People’s Pharmacy: Could high-dose Tums cause trouble?

Q. I just heard about bismuth toxicity from habitually taking Pepto-Bismol for a long time. Are you aware of anything similar for people who take more than the recommended dose of Tums long-term?

A. Taking more than the recommended dose of calcium carbonate (Tums or any dietary supplement) can result in something called the milk-alkali syndrome. In this metabolic imbalance, people develop high levels of calcium in the blood and possible kidney injury along with alkaline blood. They may experience symptoms of calcium overload such as headache, dizziness, nausea or loss of appetite (StatPearls, Feb. 19, 2023).

Many people take calcium carbonate as a calcium supplement to try to prevent osteoporosis. A review of the literature concluded, however, “The evidence suggests that calcium, vitamin D, or calcium plus vitamin D supplementation has no effect on bone mineral density at any site (hip or spine) in healthy premenopausal women.” (Cochrane Database of Systematic Reviews, Jan. 27, 2023).

A separate analysis of medical research suggests that calcium from food has several benefits, but calcium supplements may increase the risk of kidney stones and cardiovascular complications (Clinical Interventions in Aging, Nov. 28, 2018).

Q. After two years of suffering, I was diagnosed with hyperthyroidism. To control the rapid heart rate and shaking, my doctor prescribed propranolol. I was also put on anti-thyroid medicines to try to get my thyroid hormone level under control.

When I had allergic reactions to those meds, my thyroid was surgically removed. Then I began a long, frustrating process of trying different doses of Synthroid. It turned out that I am also allergic to Synthroid.

Finally, my doctor put me on natural thyroid extract. The first prescription was like a difference of night and day. Within a week, I began to feel much better. Now, after a second dose adjustment, my thyroid hormone is nearly at the right level. My weight is starting to get back to normal, my head is clear, my anxiety is almost gone, my heart rate is nearly normal, and my bones do not ache. This compounded medicine has saved my life and my sanity. Why don’t more doctors prescribe it?

A. Most endocrinologists are taught that synthetic levothyroxine (e.g., Synthroid) is preferred over natural thyroid hormones. That’s because the dose can be controlled precisely.

But a functional thyroid gland produces two hormones, T4 and T3. Levothyroxine is T4 alone, whereas desiccated thyroid extract contains both T4 and T3. Some people report feeling healthier when they take both hormones. That may be due to a genetic difference in their ability to convert inactive T4 to T3, the active form.

You can learn more about natural thyroid as well as the diagnosis and treatment of both underactive and hyperactive thyroid glands in our “eGuide to Thyroid Hormones.” You will find this online resource under the Health eGuides tab at www.PeoplesPharmacy.com.

Q. I am a physician. While on a statin, I developed severe dry eye and dry mouth. I did not recognize the association and my ophthalmologist had never heard of it either. Nor had cardiologists I asked about it. Eventually, I developed a corneal ulcer.

On the National Institutes of Health website, I searched “statin and dry mouth.” This is a known problem. After stopping the statin, my eyes and mouth are now back to normal. My quality of life is vastly improved.

A. A study of nearly 40,000 individuals found that those taking a statin to lower cholesterol were significantly more likely to have dry eyes (American Journal of Ophthalmology, October 2020).

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”