The thyroid gland is a part of your endocrine system. This butterfly-shaped gland produces the thyroid hormones that regulate the body's metabolism. Sometimes the thyroid can malfunction, grow too large, develop nodules or become cancerous. Any of these conditions may require surgery, and after surgery, some people may develop problems with serum calcium levels because of injury to the parathyroid glands.
Thyroidectomy
Surgery on the thyroid is called a thyroidectomy. The surgeon may remove the entire thyroid -- called a total thyroidectomy -- or part of the thyroid, which is called a partial or sub-total thyroidectomy. When the thyroid is completely removed, you will need to take oral thyroid medication for the rest of your life. Total thyroidectomy is recommended for goiter, or overgrowth of the thyroid gland, and for cancer of the thyroid. Thyroid nodules can often be managed with a partial thyroidectomy.
Parathyroid Glands
The parathyroid glands are four small glands located behind the thyroid gland. These highly vascular, pea-sized glands regulate calcium levels in the body by secreting parathyroid hormone. The normal calcium range in the blood is between 8.5 and 10.5; low concentrations, called hypocalcaemia, can result after surgery on the thyroid gland if the parathyroids or their blood supply are injured during the surgery. Calcium is critical for proper nerve function and muscle contraction, so hypocalcaemia can cause cramps or tingling sensations.
Research
Most patients do not require calcium supplementation after a thyroidectomy, according to a study published in the September 2006 "Ear, Nose and Throat Journal." The researchers studied 40 patients after total thyroidectomy for cancer or goiter. Five patients needed calcium supplementation in the hospital, but only 3 patients required supplements after discharge. A similar study in the October 2002 "Otolaryngology Head and Neck Surgery" found calcium levels in the first 6 to 12 hours after surgery determined whether patients would need calcium supplementation.
More Research
Patients who received calcium and vitamin D supplementation after surgery had minimal symptoms related to hypocalcaemia and their serum calcium levels recovered earlier than in the group that was not given supplements, according to research published in the November 2006 "American Journal of Surgery." The researchers used 3 g of calcium and 1 g of vitamin D daily for two weeks. These results were confirmed by a similar but larger study published in the January 2009 issue of "Cancer."
Considerations and Warnings
Calcium supplementation after thyroidectomy should be done on an individual basis under the direction of a health care professional. The exact dose may vary. Dr. Kirk Faust, an endocrine surgeon who specializes in thyroid surgery, recommends 3 extra strength calcium-enriched antacids every six hours or with each meal and at bedtime. Consult a health care professional for any questions or concerns about calcium supplementation.
References
- MedLinePlus; Thyroid Gland Removal; Shabir Bhimji, MD and David Zieve, MD; May 2011
- "Ear, Nose and Throat Journal'; The Management Of Post-Thyroidectomy Hypocalcaemia; L. Szubin, et.al,; September 1996
- "Otolaryngology Head and Neck Surgery"; Predicting Calcium Status Post Thyroidectomy with Early Calcium Levels; Murad Husein, MD, et.al.; October 2002
- "American Journal of Surgery"; Routine Oral Calcium And Vitamin D Supplements For Prevention Of Hypocalcaemia After Total Thyroidectomy; J.L. Roh and C. I. Park; November 2002
- "Cancer"; Prevention Of Postoperative Hypocalcaemia With Routine Oral Calcium And Vitamin D Supplements In Patients With Differentiated Papillary Thyroid Carcinoma Undergoing Total Thyroidectomy Plus Central Neck Dissection; J.L. Roh, et.al.; January 2009
- EndocrineSurgeryNC.com; Thyroidectomy; Kirk Faust, MD
