A man drank too much milk and ended up in the emergency room. (This is a stock image.) (Photo credit: Mike_shots via Shutterstock)
Patient: 54-year-old man from Rotterdam, Netherlands.
Symptoms: A man presented to the emergency room after eight days of shortness of breath, sweating, frequent urination, and thirst. He also had abdominal bloating.
What happened next: Two days before going to the emergency room, the patient visited his doctor, who found that he had elevated blood sugar, which meant he had newly diagnosed diabetes, also known as “de novo diabetes.”
The doctor prescribed metformin, a drug that helps lower blood sugar. However, the symptoms did not improve, and the shortness of breath and abdominal discomfort only worsened. Later, in the emergency room, the man reported that he had been drinking about 6 gallons (22 liters) of whole milk a day for the past two days “to quench his thirst,” doctors wrote in the case report.
When emergency room medics ran a blood test, they noticed that the man’s blood was paler than usual and “looked milky.” His blood sugar was extremely high: 1,350 milligrams per deciliter. (Normal glucose levels are 70 to 99 milligrams per deciliter.) His triglyceride levels — fats in the blood — were also dramatically elevated, to 16,713 milligrams per deciliter; normal triglyceride levels are typically under 175 milligrams per deciliter, according to the report.
Diagnosis: Doctors concluded that by drinking too much full-fat milk, the patient had flooded his bloodstream with fat and sugar, causing his triglyceride levels to skyrocket, resulting in increased abdominal pain and breathing problems. Extremely high triglyceride levels can lead to chylomicronemia syndrome, a condition associated with difficulty breathing and abdominal pain. The syndrome can also cause memory loss, pancreatitis (inflammation of the pancreas), and changes in the color of the retina.
Treatment: Because the patient's glucose levels were so high, he was admitted to the intensive care unit, where he was given saline and insulin, a hormone responsible for transporting sugar into cells. His abnormally high triglyceride levels put him at risk for acute pancreatitis, so doctors began plasmapheresis to remove the excess fat. Two plasmapheresis sessions were performed over the next two days, which brought the patient's triglyceride levels down to acceptable levels.
The man continued to take insulin and metformin, as well as statin drugs to lower cholesterol and prevent heart disease. Doctors also recommended lifestyle changes to control his sugar intake. When he was re-evaluated six weeks later, his triglyceride levels remained slightly elevated at 245 milligrams per deciliter, but he was otherwise in good health.
What makes this case unique: Milk is a source of calcium, protein, magnesium, and vitamins A and D, and moderate consumption is thought to be healthy, except for people with lactose intolerance. However, the U.S. Department of Agriculture's dietary guidelines recommend no more than 3 cups (0.7 liters) of dairy products per day for adults (some nutritionists argue that even that amount is excessive).
However, the doctors in the emergency room calculated that, given the nutritional value of whole milk, their patient had likely consumed 70 ounces (1,980 grams) of sugar and 53 ounces (1,496 grams) of fat over the two days of his binge. By comparison, the recommended daily allowance of sugar for adult men is 1.3 ounces (36 grams), and the intake of saturated fats, such as those found in
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