Hypoparathyroidism (hypoPT) hypocalcemia is the most common complication of total thyroidectomy (TT). Therefore, it is critical for the thyroid surgeon to promptly identify patients at risk and employ early strategies to control symptoms, avoid long-term consequences, and contain cost. Various management strategies are employed including serial monitoring of post–operative serum calcium, routine, or selective calcium supplementation, and recently iPTH monitoring. The normal short half-life of iPTH (3-5 min) along with the fragile nature of the parathyroid gland can lead to hypoPT within minutes of surgical treatment and can precede a drop in serum calcium which may take 48-72 hrs., to reach its minimum leading to increased hospitalization, cost, and serial investigations.

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