Aspirin, Citric Acid, Sodium Bicarbonate & Nutrient Depletion
Also searched as Alka-Seltzer Pain Reliever and Antacid. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.
Aspirin, Citric Acid, Sodium Bicarbonate has been associated with depletion of FOLIC ACID, IRON, VITAMIN C and PHOSPHATE SALTS and 2 more. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Aspirin, Citric Acid, Sodium Bicarbonate long-term, worth raising with your pharmacist or healthcare provider.
Take more than one medication? Open the checker with Aspirin, Citric Acid, Sodium Bicarbonate pre-loaded and add the rest to see overlapping nutrient signals.
Reported nutrient depletions with Aspirin, Citric Acid, Sodium Bicarbonate
Each record below is shown as published in our licensed clinical database, with its evidence rating and citations. Expand a section for food sources and talking points.
FOLIC ACID
Insignificant DepletionANTACIDS
Folic acid absorption in the small intestine is optimal at a pH of 5.5-6. Chronic use of large doses of antacids can reduce folic acid absorption, but this is likely only significant if dietary folate intake is very low. Advise patients to maintain the recommended daily intake of folic acid in their diet. For information on foods that are rich in folate, see our chart.
Folic acid is a B vitamin your body uses to build new cells and keep your DNA healthy. The sodium bicarbonate in this product is an antacid, and antacids can slightly raise the pH in your small intestine, which is where folate is best absorbed at a mildly acidic level. In theory, that shift could reduce how much folate you take in, but for most people using this product, the effect is too small to matter. Just aim to eat folate-rich foods regularly, and if you have any concerns, your pharmacist or doctor is a great resource.
What Folic acid (folate) does & food sources
Folate is needed for cell division, red blood cell formation, and healthy fetal development.
Common food sources:
- Leafy green vegetables
- Beans, lentils, and peas
- Fortified grains and cereals
- Citrus fruits
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask your provider whether folate monitoring or supplementation is appropriate for you — this matters most before and during pregnancy, and with long-term use of certain seizure or arthritis medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Folate needs are individual. With some medications (for example, methotrexate), folic acid is often prescribed deliberately on a specific schedule — follow your prescriber's instructions rather than adding your own.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: High-dose folic acid can mask vitamin B12 deficiency, so the two are often evaluated together.
Learn more about this nutrient: Folic Acid — uses, safety & interactions
References (2)
- Russell RM, Golner BB, Krasinski SD, et al. Effect of antacid and H2 receptor antagonists on the intestinal absorption of folic acid. J Lab Clin Med 1988;112:458-63.
- Shils ME, Olson JA, Shike M, Ross AC, eds. Modern Nutrition in Health and Disease. 9th ed. Baltimore, MD: Williams & Wilkins, 1999.
IRON
Insignificant DepletionANTACIDS
Gastric acid is important for absorption of dietary, non-heme iron. Antacids may therefore reduce iron absorption by increasing gastric pH and reducing iron solubility. This isn't likely to be clinically significant in most people with adequate dietary iron intake. However, antacids can reduce absorption of iron from supplements by 30% to 40%, and reduced efficacy has occurred occasionally. Advise patients who need iron supplements to avoid antacids or separate the doses as much as possible.
Iron is something your body needs to carry oxygen in the blood and keep your energy up. The sodium bicarbonate in this product works as an antacid, and antacids can raise the pH inside your stomach, which makes it harder for your gut to absorb the form of iron found in food and supplements. For most people eating a balanced diet, this interaction is considered insignificant and no supplement is needed. If you happen to take iron supplements, though, it is worth asking your pharmacist about spacing the two apart by a couple of hours, just to be safe.
What Iron does & food sources
Iron is the core of hemoglobin, which carries oxygen in red blood cells.
Common food sources:
- Red meat and poultry
- Beans and lentils
- Fortified cereals
- Spinach (plant iron absorbs better with vitamin C)
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Iron status is easy to assess (ferritin, iron studies, blood counts). Ask your provider before supplementing — unexplained low iron always deserves a medical evaluation for the cause, not just replacement.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Iron supplements commonly cause constipation or stomach upset and interfere with the absorption of several medications (thyroid medication, some antibiotics). Do not take iron "just in case" — excess iron is harmful.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Never self-treat suspected anemia; the underlying cause matters as much as the iron level.
