I had a total thyroidectomy 2 weeks ago and after the surgery, my calcium dropped to 7.4. i was in the hospital for 3 extra days. my calcium is now 7.1 and parathyroids have gone. your thoughts?

Hypocalcemia: Hypocalcemia after total thyroidectomy is common. You might be on oral calcium supplements for a time, but the vast majority of parathyroids will start to work eventually. Long term hypocalcemia is rare after thyroidectomy. It usually just takes time.

It's a waiting game: I agree that permanent profound hypoparathyroidism is rare. It would be nice to know if you have any detectable parathyroid hormone. If you do, then your prognosis is better. Often your body will reset its low point. You would still be on calcium supplementation and possibly calcitriol, but at lower doses. You will tolerate lower levels with less side effects. Hang in there.

Possible: It is possible some parathyroid tissue was removed. If your levels come back to normal, it means that the remaining parathyroid needing some more time to catch up. You do not need all the parathyroid to have normal calcium regulation.

Low calcium: Stack BC Jr, Bimston DN, Bodenner DL, Brett EM, Dralle H, Orloff LA, Pallota J, Snyder SK, Wong RJ, Randolph GW. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY DISEASE STATE CLINICAL REVIEW: POSTOPERATIVE HYPOPARATHYROIDISM - DEFINITIONS AND MANAGEMENT. Endocr Pract. 2015 Jun;21(6):674-85. doi: 10.4158/EP14462.DSC. PubMed PMID: 26135962.