The Daily Consumption of Cola Can Determine Hypocalcemia: A Case Report of Postsurgical Hypoparathyroidism-Related Hypocalcemia Refractory to Supplemental Therapy with High Doses of Oral Calcium
The consumption of soft drinks is a crucial factor in determining persistent hypocalcemia.
The aim of the study is to evaluate the biochemical mechanisms inducing hypocalcemia
in a female patient with usual high consumption of cola drink and persistent hypocalcemia,
who failed to respond to high doses of calcium and calcitriol supplementation. At
baseline and after pentagastrin injection, gastric secretion (Gs) and duodenal secretion
(Ds) samples were collected and calcium and total phosphorus (Ptot) concentrations
were evaluated. At the same time, blood calcium, Ptot, sodium, potassium, chloride,
magnesium concentrations, and vitamin D were sampled. After intake of cola (1 L) over
180 min, Gs and Ds and blood were collected and characterized in order to analyze
the amount of calcium and Ptot or sodium, potassium, magnesium, and chloride ions,
respectively. A strong pH decrease was observed after cola intake with an increase in
phosphorus concentration. Consequently, a decrease in calcium concentration in Gs
and Ds was observed. A decrease in calcium concentration was also observed in blood.
In conclusion, we confirm that in patients with postsurgical hypoparathyroidism, the
intake of large amounts of cola containing high amounts of phosphoric acid reduces
calcium absorption efficiency despite the high doses of calcium therapy
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