Milk-alkali syndrome causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]

Currently, the main cause of milk-alkali syndrome is calcium carbonate consumption, mostly in postmenopausal women for osteoporosis prevention or treatment or in patients on glucocorticoid therapy (for example in organ transplantation), and chronic renal disease.With the introduction of histamine antagonists and decrease in antacid consumption since the 1970s, the incidence of milk-alkali syndrome has decreased significantly. However, since the 1990s, there has been an increase in milk-alkali syndrome mostly due to increase in calcium and vitamin D consumption in postmenopausal women for osteoporosis prevention.

With the introduction of histamine antagonists and decrease in antacid consumption since the 1970s, the incidence of milk-alkali syndrome has decreased significantly. However, since the 1990s, there has been an increase in milk-alkali syndrome mostly due to increase in calcium and vitamin D consumption in postmenopausal women for osteoporosis prevention.^[1][2][3]

Currently, the main causes are:^[4]

• Calcium carbonate consumption in:
  • Postmenopausal women for osteoporosis prevention or treatment.
  • Patients on glucocorticoid therapy:
    • Organ transplantation
    • Autoimmune disorders
    • Inflammatory disorders
  • Chronic renal disease
• Betel nut chewers in the Far East (due to the lime paste (calcium oxide and calcium hydroxide) consumed during betel nut chewing).^[5]
• There have been reports of milk-alkali syndrome in pregnant women.^[6][7]

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