the demineralized water and the ordinary filtered water even more insignificant.  Other online resources for researching nutrient levels in food, USDA Nutrient Database, SelfNutritionData (this was a good resource, but you now have to register), NutriDB, Food Nutrient Database.

Since water from reverse osmosis and distillation systems are about two to four times more expensive respectively than good filtered water, the only negative impact I can see to these methods of treatment for most people is to the pocket book. 

Another fact to consider � probably over 50% of the water you take into your body throughout the day is very heavily contaminated.  Think of drinking coffee, tea, juice, smoothies, wine, beer, etc.  These beverages contain a very complex mix of organic and inorganic chemicals.  Even "solid" food contains significant amounts of water � cooked meat, for example, contains over 50% water.  Most people do not consider their dinner to be contaminated water, but technically it is.  The point � compared to most of the water that enters your body containing grams of salts and minerals, the debate over the few milligrams of calcium and magnesium that are in non-demineralized water and missing in the pure demineralized water seems rather pointless.

**Several visitors have commented that drinking too much demineralized water can lead to ion imbalances in the body which can cause serious health problems.  This is true, but so can drinking too much regular water.  The condition is known as water intoxication.  The discussion above assumes that people are eating regularly, getting enough minerals in the diet and supplements, and not drinking an excess of any type of water.

If, however, your water contains contaminants, like nitrates or heavy metals that are not removed by a specific filtration system, then reverse osmosis and distillation treatment methods are a good options (often the most economical option) for producing clean, safe water for drinking and cooking.

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References about digestion and absorption:

From Absorption of Water and Electrolytes by R. Bowen, 1995
The small intestine must absorb massive quantities of water.  A normal person or animal of similar size takes in roughly 1 to 2 liters of dietary fluid every day.  On top of that, another 6 to 7 liters of fluid is received by the small intestine daily as secretions from salivary glands, stomach, pancreas, liver and the small intestine itself.
By the time the ingesta enters the large intestine, approximately 80% of this fluid has been absorbed.  Net movement of water across cell membranes always occurs by osmosis, and the fundamental concept needed to understand absorption in the small gut is that there is a tight coupling between water and solute absorption.  Another way of saying this is that absorption of water is absolutely dependent on absorption of solutes, particularly sodium:

Water - extracted from Nutrient Absorption by M. Ellert, 1998
An important function of both small intestine and colon is the absorption of water and electrolytes.  Approximately 2000 ml of food and drink is ingested daily, and the volume of gastrointestinal secretions (salivary, gastric, biliary, pancreatic and intestinal) is about 8,000 ml daily; therefore, approximately 10 liters of fluid enters the intestine each day.  Of the 8 liters secreted, about 1 - 1.5 liters enter as saliva, 2 - 3 liters are secreted by the stomach, about 2 liters enter as bile and pancreatic secretion (about 1 liter each), and about 2 liters are secreted by the small intestine.  (Please note that these figures are approximate, not absolute.  Volumes may vary, depending on experimental method and conditions.)

Of the 10 liters which enters the gut each day, only about 1 liter passes into the colon, about 90% having been absorbed across the small intestinal epithelium.  Only about 150 ml is lost in the feces daily, with the remainder being absorbed by the colon. It should be obvious that any derangement in intestinal fluid absorption would profoundly influence the balance of fluid and electrolytes in the body, and that the normal functioning of the intestines plays a significant role in regulating water and electrolyte balance.  The net absorption or net secretion of water in the intestine is the result of bidirectional movements of water from mucosa to serosa (m�>s flux or absorption) and from serosa to mucosa (s�>m flux or secretion).  In the human intestine, these unidirectional fluxes exceed net movement 2 -3 fold.  The rate and direction of net fluid movement depend on tonicity of the meal, and move toward the achievement of isotonicity {equal concentration of water on both sides of a membrane - RJ}. 

