Will I need to take medications after parathyroid surgery?
After surgery, you will need two things, which are over-the-counter: 1. Calcium and Vitamin D 2. Pain control
Most patients will not need any prescription medications after surgery. I generally recommend over-the-counter medications for pain control, such as ibuprofen (Motrin, Advil) and acetaminophen (Tylenol). Narcotics have side effects and are usually not more effective than the over-the-counter options, but some patients will need a small amount of narcotics for pain control.
After parathyroid surgery, I recommend that everyone take over-the-counter calcium and Vitamin D supplements. When parathyroid tumors or hyperplastic parathyroid glands are removed, the PTH drops quickly, and the blood calcium level drops over the next day. This is expected if you have been cured. Since your body doesn’t like fast and large shifts in calcium, we want to slow down that process by having patients take calcium and Vitamin D. Also, the calcium can drop too low in the first days and week after surgery, and we want to prevent that. The amount of calcium you will need depends on how high your calcium was before the operation. Vitamin D helps your intestines absorb calcium, so you need to take this also. Vitamin D and calcium are often combined in supplements. Magnesium supplements may also be recommended, particularly in cases in which high doses of calcium are required.
On the day of surgery, I give every patient detailed instructions on my recommended doses of calcium and Vitamin D. I taper the dose down over a few weeks, down to a maintenance dose that is based on your historical calcium levels and bone status (for example, if you have osteoporosis).