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Aliskiren + Hydrochlorothiazide
Depletes
Prolonged use of Aliskiren + Hydrochlorothiazide can impact 11 essential nutrients.
Folic Acid
Studies indicate thiazide diuretics may act like folate antagonists, potentially leading to folate deficiency. Research suggests long-term use (over six months) can significantly decrease blood folate levels while increasing homocysteine, a potentially harmful amino acid linked to vascular disease. Folate supplementation should be considered while on thiazide diuretics.
Replace with Folate (.2mg as L-5-Methylfolate) (0.34 DFE)
Research: Maron BA, Loscalzo J. Homocysteine. Clin Lab Med. 2006 Sep;26(3):591-609, vi. doi: 10.1016/j.cll.2006.06.008. PMID:...
Zinc
Thiazide diuretics, a common medication for high blood pressure, can increase how much zinc your body gets rid of through urine. It's advisable to monitor your blood zinc levels while taking these medications and consider zinc supplementation.
Replace with Zinc (as zinc bisglycinate and (TRAACS™) (12.5mg)
Research: Cohen N, Golik A. Zinc balance and medications commonly used in the management of heart failure. Heart Fail Rev. 2006...
Magnesium
Taking thiazide diuretics long-term can increase magnesium loss. Monitoring magnesium levels and considering supplementation might be necessary when taking thiazide diuretics for an extended period of time.
Replace with Magnesium Citrate (50 mg)
Research: Cunha A.R., D’El-Rei J., Medeiros F., Umbelino B., Oigman W., Touyz R.M., Neves M.F. Oral magnesium supplementation improves...
Potassium
Thiazide diuretics can cause potassium to leave your cells. These medications work by making your kidneys flush out water and sodium, but unfortunately, potassium gets swept along too. This raises the risk of a moderate or severe potassium deficiency, called hypokalemia and potassium supplementation should be considered.
Replace with Potassium (as citrate and gluconate) (99 mg)
Research: Rodenburg EM, Visser LE, Hoorn EJ, Ruiter R, Lous JJ, Hofman A, Uitterlinden AG, Stricker BH. Thiazides and the risk of...
CoQ10
Thiazide diuretics may decrease the effectiveness of enzymes in your heart that rely on CoQ10 for function. This nutrient is essential for cellular energy production. Patients taking these medications might consider CoQ10 supplementation to address potential deficiencies.
Replace with 50% Ubiquinone and 50% Ubiquinol (50 mg)
Research: Holm L, Holmer G, Mortensen SA, Stender S. Coenzyme Q10 in health and disease. Eur J Clin Nutr. 1999;53:764-770. Coenzyme...
Also Benefits From:
Grape Seed Extract
Grape Seed Extracts (GSE) are rich in polyphenols, specifically proanthocyanadins, that provide benefits to the cardiovascular system especially in area of inflammation, hypertension and cardiovascular disease. Studies suggest that the consumption of GSE that is rich in proanthocyanadins, helps protect against myocardial injury, helps lower blood pressure, reduce inflammation, decrease the size of carotid plaque and inhibiting dangerous platelet adhesions and aggregation thereby reducing cardiovascular mortality. 
Research: Schön C, Allegrini P, Engelhart-Jentzsch K, Riva A, Petrangolini G. Grape Seed Extract Positively Modulates Blood Pressure...
Niacin
Niacin, a form of vitamin B3, offers a potential double benefit for heart health. It can help lower LDL ("bad") cholesterol and triglycerides, while also raising HDL ("good") cholesterol. This favorable cholesterol profile can reduce the risk of heart disease. But niacin's benefits might extend beyond cholesterol. Some studies suggest it may also play a role in lowering blood pressure. Niacin seems to work by causing blood vessels to relax and dilate, which could improve blood flow and potentially reduce strain on the heart, thereby lowering blood pressure.
Research: Digby JE, Ruparelia N, Choudhury RP. Niacin in cardiovascular disease: recent preclinical and clinical developments....
Taurine
Beyond its general health benefits, Taurine shines for its potential to support a healthy heart and blood pressure. This amino acid boasts anti-inflammatory and antioxidant properties, which may help protect against hypertension. Studies suggest it can modulate blood sugar levels, potentially reducing the risk of diabetes and its complications like heart disease. Taurine's overall impact on the cardiovascular system is promising, with some evidence indicating it may be essential for proper heart function and development.
Research: Ahmadian M, Dabidi Roshan V, Ashourpore E. Taurine Supplementation Improves Functional Capacity, Myocardial Oxygen...
Vitamin B12
Vitamin B12 plays a crucial role in cardiovascular health by regulating homocysteine levels. Homocysteine is an amino acid, and high levels in the blood are a risk factor for heart attack and stroke. Vitamin B12 acts as a key player in the homocysteine metabolism process, helping to convert it into other beneficial compounds. By keeping homocysteine in check, Vitamin B12 may help reduce the risk of cardiovascular problems.
Research: Celik SF, Celik E. Subclinical atherosclerosis and impaired cardiac autonomic control in pediatric patients with Vitamin B12...
Vitamin B6
