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!
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Elle Russ web site
Primal Blueprint Podcast
http://blog.primalblueprint.com/
Yahoo Natural Thyroid Support Group
https://beta.groups.yahoo.com/neo/groups/NaturalThyroidHormones/info
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.
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Bianco Lab
Bianco Lab on Facebook
https://www.facebook.com/biancolab/
NHANES Survey
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.
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:
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In this interview, items discussed include:
Dr. Ralph P. Tufano is the Director of the Division of Head and Neck Endocrine Surgery at The Johns Hopkins School of Medicine, and conducts thyroid and parathyroid surgery with a focus on optimizing outcomes. He is a recognized world authority on the management of thyroid cancer, thyroid nodules, benign thyroid diseases and parathyroid disease. He has expertise in the management of thyroid cancer nodal metastases, advanced and invasive thyroid cancers as well as recurrent thyroid cancers. His work in molecular markers, improving surgical outcomes, nerve monitoring and exploring novel treatment techniques for thyroid and parathyroid diseases has helped the medical field tailor and personalize treatment for patients with these conditions. He is a Charles W. Cummings Professor, sits on the American Thyroid Association Board of Directors, is Director of the Division of Head and Neck Endocrine Surgery, and is a part of the Department of Otolaryngology-Head and Neck Surgery. He conducts approximately 450 thyroid surgeries annually.
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In this interview, the following topics are discussed:
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Thyroid Change Resources
Website: www.ThyroidChange.org
Facebook: www.facebook.com/ThyroidChange
Twitter: www.twitter.com/ThyroidChange
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.
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Dr. Wartofsky is Professor of Medicine, Georgetown University School of Medicine and Chairman Emeritus, Department of Medicine, MedStar Washington Hospital Center. He trained in internal medicine at Barnes Hospital, Washington University and in endocrinology with Dr. Sidney Ingbar, Harvard University Service, Thorndike Memorial Laboratory, Boston. Dr. Wartofsky is past President of both the American Thyroid Association and The Endocrine Society. He is the editor of books on thyroid cancer for both physicians and for patients, and thyroid cancer is his primary clinical focus. He is the author or coauthor of over 350 articles and book chapters in the medical literature, is recent past Editor-in-Chief of the Journal of Clinical Endocrinology & Metabolism, and is the current Editor-in-Chief of Endocrine Reviews.
In this episode, Dr. Wartofsky discusses the following:
Related episodes:
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Andrew J. Bauer, MD is an Associate Professor of Pediatrics at the Perelman School of Medicine, University of Pennsylvania and serves as the Director of the Thyroid Center in the Division of Endocrinology and Diabetes at The Children’s Hospital of Philadelphia. Dr. Bauer maintains active membership as a fellow in the American Academy of Pediatrics (FAAP), the Endocrine Society, the Pediatric Endocrine Society, and the American Thyroid Association. He also volunteers as a consultant for the Thyroid Cancer Survivors Association and the Graves’ Disease and Thyroid Foundation. In the American Thyroid Association Dr. Bauer has recently served as a member of the pre-operative staging committee, the thyroid hormone replacement committee, and as a co-chair for the task force charged to author guidelines on the evaluation and treatment of pediatric thyroid nodules and differentiated thyroid cancer. His clinical and research areas of interest are focused on the study of pediatric thyroid disease, to include hyperthyroidism, thyroid nodular disease, thyroid cancer, and inherited syndromes associated with an increased risk of developing thyroid nodules and thyroid cancer.
In this episode Dr. Bauer shares the complexities of managing children with thyroid nodules, and differentiated thyroid cancer. This is a must listen interview for parents whose child has a thyroid nodule or thyroid cancer diagnosis.
There are a several important differences in how pediatric thyroid nodules and differentiated thyroid cancer (DTC) present and respond to therapy. Kids are less frequently diagnosed with a thyroid nodule; however, the risk for malignancy is four- to fivefold higher compared with an adult thyroid nodule. For DTC (specifically papillary thyroid cancer), more than 50% of pediatric-aged patients will have metastases to cervical lymph nodes at the time of diagnosis, but because the tumors typically retain the ability to absorb iodine (retain differentiation), disease-specific mortality is very low, with > 95% of pediatric patients surviving from the disease. This is true even for children with pulmonary metastases, which occur in approximately 15% of patients who present with lateral neck disease.
