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What Are The Side Effects Of Citric Acid Overdose?

5 Side Effects Of Citric Acid

Citric acid, the most widely used food preservative and additive, is generally harmless. However, its frequent or excessive intake weakens the tooth enamel and dentin, making your tooth decay. It also increases aluminum toxicity in the body which may lead to kidney problems, anemia, or nerve damage. Studies have also pointed out that it can increase the risk of free radical damage and cancer.

Does having a few sodas or a few glasses of lemon juice give you an acid reflux? That’s possibly a side effect of the citric acid in these two drinks. Citric acid, which adds the distinctive tartness to citrus fruits like lemon, lime, sweet lime, orange, pomelo, grapefruit, clementine, and tangerine, is generally harmless. In fact, it is a part of your metabolic cycle and is recommended to prevent certain conditions like anemia and kidney stones. But citric acid overdose can have side effects both immediately and in the long run.

Citric Acid Overdose

While citric acid is most concentrated in citrus fruits, almost all packaged foods and beverages, such as jellies, ketchup, processed cheese, ice-creams, sorbets, baby foods, canned foods, chips, ready-to-eat snacks, juices, sodas, energy drinks, and wines, contain citric acid either as a flavoring agent or as a preservative.

It is even used in certain medicines and supplements – the tanginess in your vitamin C (ascorbic acid) tablets comes from a citric acid flavoring.

Citric acid is the most widely used flavoring agent and preservative, used in everything from sodas to medicines.

The amount of citric acid added to packaged foods is quite low. Usually, as a preservative, about 1/2 a teaspoon (about 4.5 g) of citric acid powder is added to 1 quart (about 0.9 L) of canned food.1

It is unlikely that having canned food or ketchup occasionally can cause side effects. But most aerated beverages contain citric acid. The risk of overdosing on citric acid rises from one too many glasses of these sodas and lemon juice, which has the highest concentration at 48 g/L,2 or other citrus fruit juices.

As per a Saudi Arabian study, energy drinks have the highest amount of citric acid at 7.3 g/L, followed by synthetic fruit juices at 2.79 g/L and soft drinks at 1.76 g/L.3 But as a 2007 study published in General Dentistry found, soft drinks, even the diet versions, are highly acidic due to their citric acid or phosphoric acid content.4

In the short term, citric acid overdose can cause a sore throat, stomach ache, or diarrhea. Having juices and drinks laden with citric acid for years together can cause other more concerning side effects like tooth erosion and aluminum toxicity.

5 Side Effects Of Citric Acid Overdose

1. Can Cause Stomach Problems And Sore Throat

In the short term, excessive citric acid can give you a sore throat. If you already have a sore throat, having foods or beverages rich in citric acid can make it worse. The same holds for canker sores and gum wounds in the mouth.5

Citric acid overdose can also cause nausea, vomiting, stomach ache, diarrhea, and even black or tarry stool.6 If you are prone to gastric disorders, stomach ulcers, or acid reflux, citric acid may worsen the condition. This is why, despite their many benefits as a vitamin C food, lemons are best avoided by patients of GERD.

You may also want to keep your baby off citrus fruits like lemon or oranges until they are a year old, maybe even a little longer if they suffer from acid reflux. If you notice rashes or redness on your baby’s skin after you’ve given them a citrus fruit juice, it’s probably a side effect of citric acid.

2. Can Trigger An Allergy

While this is not really a side effect and will certainly not be experienced by many, if you are allergic to citric acid, you may experience dizziness, confusion, sweating, weakness, and tingling in the limbs and around the mouth. In such cases, you must see a doctor immediately.

3. Can Erode Teeth Enamel

The most prominent side effect of citric acid overdose for a long time is dental erosion. Though citric acid is a weak acid, it can erode the calcium in tooth enamel. A 2006 study found that some sodas can erode teeth down to the dentin level, the layer beneath the enamel.7

Drink citrus juices with a straw to minimize contact with your teeth. Brush your teeth after 30 minutes.

The researchers in the 2007 General Dentistry study found the erosive property of sodas can be attributed to their sugar and citric acid content. While diet soda has less sugar, it still has a high amount of citric acid. The most concerning fact about sodas is that they start corroding the teeth right from the moment of contact.8 In fact, the damage caused to your teeth when you drink diet soda is the same as consuming meth or cocaine.9

However, among all sodas and juices, lemon juice has the most corrosive effect on teeth.10 Skip the soda to avoid other effects like obesity and heart disease, but don’t give up on lemon juice entirely. Use a straw to minimize contact and brush your teeth after 30 minutes.11

Keep your kids off sodas and strong juices because citric acid can cause more damage to their teeth.

A study found that it was possible to protect teeth from erosion to some extent – not completely – by supplementing the citric acid with a mixture of calcium, phosphate, and fluoride.12 When you buy soft drinks or energy drinks next, look out for those fortified with these minerals or glycerophosphates.13

4. Can Cause Aluminum Toxicity

Citric acid is known to increase the absorption of aluminum in your body.14 You may wonder how aluminum gets into your body unless you’re consuming foil. Well, aluminum can sneak in through antacids and other medication like some vaccines, baking powder, food colorings, emulsifiers in cheese spreads and more.

According to a study, rats fed with citric acid were found to have elevated aluminum concentrations in the cerebral cortex and bones. Those fed with aluminum citrate showed significantly high aluminum concentrations in all brain regions.15 This is of concern because aluminum is toxic to the nerves and has been linked with Alzheimer’s disease and other neurodegenerative diseases such as Parkinson’s disease.16

Beside that, when too much aluminum accumulates in other areas of the body, mostly in bones and kidneys, it can lead to kidney dysfunction and anemia.17

5. Can Cause Cancer

A more worrying but under-researched side effect of citric acid used as an additive seems to be DNA damage. A study treated some human immune system cells with citric acid in concentrations used in foods. All the cells showed signs of DNA damage that are linked to cancer formation.