The intestinal mucosal surface consists of a bimolecular lipid membrane, which (presumably) contains small pores or channels.  Water and water-soluble substances can hypothetically enter the cell through these pores only, while lipid-soluble substrates can directly cross the lipid cell membrane.  Specialized protein pores, referred to as aquaporins (AQP) have been identified in many tissues, including colon epithelium; water channel isoforms in small intestinal epithelium remain to be discovered.  Intestinal absorption of water is a passive process and requires movement of solutes. Water accompanies solute and moves across the intestinal mucosa in response to osmotic gradients.  The rate of water uptake in any region of the intestine is a function of solute absorption in this region.  All areas of the intestines (including small bowel and colon) absorb water, the relative amounts absorbed depending on the presence of solutes {things dissolved in water, sodium, calcium, sugar, etc. - RJ}, and the types of solutes present. In the jejunum, the active transport of sugars and amino acids causes passive movement of salt and water, which accounts for most of the water uptake in this area.  In the ileum, most water movement is accounted for by active sodium transport.

As described in Johnson's (Gastrointestinal Physiology), coupled water and sodium transport involves a specialized mechanism that pumps sodium into the lateral spaces, resulting in relatively high osmotic pressure in that region.  Water then enters the lateral space from the cell (transcellular flux) and � perhaps � the lumen (paracellular flux), reducing the osmotic pressure but increasing the hydrostatic pressure.  Fluid is then forced out of the lateral space into the interstitial space.  The net effect is that isotonic fluid is transported from the lumen into the extracellular fluid.  This hypothesis of fluid absorption is illustrated in Figure 12-5, on page 137 of the Johnson resource.

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Argument 3:  Distilled water is more acidic than regular water and that's bad. 

Response 3:  Basically this is a bogus marking claim made by those who market alkaline (ionized) water products.  Any water can absorb carbon dioxide from the atmosphere and become somewhat acidic.  This insignificant acidity has no effect whatever on your health or on the pH of your stomach, blood or cells. Read my detailed discussion on alkaline water here.

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Argument 4:  Distilled water is dead (or has lost its vital force) and that's bad.

Response 4:  As noted above, distilled water is not "dead" nor has it lost its "vital force".  These ideas are scientifically and philosophically meaningless.  All water molecules, whether from a distiller, a water tap, a rain cloud, or a pristine natural spring are exactly the same physically, chemically and energetically.  Water molecules are not alive by any definition of life one cares to use.  Nor do water molecules embody some special, undefined "vital force".  And, despite Emoto's pretty pictures of ice crystals, water is not capable of modifying its behavior in response to human thoughts, words or music.  Water is a simple inorganic molecule made up of one atom of oxygen and two atoms of hydrogen.

Over the years I have received testimonials from many visitors who claim to have been harmed by drinking distilled water, and I have heard from about the same number who swear that they drink distilled water regularly and have had excellent health or have been cured of some health problem.   The problem with testimonials

I remain of the belief that as long as a person consumes sufficient calcium and magnesium from their food or supplements, it will make no difference whether or not they drink distilled water or tap water that has had harmful contaminants removed by a quality filtration system.

Heads - Question Randy,  I stumbled across your website and would have to disagree with you on your article about distilled water and needing to drink buckets of it to have a problem. Several years ago my kidneys almost shut down, I was drinking about 4-6 glasses of distilled water a day. I'd get oedema in my hands/fingers and feet and ankles....so I began drinking more distilled water...up to 8 glasses a day as I thought I maybe dehydrated....the oedema got a lot worse and I didn't feel well at all. A nurse friend suggested I stop drinking the distilled water and the following day my oedema was about 50% better and the following day completely gone.   Hence my water distiller went to the rubbish dump and was a waster of a lot of money. Just one more thing I remembered.....I'm not sure if you've heard of Dr. Masaru Emoto from Japan, he 'grows' water crystals from different waters around the world....quite fascinating. I heard him speak once here in Wellington New Zealand. He's come up with some beautiful formations resembling snow flakes. Distilled water is always a horrible distorted picture. I think one of his websites is www.hadousa.com Kind regards, Sally

Heads - Answer
I very much appreciate your comments and your experience, Sally � I am quite interested in this topic, and welcome any ideas and evidence on either side of the discussion.

Drinking 4 to 6 eight glasses of distilled water a day should not cause a health problem � relative to drinking the same quantity of non-distilled water.  The two types of water are not different � certainly not in the chemical and physical behavior of the water molecules.

