Mineral waters - drinks or drugs?

Background

Traditional health resorts in Central Europe have been renowned for the (perceived) effects of mineral rich and sometimes hot springs on a variety of medical conditions. In addition to the external application (i.e. serial baths), so called mineral water cures consisting of ingestion of respective mineral waters according to a defined schedule have been very popular, yet modern text books usually fail to mention this type of intervention. We were therefore interested if there is any evidence that taking mineral water can produce clinically relevant effects beyond placebo.

Methods

We are presently carrying out exhaustive literature searches (common databases as well as hand searches) on all major mineral (sodium, potassium, calcium, magnesium, fluoride, chloride) and other relevant compounds (carbondioxide, hydrogencarbonate, sulphate).

Results

Bioavailability studies exist for most of those substances suggesting effective absorption via active and/or passive mechanisms. Contents differ considerably between different springs, and can reach impressingly high concentrations of certain compounds.

There is considerable evidence for several compounds to induce clinically relevant effects. Bicarbonates, in concentrations above 1.2 g/l, seem to be as effective for dyspepsia and heart burn as antacids, and stimulate pancreas and bile secretion. Constipation can be treated effectively with similar concentrations of sulphates. Magnesium supplementation is probably effective in the metaphylaxis of urolithiasis, and calcium in osteoporosis.

Conclusion

Mineral waters may well be used as drugs in the treatment of a variety of clinical conditions. The use of an appropriate bottled mineral water can be considered a convenient form of treatment/supplementation and save a patient from the hassle of regularly taking respective medication.