After reading a very interesting article by  Greg Reyneke titled “Is water undermining your metabolic health (Linkedin)?,  (Substack Users) I decided to ask Grok for more information about this topic.  Why? I have been diagnosed with a fatty liver and high blood pressure .

Grok Response

Drinking water quality affects metabolic health through contaminants that promote insulin resistance, inflammation, and oxidative stress, as well as through beneficial minerals that support cardiovascular and metabolic functions. Poor water quality can contribute to risks for metabolic syndrome (a cluster of conditions including high blood sugar, abnormal cholesterol, high blood pressure, and excess abdominal fat), type 2 diabetes, obesity, and related issues, while adequate hydration with clean water generally supports metabolism. (Source: https://journals.lww.com/epidem/fulltext/2006/11001/drinking_water_quality_and_metabolic_syndrome.605.aspx)

Negative Impacts from Contaminants

Many common drinking water pollutants act as endocrine disruptors or metabolic toxins:

• Heavy metals like arsenic: Chronic exposure via drinking water is strongly linked to insulin resistance, beta-cell dysfunction in the pancreas, glucose intolerance, and higher diabetes risk. This occurs through oxidative stress, impaired insulin signaling, and inflammation. Associations appear even at relatively low levels in some studies, with stronger evidence at higher exposures (e.g., ≥150 µg/L). Arsenic contaminates groundwater in many regions worldwide. (Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC10601382/ and https://www.diabetesandenvironment.org/home/environmental-chemicals/arsenic)

• PFAS ("forever chemicals"): These persistent compounds, often from industrial sources or firefighting foam, enter water supplies and are linked to obesity, type 2 diabetes, dyslipidemia (abnormal blood fats), insulin resistance, and non-alcoholic fatty liver disease. They disrupt hormone signaling, lipid metabolism, and energy balance. Millions of people have elevated exposure through contaminated tap water. (Note:  It is important to remember that in general the primary exposure route for these compounds for the average citizen is via their food and diet, unless your in an area with extremely high levels of PFAS related compounds in the drinking water).

• Select Anions: Nitrite and sulfate levels and even calcium carbonate in water have been associated with higher metabolic syndrome prevalence.  (Source: https://journals.lww.com/epidem/fulltext/2006/11001/drinking_water_quality_and_metabolic_syndrome.605.aspx and https://www.unep.org/interactives/wwqa/technical-highlights/health-and-water-quality )
  
  
• Organic micropollutants (pesticides, pharmaceuticals) and endocrine disruptors can promote obesity, diabetes, and thyroid issues via hormonal interference. (Source: https://www.niehs.nih.gov/health/topics/agents/endocrine  )

• Fluoride (at higher levels): While beneficial for dental health at optimal low concentrations, excessive exposure is studied for potential metabolic effects like altered glucose metabolism, insulin resistance, and gut dysbiosis in some research, though evidence is mixed and often tied to naturally high levels rather than community fluoridation.  (https://pmc.ncbi.nlm.nih.gov/articles/PMC12513868/)

• Microplastics/nanocolloids and other pollutants: Emerging evidence links them to gut microbiome disruption, which can influence obesity and metabolic disorders.  (Source: https://www.sciencedirect.com/science/article/pii/S0160412020322571)

These effects are often dose- and duration-dependent, with greater risks from long-term exposure. Vulnerable groups include children, pregnant people, and those with pre-existing conditions. Poor water quality can also indirectly harm metabolism by causing infections or forcing reliance on sugary beverages.  (Source: https://stateofchildhoodobesity.org/why-drinking-water-quality-matters/)

Positive or Protective Aspects

• Adequate hydration: Plain water supports metabolic processes (e.g., thermogenesis, fat metabolism, appetite regulation). Drinking enough can modestly boost metabolic rate, aid fat loss, and help mitigate aspects of metabolic syndrome (e.g., by suppressing certain hormones like vasopressin linked to obesity in animal models). (Source: https://news.cuanschutz.edu/news-stories/water-may-be-an-effective-treatment-for-metabolic-syndrome and https://www.caseymeans.com/learn/newsletter-56 )