Your story is very compelling, but with a sample size of one, and no control, there is no way to know what the actual cause was of your recovery, although the timing was certainly suggestive.  The evidence would have been more compelling if, instead of simply switching to non-distilled water you had someone �blind� the water you drank. 

For example, for a week or two you would only drink either the distilled or regular water (but not know which it was) and record how you felt.  After a period of time you would get the other type of water to drink for a couple of weeks (again, not knowing whether it was distilled or regular) while maintaining your health record.  After the trial period you would give your notes to another person (not the one who blinded the water) who would summarize any health differences you recorded for the two periods during which you were drinking the distilled or non-distilled water.  

That kind of blinded experiment, performed on dozens to hundreds of individuals (randomized into different treatment or control groups), is the basis for much of what we understand about the workings of nature.  Blinding and randomization are two tools that help minimize the effects that emotional involvement, judgment calls, bias (intentional or unintentional), expectations (power of suggestion), spontaneous remissions, and so forth can have on the results of experiments.  if the investigators and/or the experimental subjects are aware how the treatments are being administered and what the "expected" outcome is, almost certainly there will be bias in the answers provided, the data collection and analysis of the results.

I simply have not found any published experiments that document a difference in health between drinking distilled vs. �regular� water although I keep looking.

I have heard of "Dr." Masaru Emoto, and I am completely skeptical of his work.  It is unlikely, for instance, that beautiful ice crystals would ever grow in distilled water because the crystals need a nucleation point � an impurity in the water or defect on the slide � on which the crystal can begin to grow.  The purer the water, the less likely a beautiful crystal would form.  He has, to the best of my information, published no papers detailing results of blinded experiments in any reputable scientific journal, and his work is not recognized by the scientific community.

Kenneth G. Libbrecht of Caltech, the world's foremost snowflake researcher and photographer, has this to say about Emoto's work, "If you think it defies common sense that water does this, you are right. In fact water does not respond to thoughts and feelings - it's just water. How then does one explain Mr. Emoto's experiments? My best guess is that Mr. Emoto grows hundreds of crystals and then selects different shapes to demonstrate whatever point he wishes to make. For example, when the water was exposed to classical music he picks out some beautiful crystals to show us. For rock-and-roll, he selects some ugly crystals and shows us those. He then concludes that classical music makes beautiful crystals while rock-and-roll makes ugly ones. What he does not show us is that both musical treatments made the same numbers of beautiful and ugly crystals. The "treatments" actually had no effect."  In addition to providing some extraordinary photographs of water crystals he completely dismisses the work of Masaru Emoto.  You can read my additional comments and a review and analysis of Dr. Masaru Emoto�s published work on the effects of external stimuli on the structural formation of ice crystals.

I have looked for studies on health effects of distilled water going back to the early 70s at pubmed � the principle search engine for articles published in medical-related journals.  I used different search terms: "distilled water" health (960 articles), "drinking water" distilled (391 articles), "water absorption" distilled (42 articles) and  "demineralized water" health (17 articles).  Unfortunately, none of the more than 1,000 articles that had distilled water in their title or abstract dealt with health effects of distilled water.  Similarly, restricting the Google search on "distilled water and health"  to .edu sites (one way to 'weed out" a lot of the bias on the web) also yielded no answers.

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Tails - Question Hello, I came across your site while researching the ever confusing controversy on drinking and cooking with distilled water.  Like you, I have not found an evidence that it can cause harm esp. since most of your minerals, etc. should come from the food one eats, not the water one drinks. I have noticed one thing in using distilled water.  My dog who had shown elevated levels of calcium which signaled a parathyroid growth which can become very serious showed completely normal levels of calcium after two weeks on distilled water and organic food thus the Vets did not have cause to do surgery. I have no idea which or whether either caused this change & I'm still monitoring it just in case but it certainly makes me wonder.  I have heard that distilled water only removes the inorganic properties from the body � the harmful ones and I thought perhaps the distilled water helped take the overload of calcium that the PTH was producing out resulting in normal levels. Do you have an opinion either way on drinking distilled water or purified water?  I'd like to continue drinking it but if it could cause problems with bone formation, arthritis, things like that, I don't want to really go down that road. I appreciate your info. Thanks.

