Calcium Supplementation
About Calcium Supplementation After Thyroid Surgery
If you are undergoing total thyroidectomy (removal of your entire thyroid gland, you will need to take calcium supplements after your operation in order to prevent a complication called hypocalcemia (low calcium levels in the blood). This is a potentially serious side effect, but can be prevented or taken care of easily if caught early and treated appropriately.
On this page, you’ll find important instructions on how to take calcium supplements after having a total thyroidectomy.
Please note: these instructions only apply if you are a patient at Beach Cities ENTS. If you have had your surgery elsewhere, please follow your own surgeon’s instructions.
Instructions for Taking Calcium Supplements After Thyroid Surgery
Take your calcium in the EXACT dose told by your doctor. Do not change the dose unless you are told to do so by either your surgeon or your endocrinologist.
Try to take your calcium with a meal, or a glass of orange juice. Calcium needs an acidic environment in the stomach to be absorbed.
If you experience any symptoms of hypocalcemia (see below), take two extra calcium pills right away and wait 1 hour. If you are still having symptoms of hypocalcemia after that, call your BCENTS doctor right away. If you cannot reach your doctor, please go to the nearest emergency room. You will need to have your blood drawn to check your calcium level and may need to get calcium through an IV.
Your doctor may give you other medications to help your body absorb calcium better. These may include vitamin D or magnesium supplements. Please take these exactly as instructed by your doctor.
What are symptoms of hypocalcemia?
Numbness or tingling around the lips, or on the fingers or toes (this is the most common symptom, and usually the first one).
Muscle spasms in the hands, feet, or jaw
In serious cases: throat spasm, heart palpitations
If you experience any of these symptoms at any point during the first few weeks after total thyroidectomy, you should inform your BCENTS surgeon right away.
More information about hypocalcemia
Why does hypocalcemia happen after thyroid surgery?
During thyroid surgery, there are 4 small glands very close to the thyroid, called the parathyroid glands, which need to be found and preserved without being damaged. These glands are responsible for controlling the calcium level in your blood. These parathyroid glands have a very delicate blood supply which can easily be interrupted during thyroid surgery, causing them to temporarily not function well. When this happens, the level of calcium in your blood can drop, causing hypocalcemia.
How common is hypocalcemia?
Temporary hypocalcemia is relatively common after total thyroidectomy, and can occur in
15-30% of all total thyroidectomy cases. In the vast majority of cases it is temporary, lasting a few days to weeks. Occasionally it may take a few months to resolve. Permanent hypocalcemia is rare and may occur 1-2% of the time.
How is hypocalcemia found? How is it treated?
Immediately after your thyroid surgery is completed, your BCENTS surgeon will do a blood test to determine how well your parathyroid glands are working, called a PTH level (parathyroid hormone level).
If your PTH level is normal, your chances of developing hypocalcemia are extremely low. You will be given a low dose calcium supplement to take for one week or so, and as long as you don’t develop any symptoms of hypocalcemia, you should be able to stop the calcium after one week.
If your PTH level is low, your chances of developing hypocalcemia increase. In this case, you will need to have your calcium level checked every 6 hours while you are in the hospital, and will need to be given a higher dose of calcium for several weeks. Sometimes, you may need to take a special vitamin D supplement as well (vitamin D helps your body absorb calcium better). Your BCENTS surgeon will then repeat your blood tests again a few days after you leave the hospital.
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