BACKGROUND: Our goal was to determine whether routine oral calcium (OC) and
vitamin D (VD) administration can effectively prevent symptoms of hypocalcemia
after total thyroidectomy.
METHODS: Seventy-nine patients who underwent total thyroidectomy were randomly
allotted to one of the following groups: (1) group A, no treatment; (2) group B,
OC 3 g per day; (3) group C, OC 3 g + VD 1 mg per day. Treatment was started on
postoperative (PO) day 1 in groups B and C.
RESULTS: Fewer patients in groups B and C experienced symptoms when compared with
group A (P =.005). Patients in groups B and C had only minor symptoms, whereas 2
patients in group A experienced major symptoms and 6 required intravenous calcium
(P <.01). The rate of hypocalcemia was slightly lower in group C (P = not
significant). Treatment was discontinued by PO day 7 in all but 8 patients. Two
patients still required treatment 6 months after operation (2.5%). PO parathyroid
hormone levels did not differ in the 3 groups (P = not significant).
CONCLUSIONS: Routine supplementation therapy with OC or VD effectively prevents
symptomatic hypocalcemia after total thyroidectomy and may allow for a safe early
discharge. Further studies are necessary to determine the best treatment. The
combination of OC and VD may further reduce the rate of PO hypocalcemia, without
inhibiting parathyroid hormone secretion.
- calcium supplementation
- vitamin D supplementation