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One man says he underwent a liver transplant after drinking the water.

By Colleen Murphy
March 25, 2021
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The US Food and Drug Administration (FDA) is recommending that people not drink, cook with, sell, or serve the "Real Water" brand of alkaline water—after several reports that people who consumed this bottled water later developed acute non-viral hepatitis and, eventually, acute liver failure.

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Credit: Getty Images / Design by Jo Imperio

The advisory about the water was updated on March 19 and will be in effect until FDA officials determine if the water caused the cases of hepatitis and liver failure. Right now, with the investigation ongoing, the FDA says evidence appears to link the water to the hepatitis cases: "The consumption of 'Real Water' brand alkaline water is the only common link identified among all of these cases to date" stated the FDA.

Non-viral hepatitis is an inflammation of the liver that can cause scarring on the liver (cirrhosis), liver cancer, liver failure, or death, according to Aurora Health Care, a Midwest medical provider. There are three types of non-viral hepatitis: alcoholic hepatitis is caused by drinking too much alcohol; autoimmune hepatitis is caused by the immune system attacking the liver; and toxic hepatitis is caused by chemicals, drugs (prescription and over-the-counter), and nutritional supplements.

The FDA made the advisory after learning that five infants and children in Nevada had developed acute non-viral hepatitis in November 2020. All five cases resulted in acute liver failure. A hepatitis virus is the most common cause of acute liver failure, which is "loss of liver function that occurs rapidly—in days or weeks—usually in a person who has no preexisting liver disease," per the Mayo Clinic.

While the cause of these illnesses was not known at the time, it turns out that all of the infants and children became sick after consuming the Real Water brand of alkaline water. Five other people, including two adults and three children, also had less severe symptoms after drinking the water.

Since the FDA announcement, three lawsuits have been filed against the company, reported the Las Vegas Review-Journal. One of those lawsuits was filed on March 22 by five people who say they got sick—as long ago as November 2018—after drinking the water. Two of those people also had acute liver failure; one man had to be airlifted to a hospital for a liver transplant.  

The company's site states that Real Water is "a premium, drinking water" that "can help your body to restore balance and reach your full potential." Real Water bills itself as alkaline water, which means it has a higher than average pH level—usually between 8 or 9 (Real Water's pH is 9.) "The alkaline water industry claims that problems can arise when the body becomes acidic, and that their products can neutralize pH and promote a better balance," Health previously reported.

In response to the FDA investigation, the Real Water company released a video statement on March 23 addressing the product's safety. In it, the company's president, Brett A. Jones, said that even though the illnesses have only occurred in Nevada, Real Water has issued a voluntary recall of all their water products throughout the US. "We, at Real Water, take the safety of our products and concern for our customer's health seriously," the company said in a press release. "Real Water takes great strides in every way to make sure our product is safe for consumption. Our goal is to diligently work with the FDA to achieve a swift resolution."

The FDA says that anyone who is experiencing symptoms of non-viral hepatitis should contact their doctor. "Symptoms of all types of hepatitis, including non-viral hepatitis, are similar and can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay or gray-colored bowel movements, joint pain, yellow eyes, and jaundice," the FDA reports.

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