Tails - Answer -
Distilled water definitely seems to be a topic of interest and confusion to lots of people � no wonder, with all of the Internet sites authoritatively proclaiming diametrically opposed health effects from drinking it.  I get periodic questions about health effects of distilled water, and occasionally testimonials like yours.

It would have been a bit more helpful to the discussion if you had tried to either treat your dog with a change in water or diet separately instead of at the same time, but hindsight is always a better predictor of outcome than foresight.  If you had just changed the type of water your dog drank and then noticed that the symptoms were better, that would have been an interesting observation in favor of drinking low-mineral water � for that condition.  However, as I point out elsewhere, results from an experiment with a sample size of one, while interesting, do not provide reliable evidence that a hypothesis (theory) is true or false.

If elevated calcium levels and parathyroid growth was a fairly common problem in dogs and the Vet was willing to do some experimentation, he could set up some blinded trials � treating one group with distilled water and another group with purified water (neither the Vet nor the owners would know which treatment the dogs were given).  If statistically significant differences were found between the two groups that would indeed demonstrate that distilled water might have some health effect.

A question about the article that discusses demineralized water and health from the World Health Organization

A recent question from a visitor I have also been doing a great deal of research and experiments on water quality and was very interested to come across your web site.  I am a qualified nutritional therapist and have been seeking ways to make high quality water in the city for those of us not lucky enough to have our own spring water.  have a RO system in my house and like you I have found it difficult to find reliable information regarding the health risks of drinking demineralised water.  I recently came across a W.H.O guide that I thought you might be interested in reading which seemed to indicate there are health affects from drinking completely pure water: http://www.who.int/water_sanitation_health/dwq/nutrientschap12.pdf Like you, logically I wouldn't have thought the minute amounts of minerals in natural water would make a difference to health and yet the research does not seem to support this view.  Also, it is interesting to note that minerals is aqueous solution seem to be absorbed better by the body that those in food or supplements. I just thought you may be interested to read the report and would love to hear your views on it. Regards, Tim

Thanks for the link and questions, Tim -

I discuss the specific paper you referenced because it is one of the two recent sources for the claim that drinking distilled water is harmful to the ordinary person.  The other article is Early Death Comes With Regular Drinking Of Distilled Water by Zoltan P. Rona that I address in a letter I sent him asking for evidence to support his claim (with no reply yet).

I read the WHO document very carefully, because I thought that an article, presumably endorsed by the WHO, would contain some good, scientifically valid information.  Yet after reading the paper, I remain very skeptical about a lot of the information presented in it. 

I don't know if you looked through the references, but most of them were about population studies showing differences between groups that drank hard vs. soft water.  That observation is fairly common in the literature, but there is, to the best of my understanding, no consensus among researchers on the CAUSE of the slight, variable, and sometimes non-existent association between higher rates of various diseases and the population drinking soft water.  I have never seen the difference conclusively explained by the actual difference in levels of calcium, magnesium, and other minerals between the two populations.  The main point is that soft water (lacking calcium, magnesium, and other "hardness minerals") is NOT distilled water, and one cannot use negative health effects of drinking soft water (if any are conclusively demonstrated) to support a claim that distilled water (containing no minerals or other contaminants) is harmful.

It is fairly tedious to track down every reference used by an author making an argument or proving a point and try to determine if the author of the paper in question used the reference properly to support the argument or whether the investigator(s) experimental methods were sound.  I only looked at a couple of examples.  A lot of his references were from what appeared to be obscure journals that would be difficult to find anyway.

I will make a few comments below, but the best article I have found to discuss the findings an earlier WHO study that reached similar conclusions is Clean the Water: When it is muddied by Misinformation by the Canadian Water Quality Association

in the WHO article Kozisey presents 6 sections that he introduces as "The possible health consequences of low mineral content water consumption are discussed in the following categories:"

1) Direct effects on the intestinal mucous membrane, metabolism and mineral homeostasis or other body functions.
At the end of this section Kozisek discusses water intoxication (hyponatremic shock) and states:
"A more severe course of such a condition coupled with brain oedema, convulsions and metabolic acidosis was reported in infants whose drinks had been prepared with distilled or low-mineral bottled water" (CDC 1994).

