Pre-operative Vitamin D often helps (thyroidectomy in this case)

Created June 2021

Use of pre-operative calcium and vitamin D supplementation to prevent post-operative hypocalcaemia in patients undergoing thyroidectomy: a systematic review

J Laryngol Otol. 2021 Jun 14;1-6. doi: 10.1017/S0022215121001523

A S Khatiwada 1, A S Harris 1

The amount of vitamin D given depends on the patient and the reason for the surgery 200,000 IU taken over a period of 2 -20 days is typical The Vitamin D should be taken at least 1 week before so that the levels have fully responded Giving vitamin D as the day of the surgery is not as good as given before, but is better than none at all A different form of Vitamin D can be given if the person has poor gut, poor liver, or poor kidney * Give Vitamin D before all spinal surgeries – no testing needed – June 2020 * Half as many problems if take Vitamin D (300,000 IU) before thyroidectomy – RCT Jan 2021 * Vitamin D is needed before many surgeries – many studies and RCTs

Objective: This systematic review aimed to establish the evidence behind the use of pre-operative calcium, vitamin D or both calcium and vitamin D to prevent post-operative hypocalcaemia in patients undergoing thyroidectomy.

Method: This review included prospective clinical trials on adult human patients that were published in English and which studied the effects of pre-operative supplementation with calcium, vitamin D or both calcium and vitamin D on the rate of post-operative hypocalcaemia following total thyroidectomy.

Results: Seven out of the nine trials included reported statistically significantly reduced rates of post-operative laboratory hypocalcaemia (absolute risk reduction, 13-59 per cent) and symptomatic hypocalcaemia (absolute reduction, 11-40 per cent) following pre-operative supplementation.

Conclusion: Pre-operative treatment with calcium, vitamin D or both calcium and vitamin D reduces the risk of post-operative hypocalcaemia and should be considered in patients undergoing total thyroidectomy.

Tags: Trauma and surgery