Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

Digest Plus Ingredients & Drug Interactions

by Genestra Brands

Digest Plus label
See full label image
Tablet Or Pill Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Digest Plus against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Digest Plus is a dietary supplement by Genestra Brands with 6 active ingredients. Its ingredients are commonly taken for replacing fluids and electrolytes, preventing dehydration during exercise or illness, treating low blood sodium (under medical care).Based on those ingredients, 244 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Sodium, Betaine Hydrochloride, Papain. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Digest Plus by Genestra Brands

Ask about any prescription or over-the-counter medication and we check it for interactions with Digest Plus by Genestra Brands — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Digest Plus by Genestra Brands

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Partial disclosure
Ingredient Transparency · database check
Partial

Most active ingredients list an amount, but at least one is hidden in a blend or missing.

Why this rating?
  • The label discloses an exact amount for 5 of its 8 active ingredients.
  • “Pancreatin” is listed as a grouped ingredient — the label gives one combined amount (65 mg) without saying how much of each component you get.

Digest Plus contains 8 active ingredients: sodium, amylase, L-glutamic acid, betaine hydrochloride, protease, lipase, papain, and pancreatin. Most of these are digestive enzymes—protease breaks down protein, lipase breaks down fat, papain is a protein-digesting enzyme from papaya, and pancreatin is a blend of enzymes.

Betaine hydrochloride and L-glutamic acid are meant to support stomach acid and digestion. The tablet also contains several inactive ingredients (cellulose, silica, glycerin, flavoring, and others) that serve as binders and fillers.

Does it work?

Strong evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Strong

Clinical evidence supports at least one of this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: digestive support and enzyme supplementation.
  • We looked for evidence on: Dyspepsia, Pancreatic insufficiency, Pancreatic cancer, Cystic fibrosis, Exercise-induced muscle soreness, Wound healing — and 3 related terms.
  • The strongest evidence on file: Sodium is rated "Likely Effective" for Cystic fibrosis (Natural Medicines).
  • Also on file: Papain is rated "Insufficient Reliable Evidence To Rate" for Cancer, Exercise-induced muscle soreness, Wound healing.
  • Also on file: Lipase is rated "Insufficient Reliable Evidence To Rate" for Dyspepsia.

The evidence backing these ingredients is limited. Sodium has been rated likely effective for cystic fibrosis and possibly effective for amphotericin B kidney toxicity (a severe side effect of an antifungal drug), but the other conditions we hold data for—bipolar disorder, congestive heart failure—have insufficient reliable evidence.

For betaine hydrochloride, papain, and lipase, our data shows insufficient reliable evidence to rate them for their intended uses: dyspepsia (indigestion), food allergies, hay fever, muscle soreness, parasites, and inflammation. The reality is that while digestive enzyme supplements are widely used, the clinical evidence supporting them is not firmly established in our records.

The evidence, ingredient by ingredient Sodium Betaine Hydrochloride Papain Proteolytic Enzymes (proteases) Pancreatic Enzyme Products Lipase

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 5 of the 5 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 5 of 5.
  • General safety write-ups exist for 5 of 5.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Sodium is well tolerated at normal dietary amounts, but the product contains supplemental sodium—too much increases blood pressure and strains the heart and kidneys. The safety data notes advise against sodium supplements or high intake without medical guidance.

Betaine hydrochloride may irritate the stomach and is unsafe for people with ulcers, gastritis, or acid reflux; it should be avoided in pregnancy and is unsafe during breastfeeding. Papain is generally tolerated as a food but may cause allergic reactions and digestive upset in some people; concentrated or unripe papaya products are best avoided in pregnancy, and supplemental papain should be avoided while breastfeeding.

Protease and pepsin are generally well tolerated but rarely may trigger allergic reactions. Lipase is generally well tolerated in supplement form.

For all three enzymes—protease, pepsin, and lipase—safety data in pregnancy and breastfeeding is limited or absent, so medical advice is recommended.

