Episode Archive

Endocrine

60: Pregnancy and Thyroid⎥Hypothyroidism and Hyperthyroidism, with Dr. Angela Leung from UCLA

In this episode, the following topics are explained:
* Optimizing thyroid health prior to conception
* Thyroid issues that affect pregnancy
* Hypothyroid as result of surgery or Hashimotos
* Hyperthyroidism and pregnancy
* Adjusting current thyroid treatment, meaning optimizing thyroid levels by adjusting dosage of thyroid medication
* TSH levels in light of pregnancy
* Planned pregnancy usually means a dose increase

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Endocrine

59: No Biopsia es 100% Exacta⎥Exámenes Moleculares son los Mejores, con Dr. Paul Y. Casanova

Dr. Paul Y. Casanova-Romero, M.D., M.P.H., F.A.C.P., F.A.C.E, E.C.N.U, que se unió a Palm Beach Diabetes y Endocrine Specialists en 2012, recibió su grado médico con honores (Summa Cum Laude) y Doctor en Ciencias Médicas (DMSc), de la Universidad de Zulia, la Escuela de Medicina en Venezuela.
* ¿Cómo se identifican los nódulos y por qué ocurren? autoexamen o en la oficina del médico
* La mayoría de los nódulos son benignos pero ocurren porque en mas de 70% de la población
* ¿Qué tests puede realizar un médico para evaluar el nódulo?
* Ninguna test es 100%
* Ultrasonido – qué están buscando en general
* Que es ojo fina y el proceso general
* Tests moleculares
* ¿Qué tipos de resultados se pueden obtener de la citología y qué significan?
* La mayoria de ojo finas son benigno

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Pathology

58: No Biopsy is 100% Accurate⎥Molecular Testing Gets Close, with Dr. Bridget Brady from Austin Thyroid Surgeons

Dr. Bridget Brady is Austin’s first fellowship-trained endocrine surgeon.
In this episode the following topics are discussed:
Austin Thyroid Surgeons sees 30 patients per week with thyroid nodules
Up to 80% of US population could have a thyroid nodule(s)
less than 5% of Dr Brady’s thyroid nodule patients test positive for cancer
How relevant is what I don’t know won’t hurt me in thyroid cancer and biopsies of nodules?
BETHESDA system or the middle category, also known as indeterminate
For thyroid nodules that are indeterminate, historically a surgery would be performed 
With molecular testing, surgery can be decreased by up to 50%
Afirma molecular testing uses messenger RNA
If Afirma comes back suspicious it does NOT necessarily mean it is cancer

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Functional medicine

57: The Gut⎥Antibiotics Danger, Fixing Inflammation, and Thyroid Health, with Dr. Lisa Sardinia

Dr. Lisa Sardinia is an associate professor in the Pacific University Biology Department. In this episode we discuss:
Majority of antibiotics given to children under three are for upper respiratory issues, fact is antibiotics do not work for such issues
85% of antibiotics used are given to food sources, and released into the environment including soil and water
Danger of consuming emulsifiers
Cow’s milk
US has low gut diversity — more diversity means more resilience
Autism and gut connection
Resetting your gut microbiota by changing diet

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Functional medicine

56: Levothyroxine and Hair Loss⎥Thyroid Health, with Dr. Susanne Breen

In this episode, the following topics are discussed:
* Fatigue, hair loss, weight gain, anxiety, and depression.
* Sub-clinical hypothyroidism
* Standard range for TSH has changed over the years, .5 – 1.5 TSH is optimal
* Armour Thyroid vs Levothyroxine
* If antibodies are involved than it is most likely related to the gut
* Getting off thyroid medication
* Testing: TSH, free T3 T4, TPO antibodies, reverse T3
* Getting motivated and inspired by fixing thyroid
* Selenium
* Iodine
* Thyroid supplements
* Treating fertility

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Endocrine

55: Thyroid Cancer Treatment and Surgery Explained⎥Dr. Gerard Doherty from Harvard Medical School

* 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?

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