Teriparatide (Forteo) in the Treatment of Patients With Postoperative Hypocalcemia

Inclusion Criteria: 1. Patients who are scheduled for total thyroidectomy, and/or extensive neck dissections (pharyngectomy, laryngectomy, unilateral/bilateral/central neck, and/or mediastinal lymph node neck dissections). 2. Patients who develop, between 18-24 hours after surgery, hypocalcemia as defined by a corrected serum calcium \<8.0mg/dL. \[Corrected serum calcium (mg/dL) = Measured calcium + (4-albumin) x 0.8\] Exclusion Criteria: 1. Patients who have jejunal tubes 2. Patients \<18 years old. 3. Treatment with teriparatide or calcitriol (Rocaltrol) within 1 month prior to surgery 4. Treatment with a bisphosphonate within 3 months prior to surgery 5. Hypercalcemia (corrected serum calcium \>10.5mg/dL) or hypocalcemia (corrected serum calcium \<8.4mg/dL) on preoperative labs (drawn within 21 days of surgery) 6. Paget's disease of bone 7. Elevated alkaline phosphatase \> institutional upper limit of normal (ULN) 8. History of external beam irradiation to the skeleton 9. History of skeletal metastases 10. History of untreated gout 11. History of unstable angina pectoris 12. History of symptomatic orthostatic hypotension 13. Pregnancy (as screened by a serum/urine pregnancy test) or breast-feeding. Female subjects of childbearing potential must have a negative pregnancy test within 7 days of surgery. Postmenopausal women (absence of menses for 12 months) or women with history of hysterectomy or bilateral oophorectomy will not be required to have a pregnancy test. Male and female patients of reproductive potential must agree to utilize an effective form of contraception throughout the study period. The definition of effective contraception will be based on the judgment of the Investigator or designated associate. 14. Hepatic and renal dysfunction defined by the following parameters: (a) Serum AST (SGOT) and ALT (SGPT) \> 3 times the institutional ULN, (b) Total serum bilirubin \> 2 times the institutional ULN, (c) Serum creatinine \> 1.5mg/dL or estimated creatinine clearance \< 40mL/min 15. Psychiatric illness or social situation that would limit compliance with study requirements 16. Concomitant use of digoxin 17. Patients may not be receiving any other investigational agents or have participated in any investigational drug study within 28 days preceding the start of study treatment.