I tracked down a paper written by the same authors on the same topic several years later (which included the two 1993 cases in the 1994 CDC article) and added several additional cases. The relevant section is quoted below:

Hyponatremic Seizures Secondary to Oral Water Intoxication in Infancy: Association With Commercial Bottled Drinking Water - Robert C. Bruce and Robert M. Kliegman.  If that link doesn't work, go to Pediatrics home page and search for the document

From Bruce and Kliegman's paper "Infants of parents living in poverty and uninformed of the risks of feeding fluids other than infant formula to their babies are particularly at risk.  Young infants with vomiting and diarrhea are especially prone to developing hyponatremia if fed fluids lacking sufficient sodium, but even those who are otherwise well may develop symptomatic hyponatremia as a result of being fed excess solute-free water.  Most often tap water, either in the form of supplemental feedings or overly dilute formula, has been given in excessive amounts over relatively short periods of time."

Careful reading of the paper by Bruce and Kliegman shows that they are talking about the effects of too much water of any kind on the infant - they do not mention distilled water at all (solute-free seems to refer to water without formula, not water without ions), but they do mention an excess of tap water and later go on to state that the same problem can occur with feeding too much juice.

This kind of miss-interpretation of another paper's results is unfortunately fairly common with people digging through papers to find evidence to support their favorite idea.  Kozisek does it again at the beginning of the section where he uses a paper that reports harmful effects of distilled water introduced directly into the small intestine - that has nothing to do with the effect of water, distilled or otherwise, that goes through the stomach first.  "A study by Williams (1963) reported that distilled water introduced into the intestine caused abnormal changes in epithelial cells of rats, possibly due to osmotic shock."  This is no doubt a true statement - any tissue exposed directly to distilled water (or most tap water for that matter), would experience osmotic shock.  This truth seems to be of limited relevance to the discussion of the health effects of drinking distilled water.

A Brief discussion of the other main categories in Kozisek's paper

2) Practically zero calcium and magnesium intake.
This section and the next talk about the epidemiological studies that seem to show populations drinking soft water tend to have more health issues, particularly heart problems, than those that drink hard water.  As I mentioned above, soft water is not distilled water, and although the observation seems to be fairly repeatable (although many studies have not seen this difference), the cause seems to be extremely elusive.  These studies certainly do not prove that distilled water is harmful if the diet supplies sufficient mineral nutrients - or if supplements are taken.

3) Low intake of other essential elements and microelements..
"Although drinking water, with some rare exceptions, is not the major source of essential elements for humans, its contribution may be important for several reasons.  The modern diet of many people may not be an adequate source of minerals and microelements.  In the case of borderline deficiency of a given element, even the relatively low intake of the element with drinking water may play a relevant protective role.  This is because the elements are usually present in water as free ions and therefore, are more readily absorbed from water compared to food where they are mostly bound to other substances."
As pointed out elsewhere, two liters of very hard water (the typical person consumes about two liters of water per day) with 17 gpg of hardness will only contain about 232 milligrams (mg) of calcium.  This is about 10 percent of a person's minimum daily requirement for calcium and would require a person to consume about 20 liters of water to meet their requirement by water alone.  Most of a person's total dietary mineral intake comes from food, and as I discuss in the Health Effects section, one purpose of digestion is to release minerals from organic molecules and dissolve them so they can be absorbed - there are only a few situations where the type of food significantly interferes with mineral uptake in the intestines.

4) Loss of calcium, magnesium and other essential elements in prepared food..
I spotted one reference in the paper to support this section - I have not been able to find any others.  I found a copy of the article cited in Kozisek's paper.  This is an interesting study, but I would like to see several more with some explanation of why the difference of a relatively few ions of calcium and magnesium in the water can cause the changes reported.  If you are concerned about this potential problem, probably adding a pinch of salt would restore the osmotic balance and prevent mineral loss.

5) Possible increased dietary intake of toxic metals leached from water pipe..
This section may be true, but it has nothing to do with whether or not distilled water is inherently bad for health.  Softened water is NOT distilled water - and distilled water is never sent through municipal water pipes.  Even so, I've read many articles (by water softener companies mostly) that dispute this statement stating that softened water is not solute free - calcium and magnesium are just replaced by sodium (or potassium) and thus will not leach toxic metals from pipes any more than hard water.

