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calcium + vitamin D + active vitamin D is a therapeutic combination regimen developed by Aarhus University Hospital for the management and prevention of postoperative hypoparathyroidism following total thyroidectomy. This regimen includes high-dose elemental calcium, vitamin D (cholecalciferol), and active vitamin D (such as calcitriol or alfacalcidol). The mechanism involves providing a direct source of calcium while the vitamin D components, particularly the active form, bind to the Vitamin D Receptor (VDR) to enhance intestinal calcium absorption and maintain serum calcium levels, effectively bypassing the requirement for parathyroid hormone (PTH) which is often deficient or absent post-surgery.
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