Abstract
The milk-alkali syndrome is a well-documented consequence of excessive calcium and alkali intake first recognized in association with early 20th century antacid regimens. The syndrome became rare after widespread implementation of modern peptic ulcer disease therapies. With recent trends in osteoporosis therapy coupled with widely available calcium-containing supplements, the milk-alkali syndrome has reemerged as an important clinical entity. Our case illustrates a patient who self-medicated his peptic ulcer disease with a regimen resembling a common early 20th century dyspepsia regimen. When superimposed upon chronic high calcium supplementation, the patient became acutely ill from the milk-alkali syndrome. When taken to excess, or used inappropriately, medications and supplements ordinarily considered beneficial, can have harmful effects. Our case underscores the importance of obtaining a thorough medication history including use of over-the-counter supplementation.
Similar content being viewed by others
References
Cooke AM. Alkalosis occurring in the alkaline treatment of peptic ulcers. Quart J Med. 1932;25:527.
Sippy BW. Gastric and duodenal ulcer: medical cure by an efficient removal of gastric juice corrosion. JAMA. 1915;64:1625.
Grundfast MB, Still CD, Komar MJ. Hypercalcemia and peptic ulcer disease-related milk-alkali syndrome. Nutr Clin Prac. 2003.
Gordon MV, Hamblin PS, McMahon LP. Life-threatening milk-alkali syndrome resulting from antacid ingestion during pregnancy. MJA. 2005;182(7):350–1.
Orwoll ES. The milk-alkali syndrome: current concepts. Ann Intern Med. 1982;97:242–8.
McMillan DE, Freeman RB. The milk alkali syndrome: a study of the acute disorder with comments on the development of the chronic condition. Medicine. 1965;44:485–501.
Muldowney WP, Mazbar SA. Rolaids-yogurt syndrome: a 1990s version of milk-alkali syndrome. Am J Kidney Dis. 1996;27(2):270–2.
Beall DP, Scofield RH. Milk-alkali syndrome associated with calcium carbonate consumption. Medicine. 1995;74:89.
Jacobs TP, Bilezikian JP. Rare causes of hypercalcemia. J Clin Endocrinol Metab. 90(11):6316–22.
Wu K, Chuang R, Wu FL, et al. The milk-alkali syndrome caused by betelnuts in oyster shell paste. Clin Toxicol. 1996;34(6):741–5.
Norton SA. Betel: consumption and consequences. J Clin Endocrinol Metab. 1998;38(1):81–8, Jan.
Kallner G, Karlsson H. Recurrent factitious hypercalcemia. Am J Med. 1987;82:536–8.
Frame B, Jackson G, Kleerekoper M, Rao D, DeLorenzo A, Garcia M. Acute severe hypercalcemia a la Munchausen. Am J Med. 1981;70:316–9.
Conflict of Interest Statement
None disclosed.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Caruso, J.B., Patel, R.M., Julka, K. et al. Health-Behavior Induced Disease: Return of the Milk-Alkali Syndrome. J GEN INTERN MED 22, 1053–1055 (2007). https://doi.org/10.1007/s11606-007-0226-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11606-007-0226-0