Side effects, ingredient by ingredient Sodium Betaine Hydrochloride Papain Proteolytic Enzymes (proteases) Pancreatic Enzyme Products Lipase

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 3 of the 5 matched ingredients can interact with medications — Papain, Betaine Hydrochloride, Sodium.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; lithium.
  • For scale: 243 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check with your pharmacist if you take any of these before starting Digest Plus: blood pressure medications (antihypertensives), lithium, corticosteroids, warfarin (a blood thinner), H2-blockers, antacids, or proton pump inhibitors (PPIs)—these have moderate to minor interactions with sodium, papain, or betaine hydrochloride. Also flag any sodium-containing medications, didanosine (Videx), tolvaptan (Samsca), or sodium phosphate bowel-prep solutions.

Your pharmacist can help you decide if it's safe to use together or if timing needs to change.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glancePartially disclosed formula with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Digest Plus is a multi-enzyme digestive supplement whose individual ingredients lack strong clinical evidence for their intended uses. If you take blood pressure medications, lithium, warfarin, or stomach-acid-reducing drugs, talk with your pharmacist before starting—this product's sodium and papain content could interfere.

Avoid it if you have ulcers or gastritis. Those pregnant or breastfeeding should check with their doctor or pharmacist first, since safety data is limited.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 6 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 23, 2020.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Digest Plus, straight from the product label.

Brand Genestra Brands
Barcode (UPC) 883196105359
Net contents 90 Tablet(s)
Market status On market
Date entered into DSLD Oct 23, 2020
DSLD ID 239059
Product type Other Combinations
Supplement form Tablet Or Pill
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Digest Plus by Genestra Brands, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Tablet(s)
Maximum serving Sizes:
1 Tablet(s)
Servings per container
90
UPC/BARCODE
883196105359
IngredientAmount% DV
Sodium5 mg1%
Amylase0 NP--
L-Glutamic Acid162.5 mg--
Betaine Hydrochloride162.5 mg--
Protease0 NP--
Lipase0 NP--
Papain65 mg--
Pepsin25 mg--
Pancreatin65 mg--

Other ingredients: Cellulose, Hyprolose, Ascorbyl Palmitate, Croscarmellose Sodium, Silica, natural Vanilla flavor, Hypromellose, Glycerin

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions

Recommended Dose: Take 1 tablet with each meal or as recommended by your health professional.

Precautions

Warning: If you are sensitive to pancreatic enzymes or pork proteins, do not use.

If you are pregnant, lactating, taking any medication, or have an allergy to latex or fruits or have any health condition, consult your health professional before use.

If you are pregnant, lactating, taking any medication, or have an allergy to latex or fruits or have any health condition, consult your health professional before use.

Discontinue immediately if a burning sensation occurs. Not recommended for people with ulcers.

If allergy occurs, stop use.

If nausea, vomiting, abdominal pain or heartburn occur, stop use and consult your health professional.

Keep out of the reach of children.

Use only if safety seal is intact.

Contains: Sulphites

Storage

Store in a cool, dry place.

FDA Disclaimer Statement

This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

General Statements

Contents may not fill package in order to accommodate required labeling. Please rely on stated quantity. Scan to learn about our quality excellence

FDA Statement of Identity

Dietary Supplement

Formula

Provides enzymes and HCL for healthy digestive function

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Digest Plus by Genestra Brands label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Digest Plus label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Digest Plus by Genestra Brands

These are the 6 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Tablet(s) Dosage formTablet Or Pill Servings per container90 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Sodium

Interacts with
205 drugs
5 mg per serving

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...

Sodium monograph & interactions

L-Glutamic Acid

162.5 mg per serving

Betaine Hydrochloride

Interacts with
36 drugs
162.5 mg per serving

Betaine hydrochloride is a supplement used to temporarily increase stomach acid in people who may have low acid levels. Evidence for its benefits is l...

Betaine Hydrochloride monograph & interactions

Papain

Interacts with
2 drugs
65 mg per serving Form: Papaya

Papain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food an...

Papain monograph & interactions

Pepsin

No known
interactions
25 mg per serving Form: Porcine Stomach

Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), tr...