6) Possible bacterial re-growth
This section may be true too, but it has absolutely nothing to do with whether or not distilled water is inherently bad for health based on lack of mineral content. 
_________________________________

As I mentioned elsewhere I have searched in vain for good scientific papers that address this topic and provide a clear explanation of how small differences in ion content in water before it reaches the stomach can lead to drastic metabolic differences later when it reaches the intestine.  I have yet to find more than a couple of papers on the topic, much less a good explanation.

Anyway, that's my two-cent contribution to the discussion.  F. Kozisek may be associated with WHO, but I am not impressed with his analysis and conclusions about distilled water.

Best wishes..

Randy

Hello Dr. Rona -

I have published a website (www.cyber-nook.com) on drinking water for over 15 years. My goal is to provide visitors with accurate, unbiased information on drinking water contaminants and their health effects, describe effective drinking water treatment methods, and warn visitors about drinking water scams.

One of most common search terms people use to find my site is "distilled water and health". Many questions I receive are from people confused by the contrast between my discussion on distilled water and the article you wrote, "Early Death Comes From Drinking Distilled Water", both of which come up on the first page of a Google search on distilled water.  I noticed that the article on your website is currently titled a less alarming, Early Death Comes With Regular Drinking Of Distilled Water.  That qualification helps, but it still does not address the apparent lack of support for the claims you make as outlined below.

I regularly review pubmed and other sources to try and find legitimate studies to support either of the opposing claims that:

A) distilled water is "better for health" than "regular" water that is free from harmful contaminants.
B) distilled water is "worse for health" than "regular" water that is free from harmful contaminants.

So far I have failed to find any studies that would convince me that either claim is true for individuals with normal health� Actually, I have been able to find very few real studies at all on the subject. That fact alone leads me to the conclusion that drinking distilled water is not a health issue - if it were, I would expect to find research that would quantify the harm/benefit of drinking distilled water and provide a mechanism to explain the effects.

Yesterday I received an e-mail that contained this statement, "...Recently I was frustrated because Dr. Mercola, Dr. Zoltan Rona and others began to criticize R.O. because of its "high" acidity. I had thought of the fact that water goes to the stomach and blends with whatever foods are in it but what did I know, I have never even taken chemistry much less have a B.S. in a related field..."

That note finally convinced me to re-read your paper. Even though you do indicate that "water filtered through reverse osmosis tends to be {pH} neutral and is acceptable for regular use provided minerals are supplemented." your paper still provides me no convincing evidence to support the rather alarming claims you make about distilled water. I went to your website, and I am questioning the statements below copied directly from your paper:

I would like to request that you provide me references to good-quality research papers or other evidence to support the following statements you made in the paper:

A) Distilled water is free of dissolved minerals and, because of this, has the special property of being able to actively absorb toxic substances from the body and eliminate them. Studies validate the benefits of drinking distilled water when one is seeking to cleanse or detoxify the system for short periods of time (a few weeks at a time).
Where are references to clinical trials that support that claim and describe a mechanism whereby distilled water "actively absorbs toxic substances from the body" any more effectively than regular water. How would the absence mineral ions in a glass of water cause those specific water molecules to behave differently in the intestine, be absorbed differently into the blood stream, or "absorb" and transport "toxins" differently than regular water?  Specifically:
a) I have always been confused by the phrase that water "...actively absorbs toxic substances from the body". What are "toxins" and how are they different from ordinary metabolic waste products?
b) How does that process differ from the normal transport of waste products from cells to the kidneys, lungs, skin, etc. by water in the blood or lymph, and how can that process be altered by drinking a specific type of water?
c) How would distilled water be able to selectively absorb and transport toxic substances from the body any differently than regular water?
d) Once the water enters the blood stream distilled water is absolutely no different from regular water. Water enters the body as individual molecules through osmosis, and the presence or absence of a few milligrams of mineral ions will not significantly change the rate of water entry or the properties of the water molecules that enter the blood stream.

