Decoding Physiology: Calcium Alkali Syndrome Part 1

A patient presents with hypercalcemia. The first two etiologies that should come to mind are primary hyperparathyroidism and malignancy. But if those are ruled out, what's next? Calcium alkali syndrome is the third most common cause of hypercalcemia. Formerly known as "milk alkali syndrome," this metabolic disturbance happens when a patient ingests excess calcium and an absorbable alkaline substance (classically calcium-carbonate, aka Tums). In this first of a 2-part series, we dive into the pathophysiology of how calcium alkali syndrome occurs and in which situations the body fails to compensate. Part 2 will cover the fascinating kidney physiology that perpetuates and worsens the metabolic derangements created by the syndrome.
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For education purposes only. Not to be used for medical advice. Check out our website to find past episodes, give us feedback, find out how to join live, and more: www.decodingdx.com/home
Time stamps
0:00 Intro
0:15 Clinical presentation
1:43 Basics of calcium absorption
2:23 Create the problem: vitamin D & dietary intake
3:31 Fail to compensate
4:43 Bone deposition
5:26 Worsen the problem
5:47 Summary
Opening and closing song: "E.R.F." by Bensound.com

[@tszlachetka]

Super helpful video and easy to listen to! Reviewing for USMLE and wanted a good in depth explanation of this and this is perfect - listening to part 2 right after this!

[@rdance3]

I'm carnivore and don't eat carbs at all. ZERO carbs. Recently, I was sick with a virus. Just before, what I thought was full recovery, I became very weak. I suddenly needed sugar. I ate three packets of sugar and a Snickers Bar and soon felt better. When I got home, I ate two bowls of icecream. The next day, I was still a little weak so I had a small bowl of icecream and a protein shake. Less than an hour later, I was in the Emergency Room. There, I was given three IV bags and two big Potassium pills. I was told that my Potassium was low, which I found strange because I salt my meat with a 50/50 blend of NaCl and Potassium Citrate. I actually had an electrlyte drink that morning with added dextrose. My discharge papers say Accute Respiratory Alkalosis but I can't help but think that it was metabolic and due to my etreme insulin sensitivity and my sugar intake. I wasn't haveing diarrhea and only vomited once. Potassium being low makes me think that it wasn't Milk-Alkali Syndrome but all that icecream that I consumed makes me wonder. 3 weeks prior, my Potassium was 4.9.