Annals of Surgical Oncology

, Volume 18, Issue 3, pp 777–781 | Cite as

The Value of Postoperative Parathyroid Hormone Levels in Predicting the Need for Long-Term Vitamin D Supplementation after Total Thyroidectomy

  • Tracy S. Wang
  • Ashley K. Cayo
  • Stuart D. Wilson
  • Tina W. F. Yen
Endocrine Tumors



Few studies have examined the need for vitamin D supplementation after total thyroidectomy. This study examines the role of postoperative day (POD) 1 serum calcium and parathyroid hormone (PTH) levels in predicting the need for long-term vitamin D supplementation after total thyroidectomy.


A retrospective, single institutional study of patients who underwent total thyroidectomy between January 2007 and December 2008 was performed. Data collected included extent of surgery, final pathology, postoperative calcium (mg/dl) and PTH (pg/ml) values, and duration of vitamin D supplementation. Patients were divided into 4 groups based on POD1 PTH values: group 1 (<5.0); group 2 (5.0–10); group 3 (10.1–20); and group 4 (>20).


Of the 104 patients, 26 were in group 1, 12 in group 2, 18 in group 3, and 48 in group 4, with median PTH values of <2.5, 8.2, 14.1, and 30 pg/ml, respectively. All 7 (7%) patients who required vitamin D supplementation >1 month were in group 1. The positive predictive value of POD1 PTH <5.0 in predicting supplementation >1 month was 27% (sensitivity 100%, specificity 80%). Seventy-eight patients had a POD1 PTH level ≥5, and none required vitamin D supplementation >1 month (100% negative predictive value). The positive predictive value of various POD1 calcium thresholds (<7.5, <8.0, and <8.5 mg/dl) was 17, 14, and 15%, respectively.


Postoperative PTH levels better predict long-term hypocalcemia requiring vitamin D supplementation than serum calcium levels. A PTH level ≥5.0 may identify patients who can be safely discharged without routine vitamin D supplementation.


Total Thyroidectomy Central Neck Dissection Postoperative Hypocalcemia Lateral Neck Dissection Oral Calcium Supplementation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest

All authors have nothing to disclose.


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Copyright information

© Society of Surgical Oncology 2010

Authors and Affiliations

  • Tracy S. Wang
    • 1
  • Ashley K. Cayo
    • 1
  • Stuart D. Wilson
    • 1
  • Tina W. F. Yen
    • 1
  1. 1.Division of Surgical Oncology, Department of SurgeryMedical College of WisconsinMilwaukeeUSA

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