Calcium and vitamin D supplementation after total thyroidectomy in thyrotoxic patients

Abstract

Objective Evaluation of the efficacy of routine postoperative oral calcium and vitamin D supplementation in preventing symptomatic hypocalcemia after total thyroidectomy in cases of hyperthyroidism. Background Thyroidectomy is the most common surgical procedure performed in the neck by surgeons. Hypocalcemia is the most frequent complication after total thyroidectomy, and it is the main cause of prolonged hospital stay. Patients and methods Thirty patients who underwent total thyroidectomy for toxic goiters were randomly assigned to routinely receive or not receive oral calcium (3 g/day) and vitamin D (1 μg/day) for 4 weeks. Hypocalcemic symptoms and signs, and total serum calcium and parathormone levels were monitored and compared between the two groups. Results The incidence of symptomatic and laboratory hypocalcemia was lower in the treatment group receiving the supplement than in the control group not receiving the supplement: one of 15 patients (6.7%) versus five of 15 (33.3%). The hypocalcemic symptoms were minimal in the treatment group, but more severe in the control group not receiving the supplement. Serum calcium levels decreased in both groups after surgery, but were less in the treatment group. Conclusion Routine administration of oral calcium and vitamin D supplementation may be effective in reducing the incidence and severity of hypocalcemia after total thyroidectomy.