Assessment of calcium homeostasis after total thyroidectomy in differentiated thyroid carcinoma

Abstract

Background: After total thyroidectomy, hypocalcaemia can be transient or permanent. Most of the patients are being prescribed long term calcium supplementation despite preserving parathyroid glands. We have tried to study the various calcium homeostatic factors to predict the long term calcium levels in differentiated thyroid carcinoma following total thyroidectomy. Method: Study was conducted in a tertiary care centre and a total number of 28 patients of differentiated thyroid carcinoma were retrospectively analysed who underwent surgery from 2013 - 2015. Post surgery patients were given thyroxine and calcium supplementation with regular monitoring of thyroid function test and serum calcium. Serum Parathormone(PTH) levels were recorded after minimum of one year of completion of surgery. Results: Out of 28 patients, 26 patients have serum parathormone within normal range (15-65 pg/ml). Only two patients have low serum PTH values (<15pg/ml). Total number of 23 patients are taking calcium supplementation out of which 21 patients have normal parathormone value. None of the patients without calcium supplementation have low parathormone levels. Conclusion: Our study reveals optimum calcium homeostasis in patients undergoing total thyroidectomy. A long term follow up of these patients is required so that many patients with normal PTH levels may not require calcium supplementation.

Keywords

• Calcium metabolism
• hypocalcemia
• thyroid surgery