The Role of Magnesium in Post-thyroidectomy Hypocalcemia

Area of Science:

• Endocrinology
• Neurosurgery
• Internal Medicine

Background:

• Hypomagnesemia prevalence and its association with hypocalcemia post-thyroidectomy are not fully understood.
• Thyroidectomy can disrupt calcium and magnesium homeostasis, leading to potential complications.

Purpose of the Study:

• To determine the prevalence of hypomagnesemia in patients undergoing thyroidectomy.
• To evaluate the relationship between hypomagnesemia and transient/severe hypocalcemia post-thyroidectomy.

Main Methods:

• Prospective observational study of 50 patients undergoing thyroidectomy.
• Pre- and postoperative measurement of calcium, albumin, magnesium, phosphorous, and parathormone (PTH).
• Documentation of hypocalcemia signs/symptoms and perioperative fluid volume.

Main Results:

• Preoperative hypomagnesemia was observed in 24% of patients; postoperative hypomagnesemia rose to 70%.
• Postoperative hypocalcemia occurred in 30% of patients, with severe cases (6%) associated with low PTH and hypomagnesemia.
• Higher perioperative fluid volume and low postoperative PTH were significant risk factors for hypocalcemia.

Conclusions:

• Preoperative hypomagnesemia is prevalent, and postoperative hypomagnesemia is common after total thyroidectomy.
• Postoperative magnesium and calcium levels show similar trends; hypomagnesemia is associated with severe hypocalcemia.
• Parathyroid function and fluid status are key factors in post-thyroidectomy hypocalcemia; magnesium's role in severe cases warrants further study.