Post operative hypocalcemia

Low Calcium after thyroidectomy

  • Most common complication after total or near total thyroidectomy is hypocalcemia due to hypoparathyroidism.  Post thyroidectomy hypoparathyroidism is usually related to disruption of the blood supply to parathyroid glands.
  • A patient needs only a single healthy parathyroid gland to have normal parathyroid function.

Symptoms of hypocalcemia

  • Could be asymptomatic or show up as:
  • mild paresthesias
  • Painful tentany
  • muscle aches
  • weakness or twitching
  • Larngeal spasm
  • Arrythmia


  • Parathyroid hormone measurement after surgery.  Possibly consider this protocol.  If less than 10 (pg/ML) supplement with calcium and calcitriol.  If between 10-20 supplement with calcium.  If greater than 20 – then no supplementation.
  • PTH is secreted by the chief cells of the parathyroid gland.
  • Acts to increase the concentration of calcium in the blood
  • PTH half life is about 4 minutes.

what is Calcitriol?

  • Hormonally active form of vitamin D.
  • After thyroidectomy, supplimentation with Calcitriol may supress PTH levels.

A main reason for hospitalization overnight after  total thyroidectomy

To monitor for the risk of hypocalcemia.

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