{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T05:57:16Z","timestamp":1780984636224,"version":"3.54.1"},"reference-count":17,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2015,3,9]],"date-time":"2015-03-09T00:00:00Z","timestamp":1425859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The ingestion of large amounts of milk and antacids to treat peptic ulcer disease was a common cause of hypercalcemia in the past (the \u201cmilk-alkali syndrome\u201d). The current popularity of calcium and supplements has given rise to a similar problem. Objectives: To evaluate the prevalence and characteristics of hypercalcemia induced by calcium intake (\u201ccalcium supplement syndrome\u201d; or CSS) in hospitalized patients. Methods: We conducted a retrospective; electronic health record (EHR)-based review of patients with hypercalcemia over a 3-year period. Diagnosis of CSS was based on the presence of hypercalcemia; a normal parathyroid hormone (PTH) level; renal insufficiency; metabolic alkalosis; a history of calcium intake; and documented improvement with treatment. Results: Of the 72 patients with non-PTH mediated hypercalcemia; 15 (20.8%) satisfied all the criteria for the diagnosis of CSS. Calcium;  vitamin D; and multivitamin ingestion were significantly associated with the diagnosis  (p values &lt; 0.0001; 0.014; and 0.045 respectively); while the presence of hypertension; diabetes; and renal insufficiency showed a trend towards statistical significance. All patients received intravenous fluids; and six (40%) received calcium-lowering drugs. The calcium level at discharge was normal 12 (80%) of patients. The mean serum creatinine and bicarbonate levels decreased from 2.4 and 35 mg\/dL on admission respectively; to  1.6 mg\/dL and 25.6 mg\/dL at discharge respectively. Conclusion: The widespread use of calcium and vitamin D supplementation can manifest as hypercalcemia and worsening of kidney function in susceptible individuals. Awareness among health care professionals can lead to proper patient education regarding these health risks.<\/jats:p>","DOI":"10.3390\/jcm4030414","type":"journal-article","created":{"date-parts":[[2015,3,9]],"date-time":"2015-03-09T11:47:19Z","timestamp":1425901639000},"page":"414-424","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Hypercalcemia Associated with Calcium Supplement Use: Prevalence and Characteristics in Hospitalized Patients"],"prefix":"10.3390","volume":"4","author":[{"given":"Maria","family":"Machado","sequence":"first","affiliation":[{"name":"Division of Endocrinology, University of South Carolina School of Medicine,  Columbia, SC 29203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Araba","family":"Bruce-Mensah","sequence":"additional","affiliation":[{"name":"University of South Carolina School of Medicine, Columbia, SC 29203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Whitmire","sequence":"additional","affiliation":[{"name":"Research Unit, Department of Internal Medicine, University of South Carolina School of Medicine, Columbia, SC 29203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Rizvi","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, University of South Carolina School of Medicine,  Columbia, SC 29203, USA"},{"name":"Department of Medicine, University of South Carolina School of Medicine,  Columbia, SC 29203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2015,3,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1056\/NEJM194905192402001","article-title":"Hypercalcemia without hypercalcuria or hypophosphatemia, calcinosis and renal insufficiency; a syndrome following prolonged intake of milk and alkali","volume":"240","author":"Burnett","year":"1949","journal-title":"N. 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