Doctor Interviews
79: 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
78: 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
77: 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
76: Hypothyroidism — Diagnosis, Treatment, and Medication with Dr. Leonard Wartofsky from MedStar
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
75: Thyroid Cancer Does Not Respond to RAI⎢Treatment Options
In this episode, topics include:
* Drug therapy for patients that fail standard therapy; including surgery and RAI
* Not all patients have same behavior for their cancer
* Some cancers are aggressive
* Not many thyroid cancer patients are affected by this; maybe a few thousand in the U.S., but not tens of thousands
* What is the treatment protocol for therapy?
* Lenvatinib or Sorafenib is the treatment for refectory thyroid cancer
* Lenvatinib tends to be more effective
* Sorafenib is tolerated by the patient better
* Other options to consider include, molecular profiling or some thyroid cancers carry mutation that is targetable, or BRAF
* BRAF inhibitors used with thyroid cancer patients
* Molecular profiling
* DNA sequencing
74: Thyroid and Pregnancy⎥Why It Matters, with Dr. Elizabeth Pearce from Boston University
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