Endocrinol Diabetes Metab. 2026 Jan;9(1):e70129. doi: 10.1002/edm2.70129.
ABSTRACT
OBJECTIVE: Postoperative hypocalcemia and hypoparathyroidism are common complications after thyroidectomy, often impairing quality of life (QoL). This study investigates the impact of preoperative calcium and magnesium supplementation on postoperative QoL and hypocalcemia in patients undergoing total thyroidectomy for symptomatic nodular goitre or Graves’ disease.
METHODS: A total of 62 patients undergoing thyroidectomy for benign thyroid diseases were randomised into two groups. The intervention group (IG, n = 31) received 500 mg calcium carbonate thrice daily and 300 mg magnesium carbonate once daily for 2 weeks preoperatively, while the control group (CG, n = 31) received no supplementation. Laboratory parameters (Ca, Mg, PTH, 25-OH-Vitamin D) were measured at study enrolment (T1), preoperatively (T2), immediately postoperatively (T3) and 6 weeks post-discharge (T4). QoL was assessed using EQ-5D and ThyPro39de questionnaires.
RESULTS: QoL significantly improved postoperatively in both groups. Patients with Graves’ disease in the IG reported earlier QoL improvements immediately post-surgery (T3). Postoperative hypocalcemia occurred in 19.4% of IG patients and 25% of CG patients, with hypoparathyroidism in 16% and 23%, respectively. The IG demonstrated higher postoperative calcium levels and fewer hypocalcemia symptoms, especially in Graves’ disease patients (not significant). Vitamin D deficiency was prevalent (66.7%) but showed no correlation with hypocalcemia.
DISCUSSION: Preoperative calcium and magnesium supplementation might have positive effects on postoperative QoL, especially in Graves’ disease patients, and may reduce hypocalcemia symptoms. This simple, inexpensive and low-risk intervention may be beneficial in the preoperative setting prior to thyroidectomy. Although the observed effect did not reach statistical significance, it could still be of clinical relevance. The additional benefit of preoperative magnesium supplementation seems to be of minor significance, while the effect of pre-existing vitamin D deficiency remains uncertain.
PMID:41319240 | DOI:10.1002/edm2.70129
