Objectives 

To examine the utility of PTH levels in predicting post-thyroidectomy symptomatic hypocalcemia.

Methods

This retrospective pilot study includes 18 patients, from February 2024 to June 2024 who underwent total thyroidectomy, (with and without central and lateral neck dissection), in our tertiary care hospital. Measurement of serum PTH, serum calcium, and albumin was done preoperatively on day of admission and Serum PTH levels was monitored 3 hours after removing the thyroid specimen on day of surgery for its change and prediction of hypocalcemia, in euthyroid patients.

Results

The mean age for 13 females (72.2%) was 39.9 years, whereas that for 5 males (27.7%) was 62.8 years, undergoing total thyroidectomy. The main indication for surgery in 11 patients (61.1%) was papillary carcinoma thyroid and in 7 patients (38.3%) was multi nodular goitre. There was a mixture of both malignant and benign diseases. Three hours after surgery, 9 patients, (50%), had serum PTH levels of <15 pg/ml and 9 patients (50%) had signs of hypocalcemia in late postoperative period with 9 (50%) showing early serial decline in serum calcium levels. Thus, postoperative calcium supplementation was given, forming a significant correlation. Vitamin D was not a limiting factor, as it was found to be low in all patients.

Conclusions

PTH measurements at 3 hours after total thyroidectomy are an accurate predictor for the development of hypocalcemia and allows starting early calcium supplements for the asymptomatic patients with PTH level of less than 15 pg/ml. This confirms the value set by the American Thyroid Association. It can be used in daily clinical practice as an indicator.