• Mineral content (e.g., magnesium, calcium, bicarbonate): Hard or mineral-rich waters provide electrolytes that support blood pressure regulation, insulin sensitivity, lipid profiles, and cardiovascular health. Low-mineral water may increase risks like elevated homocysteine or worsened lipids. Bicarbonate-rich waters may help with acid-base balance and metabolic function. Ideal water is often described as higher in magnesium/calcium and lower in sodium.  This is one reason we suggest a remineralizer on Reverse Osmosis Systems (Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC10034051/ , https://www.amjmed.com/article/S0002-9343(98)00189-2/abstract , and https://www.heart.org/en/news/2019/05/07/could-adding-minerals-to-drinking-water-fight-high-blood-pressure )

Practical Implications

Water quality varies widely by location (municipal treatment, groundwater, pipes, agriculture/industry runoff).  It is important to follow the path to clean water and healthy living.  This path includes two very important steps:  Step 1: Learn/ Get Informed and Step 2: Get Tested, and then Step 3: Act. 

Step 1: Learn and Get Informed

Reading blog posts and articles on these topics is wise, but you should also seek advice from a medical professional and please visit the Know Your H20 Portal and bookmark the site and sign up for our free newsletter.   We strongly suggest using the sensors you were born with and use are Drinking Water Diagnostic Tool,

• If you are having a problem, Try Using this Free Diagnostic Tool to better understand the problem.

Step 2: Get Tested

It may be necessary to review the Consumer Confidence Report for your drinking water if the water comes from a regulated public water system or in many cases you will need to get your water tested yourself using a combination of  DIY screening tests or informational or certified water testing services.  When you get your water testing results back, they should be reviewed by a professional and you can use our free educational booklet to help with this process.  Note: If we facilitate your water testing, the process includes a review and recommendations by a professional).

• Try using a DIY Diagnostic Test Kit – test at home, no sales pressure.
• Get Your Well Water Tested or Get Your City Water Tested.

Step 3: Act

The most important action is to review the data from the DIY testing kit or informational water testing kit to better understand the problem and seek advice from a trusted professional.  Trusted professionals can include local well drilling contractors, master plumbers, WQA professionals, or the Know Your H20 Team.  The first step is not to simply install a water treatment system.

After you find one or more water professionals, send them a copy of the informational testing data you generate and get their opinion and advice.   You could also request a free copy of our drinking water guide.  If you are looking for WQA professional in your area, try the following websites:  Know Your H20 Professionals and the WQA contractor database.

Solutions include:

• Using certified filters (e.g., for PFAS, arsenic, lead, chlorine by-products, iron, manganese) to fix a problem that has been identified.  
  
  
• Choosing mineral waters judiciously. (Note sure of the meeting of this comment, but it important to not drink just deionized water.  Your body needs some minerals that can be in water and water is not just hydrogen and oxygen. )
  
  
• Ensuring safe, sufficient intake (typically 2–3+ liters/day for adults, adjusted for activity/climate).
  
  

Overall, clean, mineral-balanced water is supportive of metabolic health, while chronic exposure to toxins can exacerbate risks alongside diet, exercise, genetics, and other factors. Public health measures like better regulation and filtration access are key.

NO ! In the case of individuals that are service by community water supply systems the key is proper overcite and monitoring of these individuals to review the Consumer Confidence Report for the system.  For private well owners, the key is proper education outreach with fact-based information to allow individuals to make a choice and decision what is best for themselves and their family.  

Consult recent local water quality reports and a healthcare provider for personalized advice, especially if you have metabolic concerns. Research continues, as causal links strengthen with better exposure data.  If you need financial help for a private water system, you may want to read this article.

Learn More about the Path to Clean Water.