Preoperative Calcium Supplements May Improve Post-Thyroidectomy Outcomes in Patients with Graves's Disease: Study
Germany: Preoperative calcium supplementation may help improve postoperative quality of life and reduce symptoms of hypocalcemia, particularly in patients with Graves' disease undergoing thyroidectomy. Although the results were not statistically significant, the intervention is simple, low-cost, and low-risk, suggesting potential clinical relevance. Further, the added benefit of magnesium appears minimal.
These are the results from a recent study published in Endocrinology, Diabetes & Metabolism that explored whether taking calcium and magnesium before thyroid surgery can help patients avoid postoperative hypocalcemia and improve their recovery experience.
Conducted by Navid Tabriz from Pius-Hospital Oldenburg, University Hospital for Visceral Surgery, Carl von Ossietzky University Oldenburg, Germany, and colleagues, the research sheds light on a straightforward intervention that may support better outcomes after total thyroidectomy.
Hypocalcemia is among the most frequent complications following thyroid removal, often resulting from transient or permanent hypoparathyroidism. These calcium fluctuations can significantly impair a patient’s quality of life, causing symptoms such as tingling, numbness, muscle cramps, and, in severe cases, cardiac complications. With thyroidectomy commonly performed for conditions such as symptomatic nodular goitre and Graves’ disease, strategies to reduce postoperative complications remain clinically important.
To evaluate the potential benefits of supplementation, the investigators enrolled 62 patients scheduled for total thyroidectomy due to benign thyroid disorders. Participants were randomly assigned to receive either preoperative supplementation—comprising 500 mg of calcium carbonate three times daily along with 300 mg of magnesium carbonate once daily for two weeks—or no supplementation.
Researchers assessed biochemical parameters, including calcium, magnesium, parathyroid hormone (PTH), and vitamin D at four time points, alongside patient-reported quality-of-life scores using EQ-5D and ThyPro39de questionnaires.
The key findings of the study were as follows:
- Quality of life improved in both the supplementation and control groups after surgery, reflecting the benefit of treating the underlying thyroid disease.
- Patients with Graves’ disease who received supplementation experienced earlier postoperative improvement, particularly immediately after surgery.
- Rates of postoperative hypocalcemia were slightly lower in the supplementation group (19.4%) compared with the control group (25%).
- Hypoparathyroidism occurred in 16% of the supplementation group and 23% of the control group, indicating a modest but nonsignificant advantage.
- Laboratory results showed higher postoperative calcium levels in the supplementation group, with the most notable gains seen in patients with Graves’ disease.
- Symptoms of hypocalcemia were milder among individuals who received supplementation.
- Vitamin D deficiency was common, affecting around two-thirds of participants.
- No clear link was found between vitamin D deficiency and the development of postoperative hypocalcemia.
The study suggests that preoperative calcium—and to a lesser extent magnesium—may support smoother recovery following thyroidectomy, even though the impact did not meet statistical thresholds. The authors emphasize that the simplicity, affordability, and safety of supplementation make it a potentially valuable addition to preoperative care, particularly for high-risk patients. Magnesium, however, appeared to contribute minimal additional benefit.
The researchers highlight the need for larger, placebo-controlled trials to confirm these findings and determine optimal supplementation duration. They also recommend long-term follow-up, including assessments at six months, to better understand sustained quality-of-life improvements and to rule out persistent hypoparathyroidism.
Reference:
Tabriz, N., Fried, D., Uslar, V., & Weyhe, D. (2025). Impact of Preoperative Calcium and Magnesium Supplementation on Quality of Life and Hypocalcemia Post-Thyroidectomy. Endocrinology, Diabetes & Metabolism, 9(1), e70129. https://doi.org/10.1002/edm2.70129
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