With the high risk for malignancy and the invasive potential of the cancer, there has been a stronger tendency to take kids with thyroid nodules to the operating room (OR) and to administer RAI to those found to have DTC. With a greater realization of the increased risk for surgical complications as well as the short- and long-term complications of RAI treatment, the guidelines emphasize the need for appropriate preoperative assessment of nodules, and the approach to surgical resection, and they provide a stratification system and guidance for surveillance to identify which patients may benefit from RAI. The stratification system, called the "ATA pediatric risk classification," is not designed to identify patients at risk of dying of disease; it is designed to identify patients at increased likelihood of having persistent disease.
We have known about these differences for years, but the approach to evaluation and care has never been summarized into a pediatric-specific guideline. The adult guidelines aren't organized to address the differences in presentation, and the adult staging systems are targeted to identify patients at increased risk for disease-specific mortality. So, the adult guidelines are not transferable to the pediatric population.
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Not all thyroid cancer patients who receive a thyroidectomy require radioactive iodine, but for those whose cancer maybe more aggressive and spread beyond the thyroid area, often radioactive iodine (RAI) is protocol.
RAI treatment may vary depending on the hospital. For example, in this interview you hear protocol for RAI at Cedars Sinai.
In this interviews, Dr. Alan Waxman explains what occurs leading up to, during, and after RAI. Topics discussed include:
Alan D. Waxman, MD is Director of Nuclear Medicine at the S. Mark Taper Foundation Imaging Center at Cedars Sinai. He is also a member of the Saul and Joyce Brandman Breast Center – A Project of Women’s Guild and the Thyroid Cancer Center at Cedars-Sinai Medical Center. He is a clinical professor of radiology at Los Angeles County + University of Southern California (USC) Medical Center. Dr. Waxman’s participation in research has led to the development of many new imaging techniques and equipment adaptations. A leading expert in nuclear medicine imaging, Dr. Waxman has directed efforts to develop innovations in whole-body tumor imaging using new and existing radiolable compounds. Dr. Waxman is an active member and officer of the Society of Nuclear Medicine. He has authored numerous publications and lectured extensively throughout the world. Dr. Waxman is a graduate of the USC Medical School, where he completed his postgraduate training. He also completed a clinical research fellowship at the National Institutes of Health.
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Salivary gland toxicity after radioiodine therapy for thyroid cancer.
RELATED EPISODES
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/
In this interview, some of the key points include:
Jody Gelb is a Broadway singer and actress. Six months ago she was diagnosed with papillary thyroid cancer, during a doctor's visit for an unrelated issue. This news sparked immediate research and discovering an alternate path that does not include surgery.
In this episode, the following topics are discussed:
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Diagnosed with Thyroid Cancer and You Say No to Surgery with Dr. Louise Davies
1 in 3 People Die With Thyroid Cancer — Not From with Dr. Seth Landefeld from UAB
Overdiagnosed: Making People Sick in the Pursuit of Health
Jody Gelb
Dr. Alan Farwell is an endocrinologist, Director of the Endocrine Clinics at Boston Medical Center, and Associate Professor of Medicine at Boston University School of Medicine, in Massachusetts.
In addition to his extensive academic and clinical activities, Dr. Farwell has been extremely active and served in multiple capacities in the ATA, including as Chair of the Education Committee and the Patient Education and Advocacy Committee, and as a member of the Program Committee and the Website Task Force Publications Committee. He has served two terms on the ATA Board of Directors, is the founding and current Chair of the ATA Alliance for Patient Education.
Dr. Farwell has been an Associate Editor and member of the Editorial Board of Thyroid, and since 2009 has been Editor-in-Chief of Clinical Thyroidology for the Public.
In this interview, we discuss the following topics:
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Dr. Brady was named director of endocrine surgery for the new medical school in Austin. She was also recently chosen to teach general surgeons seeking additional training in endocrine surgery. Dr. Brady instructs these endocrine surgeons from the Baylor Scott and White fellowship program.
In this episode the following topics are discussed:
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