After thyroidectomy, tingling or cramps are most likely signs of which electrolyte disturbance?

• A. Hyperkalemia
• B. Hypocalcemia
• C. Hypernatremia
• D. Hypomagnesemia

Answer: (B)

After thyroidectomy, the parathyroid glands are at risk of damage or removal, leading to reduced parathyroid hormone and hypocalcemia. Calcium is key for stabilizing nerve and muscle membranes; when calcium levels drop, nerves become more excitable, producing tingling around the mouth and in the extremities, muscle cramps, and even tetany. This pattern of symptoms is classic for low calcium due to hypoparathyroidism after thyroid surgery. Other disturbances don’t fit this immediate post-surgical picture: hyperkalemia typically causes weakness and heart rhythm issues, hypernatremia leads to dehydration and mental status changes, and while low magnesium can cause similar signs, the scenario most strongly points to hypocalcemia from impaired PTH.