Summary about Disease
Milk-alkali syndrome is a condition characterized by high levels of calcium in the blood (hypercalcemia), metabolic alkalosis (increased blood pH), and kidney problems (renal insufficiency). It typically occurs due to excessive intake of calcium and absorbable alkali, often from calcium supplements and antacids.
Symptoms
Symptoms can vary depending on the severity of the syndrome. Mild symptoms may include:
Nausea
Vomiting
Weakness
Constipation
Headache More severe symptoms may include:
Confusion
Lethargy
Mental status changes
Dehydration
Kidney failure
Cardiac arrhythmias
Causes
The primary cause is excessive intake of calcium and absorbable alkali. Common sources include:
Calcium supplements (e.g., calcium carbonate)
Antacids containing calcium carbonate (e.g., Tums, Rolaids)
High calcium diets combined with alkali ingestion Historically, it was associated with peptic ulcer treatment using milk and alkali. However, in modern times, it's more commonly linked to calcium supplementation, often for osteoporosis prevention or treatment.
Medicine Used
Treatment focuses on reducing calcium levels and managing symptoms. Medications may include:
Intravenous fluids (IV): To correct dehydration and promote calcium excretion through the kidneys.
Calcitonin: A hormone that lowers calcium levels in the blood.
Bisphosphonates: Inhibit bone resorption and help lower calcium levels (used in more severe or chronic cases).
Corticosteroids: May be used in some cases to reduce calcium absorption.
Diuretics (e.g., loop diuretics like furosemide): to increase calcium excretion in urine but require careful monitoring to avoid dehydration and electrolyte imbalances. The primary treatment is discontinuation of the calcium and alkali source.
Is Communicable
No, milk-alkali syndrome is not communicable. It is caused by excessive intake of calcium and alkali and is not infectious or contagious.
Precautions
Monitor Calcium Intake: Be aware of your calcium intake from supplements, fortified foods, and antacids.
Consult Healthcare Provider: Discuss calcium supplementation with your doctor, especially if you have kidney problems or are taking other medications.
Read Labels: Carefully read the labels of antacids and calcium supplements to understand the dosage and ingredients.
Avoid Excessive Alkali Intake: Limit the use of antacids containing calcium carbonate, especially in combination with calcium supplements.
Stay Hydrated: Adequate hydration helps the kidneys function properly.
How long does an outbreak last?
There are no "outbreaks" of milk-alkali syndrome, as it is not an infectious disease. The duration of symptoms depends on the severity of the condition, the amount of excess calcium and alkali ingested, and how quickly treatment is initiated. Symptoms can resolve within days to weeks after stopping the offending agents and receiving appropriate medical care. Kidney damage can be permanent if the condition is severe and left untreated for an extended period.
How is it diagnosed?
Diagnosis is based on:
Blood Tests: Elevated serum calcium levels, elevated blood pH (alkalosis), and elevated creatinine levels (indicating kidney problems). Parathyroid hormone (PTH) levels may be suppressed.
Patient History: A thorough history of calcium and antacid intake.
Urine Tests: To assess kidney function and calcium excretion.
Electrocardiogram (ECG): To assess for cardiac abnormalities associated with hypercalcemia.
The diagnosis often involves ruling out other causes of hypercalcemia.
Timeline of Symptoms
The timeline of symptoms can vary. It may develop gradually over weeks or months as calcium and alkali accumulate. It can also present more acutely if a large dose of calcium or alkali is ingested. There is no specific progression timeline. Symptoms appear as calcium levels rise and kidney function declines.
Important Considerations
Kidney Function: Pre-existing kidney problems increase the risk of milk-alkali syndrome.
Vitamin D: Excessive vitamin D intake can increase calcium absorption and exacerbate the syndrome.
Elderly: Older adults are more susceptible due to age-related kidney function decline and potentially higher rates of calcium supplementation.
Drug Interactions: Certain medications can affect calcium levels or kidney function, increasing the risk.
Severity: The severity of milk-alkali syndrome can range from mild and asymptomatic to life-threatening, requiring prompt medical intervention.