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Scientific Oral Presentations

Endocrine Surgery

Session: Scientific Oral Presentations 1 - Endocrine Surgery

Effect of Pre-operative Vitamin D Supplementation on Post-operative Hypocalcemia After Total Thyroidectomy: A Systematic Review

Sunday, October 12, 2025
3:24 PM - 3:30 PM EDT
Location: 128
Disclosure(s):
Allan Rehn Wang, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Chau T. Nguyen, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Marilene B. Wang, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Hypocalcemia is the most common complication after thyroidectomy. Pre-operative vitamin D deficiency is a major modifiable risk factor for post-operative hypocalcemia. The purpose of this study is to perform a systematic review of trials examining the effect of pre-operative vitamin D supplementation on post-operative hypocalcemia after total thyroidectomy.

Methods: Systematic review of studies identified from a comprehensive search of PubMed, Medline, and Google Scholar databases. The last updated search was on January 24, 2025. Analysis was performed according to PRISMA guidelines. Studies were included if they examined the effect of pre-operative vitamin D supplementation alone on rates of post-operative hypocalcemia after total thyroidectomy when compared to placebo. Studies were excluded if they also employed pre-operative calcium supplementation or other medication supplementation.

Results: Five published trials including 617 patients met criteria. 491 (79.5%) were female. The most common indication was multinodular goiter (411, 66.6%), followed by malignancy (108, 17.5%). There were a variety of supplementation regimens, ranging from two days to four weeks of pre-operative supplementation. All studies reported the incidence of post-operative hypocalcemia. Pooled together, the rate of hypocalcemia was significantly lower (χ2=10.3, p=0.0013) in the supplemented group (26.0%, 81/312) compared to the placebo group (38.0%, 116/305). Reporting of other outcomes was heterogeneous but overall positive, with individual studies noting decreased need for intravenous calcium supplementation, reduced length of hospital stay, decreased duration of hypocalcemia, and decreased rates of hypocalcemia when the cohort was stratified by post-operative parathyroid hormone level. There were no adverse effects attributed to vitamin D supplementation in any of the studies.

Conclusions: Though the published literature is heterogeneous, pre-operative vitamin D supplementation appears to be safe and to improve rates of post-operative hypocalcemia after total thyroidectomy.

    Presenting Author(s)

  • AW

    Allan Rehn Wang, MD

    Resident Physician
    UCLA Head and Neck Surgery
    Los Angeles, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Chau T. Nguyen, MD

    Director, Division of Otolaryngology-Head and Neck Surgery
    Ventura county medical center
    Ventura, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Marilene B. Wang, MD

    Professor
    UCLA Head and Neck Surgery
    Los Angeles, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.