Pepsin monograph & interactions

Pancreatin

Interacts with
1 drug
65 mg per serving Form: Porcine Pancreas

Pancreatic enzyme products supply the digestive enzymes (lipase, protease, and amylase) that some people cannot make enough of, helping them break dow...

Pancreatin monograph & interactions

Other (inactive) ingredients: Cellulose, Hyprolose, Ascorbyl Palmitate, Croscarmellose Sodium, Silica, Natural Vanilla flavor, Hypromellose, Glycerin. These complete the product’s ingredient list but are not active constituents.

Interaction report

Digest Plus by Genestra Brands Drug Interactions

Want to check YOUR meds against Digest Plus?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
244Drugs
208 Moderate 36 Minor

Ingredients driving the most interactions

Sodium 205
Betaine Hydrochloride 36
Papain 2
Pancreatin 1

Individual Drug Interactions

The ingredients in Digest Plus interact with 244 drugs. Click any drug to see the details.

4 of the 6 ingredients in Digest Plus interact with drugs. Each result below shows which ingredient is responsible. Sodium Betaine Hydrochloride Papain Pancreatin

Each ingredient & the kinds of drugs it affects

For each ingredient in Digest Plus with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Sodium7 drug types · 205 drugs

Antihypertensive Drugs

Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.

Likelihood Probable Evidence A
Corticosteroids

Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.

Likelihood Possible Evidence D
Didanosine (Videx)

Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.

Likelihood Probable Evidence C
Lithium

Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.

Likelihood Probable Evidence B
Sodium Phosphates

Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Sodium-Containing Drugs

Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Tolvaptan (Samsca)

Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.

Likelihood Probable Evidence C
Sodium full monograph & interactions

Betaine Hydrochloride3 drug types · 36 drugs

Antacids

Betaine hydrochloride increases stomach acidity and could decrease the effects of antacids.
In human research, betaine hydrochloride increases stomach acidity. Antacids are taken to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with antacids might decrease the effects of the antacids.

Likelihood Possible Evidence D
H2-Blockers

Betaine hydrochloride increases stomach acidity and could decrease the effects of H2-blockers.
In human research, betaine hydrochloride increases stomach acidity. H2-blockers are used to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with H2-blockers might decrease the effects of H2-blockers.

Likelihood Possible Evidence D
Proton Pump Inhibitors (Ppis)

Betaine hydrochloride increases stomach acidity and could decrease the effects of PPIs.
In human research, betaine hydrochloride increases stomach acidity. PPIs are used to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with PPIs might decrease the effects of PPIs

Likelihood Possible Evidence D
Betaine Hydrochloride full monograph & interactions

Papain1 drug type · 2 drugs

Warfarin (Coumadin)

Theoretically, papain might increase the effects and side effects of warfarin.
In one case report, a patient previously stable on warfarin was found to have an international normalization ratio (INR) of 7.4, which was attributed to ingestion of a supplement containing papain from papaya extract.

Likelihood Possible Evidence D
Papain full monograph & interactions

Pancreatin1 drug type · 1 drug

Acarbose (Precose, Prandase)

Theoretically, pancreatic enzyme products may reduce the effects of acarbose.
The digestive enzymes present in pancreatic enzyme products may break down acarbose, reducing its effects.

Likelihood Possible Evidence D
Pancreatin full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Digest Plus, from the product label.

Genestra Brands

Name
Seroyal USA
City
Pittsburgh
State
PA
ZipCode
15275
Phone Number
1-888-737-6925
Web Address
seroyal.com
Pharmacist Counseling Corner

