Nickan Research Institute Journal of Parathyroid Disease 2345-6558 11 1 2023 01 01 Hypocalcemia in thalassemia major patients requires an extra-careful approach e11203 e11203 10.34172/jpd.2023.11203 EN Mohammad Bahadoram https://orcid.org/0000-0002-7106-9799 Bijan Keikhaei https://orcid.org/0000-0002-3087-7650 Mohammad Davoodi Najmeh Nameh Goshay Fard Pouria Ghiasi Esma'il Akade https://orcid.org/0000-0001-7722-0165 LETTER 10.34172/jpd.2023.11203 2022 03 17 2023 05 12 Thalassemia is a hematological disorder caused by a gene mutation that leads to defective synthesis of hemoglobin complex. One of the complications of thalassemia is hypocalcemia which is presented with paresthesia, muscle spasm, low-serum calcium, and intracranial calcification. Hypocalcemia can affect thalassemic patients via various mechanisms. Blood transfusion-related and transfusion-independent iron overload, drug side effects, vitamin D3 deficiency, and genetic disorders and polymorphisms are among the etiologies of hypocalcemia in major thalassemia. A careful approach to the differential etiology of this phenomenon is crucial for a resultful treatment.