Tap Water & The Microbiome

Human beings are 65-75% water. This makes water essential to human survival and health. In my practice, I generally recommend people drink half their body weight in ounces of water per day. I also recommend that my patients filter their water. Let’s dive into why.

Most people are aware of the effects of diet on health and the microbiome, but what is less considered are the toxic exposures in tap water that can disrupt overall health. Furthermore, the association between diet and the gut microbiome has been researched and discussed at length, but effects of drinking water on the microbiome has largely been overlooked. The relationship between tap water and the microbiome is a topic that deserves a deeper look, as tap water contains a multitude of contaminants that contribute to health deterioration.

The Dirty on Tap Water

Tap water varies by location, but almost all tap water in the USA contains harmful contaminants like chlorine, fluoride, arsenic, pesticides, heavy metals and pharmaceutical drugs. Some of these contaminants are put into municipal water on purpose, and some are present due to environmental contamination. The chemicals placed in water supplies are regulated, but the legal limit is often hundreds of times higher than what scientists and public health agencies recommend. An alarming report published by the Environmental Working Group goes over many of these contaminants in detail. Here’s a snapshot of some of the biggest offenders.

Chlorine has routinely been used worldwide as a sanitizer in water as it is cost-effective and has strong anti-microbial properties, allowing it to act like a mild antibiotic. While chlorination of water has served a protective purpose with regard to the spread of infectious disease, the process of water chlorination causes the formation of a more toxic family of chemicals called trihalomethanes. Trihalomethanes form when chlorine reacts with rotting organic matter like manure from livestock, fallen leaves and sewage. One of the worst offenders in this class is chloroform, which is a known carcinogen.

Fluoride is a trace element that has been added to tap water since the 1950’s to prevent dental cavities. Today, not every municipal water system adds fluoride to their water, but a majority still do. Fluoride ingestion can cause mottling or weakening of teeth, a condition called dental fluorosis. It is also linked to kidney damage, increased hip fractures, osteosarcomas, arthritis, hypothyroidism, ADHD, and lowered IQ in children.

While the fluoridation of drinking water has been largely celebrated as a major success in terms of public health, recent studies show that topical fluoride or the use of hydroxyapatite in toothpaste can be a good alternative to cavities without the side effects that chronic fluoride exposure presents.

Volatile Organic Chemicals (VOC’s) are things like pesticides, herbicides and other chemicals that get into water systems due to agricultural runoff and contamination. Exposure to VOCs is linked to chronic illness such as birth defects, certain types of cancer and other types of immune dysregulation.

Effects of Tap Water on the Microbiome

While this is largely an unstudied area of research, studies on mice show that drinking tap water changes the microbial composition of the gut microbiome. This may be from chlorine or chlorine byproducts. Another small study done in the UK looked at the microbiomes of twins in different regions based on the contaminants in tap water and found a relationship by region in how the contaminants influenced the microbiome.

Levels of chlorine in tap water have been tested and are safe in terms of toxicity for individuals, but what we don’t have a clear picture of is how it affects the trillions of microorganisms that live within the ecosystem of our microbiome. It is proposed that chronic exposure to chlorine is a risk factor for gut dysbiosis. A population that is particularly at risk is infants and young children, whose microbiomes are vulnerable to environmental factors during their early years.

There are very few studies on the relationship between fluoride exposure and the microbiome, but some associations can be made as fluoride has be identified as a potential risk factor for inflammatory bowel disease (IBD) and fluoride exposure, depending on dose, has been shown to change the composition of the gut microbiome and production of short chain fatty acids (SCFA).

Cleaning Up Your Water Supply

In order to decrease exposure to these harmful contaminants, it is important to filter your water. Everyone’s water is different and there are many different types of water filters. The EWG has a wonderful tap water database where you can type in your zip code to find out what’s in your water. Once you know what’s in your water, it will be easier to pick out the right filter.

A few of the most common types of filters:

  • 1. Pitcher water filters are granulated activated charcoal that remove some chlorine but are not effective at removing VOC’s, fluoride, heavy metals and other hormone disrupting chemicals. The pros are that they are inexpensive and accessible, but the cons are that they are generally not the safest option.
  • 2. Carbon filters are the most common type of water filters which can remove chlorine and many other contaminants from water. These are a step up from pitcher filters. They are a good middle of the road option, but still do not remove 100% of contaminants and do not remove fluoride.
  • 3. Reverse osmosis (RO) filters will remove chlorine, fluoride and a large number of other contaminants. The downside of this type of filter is that it also strips water of essential minerals and can increase bacterial populations in filtered water that sits in a holding tank. If you do go this route, it is important to ensure you are remineralizing your water manually or have a RO system that remineralizes water after filtration.
  • 4. Under the counter, multi-stage filters generally remove the widest range of contaminants and pose the least risk. The cons are that they are generally a bit more expensive and require installation.

A few other things to consider are boiling and water storage. Boiling tap water for infants up to 12 months of age is a DIY method for families that aren’t able to invest in a water filter quite yet. In Australia, the National Health and Medical Research Council’s infant feeding guidelines recommend boiling and cooling tap water for infants who are under 1 year of age so that infants are not exposed to residual chlorine. Water storage is also important. Avoiding plastic water bottles and investing in a glass or stainless-steel water bottle will also prevent your filtered water from getting re-contaminated with harmful chemicals.

The gut microbiome is well understood at this point to be at the root of every chronic health condition people suffer from today. When the gut microbiome is out of balance, or dysbiotic, we see chronic inflammation and chronic disease rise. Ensuring we have a robust and rich microbiome is one of the best insurance practices we can implement for our health. Safe drinking water is just as important as eating a good diet for gut health, and therefore overall health.

Dr. Elizabeth Wade, ND

Naturopathic Doctor

Dr. Elizabeth specializes in reproductive health, infertility, environmental medicine, and autoimmune disease. She is committed to staying up to date in the world of microbiome research and sees her doing so as fundamental in her ability to get to the root cause of her patients’ health concerns. Dr. Elizabeth offers one-on-one health consultations at her private practice in Portland, OR to ensure everyone has access to the information needed to reverse or prevent disease in the most effective and least invasive ways possible.

Collective members are paid sponsors and receive compensation for their content, but all opinions are their own.

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