title: High-calcium mineral water as a calcium supplementing measure for post-thyroidectomy hypocalcemia.
abstract: OBJECTIVE
  The aim of this study was to test the possibility of enhancing blood calcium levels in totally thyroidectomized patients by supplementation with 1 L/d carbonate-bicarbonate-high-calcium mineral water.
  
  
  METHODS
  This study enrolled 95 outpatients, totally thyroidectomized four months earlier, and hence treated with oral calcium and vitamin-D. At recruitment, ionized blood calcium was either below (Group A; N. 55) or above (Group B; N. 40, randomly divided in Group B1 [N. 20] and Group B2 [N.20]) the lower limit of the normal range (1.12 mmol/L). For one month, Group A was treated with 1 L/d high-calcium (483 mg/L) mineral water and continued the usual therapy with Ca and vitamin-D. In contrast, Group B1 and Group B2 substituted their Ca and vitamin-D therapy with 1 L/d high-calcium mineral water (Group B1) or 1 L/d of placebo mineral water (Ca:80 mg/L) (Group B2).
  
  
  RESULTS
  After one month, a significant 7.5% increase in blood ionized-calcium levels was observed in Group A, no change in Group B1 and a significant drop below normality in Group B2 (Group B2 vs Group B1, P<0.001). Thereafter, 1 L/d of the high-calcium mineral water, given to Group B2 instead of placebo for an additional month, significantly enhanced ionized-calcium levels above the lower limit of normality (Group B2 vs Group B1, NS).
  
  
  CONCLUSIONS
  These experiments show that calcium supplementation as 1 L/d of a high-calcium mineral water may efficaciously enhance blood calcium levels in thyroidectomized patients. This complementary treatment might at least in part contribute to the prevention and/or treatment of hypocalcemia and substitute vitamin-D and calcium therapies after thyroidectomy.
authors.affiliation: Department of Internal Medicine and Biomedical Sciences, University of Parma, Parma, Italy. vittorio.coiro@unipr.it
authors.forename: V
authors.initials: V
authors.lastname: Coiro
authors.forename: G
authors.initials: G
authors.lastname: Zanardi
authors.forename: G
authors.initials: G
authors.lastname: Saccani Jotti
authors.forename: P
authors.initials: P
authors.lastname: Rubino
authors.forename: G
authors.initials: G
authors.lastname: Manfredi
authors.forename: P
authors.initials: P
authors.lastname: Chiodera
mesh_terms: D000328:Adult; D002117:Calcitriol / Q000008:administration & dosage / Q000627:therapeutic use; D002118:Calcium / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D017610:Calcium Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D002254:Carbonates / Q000008:administration & dosage / Q000627:therapeutic use; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006042:Goiter / Q000601:surgery; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D007011:Hypoparathyroidism / Q000097:blood / Q000209:etiology; D007773:Lactates / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008900:Mineral Waters / Q000032:analysis / Q000627:therapeutic use*; D010281:Parathyroid Hormone / Q000097:blood; D013963:Thyroid Hormones / Q000097:blood; D013965:Thyroidectomy / Q000009:adverse effects*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000627:therapeutic use
chemical_list: D017610:Calcium Compounds; D002254:Carbonates; D007773:Lactates; D008900:Mineral Waters; D010281:Parathyroid Hormone; C082985:Sandocal; D013963:Thyroid Hormones; D013972:Thyrotropin; D002117:Calcitriol; D013974:Thyroxine; D002118:Calcium