Thyroid cancer or another thyroid disorder can necessitate a thyroidectomy, or removal of all or part of the thyroid gland. If you take thyroid replacement hormone, you must follow specific instructions as to the time you ingest both your medication and any calcium supplementation. If you have had both your thyroid and the adjacent parathyroid glands removed, getting an adequate amount of calcium becomes a particular challenge. Sometimes, thyroid surgery in and of itself can lead to a temporary disruption of calcium levels.
Thyroid Replacement Hormone and Calcium
After all or part of your thyroid is removed, you must take a synthetic hormone pill to replace the thyroid hormones your body can no longer manufacture on its own. Doctors commonly prescribe levothyroxine for patients with decreased or absent thyroid function. Since levothyroxine must be taken on an empty stomach, patients are usually instructed to take this medication as soon as they arise in the morning, and to wait for 30 to 60 minutes before eating or drinking anything other than water. Absorption of levothyroxine can be compromised by calcium supplements, so you should take any calcium supplement either four hours before or four hours after taking this medication.
Thyroid Medication and Calcium Depletion
If you have undergone thyroid removal because of thyroid cancer, you require life-long treatment with synthetic thyroid hormone. As part of cancer suppression therapy for thyroid cancer patients, doctors typically prescribe this hormone at a higher level than they would for a person without thyroid cancer. By keeping the hormone levels high enough to suppress your TSH, or thyroid stimulating hormone, the medication helps reduce the chance than you will have any new cancer growth. Whether or not long-term suppression of thyroid stimulating hormone through such therapy can lead to an increased chance of bone loss, and thus require additional calcium supplementation, remains controversial. However, anyone on such a regimen should be carefully monitored for osteoporosis, suggests the journal "Nature Reviews Endocrinology."
Hypocalcemia Following Thyroid Surgery
Your body's four parathyroid glands, each no bigger than a grain of rice, are located behind the thyroid gland. They function as the body's calcium regulators. Because the glands are so small and sometimes even embedded in thyroid tissue, they are easily damaged or even inadvertently removed during thyroid surgery. Such damage is usually temporary, but may cause hypocalcemia, or an abnormally low blood calcium level. Symptoms usually occur about 24 to 48 hours after surgery and may include a sensation of numbness or tingling in the hands, feet and around the lips. You may also feel headache, muscle cramps or a crawling sensation on the skin.
Hypocalcemia Treatment
Your doctor will direct you to take a calcium supplement whenever you feel symptoms, which should then be relieved with 20 to 30 minutes. Problems with this disorder should abate within approximately a week of your thyroid surgery, according to the Columbia University Medical Center. Seek guidance from your physician if you continue to experience problems.