Learn more about this nutrient: Iron — uses, safety & interactions
References (3)
- Aymard JP, Aymard B, Netter P, et al. Haematological adverse effects of histamine H2-receptor antagonists. Med Toxicol Adverse Drug Exp 1988;3:430-48. PubMed
- Tatro DS, ed. Drug Interactions Facts. Facts and Comparisons Inc., St. Louis, MO. 1999.
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
VITAMIN C
Insignificant DepletionASPIRIN
Aspirin reduces tissue and leukocyte uptake of vitamin C, leaving more in the plasma to be filtered into the urine and increasing elimination. It may also reduce absorption of vitamin C from the gut. These effects are dose-related. Vitamin C supplementation has been suggested for people taking high-dose aspirin long-term. Supplements aren't needed with the low doses of aspirin used for cardiovascular indications.
Vitamin C is something your immune cells and tissues depend on for repair and fighting off illness. Aspirin appears to interfere with how well your cells hold onto vitamin C, which can push more of it out through the urine, and at higher doses it may also reduce how much your gut absorbs. That said, this combination product uses a low amount of aspirin, and the evidence puts this depletion in the 'insignificant' category, meaning most people using it occasionally have nothing to worry about. If you take aspirin daily at higher doses long-term, it is worth a quick conversation with your pharmacist.
What Vitamin C does & food sources
Vitamin C is an antioxidant that supports the immune system, collagen formation, and iron absorption.
Common food sources:
- Citrus fruits
- Bell peppers
- Strawberries and kiwi
- Broccoli and Brussels sprouts
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Frank vitamin C deficiency is uncommon with a varied diet. If your diet is limited and you take an associated medication, ask your provider whether your intake is adequate.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Vitamin C is water-soluble and generally low-risk at food-level intakes; very high supplemental doses can cause stomach upset and may not add benefit.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Learn more about this nutrient: Vitamin C — uses, safety & interactions
References (5)
- Loh HS, Wilson CW. The interactions of aspirin and ascorbic acid in normal men. J Clin Pharmacol 1975;15:36-45. DOI
- Sahud MA, Cohen RJ. Effect of aspirin ingestion on ascorbic-acid levels in rheumatoid arthritis. Lancet 1971;1:937-8. PubMed
- Wilson CW, Greene M. The relationship of aspirin to ascorbic acid metabolism during the common cold. J Clin Pharmacol 1978;18:21-8. PubMed
- Basu TK. Vitamin C-aspirin interactions. Int J Vitam Nutr Res Suppl 1982;23:83-90.
- Johansson U, Akesson B. Interaction between ascorbic acid and acetylsalicylic acid and their effects on nutritional status in man. Int J Vitam Nutr Res 1985;55:197-204.
PHOSPHATE SALTS
Moderate DepletionANTACIDS
Aluminum, calcium, and magnesium contained in antacids can bind phosphate in the gut and prevent its absorption. Antacids are sometimes used therapeutically to decrease high phosphate levels in people with chronic kidney disease. In people with normal kidney function, use of higher-than-recommended doses of antacids for prolonged periods (e.g. over 100 mL daily of Maalox for several months, or 30 mL daily for over 10 years) can cause hypophosphatemia, potentially leading to osteomalacia, fractures, nephrolithiasis, and ureter obstruction.
Phosphate is a mineral your bones, muscles, and cells depend on for energy and structure. The sodium bicarbonate in this effervescent formula acts as an antacid, and antacids can grab onto phosphate in the digestive tract before your body has a chance to absorb it. This is mainly a concern with heavy, long-term antacid use rather than occasional doses, but a "Moderate Depletion" rating means it is worth keeping an eye on. If you use this product regularly, ask your pharmacist or doctor whether your phosphate levels should be checked.
