Milk-Alkali Syndrome

Milk-alkali syndrome results from ingestion of excessive amounts of calcium and absorbable alkali (e.g., bicarbonate and citrate salts)

Historically seen during self-treatment of indi...

Calcium-containing supplement use

Symptoms of hypercalcemia (“stones, bones, moans, groans and behavioral health overtones”):

• Nausea, vomiting, constipation, abdominal pain

• Polyuria

• Menta...

Stop calcium and alkali (carbonate salts):

• Supplements

• Over-the-counter antacids

Volume expansion

• To maintain urine output of 3 L/day

Treat hypercalcemia:

• Hydra...

Kidney function

Fluid intake and output

Correction of calcium after treatment

Increase oral fluid intake.

Stop calcium and vitamin D supplementa...

Goltzman D. Nonparathyroid Hypercalcemia. Front Horm Res. 2019;51:77-90.

Malcolm  OT. Identification, treatment, and prevent...

Aggressive over-the-counter antacid or calcium supplement use can lead to hypercalcemia.

Calcium supplementation should not exceed 1.2 g/day.

Treat by stopping excess antacid/supplement ...