RecruitingNot ApplicableNCT07577570

Calcium Replacement Therapy in Postoperative Hypoparathyroidism

A Pilot Study of Calcium Replacement Therapy in Postoperative Hypoparathyroidism


Sponsor

Tartu University Hospital

Enrollment

50 participants

Start Date

Nov 18, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

The goal of this clinical trial is to evaluate whether a lower-dose calcium replacement therapy is non-inferior to a higher-dose regimen in preventing symptomatic hypoparathyroidism in patients following thyroidectomy. The hypothesis is: • lower-dose calcium replacement therapy is non-inferior to higher-dose therapy in preventing symptomatic hypoparathyroidism during the first two postoperative weeks Researchers will compare patients receiving a lower-dose calcium replacement regimen with those receiving a higher-dose regimen to assess whether the lower dose is not associated with a higher incidence of symptomatic hypoparathyroidism. Patients who develop post-thyroidectomy hypoparathyroidism are divided into groups for calcium replacement therapy. If they are asymptomatic, they will be scheduled for a follow-up visit at two weeks after surgery. During the follow-up visit, calcium metabolism will be evaluated, and treatment adjusted if necessary.


Eligibility

Min Age: 18 Years

Inclusion Criteria2

  • patients over the age of 18 undergoing surgery involving both lobes of the thyroid gland (thyroidectomy, "near-total" thyroidectomy, subtotal thyroidectomy, and "completed" thyroidectomy)
  • Based on the first post-operative day analysis, PTH levels are below the normal range (in our hospitals 1.8-7.8 pmol/l), but not so low (below 1.06 pmol/L) as to require calcium replacement therapy with calcitriol (rocaltrol)

Exclusion Criteria3

  • previously diagnosed osteoporosis; the patient is already taking calcium and vitamin D supplements prior to thyroid surgery
  • renal insufficiency (eGFR < 30)
  • patients with concomitant hyperparathyroidism undergoing simultaneous thyroidectomy and parathyroidectomy for a parathyroid adenoma

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Interventions

DRUGCalcium carbonate 1250 mg (500 mg elemental calcium) twice a day

One study group takes calcium carbonate 1250 mg (500 mg elemental calcium) twice a day (at lunchtime and in the evening)

DRUGCalcium carbonate 1250 mg (500 mg elemental calcium) 4 times a day

The second study group takes 1250 mg of calcium carbonate (500 mg of elemental calcium) four times a day (starting at noon, at approximately 4-hour intervals: at noon, in the early afternoon, in the evening, and before bedtime). This dosage regimen is prescribed because 500 mg of calcium can be absorbed at a time.


Locations(2)

East Tallinn Central Hospital

Tallinn, Other, Estonia

Tartu University Hospital

Tartu, Estonia

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NCT07577570