Low Blood Calcium after TT

[lilypad300]

Hello.
Thank you for taking the time to read this question.
I was just released from the hospital after being readmitted following a TT for Graves Disease.
I was readmitted because of symptoms of hypocalcemia. . .muscle cramping, tingling etc.
For 4 days I was on a calcium iv drip, had my blood tested every 6 hours and took supplements.
When I was released, my calcium was back up to 10.0, but I am now on 4 500mg calcium pills 4 times a day and 4 .5 calcitrol capsules twice a day.  
Is this too much?  Do you think I will have to take this much forever?
My surgeon said that none of the parathyroids were removed, and that he transplanted 1 or 2 (i can't recall) and that all I need to do is be patient.
About how long does it take for function to kick back in?
What if it doesn't?
My surgery was Monday 8/4/08

thanks in advance!

p.s.  should the calcitrol and calcium pills be taken together or is it ok to space them out?

p.p.s  while on the calcitrol, is it ok to sit out in the sun or will that be way too much

[Mark Lupo, M.D.]

This is a lot of medication - esp the calcitriol -- would retest soon to make sure Ca is not going too high.  It's tough to absorb 2000mg of calcium at once.....so 4 tabs may not be necessary.

We usually use 1-3 tabs of 500mg 3-4x/day - depending on the situation.  Rocaltrol 0.5mcg 1-2x/day usually works.  But I have had patients needing the doses that you describe, so best to retest.

It may take 2-4 weeks for the parathyroids to "wake up"

[lilypad300]

Another quick question related to the topic. . .)

I'm happy to say that my dosages have been reduced condsiderably.
(my latest bood work had me at 10.4 when I was on the mega-doses)
Now:
Calcitriol .5  twice a day
Calcium 1000mg 3 times a day

I feel like I'm tingling again (slightly), but I remember reading somewhere that tingling can happen when the parathyroids kick back in.
Is this true?
Should I be concerned?
Could it be anxiety?

Thanks!
(I get blood work Wednesday & see my doctor on Friday, I'm just paranoid I'm going to drop too low before then)

[lilypad300]

Just got back from the endo. . .and I have to say I'm a little depressed.
I was put on 2000mg of calcium 4 times a day and 2mg calcitrol twice a day to keep it up.  I had been feeling good, and was hoping that my doc would lower my dosages when I met with him today.  Unfortunately, me Saturday blood work came back on the low side (calcium 8.6) and I am to remain on the same dosages for at least another week.  Depressing!  
On another depressing note, my blood pressure was high.  I never have had high blood pressure.  The 1st time they took it, it was 150/90 (right arm)  I begged them to take it again and in my left arm it was 135/85 my doctor said not to worry about it yet, but of course I'm freaked!


Here are the results from my latest Blood Work
Tell me what you think:

Albumin              3.8              (normal range 3.2-4.9)
Glucose, Plasma 91              (normal range 50-100)
Magnesium         1.5              (normal range 1.3-2.1)
Sodium               137             (normal range 135-146)
Potassium           4.5             (normal range 3.5-5.0)
Chloride              100             (normal range  98-109)
CO2                    28              (normal range  24-32)
Anion Gap           9                 (normal range  4-16)
Urea Nitrogen       10              (normal range 7-21)
Creatinine            0.8              (normal range 07-1.4)
Calcium               8.6              (normal range 8.5-10.5)

[lilypad300]

thank you.
i am concerned about getting too much, but i am having my blood tested again on Saturday and have an appointment with my Endo. on Monday, so hopefully everything will be in sync.
If my calcium has gone too high, I hope I don't do too much damage between now and then.
thanks again!

Also, Moosey619, thanks for your input it's comforting to know that there are others who are/were in the same position as me.

[moosey619]

Hi liliypad300.

I had total Thyroid removal in April and I had to go on calcium supplement for awhile (around 6-10 weeks).  I was taking about the same amount you were and then slowly weened myself off them with my doctors approval.  If you get too much calcium in you you can start to feel sick.  I think if your not feeling sick you should be okay, but ask your endocrinologist about it.