Alternate-day Calcium Dosing May Be an Effective Treatment Option for Chronic Hypoparathyroidism
J Endocrinol Invest, 2020 Jan 3, PMID: 31900832 DOI: 10.1007/s40618-019-01173-9
T Akkan 1, M Dagdeviren 2, A O Koca 2, D T Ertugrul 2, M Altay 2
- Hypothyroidism risk reduced 32 percent in those getting vitamin D levels above 50 ng – Oct 2017
- Hypothesis Vitamin D receptor controls PTH without needing Vitamin D – Aug 2015
- Calcium Supplementation is OK provided you also take Vitamin K – Feb 2019
- More than 1.4 grams of Calcium increased male death rate by 1.4 X – Sept 2018
- Calcium and Vitamin D category with >180 Calcium studies
Purpose: Conventional treatment of chronic hypoparathyroidism consists of oral calcium supplements and active vitamin D analogs; however, some patients are unable to meet treatment goals despite the high dosage of oral calcium supplementation. We aimed to investigate the effectiveness of alternate-day oral calcium intake in patients with uncontrolled chronic hypoparathyroidism.
Methods: In this retrospective cohort study, we evaluated 66 patients with chronic hypoparathyroidism who were admitted to our hospital between January 2017 and January 2019. Fourteen patients receiving ≥ 2000 mg/day oral elemental calcium and who were admitted to emergency department or our outpatient clinic at least once in the last 3 months for hypocalcemia requiring intravenous calcium replacement were switched to the alternate-day dosing regimen in which patients took calcium orally every other day. We collected and analyzed patients' medical history information, serum and urinary parameters over a 3-month period prior to and following the treatment.
Results: Before alternate-day dosing regimen, median oral calcium intake was 3750 mg/day, oral calcitriol intake was 0.88 mcg/day, serum calcium levels were 7.71 mg/dL, serum phosphate levels were 5.35 mg/dL, and 24-h urine calcium levels were 165 mg/day. Following alternate-day dosing regimen, median oral calcium intake was 1500 mg/day, oral calcitriol intake was 0.88 mcg/day, serum calcium levels were 8.25 mg/dL, serum phosphate levels were 5 mg/dL, and 24-h urine calcium levels were 210.5 mg/day. After alternate-day dosing regimen, oral calcium intake decreased and serum calcium levels increased. The number of emergency visits dropped from 21 to 3 after alternate-day dosing regimen.
Conclusion: Patients with uncontrolled chronic hypoparathyroidism could be controlled more effectively with alternate-day dosing regimen.