Tums (Calcium Carbonate) is Appropriate for Mild Hypocalcemia
For a calcium level of 8.0 mg/dL without symptoms, Tums (calcium carbonate) is an acceptable and effective oral calcium supplement—there is no need for a different calcium supplement tablet. 1
Why Tums Works for This Situation
- Calcium carbonate is the preferred oral calcium supplement due to its high elemental calcium content (40% elemental calcium), making it efficient for supplementation 1, 2
- Tums contains calcium carbonate and is specifically listed in KDOQI guidelines as an appropriate calcium supplement, with various formulations providing 160-600 mg of elemental calcium per dose 1
- For mild hypocalcemia (calcium 8.0 mg/dL), oral supplementation is appropriate rather than intravenous therapy, which is reserved for symptomatic or severe cases (calcium <7.5 mg/dL) 2
Dosing Considerations
- Target total elemental calcium intake of 1,000-1,200 mg daily from all sources (diet plus supplements) for most adults 1
- Tums Extra Strength provides 300 mg elemental calcium per tablet, while Tums Ultra provides 400 mg 1
- Taking 2-3 tablets of Tums Extra Strength (600-900 mg elemental calcium) plus dietary calcium typically achieves adequate supplementation 1
- Do not exceed 2,000 mg total elemental calcium daily to avoid hypercalcemia and soft tissue calcification 1, 2
Important Administration Details
- Take calcium carbonate WITH meals to maximize absorption, as stomach acid improves calcium carbonate absorption 1
- This is different from calcium citrate, which can be taken without food 1
- If you have achlorhydria or take proton pump inhibitors long-term, calcium citrate may be preferable, though calcium carbonate taken with meals still works for most people 1, 3
When to Add Vitamin D
- Check 25-hydroxyvitamin D levels—if <30 ng/mL, add vitamin D supplementation alongside calcium 2
- Vitamin D is essential for calcium absorption, and deficiency is common in hypocalcemia 2, 4
- Active vitamin D (calcitriol) may be needed if hypocalcemia persists despite adequate calcium and vitamin D supplementation 2
Monitoring Requirements
- Recheck serum calcium in 2-4 weeks after starting supplementation 2
- For chronic management, monitor calcium and phosphorus every 3 months 2
- Watch for constipation, the most common side effect of calcium carbonate 1
When Tums is NOT Sufficient
- Symptomatic hypocalcemia (tetany, seizures, paresthesias) requires immediate IV calcium gluconate, not oral supplements 2
- Severe hypocalcemia (calcium <7.5 mg/dL) typically requires IV therapy initially 2
- Chronic kidney disease patients may need calcium acetate as a phosphate binder instead, though calcium carbonate can still be used as a supplement 1