This episode details the medical approach to thyroid nodules. Topics include:
• 60% of the U.S. population has thyroid nodules
• Discovered when evaluating other neck issues such as an unrelated pain
• What happens when you are told you have a thyroid nodule?
• How to know if your thyroid nodule is cancerous?
• When is surgery done despite the nodule being benign?
• Decreasing patient anxiety with quick biopsy results
• The American Thyroid Association as a resource for patients and physicians
• A word of caution about sourcing medical information from online resources
Dr. M Regina Castro is an endocrinologist in Rochester, Minnesota and is affiliated with Mayo Clinic. She received her medical degree from Central University of Venezuela and has been in practice for more than 20 years. Dr. Castro accepts several types of health insurance, listed below. She is one of 78 doctors at Mayo Clinic who specialize in Endocrinology, Diabetes & Metabolism. She also speaks multiple languages, including Spanish and French.
You have been diagnosed with thyroid cancer, and choose no surgery. Although thyroid cancer diagnosis has spiked around the world, a trend is to pass on surgery if the cancer is identified as low risk. In doing so, mortality rate does not increase and it avoids unfavorable events sometimes related to surgery, such as vocal chord paralysis, hypothyroidsm, financial costs, and lifelong thyroid hormone treatment.
In this episode, we visit with Dr. hypothyroidism, a pioneer in prescribing active surveillance in place of immediate surgery.
Dr. Miyauchi is President and COO of Kuma Hospital, Center for Excellence in Thyroid Care, Kobe, Japan. He is an endocrine surgeon, especially interested in thyroid and parathyroid diseases. He earned his MD and PhD at Osaka University Medical School in 1970 and 1978, respectively. He was Associate Professor of Department of Surgery, Kagawa Medical University until he was appointed to Vice President of Kuma Hospital in 1998. Since 2001, he is at his present position. About 2,000 operations, including about 1,300 thyroid cancer cases, are done every year at Kuma Hospital. He is currently serving as Chairman of the Asian Association of Endocrine Surgeons. He also served as Council of the International Association of Endocrine Surgeons until August 2015.
Topics covered, include:
You have been diagnosed with thyroid cancer, and contrary to your doctor's advice, you choose to not proceed with surgery. Is this a patient trend, and how often are patients making this decision?
In a qualitative analysis, Dr. Louise Davies reports on the experience of US patients who self-identify as having an over-diagnosed thyroid cancer.
How likely is death as result of thyroid cancer? In a study by H. Harach, he sites that when reviewing random autopsies, thyroid cancer was prevalent in 34% of the cadavers.
Dr. Davies states, if diagnosed with thyroid cancer, important questions to ask, include:
Dr. Davies says those who choose to opt for no surgery are sometimes called stupid by those who know them, and end up feeling isolated and anxious, with little or no support.
Louise Davies, MD, MS, FACS is an Associate Professor at Geisel School of Medicine
and Dartmouth Institute for Health Policy & Clinical Practice (TDI).
She is Chief, Otolaryngology at Veterans Administration, White River Jct., VT
Dr. Davies is an otolaryngologist - head & neck surgeon whose thyroid related research is aimed at defining and documenting the problem of rising thyroid cancer incidence and developing management approaches to the problem in ways that are safe and effective. Clinically, Dr. Davies cares for patients with both head and neck and thyroid cancer and general otolaryngology problems primarily at the VA hospital, with a limited practice at Dartmouth Hitchcock Medical Center. Her career is defined by her goal of helping patients and physicians make good decisions for their cancer care by providing clear, helpful data in useful formats at the needed time and place.
Yasuhiro Itoa and Akira Miyauchi
En este episodio, estamos con la Dra. Alicia Gauna, Jefa División Endocrinología del Hospital Ramos Mejía, Buenos Aires. Ella es Coordinadora del Comité de Recertificación de Endocrinología y Metabolismo (CREM), Directora de Beca de Dra. Florencia Rodriguez, Ministerio de Salud Pública, 2012-2013, Integrante del Comité Científico del XV Congreso Latinoamericano de Tiroides. Brasil, 2013.
En esta entrevista, Dra Gauna comparte información clave sobre hipotiroidismo y cáncer de tiroides.
