Teriparatide for Postsurgical Hypoparathyroidism

Inclusion criteria: * Patients post bilateral thyroid bed surgery (cancer, Graves disease, multinodular goiter) * Symptomatic hypocalcemia * Total calcium \< 8 mg/dL persisting after 24 hours of therapy with calcitriol (minimum 0.25 mcg twice a day) and calcium supplementation (minimum 1.5 grams of elemental calcium per day) * Parathyroid hormone (PTH) level below low end of normal range Exclusion criteria (all subjects): * Renal failure * Any prior parathyroid pathology * Pre-existing hypercalcemia * Metabolic bone diseases other than osteoporosis * Pagets disease Exclusion criteria (active treatment subjects only): * Ongoing therapy with Forteo for osteoporosis * Active non-thyroidal malignancy or suspicion of residual thyroid malignancy * History of skeletal malignancies, primary or metastatic * Pregnancy * Active or recent urolithiasis * Digitalis therapy * Patients at increased baseline risk for osteosarcoma, i.e., family history of osteosarcoma or prior radiation therapy involving the skeleton * Pediatric populations * Unexplained elevations of alkaline phosphatase