Is routine supplementation therapy (calcium and vitamin D) useful after total thyroidectomy?
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.
Bellantone
Rocco
R
Division of Endocrine Surgery, Department of Surgery, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy.
Lombardi
Celestino Pio
CP
Raffaelli
Marco
M
Boscherini
Mauro
M
Alesina
Pier Francesco
PF
De Crea
Carmela
C
Traini
Emanuela
E
Princi
Pietro
P
D000328:Adult; D000368:Aged; D002118:Calcium / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D006044:Goiter, Nodular / Q000601:surgery*; D006801:Humans; D006996:Hypocalcemia / Q000188:drug therapy* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D011183:Postoperative Complications / Q000188:drug therapy / Q000517:prevention & control; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage*
D010281:Parathyroid Hormone; D014807:Vitamin D; D002118:Calcium