From the Guidelines
Taking excessive calcium carbonate (TUMS) antacids can lead to serious health problems, including milk-alkali syndrome, kidney damage, and increased risk of cardiovascular events, and therefore, calcium intake above 2500 mg per day should be avoided. The recommended dietary intake of calcium for adults is 1000-1200 mg per day, depending on age and gender, and exceeding this amount can have adverse effects 1. Some of the potential health problems associated with excessive TUMS consumption include:
- Constipation and bloating, which are common side effects of calcium supplements 1
- Nephrolithiasis, or kidney stone formation, which can occur infrequently 1
- Increased risk of cardiovascular events, although the findings are inconsistent and inconclusive 1
- Interference with the absorption of certain medications and nutrients, such as iron, zinc, and some antibiotics
- Disruption of the acid-base balance in the stomach, potentially leading to rebound acid production when TUMS use is stopped It is essential to note that the consumption of calcium-rich foods and beverages is the preferred approach to ensuring adequate calcium intake, and supplements should only be considered when dietary intake is inadequate 1. If you are experiencing frequent heartburn requiring regular TUMS use, it is crucial to consult a healthcare provider, as this may indicate an underlying condition that requires different treatment. In general, the maximum recommended amount of TUMS is 7-8 regular strength tablets per day, and continuous use should not exceed 2 weeks without medical supervision.
From the Research
Ramifications of Excessive Calcium Carbonate Antacid Consumption
- Excessive consumption of calcium carbonate antacids can lead to hypercalcaemia, staghorn calculus formation, and renal impairment 2
- Long-standing ingestion of high doses of calcium carbonate antacids can cause calcium-alkali syndrome, which may be overlooked by clinicians if a thorough drug history is not taken 2
- High or inappropriate doses of calcium intake have been linked to an increased risk of cardiovascular diseases 3
- Excessive calcium intake can also increase the risk of kidney stones and gastrointestinal diseases 3
Health Risks Associated with Calcium Supplementation
- Calcium supplementation should be prescribed and taken cautiously, taking into account individual patients' risks and benefits 3
- The use of calcium and vitamin D supplementation can manifest as hypercalcemia and worsening of kidney function in susceptible individuals 4
- Calcium supplement syndrome (CSS) is a condition characterized by hypercalcemia, normal parathyroid hormone level, renal insufficiency, metabolic alkalosis, and a history of calcium intake 4
Comparison with Other Heartburn Treatments
- Antacids are not recommended for treatment of frequent heartburn, while proton pump inhibitors (PPIs) are effective for treatment of frequent heartburn 5
- Effervescent ranitidine 150 mg b.d. provides faster and better heartburn relief than antacids 6
- PPIs provide a sustained inhibition of gastric acid production, while antacids only transiently neutralize acid in the esophagus 5