Randomized study on oral administration of calcitriol to prevent symptomatic hypocalcemia after total thyroidectomy

Postoperative calcium levels as a diagnostic measure for hypoparathyroidism after total thyroidectomy

“…Many surgeons routinely supplement calcium and vitamin D in all patients who have total thyroidectomies (17,18). Although this practice is effective in reducing the number of symptomatic patients, it can be inconvenient because the treatment is expensive and poorly tolerated.…”

Prevention of postoperative hypocalcemia with routine oral calcium and vitamin D supplements in patients with differentiated papillary thyroid carcinoma undergoing total thyroidectomy plus central neck dissection

“…These findings are in good agreement with the results of a previous study, which reported that the rate of postoperative tetany during the first 15 days after surgery was 0% to 2.5% in patients administered oral calcium (1.5 g/day) and vitamin D (1-2 lg/day) but 7.4% in patients administered oral calcium alone (P ¼ .03). 12 Furthermore, another study found that, although the incidence of symptomatic hypocalcemia was low, administration of oral calcium (3 g/day) alone for the first postoperative week resulted in lower serum calcium levels soon after surgery than did administration of both calcium and vitamin D (1 lg/ day). 11 Although vitamin D has been reported to inhibit iPTH secretion by normally functioning parathyroid glands, 24 prior studies 11,12 and our results showed that iPTH secretion after thyroidectomy was not affected by vitamin D administration.…”

“…12 Furthermore, another study found that, although the incidence of symptomatic hypocalcemia was low, administration of oral calcium (3 g/day) alone for the first postoperative week resulted in lower serum calcium levels soon after surgery than did administration of both calcium and vitamin D (1 lg/ day). 11 Although vitamin D has been reported to inhibit iPTH secretion by normally functioning parathyroid glands, 24 prior studies 11,12 and our results showed that iPTH secretion after thyroidectomy was not affected by vitamin D administration. Therefore, early supplementation with vitamin D plus calcium should be recommended for patients undergoing total thyroidectomy plus CND.…”

“…Oral administration of calcium and vitamin D during the early postoperative period may prevent the occurrence of severe postoperative hypocalcemia. [10][11][12][13][14] This may reduce the costs incurred from multiple blood samplings to monitor the development of postoperative hypocalcemia, as well as reducing the costs associated with prolonged hospitalization.…”

“…[10][11][12][13][14] Because postoperative symptomatic hypocalcemia is rarely detected within the first 24 hours after surgery, 8,15 postoperative treatment with calcium and vitamin D may prevent postoperative hypocalcemic crisis. In addition, routine treatment with oral calcium and vitamin D may prevent hypocalcemia after total thyroidectomy, not only in PTC patients undergoing CND.…”