ALKA-SELTZER GOLD ALTERNATIVES - PH-BALANCING OPTIONS
Updated: 3 days ago
Bayer confirmed they discontinued Alka-Seltzer Gold in 2023. Many of you already know this, but it doesn't hurt to make sure, since someone may need it today. Alka-Seltzer Gold was amazing at alkalizing the body to help when herxing. Here is some information so you have some alternatives.
Many people in our community don't realize there are many options to replace it. A perk is that you can avoid the citric acid if you choose.
Bi-Carb by Klaire on Fullscript is a great alternative, according to a Lyme doctor I discussed the topic with. Bi-Carb and two other options below can be found on Fullscript at 25% off.
Short on time or energy? A quick-view graphic with the key points is at the bottom of this post.
Buy links are right under each product. Sign up here first for the Fullscript discount (25% off):
WHAT WAS ALKA-SELTZER GOLD?
- A fizzy antacid tablet you dissolved in water. Dr. Horowitz's 2024 case reports list it as sodium bicarbonate.
- Regular Alka-Seltzer contains aspirin, according to Memorial Sloan Kettering. The Gold version was the aspirin-free one.
- The company still makes other Alka-Seltzer products, but I was told to avoid their other products.
WHY LYME PATIENTS USED IT
- To alkalize during a Herx (die-off reaction). A 2017 LymeDisease.org article (older source) explains that when the body can't clear dying bacteria and inflammatory cytokines fast enough, it can lead to an acid imbalance.
- The same article shares herx tips adapted from Dr. Richard Horowitz's five-step approach. Step one is to alkalize at the first sign of symptoms with Alka-Seltzer Gold, buffered vitamin C or lemon-lime water.
- For heartburn and upset stomach. Memorial Sloan Kettering lists these as uses for sodium bicarbonate (baking soda) tablets.
WHAT LYME-LITERATE DOCTORS SAY
- Dr. Richard Horowitz recommends Alka-Seltzer Gold or sodium bicarbonate, taken only as needed and together with glutathione, for severe Herx reactions. He says this in his 2023 published study of his patients, his 2024 case reports and his 2025 Bartonella article on LymeDisease.org. His case reports also list freshly squeezed lemon or lime as another way to alkalize.
- This is doctor experience, not a controlled trial. I couldn't find any study that tested bicarbonate for Herx reactions.
- A well-known herx recipe, adapted from Dr. Richard Horowitz: 1500 mg liposomal glutathione, juice of 1 lemon, a pH-balancing supplement and 8 ounces of water. The pH-balancing supplement I use is Bi-Carb. Follow the label or your doctor's directions. More in my Herx post:
HERX - POSSIBLE SOLUTIONS
- More about glutathione and lemon water here:
GLUTATHIONE
LEMON WATER
REPLACEMENT OPTIONS
None of these contain citric acid. (Lemon juice has natural citric acid, so leave it out of your recipe if you're avoiding citric acid.)
- Bi-Carb Formula (Klaire Labs): capsules of sodium bicarbonate and potassium bicarbonate. One capsule has 90 mg of sodium and 125 mg of potassium. The label says 1 capsule a day with about 6 ounces of water, or as your doctor directs.
Buy here (Klaire Labs Bi-Carb Formula, the one I use):
- Tri-Salts (Ecological Formulas): a powder of calcium carbonate, magnesium carbonate and potassium bicarbonate. It has no sodium. The label says to mix 1/2 teaspoon in water.
Buy here (Ecological Formulas Tri-Salts):
- Herxheimer Support (Allergy Research Group): capsules with sodium and potassium bicarbonate plus turmeric and boswellia. The label says to take it with meals. Turmeric may raise the risk of bleeding if you take blood thinners, so ask your doctor first.
Buy here (Allergy Research Group Herxheimer Support):
- Baking soda (sodium bicarbonate): plain baking soda mixed in water, NOT baking powder. It has sodium but no potassium. See My Experience below for the amount I was told.
BEFORE YOU START
- Read the warning on each bottle.
- Baking soda contains sodium. If you're on a low-sodium diet, talk with your doctor first.
- Bi-Carb, Tri-Salts and Herxheimer Support also contain potassium. Always ask your doctor before adding potassium.
- Memorial Sloan Kettering notes that sodium bicarbonate may keep other medicines taken by mouth from getting into the body, so you may need to take them at a different time. Ask your doctor or pharmacist how far apart.
- Antibiotics: 2024 reviews found that antacids and mineral supplements lowered how much of some antibiotics the body absorbs, including tetracyclines (like doxycycline and minocycline) and quinolones (like ciprofloxacin). Tri-Salts contains calcium and magnesium. Ask your pharmacist how far apart to take them.
- Dr. Horowitz uses these as needed for severe Herx reactions. Don't use them every day long term unless your doctor says to.
- More is not better. A 2026 review of 78 cases found that very large amounts of baking soda can cause life-threatening problems, including a torn stomach after a huge single dose and blood that becomes too alkaline with long-term overuse. Follow your label.
- If you're pregnant or nursing, talk with your doctor first. Ask a doctor before giving any of these to children.
- Always ask your doctor before adding anything new.
MY EXPERIENCE
I used to take Alka-Seltzer Gold, but it was discontinued, so I haven't used it in many years. Now my go-to is Bi-Carb.
When I went looking for an alternative, I ordered Bi-Carb to test myself. It's easy to take, and it's an excellent brand. The sodium isn't the same as Alka-Seltzer Gold, but it's close enough for me, and it has no citric acid, which is great for those looking to avoid it.
I was told I could also use 1/4 to 1/2 teaspoon of baking soda in water (NOT baking powder) when I run out.
RELATED POSTS
HERX - POSSIBLE SOLUTIONS
HERX VS. FLARE EDUCATION
ALKALINE DIET
ACID REFLUX - POSSIBLE SOLUTIONS
SOURCES
Inokuchi et al., baking soda toxicity case and review of 78 cases, American Journal of Emergency Medicine (2026)
Memorial Sloan Kettering, About Herbs: Turmeric (2026)
Dr. Richard Horowitz, LymeDisease.org, Effective treatments for Bartonella infections (2025)
Memorial Sloan Kettering, Aspirin, Citric Acid, and Sodium Bicarbonate (2025)
Horowitz, Fallon and Freeman, case reports, Microorganisms (2024)
Wiesner et al., antacids, minerals and tetracycline antibiotics review (2024)
Wiesner et al., antacids, minerals and quinolone antibiotics review (2024)
Horowitz, Fallon and Freeman, dapsone study, Microorganisms (2023)
Memorial Sloan Kettering, Sodium Bicarbonate (2023)
Lonnie Marcum, LymeDisease.org, LYME SCI: The dreaded Jarisch-Herxheimer reaction (2017, older source, still worth reading)
Disclaimer: Rise Above Lyme makes no claims about any possible benefit of using any product mentioned within this site. Always consult with your doctor before adding anything. The information shared is based on personal experience, years of accumulated researched resources from Lyme Literate doctors and polls conducted within Lyme groups from actual patient experience using these solution ideas.
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