Vitamin B6, a crucial B vitamin, plays a significant role in heart health. It helps regulate homocysteine levels in the blood. High homocysteine is a risk factor for atherosclerosis, the buildup of plaque in arteries that can lead to heart disease. By keeping homocysteine in check, Vitamin B6 may help lower the risk of heart problems. Additionally, some research suggests Vitamin B6 may also play a role in managing hypertension (high blood pressure). While the exact mechanism isn't fully understood, Vitamin B6 deficiency has been linked to an increased risk of hypertension.
Research: Stach K, Stach W, Augoff K. Vitamin B6 in Health and Disease. Nutrients. 2021 Sep 17;13(9):3229. Yuan S, Mason AM, Carter P,...
Vitamin C
Vitamin C (Ascorbic acid) goes beyond just immune system support. This powerful antioxidant combats free radicals and oxidative stress, potentially reducing the risk of various diseases. While most recognized for its role in white blood cell production, research suggests Vitamin C may also benefit heart health and blood pressure. It might help protect against damage caused by free radicals in blood vessels, potentially lowering the risk of cardiovascular disease. Additionally, studies indicate Vitamin C may play a role in lowering blood pressure
Research: Guan Y, Dai P, Wang H. Effects of vitamin C supplementation on essential hypertension: A systematic review and...
Health Impact
Aliskiren + Hydrochlorothiazide-induced nutrient depletion can lead to a range of health problems
High Homocysteine & Vascular Risk
Meta-analyses of randomized trials show that folic acid supplementation lowers homocysteine and modestly reduces stroke and overall cardiovascular disease risk in some populations, especially where baseline folate status is low, highlighting the adverse vascular profile of folate deficiency.
Research: Li Y et al. Folic acid supplementation and the risk of cardiovascular diseases: a meta-analysis of randomized controlled...
Folate-Related Megaloblastic Anemia
Hematology and nutrition reviews describe folate deficiency as a classic cause of megaloblastic anemia and mucosal abnormalities, frequently exacerbated by medications that antagonize folate metabolism.
Research: O’Leary F, Samman S. Vitamin B12 in health and disease. Nutrients. 2010;2(3):299-316. (discussion of folate and B12 in...
Weakened Immune Response
Classic dermatology and immunology literature shows that zinc deficiency causes lymphopenia and reduced immune capacity; more recent work links marginal deficiency to impaired inflammatory and anti-microbial responses.
Research: Fraker PJ et al. The dynamic link between the integrity of the immune system and zinc status. JAMA Dermatol....
Slow Skin & Wound Healing
Experimental and clinical studies demonstrate that zinc deficiency is associated with skin lesions, delayed wound closure and abnormal inflammatory responses, while zinc repletion can improve healing outcomes in selected populations.
Research: Lin PH, Sermersheim M et al. Zinc in wound healing modulation. Nutrients. 2017;9(1):16.; News-Medical. The role of zinc in...
Muscle Cramps & Neuromuscular Irritability
Clinical reports and modern reviews note that hypomagnesemia is associated with muscle cramps and spasms; mechanistic work links low magnesium to impaired ATP handling and sustained muscle contraction.
Research: Bilbey DL, Prabhakaran VM. Muscle cramps and magnesium deficiency: case reports. Can Fam Physician. 1996;42:1471-1473.;...
Arrhythmias & Blood Pressure Changes
Cardiovascular reviews identify subclinical magnesium deficiency as a contributor to arrhythmias and hypertension, particularly in individuals on diuretics or medications that increase urinary magnesium loss.
Research: DiNicolantonio JJ et al. Subclinical magnesium deficiency: a principal driver of cardiovascular disease? Open Heart....
Weakness, Cramps & Fatigue
Clinical reviews of hypokalemia list weakness, fatigue and muscle cramps as hallmark symptoms even with moderate potassium depletion, especially in the context of diuretic use or gastrointestinal losses.
Research: Castro D, Sharma S. Hypokalemia. StatPearls [Internet]. 2025.; MedlinePlus. Low blood potassium (hypokalemia). 2023.;...
Side Effects
Common side effects of Aliskiren + Hydrochlorothiazide, some of which may be related to nutrient depletion
Review
Common side effects of Aliskiren + Hydrochlorothiazide may include:

- Dizziness or lightheadedness
- Headache
- Diarrhea or upset stomach
- Fatigue
- Muscle cramps or weakness
- Skin rash
- Difficulty breathing

Serious side effects that may require immediate medical attention include:

- Severe allergic reactions (rash, itching, swelling of the face or throat, difficulty breathing)
- Signs of high potassium levels (muscle weakness, irregular heartbeat, tingling sensation)
- Signs of low blood pressure (dizziness, fainting, blurred vision)
- Signs of kidney problems (changes in urination, swelling in the feet or ankles)
- Signs of liver problems (yellowing of the skin or eyes, dark urine, abdominal pain)

It is important to talk to your healthcare provider if you experience any of these side effects while taking Aliskiren + Hydrochlorothiazide.
Get Support
We've developed a formula to replenish the nutrients depleted by Aliskiren + Hydrochlorothiazide.
Aliskiren + Hydrochlorothiazide Support Formula

HCTZ Support

Once Daily Capsule

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Rx Not Required

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