# Vitamin D Deficiency and Its Impact on Prediction and Treatment of Postoperative Hypocalcemia in a Cohort of Patients Undergoing Total Thyroidectomy

## TL;DR

This study shows that low vitamin D levels before thyroid surgery increase the risk of low blood calcium afterward, and taking vitamin D beforehand may help prevent it.

## Contribution

The study introduces preoperative vitamin D supplementation as a potential strategy to reduce postoperative hypocalcemia risk in thyroidectomy patients.

## Key findings

- Vitamin D-deficient patients without supplementation had the highest rate of postoperative hypocalcemia.
- Clinical hypocalcemia was significantly higher in the group without vitamin D supplementation.
- Preoperative vitamin D supplementation may help reduce the risk of postoperative hypocalcemia.

## Abstract

Background: Postoperative hypocalcemia is a common complication following total thyroidectomy, leading to extended hospital stays, decreased patient quality of life, and increased healthcare costs. Recent research has explored the role of preoperative vitamin D deficiency in exacerbating this risk due to its impact on calcium homeostasis.

Methods: A prospective study was conducted at a tertiary care hospital in Southern India from March 2023 to May 2024. Patients undergoing total thyroidectomy were categorized into three groups based on their preoperative vitamin D status: Group A (Vitamin D sufficient), Group B (Vitamin D deficient with preoperative supplementation), and Group C (Vitamin D deficient without supplementation). Serum calcium levels were monitored preoperatively and postoperatively to assess for hypocalcemia.

Results: A total of 84 patients were included: Group A (n=38), Group B (n=23), and Group C (n=23). Preoperative vitamin D levels were significantly lower in Groups B and C compared to Group A. The incidence of postoperative hypocalcemia was highest in Group C (n=23; 56.5%), followed by Group A (n=38; 42.1%) and Group B (n=23; 34.8%), although differences were not statistically significant (p=0.315). However, clinical hypocalcemia was significantly higher in Group C (n=23; 56.5%) compared to Group A (n=38; 23.7%) and Group B (n=23; 21.7%) (p=0.013).

Conclusion: Preoperative vitamin D deficiency is associated with an increased risk of postoperative hypocalcemia following total thyroidectomy. Preoperative supplementation in vitamin D-deficient patients may mitigate this risk, suggesting a potential benefit in routine assessment and correction of vitamin D status before surgery to optimize patient outcomes.