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Is it safe? · Pregnancy Smart

Is how many Tums you can take while pregnant safe during pregnancy?

Assigned clinical reviewerMatt Stahl· PharmDDraft · pending clinical reviewUpdated

What does the evidence say about how many Tums you can take while pregnant during pregnancy?

  1. The upper limit for total calcium in pregnancy and lactation is 2,500 mg a day for ages 19 to 50 and 3,000 mg a day for ages 14 to 18, against an RDA of 1,000 mg and 1,300 mg respectively. 1
  2. Each over-the-counter antacid chewable pill or soft chew provides about 270 to 400 mg of calcium, calcium carbonate is 40 percent calcium by weight, and absorption from supplements is highest with doses of 500 mg or less at a time. 1
  3. Used as directed and within recommended amounts, calcium carbonate is not expected to increase the chance of birth defects above the background risk, while excessive intake can cause milk-alkali syndrome, a state of high blood calcium that can lead to kidney failure or inflammation of the pancreas. 2
  4. Antacids are meant for mild reflux symptoms. NIDDK advises against using them every day or for severe symptoms except after discussing that use with your doctor, and notes they can cause diarrhea or constipation. 3
  5. Calcium can reduce the bioavailability of both nonheme and heme iron, which is why experts suggest taking calcium and iron supplements at different times of the day. The pregnancy iron RDA is 27 mg and most prenatals carry about that amount. 4

Is how many Tums you can take while pregnant safe in each trimester?

  • First trimester. Reflux is often mild this early, so antacid use tends to be occasional. The interaction that matters most right now is with your prenatal: calcium reduces the bioavailability of iron, and experts suggest taking calcium and iron several hours apart.
  • Second trimester. Use usually climbs here. Calcium carbonate is 40 percent calcium by weight and absorption from supplements is highest with doses of 500 mg or less, so several small chews spread through the day are absorbed better than a handful at once.
  • Third trimester. The heaviest reflux stretch, and the easiest one to overshoot the calcium limit in. NIDDK is explicit that antacids are for mild symptoms and should not be used every day or for severe symptoms without discussing it with your doctor, which is the conversation to have before a daily habit sets in.

The calcium math behind an antacid habit

FigureAmountSource
Calcium in one over-the-counter antacid chewAbout 270 to 400 mgNIH Office of Dietary Supplements
Calcium RDA, pregnant or lactating, ages 19 to 501,000 mg a dayNIH Office of Dietary Supplements
Upper limit, pregnant or lactating, ages 19 to 502,500 mg a dayNIH Office of Dietary Supplements
Upper limit, pregnant or lactating, ages 14 to 183,000 mg a dayNIH Office of Dietary Supplements
Best-absorbed single dose500 mg or lessNIH Office of Dietary Supplements
Median calcium in prenatal products that contain it200 mg per serving, in 78 percent of productsNIH Office of Dietary Supplements

Frequently asked questions

Can too many Tums hurt the baby?

Used as directed and within recommended amounts, calcium carbonate is not expected to increase the chance of birth defects above the background risk. The concern with overuse is for you: excessive calcium can cause milk-alkali syndrome, which can lead to kidney failure or inflammation of the pancreas.

How many Tums is too many in one day?

Count calcium rather than tablets. Each chew supplies roughly 270 to 400 mg, and everything you get from food, your prenatal and antacids together should stay under 2,500 mg a day if you are 19 to 50, or 3,000 mg if you are 14 to 18. Follow the package directions and check your own number with your provider.

Do Tums count toward my daily calcium?

Yes. Calcium carbonate is a dietary supplement that happens to work as an antacid, and it is 40 percent calcium by weight. If you are already hitting the 1,000 mg RDA through diet and a prenatal, a few chews a day can move you a long way toward the ceiling.

Can Tums block the iron in my prenatal?

Calcium can reduce absorption of both nonheme and heme iron, and the usual advice is to take calcium and iron at different times of day. A practical version: keep your antacid away from the hour you take your prenatal.

How long is too long to be taking Tums every day?

NIDDK says antacids are for mild symptoms and should not be used every day or for severe symptoms unless you have discussed it with your doctor. A daily habit is a signal that the underlying reflux needs a plan, not more chews.

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References

  1. Calcium: Fact Sheet for Health Professionals

    NIH Office of Dietary Supplements · https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/

  2. Calcium Carbonate: MotherToBaby Fact Sheet

    MotherToBaby · https://mothertobaby.org/fact-sheets/calcium-carbonate-pregnancy/

  3. Treatment for GER and GERD: NIDDK

    NIDDK · https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/treatment

  4. Iron: Fact Sheet for Health Professionals

    NIH Office of Dietary Supplements · https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.