Hi everyone,
I’m currently on day 2 post-op after a total thyroidectomy due to Graves’ Disease (Morbus Basedow). I’m looking for some experiences or advice regarding calcium stabilization.
Background:
I had a very strong relapse recently. My labs right before surgery were significantly elevated (FT3: 10.2 pg/ml, FT4: 4.4 ng/dl). Because I had an allergic reaction to antithyroid medications (blockers), I had to be operated on while still in a hyperthyroid state.
Post-Op Complications:
The surgery itself went well, and the surgeons identified 3 parathyroid glands. However, my calcium dropped significantly on the first night.
• Ionized Calcium: Dropped to 1.0 mmol/l (needed IV infusion).
• PTH (Parathyroid Hormone): Currently at 6 pg/ml (reference range usually starts at 15).
• Symptoms: I currently have a positive Chvostek sign (my mouth twitches when tapping my cheek).
Current Treatment:
I am being treated aggressively to stabilize my levels:
• 4g of oral Calcium daily
• Additional Calcium drinking ampules (3x daily)
• Active Vitamin D (Calcitriol) twice daily
• Magnesium (3x daily)
My doctors mentioned "Hungry Bone Syndrome" because of my severe hyperthyroidism prior to surgery, combined with "stunned" parathyroids.
My Questions:
- For those who had a very high FT3 before surgery: How long did it take for your "Hungry Bones" to saturate and your calcium to stabilize?
- With a PTH of 6 pg/ml and 3 glands sighted during surgery, what are the chances of them "waking up" soon?
- Any tips on the best timing for medication (Calcium vs. Magnesium vs. active Vit D) to maximize absorption?
I’m a bit worried about the twitching and the instability of my levels. Thank you so much for your help!