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Hypomagnesemia and hypocalcemia following thyroidectomy: a prospective observational pilot study

Background: Magnesium (Mg2+) plays a role in the active transport of calcium (Ca2+) and potassium ions across cell membranes. This study highlights the prevalence of hypomagnesemia following thyroidectomy and its association with hypocalcemia. This requires early recognition and treatment to prevent the prolongation of hypocalcemia and permanent hypoparathyroidism. Methods: This was a prospective open-label observational pilot study in patients who underwent thyroidectomy. Informed consent was obtained from all the patients. The study period was from January 2019 to 2020. A total of 74 patients with normal renal function were studied. Corrected serum Ca2+, Mg2+, phosphate, and vitamin D levels were checked preoperatively and on the first post-operative day. Results: Among the studied subjects of post-thyroidectomy, 56.8% of patients had hypomagnesemia, 59.5% had hypocalcemia, and 41.9% had low levels of both Ca2+ and Mg2+ (p = 0.004). Post-operatively, among the 44 patients who had hypocalcemia, 31 developed hypomagnesemia, with mean Ca2+ and Mg2+ levels of 2.217 mmol/l (SD = 0.526) and 0.7165 mmol/l (SD = 0.079), respectively. The association between hypomagnesemia and hypocalcemia following thyroidectomy was s found statistically significant (p = 0.004). Conclusion: Hypomagnesemia following thyroidectomy was found common and to be resulting from low parathyroid hormone and low calcium levels. Thus, it is clear that hypomagnesemia worsens hypocalcemia if not treated postoperatively.