YouTube con Dra. Gauna
In this episode, we hear from Elle Russ, Author of The Paleo Thyroid Solution, and former hypothyroidism sufferer. Elle discusses:
Elle Russ is a writer, health/life coach, and host of the Primal Blueprint Podcast. She is becoming the leading voice of thyroid health in the burgeoning Evolutionary Health Movement (also referred to as Paleo, Primal, or Ancestral Health). Elle has a B.A in Philosophy from The University of California at Santa Cruz and is a certified Primal Health Coach. She sits on the advisory board of The Primal Health Coach Program created by Mark Sisson, bestselling author of The Primal Blueprint. Exasperated and desperate, Elle took control of her own health and resolved two severe bouts of hypothyroidism on her own – including an acute Reverse T3 problem. Through a devoted paleo/primal lifestyle, intensive personal experimentation, and a radically modified approach to thyroid hormone replacement therapy…Elle went from fat, foggy, and fatigued – to fit, focused, and full of life!
Elle Russ web site
Primal Blueprint Podcast
Yahoo Natural Thyroid Support Group
Dr. Schneider specializes in endocrine surgery, treating diseases of the thyroid, parathyroid, and adrenal glands. He utilizes several minimally invasive techniques to treat endocrine disorders (endoscopic thyroidectomy, minimally invasive parathyroidectomy, laparoscopic adrenalectomy, focused exploration for recurrent thyroid cancer).
This episode explores the following topics:
Dr. David Schneider
El Dr Fabián Pitoia es Médico Endocrinólogo, es Jefe de la Sección Tiroides y Coordinador del Área Investigación de la División Endocrinología del Hospital de Clínicas - Universidad de Buenos Aires, es Docente adscripto de la Facultad de Medicina - Jefe de Trabajos prácticos de Medicina B (Facultad de Medicina - UBA) y Docente de la Carrera de Especialistas en Endocrinología y Metabolismo de la UBA.
Especialidad recertificada en Diciembre de 2013.
El Dr Pitoia tiene más de 200 publicaciones de sus investigaciones, más de 50 listadas en Pubmed, ha sido primer autor de las Guías Latinoamericanas para el diagnóstico y tratamiento del cáncer de tiroides, también el primer autor de las Guías Intersocietarias Argentinas para manejo de pacientes con cáncer de tiroides 2014.
En esta entrevista, discutiremos:
Dr. Babak Larian is a highly experienced, board certified Ear, Nose, & Throat Specialist and Head & Neck surgeon. Dr. Larian is the current Clinical Chief of the Division of Otolaryngology at Cedars-Sinai Hospital in Los Angeles. Dr. Larian's Center For Head and Neck Surgery is located in Beverly Hills, California.
In this episode, Dr. Larian discusses his experience treating thyroid disorders, including his medical missions to Central America. During this interview, you will hear greater detail about the following topics:
Dr. Babak Larian
American Thyroid Association Guidelines
Combination Therapy of T4 and T3 as a way to combat Hypothyroidism
Thyroidectomy often leads to hypothyroidism-like symptoms. This includes brain fog, sluggishness, weight gain, unmotivated, and water accumulation.
Dr. Bianco’s research has revealed the connection between thyroidectomy, hypothyroidism symptoms, and T4 only therapy. Although T4 only therapy works for the majority, others report serious symptoms. Listen to this segment to hear greater detail in regard to the following topics:
Combination therapy of adding T3 to T4
85% of patients on Synthroid feel fine.
Nearly 5% of the U.S. population takes T4, as revealed by the NHANE survey
Residual symptoms of thyroidectomy include depression, difficulty losing weight, poor motivation, sluggishness, and lack of motivation. For some, there is no remedy to these symptoms.
The importance of physical activity and its benefit in treating depression
If we normalize T3 does it get rid of hypothyroid symptoms?
Overlap between menopause and hypothyroidism symptoms
Dr. Antonio Bianco, Rush University Medical Center as professor of medicine, senior vice chair in the Department of Internal Medicine and division chief of endocrinology at Rush University Medical Center. He has more than 30 years of experience in thyroid research.
Bianco’s research interests have been in the cellular and molecular physiology of the enzymes that control thyroid hormone action in which he contributed more than 200 papers, book chapters and review articles, and lectured extensively both nationally and internationally.
Recently, he has focused on the aspects of the deiodination pathway that interfere with treatment of hypothyroid patients, a disease that affects more than 10 million Americans. He is Director of Bianco Labs.
Bianco Lab on Facebook
The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in the United States. The survey is unique in that it combines interviews and physical examinations.
