Hydrogen citrate, more commonly encountered as citric acid or as the citrate ion in various salts (such as sodium citrate or potassium citrate), is scientifically validated for use in the management of overacidity, particularly in urinary and metabolic contexts. Citrate salts are widely used as systemic alkalinizers—agents that help reduce acidity in the body. When ingested, citrate is metabolized to bicarbonate, thereby increasing the buffering capacity of blood and urine and leading to a net alkalinizing effect. This makes citrate salts useful in the treatment of conditions such as renal tubular acidosis, uric acid nephrolithiasis, and other disorders where reducing systemic or urinary acidity is beneficial.

While "hydrogen citrate" specifically (the monobasic form) is less commonly referenced in clinical practice compared to sodium or potassium citrate, the underlying mechanism is identical: citrate acts as a base once metabolized, counteracting excess acid. Multiple clinical guidelines and peer-reviewed publications support the use of citrate salts for alkalinization, and their efficacy is well established in both acute and chronic settings of metabolic acidosis. However, it is not typically used for gastrointestinal overacidity (such as heartburn), where antacids like calcium carbonate are preferred. Overall, the use of citrate salts for systemic overacidity is grounded in strong scientific evidence, reflected in a high evidence rating.