Health-Behavior Induced Disease: Return of the Milk-Alkali Syndrome

Caruso, Joseph B.; Patel, Rajendrakumar M.; Julka, Karan; Parish, David C.

doi:10.1007/s11606-007-0226-0

Cited by 7 publications

(6 citation statements)

References 14 publications

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“…Intravenous fluid and furosemide were enough for restoring calcium levels; however, renal function did not recover completely (creatinine clearance: 49.8 ml/min). Similarly to our patient, cases with permanent functional and structural kidney damage have been described in the literature [12,13].…”

Section: Discussionsupporting

confidence: 79%

A Case of Hypercalcemia after Thyroidectomy

Katsarou¹,

Drakoulongona

Christopoulos

et al. 2016

BANTAO Journal

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Total thyroidectomy is complicated by hypoparathyroidism in 1-3% of patients. Hypoparathyroidism is treated with oral calcium and vitamin-D supplements. Everyday use of calcium and vitamin D can lead sometimes to hypercalcemia. Ingestion of large amounts of calcium and absorbable alkali that cause hypercalcemia, various degrees of renal failure, and metabolic alkalosis, can be associated with a diagnosis of calcium-alkali syndrome. This syndrome was first identified as milkalkali syndrome, after treatment of peptic ulcer disease with milk and alkali which was widely adopted at the beginning of the 20th century. With the introduction of histamine-2 blockers and proton pump inhibitors, the occurrence of milk-alkali syndrome became rare; however, it has emerged recently as calcium-alkali syndrome because of the wide availability and increasing use of calcium carbonate, mostly for osteoporosis prevention. We present a female patient with hypoparathyroidism who presented with hypercalcemia and alkalosis as a result of treatment with calcium carbonate, vitamin D and thiazide diuretic. The patient was treated successfully by discontinuation of the above drugs, intravenous fluid administration and enhancement of calcium renal excretion. Hypercalcemia presenting as calcium-alkali syndrome is a diagnosis that requires a high index of suspicion in order to quickly identify the disorder and initiate appropriate therapy. It is important for clinicians to keep the syndrome on their list of differential diagnosis.

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Section: Discussionsupporting

confidence: 79%

A Case of Hypercalcemia after Thyroidectomy

Katsarou¹,

Drakoulongona

Christopoulos

et al. 2016

BANTAO Journal

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“…Acid reflux symptoms can be relieved by neutralizing gastric acid with antacids, which at their simplest are just bicarbonate or carbonate salts (e.g., TUMS® is calcium carbonate). However, an early antacid regimen for peptic ulcers, based on administration of milk and CaCO 3 and still observed in the modern age in self-medicating individuals, results in adverse outcomes: the so-called ‘milk-alkali syndrome’ characterized by MAlk and hypercalcemia [230] , [231] . An alternative approach to lowering gastric pH is to use PPIs or H2-receptor agonists which dampen the signaling pathways that stimulate H + secretion.…”

Section: Applications By Organ Systemmentioning

confidence: 99%

The therapeutic importance of acid-base balance

Quade

Parker

Occhipinti

2021

Biochemical Pharmacology

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Baking soda and vinegar have been used as home remedies for generations and today we are only a mouse-click away from claims that baking soda, lemon juice, and apple cider vinegar are miracles cures for everything from cancer to COVID-19. Despite these specious claims, the therapeutic value of controlling acid-base balance is indisputable and is the basis of Food and Drug Administration-approved treatments for constipation, epilepsy, metabolic acidosis, and peptic ulcers. In this narrative review, we present evidence in support of the current and potential therapeutic value of countering local and systemic acid-base imbalances, several of which do in fact involve the administration of baking soda (sodium bicarbonate). Furthermore, we discuss the side effects of pharmaceuticals on acid-base balance as well as the influence of acid-base status on pharmacokinetic properties of drugs. Our review considers all major organs systems as well as information relevant to several clinical specialties such as anesthesiology, infectious disease, oncology, dentistry, and surgery.

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“…However, recent medical literature indicates increases in patients presenting with this syndrome [3, 5–12]. This may be attributable to increased physician awareness in diagnosis and subsequent reporting, but also the ease of availability in many over-the-counter antacid preparations containing calcium carbonate.…”

Section: Discussionmentioning

confidence: 99%

Antacids, Altered Mental Status, and Milk-Alkali Syndrome

Watson

Dellinger

Jennings

et al. 2012

Case Reports in Emergency Medicine

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The frequency of milk-alkali syndrome decreased rapidly after the development of histamine-2 antagonists and proton pump inhibitors for the treatment of peptic ulcer disease; however, the availability and overconsumption of antacids and calcium supplements can still place patients at risk (D. P. Beall et al., 2006). Here we describe a patient who presented with altered mental status, hypercalcemia, metabolic alkalosis, and acute renal failure in the context of ingesting large amounts of antacids to control dyspepsia.

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Health-Behavior Induced Disease: Return of the Milk-Alkali Syndrome

Cited by 7 publications

References 14 publications

A Case of Hypercalcemia after Thyroidectomy

A Case of Hypercalcemia after Thyroidectomy

The therapeutic importance of acid-base balance

Antacids, Altered Mental Status, and Milk-Alkali Syndrome

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