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Hydrochlorothiazide
Depletes
Prolonged use of Hydrochlorothiazide can impact 11 essential nutrients.
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...
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...
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
Hydrochlorothiazide-induced nutrient depletion can lead to a range of health problems
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.;...
Constipation & Rhythm Disturbances
Guideline and textbook sources emphasize constipation and arrhythmias as clinically significant sequelae of hypokalemia, especially at lower serum levels or in patients with underlying heart disease.
Research: Cleveland Clinic. Low potassium level (hypokalemia): causes and symptoms. 2023.; Johnson Memorial Health. Low potassium...
Statin-Related Muscle Pain & Fatigue
Randomized trials and meta-analyses in statin-treated patients have shown that CoQ10 depletion and/or low circulating levels are associated with muscle symptoms, while supplementation has produced mixed but suggestive improvements in statin-associated myalgia and muscle pain severity.
Research: Caso G et al. Effect of coenzyme Q10 on myopathic symptoms in patients treated with statins. Am J Cardiol....
Low Mitochondrial Energy & Antioxidant Defense
Mechanistic and clinical studies link lower CoQ10 status with impaired oxidative phosphorylation and higher markers of oxidative stress, particularly in tissues with high metabolic demand such as myocardium and skeletal muscle.
Research: Littarru GP, Tiano L. Clinical aspects of coenzyme Q10: cardiology and beyond. Antioxid Redox Signal....
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....
Side Effects
Common side effects of Hydrochlorothiazide, some of which may be related to nutrient depletion
Review
Common side effects of hydrochlorothiazide may include:
1. Dizziness or lightheadedness
2. Headache
3. Nausea or vomiting
4. Muscle cramps or weakness
5. Increased sensitivity to sunlight
6. Increased urination
7. Blurred vision
8. Dry mouth
9. Skin rash or itching
10. Electrolyte imbalances, such as low levels of potassium or sodium
11. Erectile dysfunction
More serious side effects that may require immediate medical attention include:
1. Severe allergic reaction, with symptoms such as rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing
2. Signs of dehydration, such as extreme thirst, very dry mouth, muscle cramps, weakness, or dark urine
3. Symptoms of high blood sugar, such as increased thirst or urination, confusion, drowsiness, flushing, rapid breathing, or fruity breath odor
4. Signs of a severe electrolyte imbalance, such as irregular heartbeat, muscle weakness, confusion, tingling in the hands/feet
5. Symptoms of low blood pressure, such as fainting, light-headedness, or dizziness
It's important to discuss any concerns or questions about hydrochlorothiazide with your doctor, and to seek medical attention if you experience any severe or persistent side effects.
1. Dizziness or lightheadedness
2. Headache
3. Nausea or vomiting
4. Muscle cramps or weakness
5. Increased sensitivity to sunlight
6. Increased urination
7. Blurred vision
8. Dry mouth
9. Skin rash or itching
10. Electrolyte imbalances, such as low levels of potassium or sodium
11. Erectile dysfunction
More serious side effects that may require immediate medical attention include:
1. Severe allergic reaction, with symptoms such as rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing
2. Signs of dehydration, such as extreme thirst, very dry mouth, muscle cramps, weakness, or dark urine
3. Symptoms of high blood sugar, such as increased thirst or urination, confusion, drowsiness, flushing, rapid breathing, or fruity breath odor
4. Signs of a severe electrolyte imbalance, such as irregular heartbeat, muscle weakness, confusion, tingling in the hands/feet
5. Symptoms of low blood pressure, such as fainting, light-headedness, or dizziness
It's important to discuss any concerns or questions about hydrochlorothiazide with your doctor, and to seek medical attention if you experience any severe or persistent side effects.
Get Support
We've developed a formula to replenish the nutrients depleted by Hydrochlorothiazide.
Shop Third-Party Supplements
Zinc Bisglycinate
by Pure Encapsulations
The Zinc supplement by Pure Encapsulations is a dietary supplement designed to support immune function and overall health, featuring highly bioavailable zinc in a hypoallergenic, vegetarian capsule.
Strength: 15 mg
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Zinc Bisglycinate
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Potassium (as gluconate)
by Pure Encapsulations
The Potassium supplement by Pure Encapsulations is a dietary supplement designed to support cardiovascular health, muscle function, and electrolyte balance, using high-quality, hypoallergenic ingredients.
Strength: 200mg
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Potassium (as gluconate)
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Magnesium (as Magnesium Citrate)
by Pure Encapsulations
Pure Encapsulations Magnesium supplement is a dietary supplement designed to support overall health by providing highly bioavailable magnesium to aid in muscle function, energy production, and cardiovascular health.
Strength: 150 mg
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Magnesium (as Magnesium Citrate)
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Folate
by Pure Encapsulations
Pure Encapsulations' Folic Acid supplement provides a high-quality, bioavailable form of folic acid to support healthy fetal development, cardiovascular health, and overall cellular function.
Strength: 800 mcg
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Folate
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COQ 10 (as Ubiquinone)
by Life Extension
The CoQ10 supplement by Life Extension is a high-quality dietary supplement designed to support cellular energy production and antioxidant protection, utilizing a bioavailable form of Coenzyme Q10.
Strength: 50 mg
Buy now
COQ 10 (as Ubiquinone)
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