What are the benefits of drinking lemon water?

Lemon Water: Limited Evidence for Health Benefits

Plain water remains the primary recommended beverage for hydration, and adding lemon provides no clinically proven benefits for morbidity, mortality, or quality of life outcomes based on current medical guidelines. 1, 2

What Major Guidelines Say About Water and Beverages

The Dietary Guidelines for Americans explicitly recognize that water should be the primary beverage consumed to meet fluid needs, with no special consideration given to lemon-enhanced or other modified water formulations. 1, 2 Water constitutes approximately 60% of body weight and is necessary for normal cellular metabolism, waste elimination, temperature regulation, and joint lubrication. 1

• For most healthy people, thirst serves as an adequate guide for fluid needs, with daily recommendations of approximately 2.7 L (91 oz) for women and 3.7 L (125 oz) for men from all sources. 1
• No major medical guideline or professional society recommends lemon water for any health condition or general wellness. 2

Potential Modest Benefits (Not Guideline-Supported)

While guidelines don't endorse lemon water specifically, limited research suggests possible minor effects:

Blood Pressure

• One observational study in 101 middle-aged women found that daily lemon intake showed negative correlation with systolic blood pressure changes over 5 months, though this effect was confounded by walking activity. 3
• This single observational study is insufficient to recommend lemon water for hypertension management, as no guidelines support this use. 3

Kidney Stone Prevention

• Lemon juice contains citric acid (approximately 5.9 gm per 4 ounces), which can increase urinary citrate levels. 4
• A small study of 12 patients with hypocitraturic calcium nephrolithiasis found that 2 liters of lemonade daily (made with 4 oz lemon juice) increased urinary citrate from 142 mg to 346 mg daily, with 7 of 12 patients becoming normocitraturic. 4
• However, this represents adjunctive dietary therapy for a specific medical condition (hypocitraturia), not a general health benefit of lemon water. 4

Uric Acid Reduction

• Animal research suggests lemon water extract may reduce uric acid levels in hyperuricemic mice, potentially through potassium citrate content rather than citric acid itself. 5
• This has not been confirmed in human clinical trials and cannot be recommended for gout or hyperuricemia management. 5

What Plain Water Already Provides

Tap water already delivers meaningful nutritional benefits without lemon addition:

• Half of major US city water sources contain 8-16% of the RDA for calcium and 6-31% for magnesium when consuming 2 L daily. 1
• Approximately 74% of the US population receives fluoridated water, which prevents dental caries. 1
• Water provides hydration without calories and is the most cost-effective beverage choice. 1, 2

Important Caveats and Pitfalls

Dental Health Concerns

• Lemon juice is highly acidic and can erode tooth enamel with frequent exposure, particularly when sipped throughout the day. 1
• If consuming lemon water, drink it quickly rather than sipping, and rinse with plain water afterward to minimize enamel exposure.

When Special Fluids Are Actually Indicated

• For exertional dehydration: Carbohydrate-electrolyte solutions (3-8% carbohydrate) are recommended by first aid guidelines, not lemon water. 1
• For clinical dehydration: Balanced crystalloid solutions or oral rehydration solutions with specific electrolyte compositions are evidence-based, not lemon water. 1, 2

Cost Considerations

• Don't encourage patients to spend money on lemon water when plain water provides equivalent hydration at lower cost. 2
• The American Heart Association, American College of Physicians, and Dietary Guidelines emphasize plain water without mentioning lemon-enhanced alternatives. 2

The Bottom Line

There is no compelling evidence that adding lemon to water provides clinically meaningful health benefits for the general population. 2 While lemon juice contains vitamin C and citric acid, these nutrients are readily available from whole fruits and vegetables, which also provide fiber and other beneficial compounds. 1 The Dietary Guidelines recommend that at least half of fruit intake come from whole fruits rather than juices. 1

For patients asking about lemon water, recommend plain water as the primary beverage and encourage whole fruit consumption to meet vitamin C needs. 1, 2