Successful management of hypoparathyroidism following total thyroidectomy with vitamin D(3) alone.

OBJECTIVE

To assess the efficacy and safety of a single administration of vitamin D3 for postoperative hypoparathyroidism.

PATIENTS AND METHODS

Twelve patients with postoperative hypoparathyroidism were enrolled for this study. They had taken calcium and vitamin D3 orally after the surgery and had shown no symptoms of hypoparathyroidism. Then, all patients had changed their regimen to a single administration of vitamin D3 (1α(OH)D3) with monitoring of serum calcium, urine calcium (u-Ca) and creatinine (u-Cre). The dose of vitamin D3 was started at 2.0μg/day and appropriately adjusted to maintain the ratio of u-Ca and u-Cre (u-Ca/u-Cre) at less than 0.3. The physical findings were carefully checked and the serum intact-parathyroid was also estimated. Those data and physical findings were monitored for at least two years.

RESULT

The maintenance dose of vitamin D3 varied from 0.5 to 3.5μg/day, and the mean dose was 2.04μg/day. All patients tolerated changes of regimen without any symptoms of hyper-/hypocalcemia.

CONCLUSION

A single administration of vitamin D3 is not only safe but also an easy and cost-effective regimen. This also makes drug control easy and worthwhile both for patients and clinicians.

LEVEL OF EVIDENCE

2c.