Recovery Tips After Parathyroid Surgery

Hi, I’m Dr. Masha Livhits, endocrine surgeon at UCLA Health. If you’re watching this video, you’re probably preparing for or recovering from a parathyroidectomy—that’s surgery to remove one or more of the parathyroid glands.

Although nobody wants to have surgery, parathyroidectomy can really improve your long-term health. Hyperparathyroidism, which is an overactive parathyroid gland, can cause high calcium, kidney stones, bone density loss and osteoporosis, or just feeling unwell, and parathyroid surgery can make a big difference.

Today I want to share a few helpful tips about what to expect during recovery, and how to manage common symptoms—especially related to calcium levels, which play a big role in how you feel after surgery.

Let’s start with what happens right after surgery.

Parathyroidectomy is often an outpatient surgery, where patients go home the same day after a brief period of observation to make sure everything is ok before getting discharged. At UCLA, we perform a superficial cervical plexus block once the patient is asleep in the operating room. This is a numbing injection that will help to numb the incision in the neck right after surgery. This helps to reduce pain after surgery and can make your recovery more comfortable.

This block can cause some temporary numbness in the neck, ears, and face—which is completely normal and not a cause for concern. It usually wears off by the next day after surgery.

But there’s another kind of numbness or tingling we need to watch for after parathyroid surgery, and that’s caused by low calcium levels. It’s important to understand the difference between symptoms of low calcium and numbness caused by the block I just described.

When we remove the overactive parathyroid gland, your body has to readjust to a new normal calcium level. Sometimes the remaining glands take a little while to “wake up” and start working again. That’s why we routinely prescribe calcium and vitamin D supplements after surgery—to help smooth that transition and prevent symptoms of low calcium.

We’ll give you specific instructions after surgery, but most patients start with calcium carbonate, usually twice a day, along with vitamin D. If you take medication for acid reflux or have had a gastric bypass, be sure to tell your surgeon, as it may affect which type of calcium your body absorbs best.

Common symptoms of low calcium after parathyroid surgery include:

Tingling or numbness around the lips
Tingling in the fingertips or toes
Muscle cramps or twitching

If you experience these symptoms in the days after surgery, it’s probably a sign that your body needs more calcium. And it’s safe and appropriate to take extra calcium if you need it. If you start feeling tingling or cramping, take an extra dose of 1,000 to 2,000 mg of calcium right away. It usually helps within 30 to 60 minutes. You can repeat the dose as needed if symptoms persist.

Of course, if your symptoms don’t improve, you should call your surgeon or endocrinologist for further instructions.

Other things to look out for during your recovery is some soreness inside the throat and swelling at the incision. Icing your neck in the first couple of days after surgery can help to lessen swelling. Soft foods like soups and smoothies can be comforting in the first day or two if your throat is very sore.

I also want to mention that everyone’s recovery looks a little different. Some people feel better within a day or two after surgery, and even have more energy or other quality of life benefits. Other patients may feel more tired for the first few weeks after surgery as their body readjusts. If you had high calcium for a long time, your body may need more time to reset.

So to summarize:

Most patients can go home the same day of their surgery
At UCLA Health, we use a numbing block that can cause temporary numbness in the neck and face, which is normal and expected.
We routinely prescribe calcium and vitamin D after surgery
Numbness or tingling around the mouth and fingertips could be signs of low calcium, and it’s OK to take extra calcium as needed
Always feel free to ask your surgeon any questions you have during your recovery

I’m Masha Livhits, endocrine surgeon at UCLA Health. Thanks for watching these recovery tips after parathyroidectomy.