Comparison of calcitriol versus cholecalciferol therapy in addition to oral calcium after total thyroidectomy with central neck lymph node dissection: a prospective randomized study.

BACKGROUND The purpose of this study was to determine the effectiveness of oral calcium plus vitamin D supplementation and to compare the effects of cholecalciferol versus calcitriol treatments on postoperative hypocalcemia. METHODS After total thyroidectomy with central neck dissection, 306 patients were divided into 4 groups according to "routine use versus on-demand use" and "cholecalciferol versus calcitriol." RESULTS Hypocalcemic symptoms developed in 101 patients (33.0%). Hypocalcemia developed less frequently in patients receiving routine supplementation regardless of vitamin D type. However, routine supplementation did not prevent severe hypocalcemia. In patients receiving on-demand supplements, calcitriol was more effective and faster acting than was cholecalciferol. CONCLUSION Routine oral calcium and vitamin D supplements are beneficial after total thyroidectomy with central neck lymph node dissection with no difference between cholecalciferol and calcitriol. If taken after the onset of hypocalcemia, however, calcitriol along with calcium carbonate seems to be more effective than is cholecalciferol with calcium carbonate.