B) "Cooking foods in distilled water pulls the minerals out of them and lowers their nutrient value."
Actually, I might be inclined to believe this statement, since there are fewer mineral ions in distilled water than in regular cooking water. Can you supply any specific studies that provide a quantitative description of the mineral loss?

C) "Distilled water is an active absorber and when it comes into contact with air, it absorbs carbon dioxide, making it acidic The more distilled water a person drinks, the higher the body acidity becomes. According to the U.S. Environmental Protection Agency, �Distilled water, being essentially mineral-free, is very aggressive, in that it tends to dissolve substances with which it is in contact.�
Studies have consistently shown that heavy consumers of soft drinks (with or without sugar) spill huge amounts of calcium, magnesium and other trace minerals into the urine. The more mineral loss, the greater the risk for osteoporosis, osteoarthritis, hypothyroidism, coronary artery disease, high blood pressure and a long list of degenerative diseases generally associated with premature aging.
I am unclear how you make the leap from the carbon dioxide in water to the premature aging argument in these two paragraphs.
First, does distilled water dissolve a significantly greater amount of carbon dioxide than "regular" water under identical conditions? If so, I would appreciate references that support that statement. I am not a chemist, but it does not seem plausible that a few milligrams of calcium/magnesium would prevent carbon dioxide from dissolving.
Second, the amount of acidity in water caused by dissolved carbon dioxide is minimal and would immediately be neutralized by the stomach contents. A glass of orange or apple juice would be far more acidic. I have seen no studies that would conclude drinking a moderate amount of acid or alkaline beverage would have any effect on the pH of the body - which is finely tuned at the cellular level in response to local chemical reactions.
Specifically, I have never seen any references that conclude that "The more distilled water a person drinks, the higher the body acidity becomes." I would be very interested to read references to any studies you can provide to support that statement.
Third, I do not understand your reference to the EPA quote "...Many metals are dissolved by distilled water". That might be an argument for not storing distilled water in metal cans, but the EPA statement is not about dissolving metals (or other substances) from the body and does not address any health-related issues that I can determine.  Regular water dissolves many metals too.

D) "The most toxic commercial beverages that people consume (i.e. cola beverages and other soft drinks) are made from distilled water. Studies have consistently shown that heavy consumers of soft drinks (with or without sugar) spill huge amounts of calcium, magnesium and other trace minerals into the urine."  Would pop prepared with filtered tap water be any less "toxic"?  I would like to read any studies you can point me to that quantify the loss of minerals from drinking soft drinks - I could use those studies on my site where I plan to devote a page to the benefits of drinking water over drinking pop.

E) "A growing number of health care practitioners and scientists from around the world have been advocating the theory that aging and disease is the direct result of the accumulation of acid waste products in the body. There is a great deal of scientific documentation that supports such a theory."
I am agnostic on this statement (I would appreciate supportive references), but I do not see how that ties into the distilled water discussion, unless there is clear evidence (as described above) that:
a) distilled water is actually significantly more acidic that "regular" water and
b) that drinking water with dissolved carbon dioxide is somehow harmful to health by contributing to "the accumulation of acid waste products in the body."

F) "There is a correlation between the consumption of soft water (distilled water is extremely soft) and the incidence of cardiovascular disease..."
There have indeed been some epidemiological studies that suggest drinking hard water is beneficial and soft water is not. The evidence is far from conclusive, there is no consensus on what might be the cause of any observed differences, and there are many studies that show no difference. Even if there were a difference in health between drinking hard and soft water, this argument has no application to the distilled water discussion, since it is dealing with hard vs. soft water coming into a home---soft water is not distilled water.

G) "The longer one drinks distilled water, the more likely the development of mineral deficiencies and an acid state. I have done well over 3000 mineral evaluations using a combination of blood, urine and hair tests in my practice. Almost without exception, people who consume distilled water exclusively, eventually develop multiple mineral deficiencies. Those who supplement their distilled water intake with trace minerals are not as deficient but still not as adequately nourished in minerals as their non-distilled water drinking counterparts even after several years of mineral supplementation."
That is an impressive number of evaluations, but again, to the best of my understanding and reading of the literature, there are no published studies to support your claims that:
a) "The longer one drinks distilled water, the more likely the development of mineral deficiencies and an acid state."
b) " ...people who consume distilled water exclusively, eventually develop multiple mineral deficiencies."
c) "Those who supplement their distilled water intake with trace minerals are not as deficient but still not as adequately nourished in minerals as their non-distilled water drinking counterparts even after several years of mineral supplementation."
Have any of these claims been tested in randomized, double-blinded clinical trials - and the results published? If so, I would be extremely interested in references so I can read the papers.

