cholecalciferol and Goiter--Nodular

Transient hypocalcemia due to parathyroid gland or vessel manipulation is a common complication following thyroidectomy. Considering the role of 25-hydroxyvitamin D (25(OH)D) in calcium hemostasis, this study aimed to evaluate the effect of preoperative vitamin D supplementation on hypocalcemia incidence in thyroidectomy patients.. In this randomized clinical trial, 100 patients scheduled for total thyroidectomy and suffering from preoperative moderate or severe vitamin D deficiency were enrolled. Patients were randomly allocated to either study or control groups using the sealed envelope method. Patients in the study group received vitamin D3 50,000-unit pearl weekly for 4 weeks prior to the operation. The control group received placebo. Total and ionized serum calcium levels were checked before surgery, the day after surgery, and 2 weeks postoperatively.. No significant difference was observed in terms of demographic data. During serial total calcium checks (5 episodes), total calcium levels changed significantly in patients who had received vitamin D supplements compared to the control group (P = 0.043). Symptomatic hypocalcemia incidence was significantly lower in patients supplemented with 25-hydroxyvitamin D (25(OH)D) (P = 0.04). Also, the requirement for intravenous calcium administration in order to treat the hypocalcemia symptoms was significantly lower in the study in comparison to the control group (P = 0.03).. Vitamin D supplementation in patients with vitamin D deficiency might lead to a lower incidence of early-onset symptomatic hypocalcemia; hence, requiring less calcium supplementation for the management of hypocalcemia.

Topics: Adenocarcinoma, Follicular; Adult; Calcium; Cholecalciferol; Female; Goiter, Nodular; Humans; Hypocalcemia; Male; Postoperative Complications; Preoperative Care; Thyroid Cancer, Papillary; Thyroid Diseases; Thyroid Neoplasms; Thyroidectomy; Vitamin D; Vitamin D Deficiency; Vitamins

Age, postoperative serum parathormone (PTH) level, and preoperative serum 25-hydroxyvitamin D(3) (25-OHD) level predict postoperative hypocalcemia after total thyroidectomy.. Prospective clinical trial.. Tertiary referral center.. One hundred thirty patients with nontoxic multinodular goiter. Patients were divided into 2 groups according to the postoperative serum calcium level. Group 1 (n = 32) consisted of patients with a postoperative serum calcium level of 8 mg/dL or less, and group 2 (n = 98) consisted of patients with a postoperative serum calcium level higher than 8 mg/dL.. The preoperative serum 25-OHD level and preoperative and postoperative serum calcium and PTH levels were determined.. The number of patients developing hypocalcemia and prediction of postoperative hypocalcemia by the serum 25-OHD and PTH levels.. Hypocalcemia developed in 32 patients (24.6%) (group 1). The preoperative serum 25-OHD level and postoperative serum calcium and PTH levels in group 1 were significantly lower than in group 2 (P = .001). With logistic regression analysis, factors that were predictive of postoperative hypocalcemia included a preoperative serum 25-OHD level less than 15 ng/mL (P < .001; odds ratio, 558.5), a postoperative serum PTH level less than 10 pg/mL (P = .01; odds ratio, 16.4), and being older than 50 years (P = .01; odds ratio, 4.6).. Age, a low preoperative serum 25-OHD level, and a low postoperative serum PTH level are significantly associated with postoperative hypocalcemia. The low preoperative serum 25-OHD level was more significant than the low postoperative serum PTH level in the prediction of postoperative hypocalcemia.

Topics: Adolescent; Adult; Aged; Cholecalciferol; Female; Goiter, Nodular; Humans; Hypocalcemia; Male; Middle Aged; Parathyroid Hormone; Predictive Value of Tests; Prospective Studies; Thyroidectomy