Calcium supplementation is an important issue for many patients with thyroid cancer (especially papillary thyroid cancer and follicular thyroid cancer) after surgery. Typically, thyroid cancer patients need calcium supplementation after surgery in two main ways:
- Patients with intraoperative parathyroid gland injury. There is a group of endocrine glands called the parathyroid glands next to the thyroid gland that can easily be “accidentally” injured during thyroid cancer surgery, causing calcium deficiency in these patients. For example, pins and needles numbness in the limbs, lips and face, or twitching of the hands and feet (“chicken claw hand”), which can be life-threatening in severe cases. Previous studies have shown that hypocalcemia generally occurs in patients within 3 days after thyroid cancer surgery, and for such patients, calcium supplements should be taken under medical supervision.
- Patients who have been taking medications for a long time. There are some patients with thyroid cancer who need to take levothyroxine sodium tablets after surgery for the purpose of replenishing thyroid hormones and inhibiting tumor recurrence. However, studies have found that long-term use of levothyroxine sodium tablets may increase the risk of osteoporosis and fractures in postmenopausal women. Calcium supplementation, on the other hand, is an important way to prevent osteoporosis and fractures.
So how do our patients know if they are calcium deficient? In addition to going to the hospital for laboratory tests, patients themselves can watch for these symptoms. For example, frequent numbness in the hands and feet, muscle twitching, joint pain or even generalized pain, and excessive sweating and fatigue are all signs of calcium deficiency. For such patients, calcium can be supplemented through food. The common high-calcium food ingredients are listed in Table 1.
Table 1. List of common high-calcium ingredients
Category
| Categories | Ingredients | Quantity |
Approximate amount of calcium/mg |
| Dairy products |
Pure milk |
1 carton about 250 ml |
270 |
| Yogurt |
1 box about 100g |
138 | |
| Milk Powder |
29g, about 5 spoons in a white porcelain spoon |
267.5 | |
|
1 slice about 17g |
132.6 | ||
| Soy products | Tofu |
Mahjong size 5 pieces |
113 |
|
Shredded tofu |
50g, the size of a fist |
102 | |
|
50g, two hand-sized pieces |
223.5 | ||
|
Hollow cabbage |
A handful for an adult woman, about 100 grams |
115 | |
|
Cabbage |
A handful for an adult woman, about 100 grams |
117 | |
|
Kale |
A handful for an adult woman, about 100 grams |
121 | |
|
Little oilseed rape |
A handful for an adult woman, about 100 grams |
153 | |
| Aquatic products |
Perch |
A piece as big as the palm of your hand, about 100g |
138 |
|
Little Yellowtail |
4 pieces a hand long, about 100g |
191 | |
|
Scallops |
3 pieces a hand long, about 100g |
431 |
|
|
8 pieces, about 100g |
146 | ||
|
10 razor clams, half hand length, about 100g |
134 |
Surveys have shown that our residents consume only about 400 mg of calcium per day through their diet. For thyroid cancer patients who have been taking levothyroxine sodium tablets for a long time after surgery, a daily intake of about 1,000 mg of calcium is usually recommended. How do you get 1000 mg of calcium from your diet? As shown in Table 2.
|
Portfolio One |
Portfolio II
|
||||
| Food | Quantity | Calcium content (mg) | Food | Quantity | Calcium content (mg) |
|
500 ml |
540 |
Milk |
300ml |
324 | |
|
100g |
127 |
Dried bean curd |
60g |
185 | |
|
5g |
50 |
Sesame sauce |
10g |
117 | |
|
50 grams |
30 |
Egg (e.g. eggs) |
50 grams |
30 | |
|
200g |
180 |
Leaf greens (such as chard) |
250g |
270 | |
|
100g |
79 |
Fish (e.g., carp) |
100g |
79 | |
| 1005 | 1005 | ||||
Note: More than 1/2 of the calcium in combination one comes from milk, which is easily absorbed and utilized. If you are really not used to drinking more milk, you can increase your intake of other calcium-rich foods by referring to combination two to ensure that you get enough calcium.
It is important to note that calcium supplements can be given when the calcium intake in the diet is insufficient. However, the choice of calcium supplements needs to take into account the elemental calcium content, safety and efficacy, and it is recommended that thyroid cancer patients communicate fully with their physicians and follow their physicians’ instructions for scientific supplementation.
In addition, adequate vitamin D increases the absorption of calcium in the small intestine, and the easiest way to promote vitamin D synthesis in the body is to – get more sunlight. It is recommended to go outside in the sun between 11:00 a.m. and 3:00 p.m. for 15 to 30 minutes each time, twice a week, and try not to apply sunscreen to avoid the effects of sun exposure. However, while sunbathing, patients should also be careful to avoid sunburn.