H) "The ideal water for the human body should be slightly alkaline�"
Again, I have not found any randomized, double-blinded studies that support this statement. What evidence exists to support the notion that slightly alkaline water would survive the stomach and produce more than a nao-flicker of change to the pH regulation processes of the body?

I) "Water filtered through reverse osmosis tends to be neutral and is acceptable for regular use provided minerals are supplemented."
a) I do not understand why water from a reverse osmosis system with nearly all of the ions removed would be expected to have any different effect in the body than distilled water.
b) Why would water from a reverse osmosis system not absorb carbon dioxide from the air and become acidic just like distilled water?
c) Why will mineral supplementation make everything ok for people drinking reverse osmosis but not distilled water?
d) It seems from this statement that your entire argument against distilled water is really based on the alleged acidity of distilled water and really has nothing to do with the mineral content.
http://www.ianrpubs.unl.edu/epublic/live/g1490/build/g1490.pdf

J) "Longevity is associated with the regular consumption of hard water (high in minerals)."
This is part of the hard vs. soft water discussion (not hard water vs. distilled water). Any differences in health/longevity that might be found for hard water drinkers could be the result of some factor (not necessarily the water) in the soft water populations that causes health problems. These studies seem to be very inconclusive.

K) "Disease and early death is more likely to be seen with the long term drinking of distilled water." Are there randomized, blinded clinical trials or epidemiological studies to support this statement?

Questions about the reply on the paper published on your site to a letter you received:

L) "I do not dispute any positive results you or your relatives have had as a result of drinking distilled water. For short term detoxification purposes, the use of distilled water can be beneficial. Beyond this, any benefits of drinking distilled water are due to the placebo effect. For long term, regular drinking purposes, the scientific literature as well as my own clinical observations do not support the consumption of distilled/soft water."
I agree with your statement, "...Beyond this, any benefits of drinking distilled water are due to the placebo effect"
However, I will require a list of the specific scientific literature you refer to which provides good supportive evidence for your claim to be able to agree with this next statement, "For long term, regular drinking purposes, the scientific literature as well as my own clinical observations do not support the consumption of distilled/soft water."

M) "For example, a 1991 study of 27 municipalities in Sweden showed an inverse relationship between water hardness (mineral content) and mortality from cardiovascular disease (Rylander et al. Magnesium and calcium in drinking water and cardiovascular mortality. Scand. J. Work Environ. Health 17:91- 4, 1991)� To the end of the reply�.
In the rest of this discussion you argue that drinking hard water is healthier than drinking soft water. As pointed out above, the evidence for this observation is not conclusive and there are plenty of papers that report no differences. As you are no doubt aware, these are all epidemiological studies, and there is no consensus about what might be the cause for any of these reported effects. Even if there is a correlation between water type and health, study design issues, differences in the populations, and a variety of other confounders, makes it very difficult to assign a cause and effect relationship and conclude that it is the presence of minerals in hard water or a lack of them in soft water that caused the observed health effects. And, soft water is not distilled water! Consequently, this argument, whether true or not, is not applicable to the distilled water discussion.

I applaud your decision to provide references to specific hard water vs. soft water studies that support your argument.

If you had provided similar references to support your claim that drinking distilled water is harmful to health (or alkaline water was healthy), I would have had more specific information to evaluate, and my website might support the claims you have made.

Thank you for taking the time to consider my request for a list of research papers that provides supportive evidence for your claims that drinking distilled water is harmful to health.

Until convinced otherwise, my position remains that distilled water is neither more harmful nor more beneficial than regular water that is free of harmful contaminants - assuming that a person is eating a reasonably normal, healthy diet.

Best wishes.

Randy