Dr. Aime Franco is professor at the University of Arkansas. She leads a research group investigating the role of thyroid hormones in tumorigenesis. She is also actively involved, both locally and nationally, advocating for the importance of biomedical research and the importance of engaging patients and survivors in cancer research.
After, completing her Ph.D. in Cancer Biology, she became a thyroid cancer research fellow at Memorial Sloan-Kettering Cancer Center in the Human Oncology and Pathogenesis Program.
Dr. Franco is a survivor of thyroid cancer, and balances her research as a mom and competitive triathlete.
in this interview we explore the following:
Does thyroid cancer have a good prognosis compared to other cancers because its different or because we are aggressive with surgery and radiation therapy?
What were some personal insecurities when facing thyroid cancer surgery?
What are the questions in regard to TSH that the medical community is overlooking?
Which prescription medication works best?
How often and when should thyroid blood markers be tested?
You may find Dr. Franco here, http://physiology.uams.edu/faculty/aime-franco/
El Dr. Carlos Simon Duque es un especialista en cabeza y cuello de Colombia. En esta entrevista, discutiremos una visión general del cáncer de tiroides, incluyendo las siguientes preguntas:
¿Qué debe saber un paciente antes de la cirugía, qué esperar?
Después de la cirugía, un paciente puede sentir síntomas como hipotiroidismo. ¿Cómo lo manejas mejor?
¿Cuáles son algunas de las luchas mas complicados que usted ve con sus pacientes después de la tiroidectomía?
¿Qué pacientes recuperan mejor? ¿Qué puede hacer un paciente para sentirse mejor después de la cirugía?
¿Cuándo es el mejor momento del día para tomar la medicina de la tiroides?
Usted ha trabajado tanto en los Estados Unidos como en Colombia, ¿cuáles son algunas de las diferencias en la atención y el tratamiento?
¿Qué has descubierto a lo largo del camino, que le dirías a usted de 30 años de edad si puede?
¿Actualmente está trabajando en algún estudio o investigación?
How well does your body make energy?
How does your body repair?
How well are your anti-oxidants working?
How well do you rid your body of free radicals?
Are you pre-conditioned to crisis?
The next generation of lab testing and diagnosis has arrived with resources such as Cyrex Labs and Nutreval.
Thyroid health issues mimic other ailments, such as inflammation, gluten intolerance, and increased permeability (leaky gut).
In this episode, hear from Dr. Engelman, recognized as one of the top doctors in functional integrative medicine, he has advanced degrees and certifications in functional, metabolic, anti-aging and stem cell medicine. Engelman Health Institute is advanced science, and personalized care. This "new medicine" incorporates the best of traditional practices and natural and alternative diagnostic modalities.
Karen Smyers has competed as a professional triathlete for 30 years. In her lengthy career, she has won seven National and four World Championship titles, including a dramatic come-from-behind victory in the Hawaiian Ironman World Championships in 1995. Her victory at the short-course ITU Triathlon World Championship just 5 weeks later still earns her the distinction of being the only woman ever to win triathlon’s two most prestigious races in the same year.
In this episode, we hear Karen describe what the calls, ‘character building’ moments, including how she approached thyroid cancer in the midst of of preparing for the 2000 Olympics.
Other obstacles included a torn hamstring, being hit by a 18-wheeler, and a broken collar bone. Regardless of the obstacle, Karen was able to stay focused on and win the Pro National Ironman Championship.
At 42 and post thyroid cancer, Karen gave birth to her second child.
Listen to this episode and you will be inspired by Karen’s determination, perseverance, and approach to living life to the fullest. And, in some cases pushing boundaries and achieving what some would say not possible.
Currently, Karen shares her experience, optimism, and passion for racing as a coach, motivational speaker and co-director of the Lincoln Kids Triathlon. She is a 1983 graduate of Princeton University and lives in Lincoln, MA with daughter Jenna, son Casey, and husband and frequent training partner Michael King.
Contact: 11 Giles Rd, Lincoln, MA 01773 email@example.com www.karensmyers.com
This interview is a part of the lifestyle stories featured on the Doctor Thyroid podcast, an opportunity to hear from athletes and overachievers, and how they approach their diagnosis, surgery, and recovery.
