Clearer protocols needed for managing postoperative hypoparathyroidism after thyroidectomy

A lack of consistency in how calcium and vitamin D supplementation is managed after thyroid surgery, particularly in the follow-up care by external healthcare providers, may lead to unnecessary over-supplementation, which could cause complications such as suppressed parathyroid hormone (PTH) levels, excessive calcium intake, and potential kidney issues, according to a study.

The retrospective study assessed 332 patients who developed hypoparathyroidism after thyroidectomy. Of the 94 patients (28.3%) who continued calcium and vitamin D supplementation, varying patterns of prescription were observed. Some patients with PTH deficiency and hypocalcemia continued supplementation, while others with normal or elevated PTH levels, but still experiencing hypocalcemia, were also treated. In addition, a group of patients with low PTH levels but normal or elevated calcium levels continued receiving the supplements.

The study advocates for a more standardized approach, suggesting that thyroid surgeons actively recommend tailored reduction plans to prevent iatrogenic PTH suppression, excessive calcium intake, and potential kidney complications.

Reference
Staubitz-Vernazza JI, Lederer AK, Bouzakri N, Lozan O, Wild F, Musholt TJ. Calcium and vitamin D substitution for hypoparathyroidism after thyroidectomy – how is it continued after discharge from hospital? Langenbecks Arch Surg. 2024;409(1):373. doi: 10.1007/s00423-024-03556-w. PMID: 39636417; PMCID: PMC11621183.