Learn more about this nutrient: Phosphate Salts — uses, safety & interactions
References (4)
- Harmelin DL, Martin FR, Wark JD. Antacid-induced phosphate depletion syndrome presenting as nephrolithiasis. Aust NZ J Med 1990;20:803-5. PubMed
- Spencer H, Menaham L. Adverse effects of aluminum-containing antacids on mineral metabolism. Gastroenterology 1979;76:603-6. DOI
- Insogna KL, Bordley DR, Caro JF, Lockwood DH. Osteomalacia and weakness from excessive antacid ingestion. JAMA 1980;244:2544-6. DOI
- Saadeh G, Bauer T, Licata A, Sheeler L. Antacid-induced osteomalacia. Cleve Clin J Med 1987;54:214-6. PubMed
VITAMIN B12
Moderate DepletionASPIRIN
Clinical research suggests that using aspirin is associated with a higher prevalence of vitamin B12 deficiency when compared with nonusers. For information on foods that are rich in vitamin B12, see our chart.
Vitamin B12 is something your nerves and red blood cells genuinely depend on, so it's worth paying attention to here. Regular aspirin use has been linked in clinical studies to a higher rate of low B12 levels compared to people who don't take it. The exact reason isn't fully pinned down, but aspirin may interfere with how the stomach and small intestine absorb B12 from food. Given the moderate rating on this one, long-term aspirin users are worth monitoring, and some do end up needing a supplement, so it's a reasonable thing to bring up with your pharmacist or doctor.
What Vitamin B12 does & food sources
Vitamin B12 supports red blood cell formation, nerve function, and DNA synthesis.
Common food sources:
- Meat, poultry, and fish
- Eggs and dairy products
- Fortified cereals and nutritional yeast
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
If you take an associated medication long-term, ask your healthcare provider whether checking a vitamin B12 level (sometimes with methylmalonic acid) is appropriate — especially if you notice fatigue, numbness, tingling, or memory changes.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
B12 status is easy to check and low levels are usually straightforward to address, so testing before supplementing is often the sensible order. High-dose folic acid can mask a B12 deficiency, which is one reason B12 and folate questions are best sorted out together with your provider.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: B12 deficiency can look like other conditions — do not self-diagnose from symptoms alone.
Learn more about this nutrient: Vitamin B12 — uses, safety & interactions
References (1)
- van Oijen MG, Laheij RJ, Peters WH, et al. Association of aspirin use with vitamin B12 deficiency (results of the BACH study). Am J Cardiol. 2004 Oct 1;94(7):975-7. PubMed
CHROMIUM
Insufficient EvidenceANTACIDS
Antacids increase gastric pH, which might decrease chromium absorption due to formation of less soluble chromium salts. However, the clinical significance of this is not clear.
Chromium is a trace mineral your body uses to help regulate blood sugar and support normal metabolism. The sodium bicarbonate in this effervescent aspirin formula acts as an antacid, and antacids raise the pH inside your stomach. That higher pH can cause chromium from food to form compounds that are harder for your gut to absorb. That said, the research here is quite thin, and right now nobody knows whether this matters in a real-world, practical sense. If you use this product regularly and have questions about your chromium levels, it is worth a quick conversation with your pharmacist or doctor.
Learn more about this nutrient: Chromium — uses, safety & interactions
References (3)
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
- Davis ML, Seaborn CD, and Stoecker BJ. Effects of over-the-counter drugs on chromium retention and urinary excretion in rats. Nutrition Research 1995;15(2):201-210.
- Seaborn CD and Stoecker BJ. Effects of antacid or ascorbic acid on tissue accumulation and urinary excretion of 51chromium. Nutrition Research 1990;10:1401-1407. DOI
This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
More about Aspirin, Citric Acid, Sodium Bicarbonate
What drug-induced nutrient depletion means
Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.
Association is not deficiency
An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.
Evidence varies by pair
Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.
When to ask about labs
If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.
Don't self-supplement blindly
Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.
Never stop a medication over this
These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.
Food first, usually
For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.
Aspirin, Citric Acid, Sodium Bicarbonate & nutrients: FAQs
Does Aspirin, Citric Acid, Sodium Bicarbonate deplete FOLIC ACID?
Should I take a supplement because I take Aspirin, Citric Acid, Sodium Bicarbonate?
Should I stop taking Aspirin, Citric Acid, Sodium Bicarbonate?
Where does this information come from?
Questions about Aspirin, Citric Acid, Sodium Bicarbonate and your nutrition?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Nutrient depletion records for Aspirin, Citric Acid, Sodium Bicarbonate are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for drug-induced nutrient depletions, supplements, and interactions — the basis for this page.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for medication overviews across the site.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.