In this case, we hear from Evan Simon, Head Strength and Conditioning Coach at Oregon State University. Evan was diagnosed with advanced Stage IV thyroid cancer, which resulted a 13 hour surgery. At the end of his surgery, Evan was told he would not be able to lift his hands overhead for 3 months, instead he broke the odds, taking him only 3 weeks.
Evan shares with us, his approach to first hearing the news, how he chose to share the news with his family, including his two young daughters, and what he did to speed his recovery. Evan will offer you tips to improve better your recovery, including physical rehabilitation and having an optimistic mindset.
During the interview, we also hear from special guest, Stasi Kasianchuk, MS, RD, Sports Dietitian at Oregon State University. Staci shares her experience in treating Evan through nutrition as a means to a better recovery, and improved lifestyle post-surgery.
University of Chicago Medicine researchers Briseis Aschebrook-Kilfoy, PhD, assistant research professor in epidemiology, and Raymon Grogan, MD, assistant professor of surgery lead the North American Thyroid Cancer Survivorship Study (NATCSS).
For their most recent research, Aschebrook-Kilfoy and Grogan recruited 1,174 thyroid cancer survivors – 89.9 percent female with an average age of 48
After treatment, thyroid cancer survivors face a lifetime of cancer surveillance and an anxiety-inducing high rate of recurrence, which could contribute to their findings.
"The goal of this study is to turn it into a long-term, longitudinal cohort," said Grogan, who hopes to develop a tool that physicians can use to assess the psychological wellbeing of thyroid cancer survivors. "But, there was no way to do that with thyroid cancer because no one had ever studied quality of life or psychology of thyroid cancer before.”
In this episode, we will explore:
The spiritual, social, psychological, and physical impacts of thyroid cancer. Some of the sometimes over-looked physical impacts include dry mouth, voice problems, dry eyes, dental problems, fatigue, dry skin, and hypoglycemia.
What happens to vocal cords after surgery? Even when not paralyzed, quality of voice is effected.
Often times, family members don't take treatment seriously. Society, healthcare professionals, and the media have minimized thyroid cancer, and in return has made patients feel minimized.
Anxiety about reoccurrence, RAI treatment, and self-concept, influence quality of life for thyroid cancer patients.
A 2011 study by Aschebrook-Kilfoy and Grogan found that thyroid cancer, which is most common in women, will double in incidence by 2019.
Dr. Jonas de Souza, Assistant Professor of Medicine, specializes in the treatment of head and neck cancer, including thyroid cancer at the University of Chicago.
Talking points of this episode:
What is the COST tool?
Patient-Centered Outcomes Research?
When is the best time to discuss costs with the thyroid cancer patient?
Who is most at risk of the increased financial burden of thyroid cancer?
How can a patient best prepare for the costs of thyroid cancer?
The COST tool for measuring the financial costs of thyroid cancer, http://www.facit.org/FACITOrg/Questionnaires
In this episode our guest is Dr. Martin Milner. Today's interview features information on optimizing medication with slow-release compounded thyroid replacement.
Can adding adjusting your medication from T4 to slow release with T3 really make you feel better? The answer is, yes! And, could also be the key to losing weight.
We also discuss the following topics, painful feet, dizziness, fatigue, hair loss, iron deficiency, chronic pain, fibromylagia, adrenal connection to to inflammation, sleep problems, muscle spasms, caution with your morning smoothies, and why you should stand up when taking T3.
Want to find a compounding pharmacy that will make your slow release T3 and T4? Start here: http://www.pccarx.com/
Dr. Milner has published several articles on new treatment protocols for hypothyroidism. Most recently, ” Hypothyroidism: Optimizing Medication with Slow-Release Compounded Thyroid Replacement” was published in the peer review journal of compounding pharmacists, International Journal of Pharmaceutical Compounding (IJPC) Vol. 9 No. 4 July/August 2005. In 2006 and 2007 he lectured around the United States guiding physicians and compounding pharmacists in the management of hypothyroidism using his protocol of slow released compounded thyroid replacement. Also to his credit are “Wilson’s Syndrome and T3 therapy – A Clinical Guide to Safe and Effective Patient Management” IJPC Vol. 3 No. 5, Sept/Oct 1999, p. 344-349 and Assessment and Management of Thermoregulation, IJPC Vol. 3 No. 5, Sept/Oct 1999, p. 350-351. Reprints of many of these and other Dr. Milner articles are available at CNMWellness.com, the medical education website of the Center for Natural Medicine. Dr. Milner co-authored chapter 14 in An Alternative Medicine Definitive Guide to Cancer by J. Diamond and W.L. Cowden, the most definitive text on alternative cancer therapies. He also served as the primary consulting physician for Judith Sach’s book Natural Medicine for Heart Disease. The has authored many articles over the years in cardiology.