Digest Plus by Genestra Brands: Common Questions

Does Digest Plus by Genestra Brands interact with any medications?
Yes. Based on its ingredients, Digest Plus has a known interaction with 244 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Digest Plus contains 6 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Will Digest Plus help with my indigestion or poor digestion?
The evidence supporting the ingredients—betaine hydrochloride, lipase, and papain—for indigestion and digestive issues is insufficient in our data. While these enzymes are widely used in digestive supplements, solid clinical proof is lacking. Your results may vary; talk with your pharmacist or doctor about whether this product is right for your situation.
Is it safe to take Digest Plus if I'm pregnant?
Safety data for most of the ingredients is limited or absent during pregnancy. Betaine hydrochloride is best avoided. Papain from unripe papaya sources is a concern. Because the picture is incomplete, talk with your doctor or pharmacist before using it during pregnancy.
Can I take this while breastfeeding?
Safety information during breastfeeding is not well established for the enzymes in this product. Betaine hydrochloride is unsafe during breastfeeding. Speak with your healthcare provider before starting.
What does betaine hydrochloride do in this product?
Betaine hydrochloride is meant to increase stomach acid to aid digestion. However, if you take stomach-acid-reducing medications like antacids, H2-blockers, or PPIs, it can work against them. It may also irritate the stomach or trigger heartburn, especially if you have ulcers or reflux.
Why is sodium in a digestive supplement?
Sodium is listed as an active ingredient, likely as part of a mineral blend or as a component of other compounds in the formula. However, this product adds supplemental sodium, which you should be cautious about—especially if you take blood pressure medications, lithium, or have heart or kidney concerns. Check with your pharmacist on the amount and whether it's safe for you.
Could this product affect my blood thinner (warfarin)?
Yes. Papain in this product may increase warfarin's effects and risk of bleeding. If you take warfarin, do not start this supplement without talking to your pharmacist or doctor first.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Not sure if Digest Plus is safe with your meds?

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Digest Plus label
Go deeper

The Full Monographs Behind Digest Plus’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Sodium

Interacts with 205 drugs

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...

Read the full Sodium monograph → Herb & supplement monograph

Betaine Hydrochloride

Interacts with 36 drugs

Betaine hydrochloride is a supplement used to temporarily increase stomach acid in people who may have low acid levels. Evidence for its benefits is limited and mostly based on tradition rat...

Read the full Betaine Hydrochloride monograph → Herb & supplement monograph

Papain

Interacts with 2 drugs

Papain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food and laboratory uses, strong human evidence...

Read the full Papain monograph → Herb & supplement monograph

Proteolytic Enzymes (proteases)

Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), trypsin, chymotrypsin, and pancreatin. Peo...

Read the full Proteolytic Enzymes (proteases) monograph → Herb & supplement monograph

Pancreatic Enzyme Products

Interacts with 1 drug

Pancreatic enzyme products supply the digestive enzymes (lipase, protease, and amylase) that some people cannot make enough of, helping them break down and absorb food. Prescription versions...

Read the full Pancreatic Enzyme Products monograph → Herb & supplement monograph

Lipase

Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy for people who cannot make enough of their...

