Post-Operative Permanent Hypoparathyroidism and Preoperative Vitamin D Prophylaxis
J. Clin. Med. 2021,10, 442. https:// doi.org/10.3390/jcm10030442
Tara Kannan Yasmin Foster David J. Ho Scott J. Gelzinnis 1, Michael Merakis 1, Katie Wynne , ZsoltJ.Balogh1,3'* and CinoBendinelli1,3
- Improve your health BEFORE surgery (prehabilitation) helps your recovery - 2018
- :In many cases taking Vitamin D years before would have elminated the need for the surgery
- Chance of dying in hospital cut in half by just 10 ng higher level of Vitamin D – April 2016
- All ICU patients with good vitamin D level survived, none who died had a good level – April 2018
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Items in both categories Thyroid and Intervention - non-daily
See also: Vitamin D is needed before most surgeries – many studies and RCTs
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Permanent hypoparathyroidism, a feared thyroidectomy complication, leads to significant patient morbidity, medical treatment, and monitoring. This study explores whether preoperative high-dose vitamin D loading decreases the incidence of permanent hypoparathyroidism. In a subgroup analysis, the study examines the predictive utility of day 1 parathyroid hormone (PTH) in permanent hypoparathyroidism. Patients (n = 150) were previously recruited in the VItamin D In Thyroidectomy (VIDIT) trial, a multicentre, randomised, double blind, placebo-controlled trial evaluating the role of 300,000 IU cholecalciferol administered orally a week before total thyroidectomy. Patients were contacted postoperatively beyond six months through a telephonic questionnaire. The primary outcome was permanent hypoparathyroidism, strictly defined as the need for activated vitamin D six months postoperatively. Out of 150 patients, 130 (86.7%) were contactable.
Permanent hypoparathyroidism occurred in 11/130 (8.5%) patients, with a lower incidence of 5.3% (3/57) in the cholecalciferol group compared to 11% (8/73) in the placebo group; however, this was non-significant (p = 0.34). In a subgroup analysis, no relationship between day 1 PTH level and the incidence of permanent hypoparathyroidism was found (p > 0.99). There was a lower rate of permanent hypoparathyroidism in the cholecalciferol group, which was not significant. The predictive utility of day 1 postoperative PTH levels may be limited to transient hypoparathyroidism.