low calcium unknown reason

I had surgery 12/5/08 for fusion of C5-C6 to repair a right sided herniated disc which was repaired thru the front, carpal tunnel and ulnar nerve repair on my left arm.  On 12/8 my hands drew up like little claws and my face tingled.  I called the surgeon scared to death that something had happened to my neck and I was going to end up paralyzed.  He refused to see me and sent me to my primary care Dr.  Long story much shorter, my calcium has dropped since the surgery.  Before it was 9.1 which was perfect, on the 8th it was 7.2 and has remained at 7.5.  I have been to the ER 1/1 and 1/10 for calcium infusions, am taking calcium and vit. D but my body isn't absorbing it.  I saw a endocrinologist Thur.1/8/09  who is running test but feels it has to do with my parathyroid glands, my thryoid was removed 30 yrs ago due to Hashimoto's thyroiditis. He gave me perscription vit D and changed my calcium to Caltrate. Many of my blood chemicals are getting out of whack and I am depressed.  The numbness. twitching and tingling started in my face and hands and has now progressed to my arms and top of my right shoulder as well.  I don't see the surgeon again until 2/28 but the ER nurse told me to go see another neurologist for a second opinion.  I don't see how this could help since it is a blood problem, however, I do know an excellent neurologist who I trust (I saw him 1 yr. before my surgery for my hand and arm, he did not recommend the surgeon I later used because he was out of his office due to cancer at the time).  I am not looking to place blame as I knew there were risk associated the surgery.  The surgeon is very well regarded in our large community and has done the same surgery on 2 friends that had excellent results.  I just need to figure out what is wrong and how to fix it. Since Hasmimoto's is an autoimmune problem could it be back?  Before my thryoid surgery I felt like there was something in my throat, I feel that again, just not as bad.  If you have any idea's I'm listening!

[bluestarmom187]

I found this when I typed in "Low calcium thyroid" on google. Maybe it helps!

One of the risks of a total thyroidectomy is the possibility of low serum calcium after the operation, either on a temporary or permanent basis. Let me explain how this might occur.

There are four small glands, a little less than pea-size, that live next to the thyroid gland that are called “parathyroid glands’. They get their name from their location and have absolutely nothing to do with thyroid gland function. These glands make a hormone called PTH, or parathyroid hormone, a hormone whose job it is to keep the level of calcium in the blood normal. It does this by many mechanisms, helping you absorb calcium from your diet, managing the calcium in bones, and so on. If one were to lose all four of his or her parathyroid glands, the serum calcium would take a serious drop and replacement calcium and Vitamin D would probably have to be taken for life.

When performing thyroid surgery, it is prudent to look for and preserve these glands immediately after locating and preserving the recurrent laryngeal nerve, discussed elsewhere. On the surface this seems like a simple thing to do, but it isn’t always for several reasons. First, not everyone has 4 parathyroid glands, some have 5 or more and others may have only three or less. Next, their location in the neck can be extremely variable, in fact, one or more may not actually be in the neck at all, but rather in the upper chest or other atypical location. Finally, they are sometimes rather nicely camouflaged sitting in the soft fatty tissues of the neck. It can often require an experienced thyroid surgeon to discern the very subtle color differences between parathyroid tissue and normal adjacent fat and soft tissue.

If one were to lose all four glands, or if all four glands died from lack of blood supply secondary to the trauma of surgery, that patient would in all likelihood have permanent low calcium after surgery. This, of course, assumes the patient has the normal number of parathyroid glands. It is possible to lose the function of one or two parathyroids and have no calcium difficulties whatsoever, because the remaining two glands can almost always take up the slack and maintain normal calcium levels. This is why we virtually never see even temporary low calcium after only a partial thyroidectomy since the glands on the unoperated side are left unmolested. Again, this always assumes the patient started out with 4 parathyroid glands, and there is never any guarantee or that.

It is for these two reasons, variation in number and variation in anatomy, two variables over which the surgeon has no control, that I always spend a little extra time with my patients preoperatively explaining all potential postoperative calcium scenarios.

Temporary low calcium levels can be seen after thyroidectomy simply because the parathyroid glands became bruised or swollen after surgery, thus making it difficult for them to produce normal amounts of parathyroid hormone. These patients may have a temporary low calcium that requires minimal or no calcium replacement and in time the parathyroid glands function well once again.

[Thypatient]

I don't have a full understanding of what your most recent surgery entailed but do want to suggest the following website that’s all about low calcium – either as a result of disease or surgery:

hypoparathyroidism.org

They are a non-profit organization and there is a forum to join and ask questions.

I have low calcium myself, so I know how you feel.

Good luck.

[BarneysMom]

My most recent surgery was the fusion c-5 & c-6, carpel tunnel and ulnar nerve surgery which were performed together 12/5/08.  I only mentioned having thyroid sugery 30 yrs. ago so no one would think my parathyroid was damaged at that time.  It was either damaged during the neck surgery or something other than the parathyroid is causing the problem.  Thank you for the website, I will go check it out.

[Thypatient]

I understand what you were saying.  I'm hoping perhaps someone over at the other site has information on low calcium maybe coming from surgeries other than thyroid.

Hope it helps in some way.  That, along with getting more answers here.

Good luck.

[redheadaussie]

It can happen that your parathyroids were slightly damaged in having the neck surgery...The way they position the neck to do the surgery can make the front of the neck, your throat, be manhandled and thus causing the parathyroids to be damaged/bruised.
Normally it is a short term thing say up to 6 months and then they come good again.
  Best to keep the amount of calcium high at the moment making sure you also take Vit D to help the body absorb it. Make sure the calcium supplement has magnesium in it too. This helps greatly.
  It's unlikely the Hashimoto's is causing all of the low calcium symptoms.
You must make sure you take a high dose of calcium every day, and not with your thyroid meds and not with any other medication like iron supplements.
Good luck!