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!

[nissah46]

My regular pharmacist said 500mg is all we absorb, so I spread out the pills by about 3 or 4 hours.  I know there are not enough hours in the day to get it all in.
Trish

[MJ13]

I take Vicative chews for my calcium.  It's a lot better than taking pills all the time.  They come in a few flavors like chocolate and caramel.  My favorite is caramel.  It's almost like eating candy.

I went thru hypocalcemia after my TT.  I was in the hospital for a week before my calcium went up to the necessary level.  It got so bad my hands were cramping and I couln't pick up a glass.  

Hope you parathyroids kick in soon.

MJ

[lilypad300]

do you really only absorb 500mg at a time?
here i am choking down 2000mg (4 giant horse pills) every 6 hours.
ugh!

i see my endo tomorrow, hopefully he'll start reducing my dosage.

thanks!

[nissah46]

I was also given everything at once in the hospital.  They would give me synthroid and 1000mg of calcium.  Not only should they not be given together, I was not getting the benefit of the calcium because we can only absorb 500mg at a time, the rest is passed.  No wonder I spent a week in hospital, trying to get my levels up.  

[lilypad300]

Thanks for the advice!
I definitely will retool my schedule to try to keep a steady stream of calcium as well as a big enough window for the synthroid.
When I was in the hospital, I was taking oral as well as iv calcium, and the pills were given to me with the synthroid, clacitrol & breakfast.  I asked about it, and the nurse said not to worry about it.
Now that I'm home. . .I'll be more vigilant.
(I have been waiting 2 hours to eat though. . .that's when I've been taking the calcium)

be well!

[Thypatient]

I did have to wake myself in the middle of the night to take the cal/vit d.  Unfortunately, that's how it needs to be.  Avoiding the consequences of overlapping those things (I’ve read scary stuff) is worth the getting up.

You mention above that in the hospital you had calcium through an IV drip – that’s the difference.  You didn’t have the digestion process to deal with; now you do.

Your plan sounds like a good one.  Also, you do know you need to wait to eat or drink at least one hour (I wait two) after taking the med, right?

Good luck.

~

I want to see that article.

[redheadaussie]

Hee hee.. You want to see my list of medications I take.. I told my doctor I need to have a 27 hour day just to make sure everything fits in the times and not interact with the others I take!
I take an anti-cholesterol tablet (thanks Mum and Dad for the genetics of that!),  4 calcium , 1 Vit D,    2 thyroxine,   1 liquid iron supplement,   1 multi-vitamin, 1 evening primrose oil,   1 Q-10 enzyme,  1 omega 3........oh and a few others I just throw in for good measure!
    Having no thyroid has certainly proven to be more of a challenge than I first realised!
Cheers!

[lilypad300]

thanks so much for the input everyone.
it's frustrating, but i'm happy to see that i'm not alone out here.
the only thing I'm having trouble with is the spacing of the synthroid & the AM calcium/vit. D.
I'm supposed to take the calcium 4 times a day so the farthest I've been able to space them out is 2 hours.  I guess I could wake myself up in the night to take the calcium at 2am and then the synthroid at 6 and then the calcium again at 10am.
Hmmmmm. . .
I thought that 2 hours a night was ok.  When I was in the hospital, they gave me the synth, calcium, vit. d AND breakfast at the same time. . .

thanks everyone!!!

p.s. that article sounds interesting.

[Backgammon48]

Thought I would throw my cents in as I just read a great artile on Hypoparathyroidism on the New England Journal of Medicine (Thanks to Stella for the site referral).  It is a recent article, July 24, 2008 and by Dolores Shoback, M.D. I paid the $10. to access it and would be happy to get it to you but it is 4 full pages.  Let me know.

[Thypatient]

Just wanted to lend my support for what you're going through.  I had the same thing happen.  As said above, hopefully the parathyroid function will kick in soon and go back to it's normal functioning.  It took months for mine to start re-functioning but unfortunately they never really fully went back to normal.  So I still take calcium/vit d two years out, not nearly as much as it used to be though.  Though sometimes I need more cal/vit d than at other times.

Here's another site that's helpful:  hypoparathyroidism.org.  But let’s hope you don’t need it long-term.

JMT - I think you'd really have to fry in the sun before that kind of vit d would interfer with the kind your taking.  So I don't think that's not much of a concern.  In fact, we just got back from vacation where I was out in the sun and actually I feel better (on the other hand, I only take .25 of vit d).  I have to be careful though, I burn and my eyes can swell (I think that's the thyroid med) if I overdue it and don't have sunscreen on.

Good luck.  And, oh yeah, you can take the cal/vit d together but please do take the advise to separate the calcium/vit d by four hours from your thyroid med.  Otherwise, the med will be absorbed by the supplements and not work well.

[redheadaussie]

That was very unfortunate for you to have to have your parathyroids transplanted. That is no doubt what is causing you such low calcium. They may take a while to kick back in and it should be that you won't need as much calcium in the future.
  You do need Vit D from the sun but it also depends on the latitude you live in. Africa gets far more than say Sweden! So taking extra is fine.
  Calcium can be given in 1200mgs  doses. ( I take that as a tablet that fizzes in water!)
Do NOT take it with your thyroid medication!!!!!! Both medications react with each other and you get no benefit from either...believe me, I had that scenario already!
  I have very low levels too, of both Vit D and Calcium. My TT was back in Dec 07 Partial in May 07 and I have had low calcium even prior to that, but it has got lower and lower each test! I take Vit D 1000 and calcium of 2400 mgs....
I suspect for you it will just take time for the parathyroids to settle.
Have you looked at parathyroid.com? It is an invaluable site!
Cheers.

[nissah46]

I take my VitD. with my first calcium of the day, but I don't take as much as you. Your pharmacist can be really helpful when it comes to how to take meds, just ask them what is the best way to take it. My parathyroids have never resumed working, although that is not so common.  I lost 2 during TT surgery and the other 2 were "stunned".  I must take 2000mg. calcium and 1000iu VitD.  My pharmacist said you can only absorb 500 mg cal. at a time, so it must be spread out during the day. I assume you are on synthroid, so don't take calcium until 4 hours after synthoid, as it will interfere with absorption of the synthroid. As far as the sun goes, I'm not sure, but I don't think we get an awful lot from the sun. Good luck.
Trish

[lilypad300]

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 vit. D?