Milk-alkali syndrome is a potential consequence of developing high levels of calcium in your blood. Too much calcium in your bloodstream is called hypercalcemia.
Taking in calcium with an alkali substance can also cause your body’s acid and base balance to become more alkaline.
If you have too much calcium in your blood, it may cause structural and functional damage in your kidneys. This can trigger symptoms such as excessive urination and fatigue.
Over time, this can lead to serious complications. For example, it can cause problems such as reduced blood flow through the kidneys, diabetes insipidus, kidney failure, and, in rare cases, death.
The condition usually improves when you cut down on antacids or high-dose calcium supplements.
This condition often involves no immediate and specific symptoms. When symptoms occur, they’re usually accompanied by related kidney problems.
Symptoms can include:
- high urine output
- headache and confusion
- pain in your abdomen
Milk-alkali syndrome was once a common side effect of consuming large amounts of milk or dairy products, along with antacids containing alkaline powders.
Today, this condition is usually caused by consuming too much calcium carbonate. Calcium carbonate is a dietary supplement. You might take it if you don’t get enough calcium in your diet, you have heartburn, or you are trying to prevent osteoporosis.
Calcium supplements are available mainly in one of two forms: carbonate and citrate.
According to the National Institutes of Health’s Office of Dietary Supplements (NIHODS), calcium carbonate is more widely available. It’s also less expensive, but it’s absorbed in a greater amount when taken with food.
As far as one of these calcium types being more convenient to take, calcium citrate is reliably absorbed regardless of if it’s taken with food or not.
Many over-the-counter (OTC) antacids, like Tums and certain formulations of Maalox, also contain calcium carbonate.
Milk-alkali syndrome often results when people don’t realize they’re consuming too much calcium by taking multiple supplements or medications that contain calcium carbonate.
Your doctor can typically diagnose this condition with a complete history, physical exam, and blood tests. Talk to you doctor about any symptoms you’re experiencing.
Provide a complete list of all prescription and OTC medications and supplements you’re taking. If you don’t provide a full history of medications, your doctor might misdiagnose your symptoms.
Your doctor will likely order a blood test to check the level of uncorrected calcium in your blood. A normal amount ranges from 8.6 to 10.3 milligrams per deciliter of blood. Higher levels may indicate milk-alkali syndrome. Your blood levels of bicarbonate and creatinine will likely also be checked.
If left untreated, this condition can lead to calcium deposits and damage to the kidneys. Your doctor may order additional tests to check for complications in your kidneys. These tests may include:
Early diagnosis and treatment can prevent permanent damage to your kidneys.
Complications of milk-alkali syndrome include calcium deposits in the kidneys, which can directly damage the kidney tissue, and reduced kidney function.
If left untreated, the condition can also lead to kidney failure and, in rare cases, death.
The goal of treatment is to reduce the amount of calcium in your diet, so cutting down on calcium supplements and antacids is often the best treatment method. Staying well hydrated by drinking an adequate amount of fluid also helps.
Complications, such as kidney damage and metabolic acidosis, also have to be treated.
If you’re currently taking calcium supplements or antacids for a specific medical condition, tell your doctor. Ask them if there’s an alternative treatment you can try.
To avoid developing milk-alkali syndrome:
- Limit or eliminate your use of antacids that contain calcium carbonate.
- Ask your doctor about antacid alternatives.
- Limit doses of supplemental calcium containing other alkali substances.
- Report continual digestive problems to your doctor.
Recommended dietary allowances of calcium
The NIHODS provides the following recommendations for daily calcium intake in milligrams (mg):
- 0 to 6 months of age: 200 mg
- 7 to 12 months: 260 mg
- 1 to 3 years: 700 mg
- 4 to 8 years: 1,000 mg
- 9 to 18 years: 1,300 mg
- 19 to 50 years: 1,000 mg
- 51 to 70: 1,000 for males and 1,200 mg for females
- 71+ years: 1,200 mg
These are the average amounts of calcium that most people in good health need to consume each day.
If you develop milk-alkali syndrome and then eliminate or reduce calcium and alkali in your diet, your outlook is usually good. Untreated milk-alkali syndrome can lead to serious complications, such as:
- calcium deposits in your body’s tissues
- kidney damage
- kidney failure
If you’ve been diagnosed with any of these complications, ask your doctor about your treatment options.