ArticleSurgical case reports2025
Paradoxical Elevation of Parathyroid Hormone Levels following Preoperative Native Vitamin D Supplementation in a Patient with Graves' Disease Undergoing Total Thyroidectomy: A Case Report.
Article in Surgical case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
- Multimodal approach enables R0 resection in advanced gastric adenocarcinoma with enteroblastic differentiation complicated by portal vein tumor thrombus.Clinical journal of gastroenterology · 2026Article
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9 authors.
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Abstract
introductionHypocalcemia is a common complication after total thyroidectomy, particularly in patients with Graves' disease and high bone turnover. Preoperative vitamin D deficiency is a known risk factor for postoperative hypocalcemia; however, the effects of vitamin D supplementation remain controversial. This is the first study to document a paradoxical increase in parathyroid hormone (PTH) levels after preoperative vitamin D supplementation in a patient undergoing total thyroidectomy. CASE PRESENTATION: We report the case of a 68-year-old woman with Graves' disease and coexisting thyroid cancer who received native vitamin D (2000 IU/day) for 4 weeks before surgery. This unexpectedly resulted in a marked increase in PTH levels and bone formation markers, suggesting the worsening of secondary hyperparathyroidism. Interestingly, fibroblast growth factor 23 levels remained unchanged despite an increase in PTH and 1,25-dihydroxyvitamin D levels. Postoperatively, she developed transient hypoparathyroidism.
conclusionsNative vitamin D supplementation may, paradoxically, worsen secondary hyperparathyroidism in some patients, highlighting the need for careful preoperative metabolic assessment and individualized management strategies.
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