A new study from
researchers at Henry Ford Hospital in Detroit finds widespread vitamin D
deficiency among patients who undergo a thyroidectomy, potentially putting them
at greater risk for developing dangerously low blood calcium levels after
surgery.
Among the
patients in the Henry Ford study, 40 percent had low vitamin D levels prior to
surgery. Those more likely to be vitamin D deficient are individuals older than
age 50, African Americans, Hispanics and patients undergoing surgery for
hyperthyroidism.
"The issue
of vitamin D deficiency in patients who are undergoing thyroid surgery can
potentially impact both the care of parathyroid glands during surgery and
calcium management after surgery," says lead study author Hamad Chaudhary,
M.D., with the Department of Otolaryngology-Head & Neck Surgery at Henry
Ford.
"By
routinely checking vitamin D levels in all patients scheduled for thyroid
surgery or selectively testing those at great risk, we may be able to improve
surgical outcomes and shorten hospital stays."
Study results
were presented this week at the 2014 American Academy of Otolaryngology-Head
and Neck Surgery (AAO-HNS) annual meeting in Orlando.
Thyroidectomy,
the surgical removal of all or part of the thyroid gland, is most often
recommended for thyroid cancer, goiter or hyperthyroidism (an over-active
thyroid). Women are more likely to undergo thyroidectomy than men.
During the past
decade, vitamin D deficiency has received a great deal of attention for the
role it may play in chronic illnesses such as cardiovascular disease and
cancer.
Hypocalcemia,
low levels of calcium in the blood, is one of the primary complications that
can arise after thyroidectomy. Depending on its duration, severity and onset,
hypocalcemia can vary from an asymptomatic biochemical abnormality to a
life-threatening disorder.
"Low
vitamin D levels have now been shown to increase this risk, even in the setting
of normal post-operative parathyroid hormone levels," notes study senior
author Michael Singer, M.D., Director, Division of Thyroid & Parathyroid
Surgery in the Department of Otolaryngology-Head & Neck Surgery at Henry
Ford.
"Providing
vitamin D supplementation to these patients prior to surgery is an easy and
inexpensive step to make their surgery safer." The Henry Ford study
gathered data from 110 patients who underwent thyroidectomy at Henry Ford
Hospital between January 2013 and December 2013. All patients were operated on
by Dr. Singer.
Patients were
included in the study if they were undergoing thyroid surgery for the first
time in the surgeons' practice. Patients had surgery for both benign and
malignant disease. Their levels of vitamin D, serum calcium, ionized calcium
and parathyroid hormone levels were assessed prior to surgery.
Among the study
participants, 40 percent were found to be vitamin D deficient, a finding
consistent with reported overall prevalence of this problem in the U.S.
The patients who
were found to have low levels of vitamin D were prescribed the vitamin D
supplementation and completed the course prior to surgery.
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