Read the full Lipase monograph →
Sources

Sources & How We Checked

Digest Plus's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 95 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Sodium 38 references
  1. Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
  2. Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
  3. Coton T, Mallaret C, Coilliot C, Carre D, Guisset M. Severe acute ulcerated gastritis induced by salt. Presse Med 2009;38(3):499-500. PubMed
  4. Frings-Meuthen P, Buehlmeier J, Baecker N, et al. High sodium chloride intake exacerbates immobilization-induced bone resorption and protein losses. J Appl Physiol 2011;111(2):537-542. PubMed
  5. Frings-Meuthen P, Baecker N, Heer M. Low-grade metabolic acidosis may be the cause of sodium chloride-induced exaggerated bone resorption. J Bone Miner Res 2008;23(4):517-524. PubMed
  6. Alam S, Johnson AG. A meta-analysis of randomised controlled trials (RCT) among healthy normotensive and essential hypertensive elderly patients to determine the effect of high salt (NaCl) diet of blood pressure. J Hum Hypertens 1999;13(6):367-74.
  7. Boudville N, Ward S, Benaroia M, House AA. Increased sodium intake correlates with greater use of antihypertensive agents by subjects with chronic kidney disease. Am J Hypertens 2005;18(10):1300-5. PubMed
  8. Bennett WM. Drug interactions and consequences of sodium restriction. Am J Clin Nutr 1997;65(2 Suppl):678S-681S. PubMed
  9. Okusa MD, Crystal LJ. Clinical manifestations and management of acute lithium intoxication. Am J Med 1994;97(4):383-9. PubMed
  10. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academy Press, 2005. Available at: http://www.nap.edu/openbook.php?record_id=10925. DOI
  11. D'Elia L, Rossi G, Ippolito R, Cappuccio FP, Strazzullo P. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr 2012;31(4):489-98. PubMed
  12. Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed
  13. Willocks L, Brettle R, Keen J, Valentine C, Pinching AJ. Formulations of didanosine (ddI) and salt overload. Lancet 1992;339(8786):190.
  14. Chen L, Zhang Z, Chen W, Whelton PK, Appel LJ. Lower Sodium Intake and Risk of Headaches: Results From the Trial of Nonpharmacologic Interventions in the Elderly. Am J Public Health. 2016;106(7):1270-5. PubMed
  15. Cook NR, Appel LJ, Whelton PK. Lower levels of sodium intake and reduced cardiovascular risk. Circulation. 2014;129(9):981-9. PubMed
  16. Cook NR, Appel LJ, Whelton PK. Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention. J Am Coll Cardiol. 2016;68(15):1609-1617. PubMed
  17. Mente A, O'Donnell M, Rangarajan S, et al. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016;388(10043):465-75. PubMed
  18. Moosavian SP, Haghighatdoost F, Surkan PJ, Azadbakht L. Salt and obesity: a systematic review and meta-analysis of observational studies. Int J Food Sci Nutr. 2017;68(3):265-277. PubMed
  19. O'Donnell M, Mente A, Rangarajan S, et al. Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med. 2014;371(7):612-23. DOI
  20. Poggio R, Gutierrez L, Matta MG, Elorriaga N, Irazola V, Rubinstein A. Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies. Public Health Nutr. 2015;18(4):695-704. PubMed
  21. Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad
  22. Mahtani KR, Heneghan C, Onakpoya I, et al. Reduced Salt Intake for Heart Failure: A Systematic Review. JAMA Intern Med. 2018 Dec 1;178(12):1693-1700. PubMed
  23. Yancy CW. Sodium Restriction in Heart Failure: Too Much Uncertainty-Do the Trials. JAMA Intern Med. 2018 Dec 1;178(12):1700-1701. PubMed
  24. He FJ, Campbell NRC, Ma Y, MacGregor GA, Cogswell ME, Cook NR. Errors in estimating usual sodium intake by the Kawasaki formula alter its relationship with mortality: implications for public health. Int J Epidemiol. 2018;47(6):1784-1795. PubMed
  25. Murthy K, Ondrey GJ, Malkani N, et al. THE EFFECTS OF HYPONATREMIA ON BONE DENSITY AND FRACTURES: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endocr Pract. 2019;25(4):366-378. PubMed
  26. Messerli FH, Hofstetter L, Syrogiannouli L, et al. Sodium intake, life expectancy, and all-cause mortality. Eur Heart J 2021;42(21):2103-2112. PubMed
  27. Graudal NA, Hubeck-Graudal T, Jurgens G. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database Syst Rev 2020;12(12):CD004022. PubMed
  28. Giatti S, Santos RB, Aielo AN, et al. Association of sodium with obstructive sleep apnea. The ELSA-Brasil study. Ann Am Thorac Soc 2021;18(3):502-510. PubMed
  29. Nan X, Lu H, Wu J, et al. The interactive association between sodium intake, alcohol consumption and hypertension among elderly in northern China: a cross-sectional study. BMC Geriatr 2021;21(1):135. PubMed
  30. Kyozuka H, Fukusda T, Murata T, et al. Impact of preconception sodium intake on hypertensive disorders of pregnancy: The Japan Environment and Children's study. Pregnancy Hypertens 2021;23:66-72. PubMed
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Betaine Hydrochloride 2 references
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See these in context on the Pancreatic Enzyme Products monograph →

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