{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T21:20:57Z","timestamp":1779916857950,"version":"3.53.1"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,1,22]],"date-time":"2019-01-22T00:00:00Z","timestamp":1548115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To quantify how frequently intraoperative parathyroid hormone levels increase during thyroid surgery and to explore a possible relationship between secondary hyperparathyroidism due to vitamin D deficiency and elevation in intraoperative parathyroid hormone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary academic center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>A total of 428 consecutive patients undergoing completion and total thyroidectomy by the senior author over a 7\u2010year period were included for analysis. All patients had baseline and postexcision intraoperative parathyroid hormone levels as well as vitamin D levels from the same laboratory. Institute of Medicine criteria were employed for vitamin D stratification (&gt;30, normal; 20\u201029.9, insufficient; &lt;20, deficient). Other data analyzed include sex, age, neck dissection status, and parathyroid autotransplantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 118 patients (27.6%) had an intraoperative parathyroid hormone elevation above baseline. Patients with vitamin D deficiency were significantly more likely to experience hormone elevation (<jats:italic>P<\/jats:italic> =. 04). When parathyroid hormone rose, it did so by a mean 32.1\u00a0pg\/mL. Patients with vitamin D deficiency demonstrated significantly larger hormone increases (<jats:italic>P<\/jats:italic> =. 03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elevation in intraoperative parathyroid hormone levels above baseline after completion and total thyroidectomy occurs in over one\u2010fourth of cases and is significantly associated with vitamin D deficiency. This study is the first to report this observation. We hypothesize that vitamin D deficiency in these patients may create a subclinical secondary hyperparathyroidism that leads to intraoperative parathyroid hormone elevation when the glands are manipulated. Additional studies will be needed to explore this physiologic mechanism and its clinical significance.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599818825467","type":"journal-article","created":{"date-parts":[[2019,1,23]],"date-time":"2019-01-23T16:44:46Z","timestamp":1548261886000},"page":"612-615","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Relationship of Vitamin D Deficiency and Intraoperative Parathyroid Hormone Elevation in Completion and Total Thyroidectomy"],"prefix":"10.1002","volume":"160","author":[{"given":"Bradley R.","family":"Lawson","sequence":"first","affiliation":[{"name":"Licking Memorial Otolaryngology Newark Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Hinson","sequence":"additional","affiliation":[{"name":"Arkansas Heart Hospital Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob C.","family":"Lucas","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Kansas Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald L.","family":"Bodenner","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences Little Rock Arkansas USA"},{"name":"Department of Geriatrics University of Arkansas for Medical Sciences Little Rock Arkansas USA"},{"name":"Thyroid Center University of Arkansas for Medical Sciences Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Brendan C.","family":"Stack","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences Little Rock Arkansas USA"},{"name":"Thyroid Center University of Arkansas for Medical Sciences Little Rock 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