Hello,

In my opinion, I would supplement patients post-parathyroidectomy (PTX) with low dose activated Vitamin D3, assuming phosphate is relatively well controlled. Patients whose PTH is suppressed by calcium and vitamin D are at risk for adynamic bone disease. So a patient who can make PTH but does not because of calcium and Vitamin D administration should have those medications reduced or removed. However, patients who have very low PTH hormone post PTX can't make PTH in many cases or make very little, depending on how much tissue was removed. In that case, the vitamin D and calcium are not playing the same role in suppressing it's production to low levels. And remember, Vitamin D has many potential (albeit unproven) benefits beyond PTH suppression, and therefore supplementation despite low PTH post-PTX should be considered.

Dr. Jordan Weinstein

Its often difficult to maintain serum ca in normal limits among these pts post parathyroidectomy, without active Vit D, even months to years after their surgery.