Hypoparathyroidism Post Thyroidectomy: Prevention, Evaluation, Management, and Application of Recent Guidelines

Area of Science:

• Endocrinology
• Surgical Complications
• Medical Guidelines

Background:

• Postsurgical hypoparathyroidism (HypoPT) constitutes approximately 75% of all HypoPT cases and is largely preventable.
• Risk factors include patient, surgical, and presurgical elements, necessitating evidence-based prevention strategies.
• This review focuses on guidelines for prevention, diagnosis, and management of postsurgical HypoPT.

Purpose of the Study:

• To review evidence-based guidelines for postsurgical HypoPT.
• To provide strategies for prevention, diagnosis, and management of postsurgical HypoPT.
• To highlight emerging therapeutic options for HypoPT.

Main Methods:

• Comprehensive literature search of PubMed, Embase, Google Scholar, and Cochrane Library up to December 2025.
• Inclusion of studies on definition, diagnosis, prevalence, risk factors, management, complications, and treatment outcomes of postsurgical HypoPT.

Main Results:

• Risk identification and mitigation strategies are outlined for postsurgical HypoPT.
• Conventional treatment involves calcium and vitamin D supplements; parathyroid hormone (PTH) replacement is an option for refractory cases.
• Pelopegteriparatide, a long-acting PTH molecule, demonstrates efficacy in maintaining serum calcium, reducing urinary calcium and phosphorus, and improving quality of life and renal function.

Conclusions:

• Postsurgical HypoPT is a significant thyroid surgery complication, but its risk is reducible through preoperative assessment and surgical technique.
• Conventional therapy remains standard, but PTH replacement therapies present promising alternatives for refractory HypoPT.
• Pelopegteriparatide offers a novel therapeutic approach with demonstrated benefits.