Role of Oral Calcium and Vitamin D Supplementation in Preventing Post-Thyroidectomy Hypocalcemia

Abstract Background: Postoperative hypocalcemia is the most frequent complication after total thyroidectomy and its inci-dence is reported in the literature between 5 and 60%. Mani-festations of postoperative hypocalcemia make it a major contributing factor of prolonged hospitalization time which looks mandatory for close observation and repeated laboratory evaluations. Aim of Study: The aim of our study was to detect impor-tance of the use of oral calcium after total thyroidectomy and if it is valuable in preventing symptomatic and laboratory hypocalcemia, and to develop a strategy of oral calcium supplementation following this type of surgery. Patients and Methods: This is a prospective randomized study conducted on 30 patients undergoing total thyroidectomy for various causes at Al Hussein university hospital from June 2016 to August 2018. Patients were allocated into 2 groups group A (15 patients) and group B (15 patients). Group A will receive supplementation with oral calcium and vitamin D for 3 weeks postoperatively. All patients will be tested for serum calcium and parathormone (PTH) level at day 2, day 7, one month and 3 months postoperatively. Most patients were female and without comorbidities. Multinodular goitre and thyrotoxicosis were the most common diagnosis. Observation of the 2 groups for hypocalcemia (clinically and laboratory) was done. Results: Symptomatic hypocalcemia in group A and B was found to be 6.6% and 33.3% respectively (p<0.05) which is statistically significant. Postoperative day 7 mean serum calcium level for group A and B was found to be 9.18±0.41 and 8.11±0.49mg/dl respectively. Postoperative day 7 mean serum parathyroid hormone level for group A and B was found to be 46.04±29.52 and 36.78±20.73pg/ml respectively. Conclusion: We conclude that calcium supplementation in the postoperative period effectively decreases the incidence and severity of hypocalcemia following operation involving excision of whole thyroid gland, and can be safely and routinely used after this procedure.