Milk-alkali syndrome is caused by excessive calcium intake, leading to hypercalcemia and alkaline blood chemistry that can damage the kidneys. It was first seen in peptic ulcer patients but can also occur in those taking calcium supplements. Symptoms include nausea, weakness, and kidney stones. Diagnosis involves blood and urine tests, and treatment involves reducing calcium intake. Patients taking calcium supplements should follow dosage recommendations to avoid the syndrome.
Milk-alkali syndrome is a form of hypercalcemia, a high concentration of calcium in the blood, caused by too much calcium intake. Patients with this condition can drink large amounts of milk, as the name implies, and also take calcium supplements to increase the amount of calcium in their diet. When the level gets too high, the blood chemistry becomes alkaline and can start to damage the kidneys. The patient may begin to experience a cascade of reactions related to renal dysfunction.
This condition was first seen in peptic ulcer patients, who were encouraged to take calcium products and drink milk to limit the effects of their ulcers. Changes in approaches to ulcer treatment have reduced the incidence in this setting. Today, milk-alkali syndrome can still be seen in some patients who take excess bicarbonate tablets to manage ulcer pain at home, but it can also be seen in patients who use calcium supplements to reduce the risk of osteoporosis and in the treatment of other diseases.
It may take up to 2 grams of dietary calcium per day to develop milk-alkali syndrome. Some patients appear to be at increased risk because their bodies absorb calcium more easily, especially if they drink vitamin D-fortified milk. Patients may develop symptoms such as nausea, decreased appetite, weakness, fatigue, and kidney stones. Paradoxically, milk-alkali syndrome may increase the risk of fractures, contrary to the expectations of patients who are used to hearing that increasing calcium intake may reduce the incidence of bone fractures.
A doctor can diagnose milk-alkali syndrome with some blood and urine tests to learn about blood chemistry and kidney function. This information, coupled with a patient interview, can provide enough data for the physician to make an authoritative diagnosis. Immediate treatment involves reducing your calcium intake to a safer level. If the patient has an underlying medical problem that has contributed to the high calcium intake, it may also be necessary to discuss alternative techniques for managing the problem.
Patients taking calcium supplements should not be at risk of milk-alkali syndrome if they follow supplement recommendations. A doctor can give a patient dosage advice to make sure the patient’s calcium intake stays within a safe range. Patients who begin to notice problems such as repeated episodes of nausea and fatigue may wish to discuss these with a doctor to explore possible causes and treatment options.
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