Dr. Milner is well published with texts, medical journal articles and studies in cardiology, endocrinology, pulmonology, oncology, and environmental medicine. Dr. Milner published in May 2005, Menopause Revolution: Smashing the HRT Myth- Alternatives to Manufactured Drug Therapy , Agora Health Books. He enjoys what he calls practicing “integrated endocrinology” balancing all the endocrine hormones using bio-identical hormone replacement and amino acid neurotransmitter precursors.
Dr. Douglas Van Nostrand, MD is the Director of Nuclear Medicine and the Program Director of the Nuclear Medicine Residency Program at Washington Hospital Center and Professor of Medicine, Georgetown University Hospital Center.
His specialty is nuclear medicine, and his primary area of interest and expertise is the nuclear medicine diagnosis and treatment of thyroid cancer. He has held numerous academic and medical society positions including Clinical Professor of Radiology and Nuclear Medicine, Uniformed Services University of Health Sciences; past President, Mid-Eastern Society of Nuclear Medicine, Director of Continuing Medical Education Department, and other elected positions of the Medical Staff of Good Samaritan Hospital. He has over 150 articles published and has been the co-editor of seven medical books including the medical textbook entitled Thyroid Cancer, A Comprehensive Guide to Clinical Management.
In this episode, get the critical questions to ask prior to committing to a surgeon. And, other useful strategies to make sure a patient gets the best outcome possible.
Today's guest is Wendy Sacks, M.D., endocrinologist in the Division of Endocrinology, Diabetes and Metabolism and the Thyroid Cancer Program at Cedars-Sinai in Los Angeles.
Some of the topics covered include radioactive iodine treatment, blood testing, the role of the pathologist, selecting the right hospital and medical team for your thyroid cancer treatment, monitoring thyroid cancer reoccurrence, and supplementation.
In this episode, Dr. Spencer, Professor of Medicine at University of Southern California, discusses the importance of testing for thyroglobulin-antibodies and thyroglobulin. Important notes from this interview include:
Dr. Spencer's major areas of research interest are thyroid physiology and pathology, thyroglobulin and thyroid cancer, immunoassay techniques, thyroid hormone metabolism, and the cost-effective use of thyroid tests. Her current research includes clinical significance of Tg and TgAb in patients with thyroid cancers, parameters for optimizing thyroid hormone suppression of TSH for DTC. Studies on hypothalamic/pituitary mechanisms for regulating TSH, and testing for thyroid dysfunction during pregnancy.
Dr. Spencer earned her PhD from Glasgow University in Scotland. She then went on to complete two fellowships, one in Clinical Biochemistry at Glasgow, and the other at the National Academy of Clinical Biochemistry.
Hear about the advances in thyroid ultra sound technology, along with the patient process from diagnosis to surgery. Key topics in this episode include how to research a surgeon, requesting a second opinion, selecting the best hospital, and the challenges faced when operating on the neck.
This episode features Dr. Joseph Sniezek, who is the Medical Director of Head & Neck Endocrine Surgery for Swedish Health Services.
Too often, the time between being told by your doctor to get an ultrasound to biopsy, often results in anxiety and a disconnect between surgeon - radiologist - pathologist. Now, with better technology, especially in the area of ultra sound, the multiple trips to specialists can be eliminated.
This episode features Dr. Shawn Soszka.
Topics covered in today’s interview include, starting your day right, tendon issues due to thyroid disease, insomnia, dizziness, painful feet, temperature testing, hypothyroidism, low dose Naltrexone, selenomethionine, and why some people feel worse when exercising. Also, discussed is adrenal function and optimal time of day for body temperature testing as related to the thyroid disease.
Dr. Soszka strives to integrate both systems of medicine. a focus on functional medicine, with emphasis on treating gastrointestinal, chronic disease, and endocrine based conditions. He specializes in: fatigue/adrenal exhaustion, thyroid disorders, digestion/gut health, autoimmune diseases.
In this episode hear from Dr. Greg Nigh, a Naturopath in Portland, OR.
Dr. Nigh will discuss the following topics: