Preoperative Vitamin D Supplementation to Reduce Hypocalcemia Following Total Thyroidectomy: Systematic Review and Meta-Analysis of Randomized Clinical Trials
Head Neck. 2025 Apr 23. doi: 10.1002/hed.28174
Luca Canali 1 2, Gian Marco Pace 1 2, Marika D Russell 3, Francesca Gaino 1 2, Luca Malvezzi 2, Gherardo Mazziotti 1 4, Andrea Lania 1 4, Giuseppe Spriano 1 2, Michael Mannstadt 5, Gregory W Randolph 3 6, Giuseppe Mercante 1 2
Objective: This study aims to determine whether preoperative supplementation of vitamin D reduces the incidence of hypocalcemia following total thyroidectomy.
Methods: Conducted in conformity with the PRISMA statement, a systematic review and meta-analysis of randomized clinical trials (RCT) was performed assessing postoperative hypocalcemia and postoperative symptomatic hypocalcemia.
Results: The search strategy yielded 3808 potentially relevant publications, with eight RCTs ultimately included. These eight trials included a total of 902 patients (22.73% male, n = 205/902), with a median age of 48.9 years (95% CI, 43.5-53.5). Four trials administered only vitamin D in the interventional arm, three trials administered both calcium and vitamin D in the interventional arm, and one trial administered vitamin D in the interventional arm and calcium in both arms. Pooled results from the eight included trials showed a reduced risk of postoperative hypocalcemia in the intervention arm (RR, 0.77; 95% CI, 0.62-0.96; p = 0.02). When excluding the studies that administered calcium supplements in addition to vitamin D, the pooled results showed a similar reduced risk of postoperative hypocalcemia (RR, 0.74; 95% CI, 0.57-0.96; p = 0.03).
Analysis of six trials reporting the incidence of postoperative symptomatic hypocalcemia (n = 564) showed a reduced risk in the vitamin D arm, with or without calcium, compared to the control arm (RR, 0.56; 95% CI, 0.34-0.93; p = 0.023).
Conclusions: Our findings suggest that preoperative vitamin D administration, with or without calcium carbonate, significantly reduces the risk of postoperative hypocalcemia and symptomatic hypocalcemia in patients undergoing total thyroidectomy.
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Many other studies have found benefits from giving Vitamin D before surgery
- Large dose Vitamin D before surgery was found to help by 35 studies
- Vitamin D is needed before many surgeries – many studies and RCTs
- Restore your Vitamin D levels before surgery (Gastric Cancer in this case) - Jan 2023
- Vitamin D before surgery improves outcome (spinal in this case) – Dec 2022
- Rotator Cuff repair using Vitamin D lowers medical cost by 46 dollars – June 2023
- Half as much AFIB after bypass if 600,000 IU of vitamin D before surgery – RCT April 2022
- Pre-operative Vitamin D often helps (thyroidectomy in this case) – June 2021
- Orthopaedic surgeries need Vitamin D – many studies
- Half as many problems if take Vitamin D (300,000 IU) before thyroidectomy – RCT Jan 2021