Low Calcium after thyroidectomy
- Most common complication after total or near total thyroidectomy is hypocalcemia due to hypoparathyroidism. Post thyroidectomy hypoparathyroidism is usually related to disruption of the blood supply to parathyroid glands.
- A patient needs only a single healthy parathyroid gland to have normal parathyroid function.
Symptoms of hypocalcemia
- Could be asymptomatic or show up as:
- mild paresthesias
- Painful tentany
- muscle aches
- weakness or twitching
- Larngeal spasm
- Arrythmia
PTH
- Parathyroid hormone measurement after surgery. Possibly consider this protocol. If less than 10 (pg/ML) supplement with calcium and calcitriol. If between 10-20 supplement with calcium. If greater than 20 – then no supplementation.
- PTH is secreted by the chief cells of the parathyroid gland.
- Acts to increase the concentration of calcium in the blood
- PTH half life is about 4 minutes.
what is Calcitriol?
- Hormonally active form of vitamin D.
- After thyroidectomy, supplimentation with Calcitriol may supress PTH levels.
A main reason for hospitalization overnight after total thyroidectomy
To monitor for the risk of hypocalcemia.