* Imaging has increased thyroid nodule discovery.
* Following patients with small thyroid cancer ? analogous to prostate cancer. Better followed than treated.
* Tiny thyroid cancers can be defined by those nodules less than 1/4 inch in size.
* Less RAI is being used as a part of thyroid cancer treatment. This means, less need to do total thyroidectomy or thyroid lobectomy.
* Dry mouth and dry eyes are risks to doing RAI. Also, there is risk to developing a second malignancy. Most of the secondary cancers are leukemia.
* Risks to operation include changes to voice and calcium levels. Thyroid surgery is a safe operation but not risk free.
* Best question for a patient to ask is, who is my treatment team?
54: Hypothyroidism⎥Weight Gain, Fatigue, and Sluggishness, with Dr. Alan Farwell from Boston Medical Center
Thyroid surgery and RAI sometimes results in hypothyroidism
Most common cause is Hashimoto’s disease
Weight gain, dry skin, constipation
Very few symptoms unique to hypothyroidism
Sleep apnea and being tired all of the time and weight gain.
Brain fog and difficulty concentrating
Blood tests diagnose hypothyroidism based on TSH levels, when elevated means it is not working too well.
Explaining TSH in laymen’s terms
Normal TSH in the U.S. is .3 to 3.5
Treating for feel rather than a number
People with elevated TSH have many of the hypothyroid symptoms, but people with normal TSH levels may also have hypothyroid symptoms
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.
In this episode, Dr. Wartofsky discusses the following:
* Hypothyroidism causes
* When is replacement thyroid replacement hormone necessary?
* The history of replacement thyroid hormone going back to 1891
* The early treatment included a chopped up sheep thyroid and served as a ‘tartar’, often resulting in vomiting
* Myxedema coma
50: Regarding Thyroid Cancer, Are You a Minimalist or a Maximalist? with Dr. Michael Tuttle from Sloan Kettering
Regarding Thyroid Cancer, Are You a Minimalist or a Maximalist?
Often, surgery is not necessary to treat thyroid cancer, but much of the decision will depend on the patient characteristic.
During this interview, Dr. Tuttle discusses the following points:
Challenges of managing thyroid cancer as outlined by the guidelines
Scaling back care for insurance-challenged patients, and adopting a plan that gets the same result without needing the expensive tests
Desired outcome is survival and no recurrence, a third is for no harm that would be caused by an unnecessary surgery
Unwanted side affects of thyroid cancer include nerve damage, parathyroid damage, and infections
In this episode, topics include:
* Hypothyroidism and hyperthyroidism during pregnancy
* Pregnant and without a thyroid
* Avoiding T3 during pregnancy, including concerns with desiccated thyroid
* If being treated for hypothyroidism already, the importance of upping dose while pregnant
* Pregnant with auto-immunity
* Pregnant with Graves’ disease
* The dangers of pregnancy and overt hypothyroidism or hyperthyroidism
48: Innovaciones en el Tratamiento del Cáncer de Tiroides, con el Dr. Hernán Tala desde Santiago, Chile
Dr. Hernán Tala es endocrinólogo de la Clinica Alemana en Santiago, Chile. Su area especialidad incluye cáncer de tiroides avanzado, endocrinologia general, y enfermedades tiroides.
Los temas presentados incluyen:
* Una mejor comprensión de la biología del cáncer de tiroides, y que no todo el cáncer de tiroides es igual. La enfermedad es única en cada paciente.
* La importancia de entender el perfil del cáncer en cada paciente.
* Diagnóstico del nódulo.
* Perfil molecular del nódulo tiroideo.
* Una pausa en la exploración universal del cáncer de tiroides.
* Vigilancia activa
Hipotiroidismo: el tratamiento, pronóstico, posibles complicaciones, y cuándo contactar a un médico.
La tiroides produce hormonas que controlan la forma como cada célula en el cuerpo usa la energía. Este proceso se denomina metabolismo.
Hipotiroidismo es una afección en la cual la glándula tiroides no produce suficiente hormona tiroidea. Esta afección a menudo se llama tiroides hipoactiva.
This is an in depth discussion about the connection between flame retardants and plastics, and thyroid cancer. These chemicals, also known as endocrine disruptors, have a clear connection to thyroid cancer occurrence.
The research is presented by Julie Ann Sosa, MD MA FACS is Chief of Endocrine Surgery at Duke University and leader of the endocrine neoplasia diseases group in the Duke Cancer Institute and the Duke Clinical Research Institute. She is Professor of Surgery and Medicine. Her clinical interest is in endocrine surgery, with a focus in thyroid cancer.
39: Thyroid Cancer Web Sites Confuse Patients with Dr. Rashika Bansal from St. Joseph’s Regional Medical Center
In this episode Dr. Bansal shares the research she presented at AACE 2017 and ENDO 2017, regarding the poor readability scores for thyroid cancer web sites.
The challenge for these web sites and health institutions is to translate thyroid education from complex to simple and easy to understand. Currently, many patients are not following up with treatment, citing confusion after being exposed to the various thyroid cancer education resources.
37: Adding T3 to T4 Will Make You Feel Better? For Some the Answer is ‘Yes’ with Dr. Antonio Bianco from Rush University
A little T3 can make a world of difference for some thyroid patients.
Antonio Bianco, MD, PhD, is head of the division of Endocrinology and Metabolism at Rush University Medical Center. Dr. Bianco also co-chaired an American Thyroid Association task force that updated the guidelines for treating hypothyroidism.
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