The study suggests that while citric acid makes dietary iron more available to the body, the salt it forms with iron generates harmful free radicals, which can go on to damage all cells and even the DNA.18 When your immune system cannot cope with this damage, your body comes under oxidative stress and then falls prey to various diseases, including cancer.

Citric acid is probably not harmful if you don’t have any medical conditions, but it’s best avoided when your body has too much iron.

This finding is worrying because citric acid is present in all citrus fruits and almost all store-bought items. However, this small-scale study was performed on cells cultured outside the human body. It is possible that if a similar test is done inside the body, the damaging effect of citric acid can be countered by the body’s natural antioxidants and by the antioxidants derived from food.

In a previous study on similar lines, researchers suggested that while citric acid is probably not harmful if you don’t have any medical conditions, it’s best avoided when your body is under oxidative stress or has too much iron.19

Don’t give up on citric acid entirely, but do cut down on synthetic, store-bought food and increase your intake of foods rich in natural antioxidants.

References   [ + ]

1. Ingredients used in Home Food Preservation. Penn State Extension.
2. Penniston, Kristina L., Stephen Y. Nakada, Ross P. Holmes, and Dean G. Assimos. “Quantitative assessment of citric acid in lemon juice, lime juice, and commercially-available fruit juice products.” Journal of Endourology 22, no. 3 (2008): 567-570.
3. Brima, E. I., and A. M. Abbas. “Determination of Citric acid in Soft drinks, Juice drinks and Energy drinks using .” Int. J. Chem. Stud 1 (2014): 30-34.
4, 8. Jain, Poonam, Patricia Nihill, Jason Sobkowski, and Ma Zenia Agustin. “Commercial soft drinks: pH and in vitro dissolution of enamel.” General dentistry 55, no. 2 (2007): 150-4.
5. Lan, W. C., W. H. Lan, C. P. Chan, C. C. Hsieh, M. C. Chang, and J. H. Jeng. “The effects of extracellular citric acid acidosis on the viability, cellular adhesion capacity and protein synthesis of cultured human gingival fibroblasts.” Australian dental journal 44, no. 2 (1999): 123-130.
6. Citric acid, potassium citrate, and sodium citrate. Michigan Medicine, University of Michigan.
7. Wongkhantee, Sea, V. Patanapiradej, C. Maneenut, and D. Tantbirojn. “Effect of acidic food and drinks on surface hardness of enamel, dentine, and tooth-coloured filling materials.” Journal of dentistry 34, no. 3 (2006): 214-220.
9. Bassiouny, Mohamed A. “Dental erosion due to abuse of illicit drugs and acidic carbonated beverages.” General dentistry 61, no. 2 (2013): 38-44.
10. Zimmer, Stefan, Georg Kirchner, Mozhgan Bizhang, and Mathias Benedix. “Influence of various acidic beverages on tooth erosion. Evaluation by a new method.” PloS one 10, no. 6 (2015): e0129462.
11. Cheng, Ran, Hui Yang, Mei-ying Shao, Tao Hu, and Xue-dong Zhou. “Dental erosion and severe tooth decay related to soft drinks: a case report and literature review.” Journal of Zhejiang University Science B 10, no. 5 (2009): 395-399.
12. Attin, T., K. Meyer, E. Hellwig, W. Buchalla, and A. M. Lennon. “Effect of mineral supplements to citric acid on enamel erosion.” Archives of oral biology 48, no. 11 (2003): 753-759.
13. Barbosa, Carolina Silveira, Lia Guimarães Montagnolli, Melissa Thiemi Kato, Fábio Correia Sampaio, and Marília Afonso Rabelo Buzalaf. “Calcium glycerophosphate supplemented to soft drinks reduces bovine enamel erosion.” Journal of Applied Oral Science 20, no. 4 (2012): 410-413.
14. Slanina, P., W. Frech, L. G. Ekström, L. Lööf, S. Slorach, and A. Cedergren. “Dietary citric acid enhances absorption of aluminum in antacids.” Clinical chemistry 32, no. 3 (1986): 539-541.
15. Slanina, P., Y. Falkeborn, W. Frech, and A. Cedergren. “Aluminium concentrations in the brain and bone of rate fed citric acid, aluminium citrate or aluminium hydroxide.” Food and chemical toxicology 22, no. 5 (1984): 391-397.
16. Yokel, R. A. “The toxicology of aluminum in the brain: a review.” Neurotoxicology 21, no. 5 (2000): 813.
17. Krewski, Daniel, Robert A. Yokel, Evert Nieboer, David Borchelt, Joshua Cohen, Jean Harry, Sam Kacew, Joan Lindsay, Amal M. Mahfouz, and Virginie Rondeau. “Human health risk assessment for aluminum, aluminum oxide, and aluminum hydroxide.” Journal of Toxicology and Environmental Health, Part B 10, no. S1 (2007): 1-269.
18. Yılmaz, Serkan, Fatma Ünal, Deniz Yüzbaşıoğlu, and Hüseyin Aksoy. “Clastogenic effects of food additive citric acid in human peripheral lymphocytes.” Cytotechnology 56, no. 2 (2008): 137-144.
19. Gautier-Luneau, Isabelle, Perrine Bertet, André Jeunet, Guy Serratrice, and Jean-Louis Pierre. “Iron-citrate complexes and free radicals generation: Is citric acid an innocent additive in foods and drinks?.” Biometals 20, no. 5 (2007): 793.

Disclaimer: The content is purely informative and educational in nature and should not be construed as medical advice. Please use the content only in consultation with an appropriate certified medical or healthcare professional.