Low Calcium 4 yrs after surgery

[WendyC2003]

I had a total thyroidectomy 4 years ago.  I went through all of the normal sysmptoms directly after surgery, (low calcium, due to "bruised" parathroid glands, throuble regulating synthroid, etc.).  Since levels have regulated, (3-4 months after surgery), things have been ok.  I do have more tiredness, fatigue, dry skin and a weakened immune system, (I catch every cold that goes by).  My recent blood worked showed my thyroid levels are fine, however, my calcium levels are extremely low.  I am now taking 2400mg of calcium a day and the doctor has given me a prescription of vitamin D. 3 weeks into this, and still low levels, tingling hands, lips and feet, cramps in legs and feet. I can not understand what would cause this to happen so long after surgery. I have been trying to reasearch but can't seem to get an explanation.
Has anyone ever dealt with this?

[devushka]

Hi Wendy. I'm sorry I can't say I've dealt with your exact problem--I had the low calcium immediately after TT (July '06, no parathyroid glands removed, but one was "bruised," as you put it) and have been on calcitriol and various amount of calcium every since. With my doctor, I'm working on slowly decreasing the doses of both, and so far I'm having some luck. It's difficult to find other cases like ours because they are so rare. Have you had your PTH (parathyroid hormone) level checked? Are you within normal ranges?  What form of vitamin D are you taking, and how much? A few observations culled from my own amateur research: take your calcium at least 4 hours after your thyroid medicine; cut down if possible on coffee/caffeine and alcohol intake; eat fewer whole grains (Yes! I've found several studies that recommend this, as whole grains interfere with calcium absorption). There are a few other people who visit this forum with similar concerns. I hope they will add to the conversation. Good luck!

[WendyC2003]

I have had blood work every week for the past 3 weeks and my PTH and synthroid levels are within normal ranges. I am taking calcitriol 0.5 mcg 2x a day. I could definately give up some coffee. As far as fewer whole grains, I LOVE THEM, but am willing to try anything at this point.  Thank you so much for your comments, I truly appreciate them.  Has your doctor indicated why your calcium levels are still low now?

[devushka]

My PTH level is very low, which accounts for the low calcium.  (As for WHY it is low when I still have at least 3 parathyroids, it's a mystery). I have no physical symptoms of low calcium, and I'm now taking 0.25 mcg calcitriol 1x day, 2000mg calcium, and 1 multivitamin (last calcium level was 8.7, which is still within normal, but just). I've been slowly cutting back on the calcitriol and it seems to be working. I hope to raise my PTH levels by making them compensate, at least that's the theory.  I still drink at least one strong cup of coffee a day, and I like whole grains, so it's a struggle. And as I mentioned, I'm not a medical professional--I'm basing that advice on two clinical studies I found linked to a medical website for people who suffer from hypoparathyroidism.  

[Josic]

Fiber should be part of a healthy diet. There are certain types of fiber that can affect the amount of calcium the body absorbs. Rhubarb, spinach, chard, and beet greens contain oxalate, which may decrease the absorption of calcium. Phytic acid, found in wheat bran, combines with calcium and also decreases its absorption. Fiber, however, is very helpful to the digestive tract, so it is important to balance the level of calcium intake with the amount and type of fiber in the diet. A diet containing up to 35 grams of fiber per day should be adequate for healthy bowel movements, without adversely affecting calcium absorption.  

I know I won't stop eating my sourdough whole grain bread, it's to crunchy and good.  

[WendyC2003]

Whole grain sour dough?  YUM!  If I have to deal with the tingling hands, lips and feet along with the muscle gramps and taking all of these meds......I think I am going to keep eating my whole grain crackers and hummus - I love them.  I do however eat a lot of green vegetables, spinach and swiss chard are 2 of them. Maybe I should take a look in that area as well.  Thank you for you input.  Every little thing I try is worth a shot.

[WendyC2003]

Any knowledge on low calcium so long after surgery? have you chatted with anyone who as similar symptoms?