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HomeHealth articleshypercalcemiaWhat Is Milk-Alkali Syndrome?

Milk-Alkali Syndrome - Causes, Symptoms, Stages, Diagnosis, and Treatment

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The milk-alkali syndrome is a condition in which there are high calcium levels in the blood. Read the article to learn more about the condition.

Medically reviewed by

Dr. Kaushal Bhavsar

Published At August 22, 2022
Reviewed AtJune 6, 2023


The human body maintains an acid-base balance called pH at all times, which helps in normal body functioning. The pH (potential of hydrogen) values range from 0 to 14, wherein 0 to 7 indicates acidic nature, and 7 to 14 indicates basic (alkaline) nature. In healthy individuals, the blood pH is maintained at 7.35 to 7.45. An elevation in these levels increases the blood alkalinity causing kidney problems.

What Is Milk-Alkali Syndrome?

The milk-alkali syndrome is a condition in which there are high levels of calcium in the blood, called hypercalcemia. Increased calcium levels cause a shift in the acid-base balance (pH) to more alkaline in nature. This condition is known as metabolic alkalosis. Increased alkaline levels can cause structural and functional damage to the kidneys, causing complications like decreased blood flow to the kidneys, kidney failure, and death in rare cases. The condition improves by reducing the intake of calcium supplements and antacids.

What Are the Other Names of Milk-Alkali Syndrome?

The other names of the milk-alkali syndrome include:

  1. Calcium-alkali syndrome.

  2. Burnett syndrome.

  3. Cope syndrome.

  4. Hypercalcemia.

  5. Calcium metabolism disorder.

What Is the Role of Calcium in the Body?

Calcium plays a pivotal role in various body functions, which include:

  • Formation of solid teeth and bones.

  • Channel for transmission of impulses along the nerves.

  • Contraction of muscles.

  • Maintaining regular rhythmic activity of the heart.

  • Formation of blood clots.

The average values of blood calcium levels are to be maintained at all times to help in proper body functioning. The following are the recommended amounts of daily calcium intake.

  • 0 to 6 months - 200 mg.

  • 7 to 12 months - 260 mg.

  • 1 to 3 years - 700 mg.

  • 4 to 8 years - 1000 mg.

  • 9 to 18 years - 1300 mg.

  • 19 to 50 years - 1000 mg.

  • 51 to 70 years - 1000 mg for males and 1200 mg for females.

  • 71 years and above - 1200 mg.

(The values mentioned above are in milligrams).

What Are the Types of Calcium Supplements?

Calcium supplements are available in two forms, namely, calcium carbonate and calcium citrate.

Among the two, calcium carbonate is the widely available, less expensive supplement that is advised to be taken with food for greater absorption. Absorption of calcium citrate does not rely on food, and it is absorbed well with or without food. Over-the-counter (OTC) medicines like Tums and Maalox, which are used as antacids, also contain calcium carbonate.

What Are the Causes of Milk-Alkali Syndrome?

  • Initially, milk-alkali syndrome occurred as a side effect of consuming excess amounts of milk and dairy products and antacids.

  • More recently, the condition occurred due to increased consumption of calcium supplements for treating bone disorders like osteoporosis (bones become weak and fragile and tend to fracture easily). Doctors also advise calcium supplements for people who do not get enough calcium through diet or people having heartburn.

  • The condition most commonly affects people who consume a diet high in calcium and take calcium supplements for certain health conditions. High levels of vitamin D in the body can also increase the severity of the milk-alkali syndrome.

What Are the Symptoms of Milk-Alkali Syndrome?

Initially, the conditions do not show any symptoms. However, long-standing cases develop symptoms that include:

  • Low back pain that occurs due to kidney stones.

  • Increased urination.

  • Constipation.

  • Confused behavior.

  • Depression.

  • Nausea and vomiting.

  • Headaches.

  • Arrhythmia is a condition in which there is an abnormal heart rhythm.

What Are the Stages of Milk-Alkali Syndrome?

Based on the duration of use of calcium supplements and antacids, the milk-alkali syndrome is categorized into three phases, namely:

  • Acute Toxemic Phase: Patients who have been using the antacid treatment for a period of one month can develop an acute toxemic phase. Symptoms like nausea and vomiting, dizziness, headache, and vertigo (spinning sensation of the head in a person who is completely still) are observed.
  • Subacute Phase: Patients can have symptoms of both acute and chronic phases.
  • Chronic Phase: Patients using calcium and antacid supplements for years tend to develop a chronic phase of milk-alkali syndrome. Symptoms include increased thirst and urination, severe itching, tremors, and mental health problems. An abnormal calcium deposition occurs in the tissues and organs in the chronic phase.

What Are the Complications of Milk-Alkali Syndrome?

Complications that can occur due to milk-alkali syndrome include:

  • Calcinosis is a condition in which there is calcium deposition in the tissues.

  • Kidney stones.

  • Kidney failure.

  • Death (rare cases).

How Is Milk-Alkali Syndrome Diagnosed?

Doctors diagnose milk-alkali syndrome based on medical history, physical examination, and blood tests. Health care professionals must be informed about the prescriptions used by the patients and any other OTC medicines being used. This prevents misdiagnosis of the condition.

The following tests may be ordered by the doctor, which include:

  • Blood Tests: Blood tests help detect the calcium levels in the blood. Normal calcium levels range from 8.6 to 10.3 mg/dL (milligrams per deciliter). An increase in these values may indicate milk-alkali syndrome.

  • Imaging Tests: X-rays, CT (computerized tomography) scans, or ultrasound scans are imaging tests useful to detect calcium deposits in kidneys.

Other diagnostic tests that help assess the calcium imbalance include:

  • Electrolyte tests can detect the mineral levels in the body.

  • GFR (glomerular filtration rate) helps to know the functioning of kidneys.

  • ECG (electrocardiogram) checks the electrical activity of the heart.

  • EEG (electroencephalogram) measures the electrical activity of the brain.

How Is Milk-Alkali Syndrome Treated?

Treatment of milk-alkali syndrome aims at reducing blood calcium levels. Doctors may advise stopping calcium, vitamin D supplements, and antacids. Staying hydrated by drinking sufficient amounts of water is also important. Treatment of complications such as kidney damage is treated accordingly.

Can Milk-Alkali Syndrome Be Prevented?

The milk-alkali syndrome can be prevented by:

  • Limiting the doses of calcium supplements.

  • Stopping the use of antacids containing calcium carbonate.

  • Enquire the doctor about antacid alternatives.

  • Report any digestive problems to the doctor and seek advice.


The milk-alkali syndrome occurs due to an increase in blood calcium levels. It is a reversible condition with a positive outlook, as the symptoms are reversed once calcium and vitamin D supplements are stopped. However, late detection can lead to kidney complications that require immediate medical care. Patients need to thoroughly explain the adverse effects of excess calcium that may be consumed involuntarily through diet or as supplements. Early diagnosis and management can be life-saving. The health care team needs to work together for better patient care and positive treatment outcomes.

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Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)


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