Can I mix Tums (calcium carbonate) and baking soda (sodium bicarbonate)?

Mixing Tums and Baking Soda: Safety Considerations

Mixing Tums (calcium carbonate) and baking soda (sodium bicarbonate) is not recommended as this combination can lead to potential electrolyte imbalances, metabolic alkalosis, and other adverse effects.

Understanding the Components

• Tums (Calcium Carbonate):

  • An antacid containing 40% elemental calcium 1
  • Used for treating gastric hyperacidity and as a calcium supplement
  • Available in various formulations (e.g., TUMS EX, TUMS Ultra) with different calcium content 1

• Baking Soda (Sodium Bicarbonate):

  • An alkalinizing agent used to treat metabolic acidosis in specific clinical contexts 1
  • Can cause significant metabolic effects when used inappropriately

Potential Risks of Combining

1. Metabolic Alkalosis Risk:

   • Both compounds are antacids that neutralize stomach acid
   • Combined use can cause excessive alkalinization of the blood
   • Sodium bicarbonate misuse has been associated with significant toxicity including metabolic alkalosis 2

2. Electrolyte Imbalances:

   • Can disrupt normal sodium, calcium, and potassium balance
   • May lead to hypernatremia, hypocalcemia, and hypokalemia 3
   • These imbalances can affect cardiac and neurological function

3. Gastrointestinal Effects:

   • Excessive antacid use can cause rebound acid production
   • Risk of gastric distension and potential gastric rupture in severe cases 3
   • GI symptoms are commonly reported with sodium bicarbonate ingestion 4

4. Serious Adverse Events:

   • Cases of hemorrhagic encephalopathy have been reported with excessive baking soda ingestion 5
   • Hospital admissions have occurred due to baking soda misuse 2

Appropriate Use of These Products

• For Acid Reflux/Indigestion:

  • Use either Tums OR baking soda as directed, not both together
  • Follow package directions for proper dosing
  • Tums is generally safer for regular use as it has fewer systemic effects

• For Calcium Supplementation:

  • Tums can be used as a calcium supplement (contains 40% elemental calcium) 1
  • Follow recommended daily intake guidelines based on age

Medical Considerations

• Kidney Function:

  • People with kidney disease should be especially cautious with both products
  • The Canadian Society of Nephrology suggests that either using or not using bicarbonate supplementation is reasonable in patients with GFR <30 mL/min/1.73 m² 1

• Medication Interactions:

  • Both products can interact with various medications by altering stomach pH and absorption
  • They can inactivate simultaneously administered medications, particularly catecholamines 6

When to Seek Medical Attention

Seek immediate medical attention if after taking either or both products you experience:

• Severe headache
• Confusion or altered mental status
• Muscle weakness or twitching
• Irregular heartbeat
• Severe stomach pain
• Difficulty breathing

Bottom Line

The safest approach is to use either Tums OR baking soda as directed for occasional indigestion, but not to combine them. For chronic digestive issues, consult with a healthcare provider rather than self-medicating with these products.