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Calcium Supplementation After Thyroidectomy

More than 50,000 thyroid operations are performed in the United States annually, and postoperative hypoparathyroidism can occur in up to 30% of cases. To protect against the development of symptomatic hypocalcemia that occurs with postoperative hypoparathyroidism, many medical centers routinely discharge patients who have undergone thyroidectomy with prescriptions for calcium supplementation. These supplements, however, can be inconvenient for patients. They may cause adverse events (eg, constipation and nausea) and may actually suppress parathyroid hormone (PTH) production. Patients discharged on calcium replacement after thyroidectomy usually undergo follow-up blood work to test serum calcium and PTH levels, causing loss of productivity for the patient and additional paperwork for the medical staff. Selective calcium supplementation may offer an effective means for eliminating the costs and burden associated with routine supplementation. Selective Calcium Supplementation “With routine calcium supplement use, clinicians must determine when and how to wean patients off supplementation when appropriate,” explains Nancy D. Perrier, MD. “Calcium supplements are relatively inexpensive, but the real burden of routine calcium supplementation comes with the additional laboratory work that is needed. Medical staff must conduct continued follow-up and communicate results to patients. Ultimately, routine supplementation increases the complexity of postoperative care.” On the other hand, according to Dr. Perrier, checking blood calcium levels shortly after thyroidectomy to determine if patients require supplementation allows providers to personalize the postoperative treatment plan with the patient prior to hospital discharge. A New Analysis for Post-Thyroidectomy Dr. Perrier and colleagues had a study published in Archives of Surgery that tested an algorithm for approaching post-thyroidectomy calcium supplementation based on a selective approach. Patients were analyzed during the postoperative period...
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