What followed was six weeks of the worst waiting I have ever done. Six weeks of researching cancer treatments for a disease I did not have. Six weeks so frightening I didn’t tell my own parents. And the thing that makes me angriest, all these years later, is that a single sentence from any one of the people I saw during that stretch would have changed all of it.

Nobody said it. Not the doctor who found it. Not the radiologist who biopsied it. Not the specialist I saw afterward.

So this episode is that sentence, and everything that should come after it.

Welcome back to Save Your Thyroid with Jennifer Holkem. This is the space where we bridge the gap between the standard of care and the future of medicine. My mission is to empower you with the knowledge you need to walk into your next appointment understanding what is actually happening in your body — and what your options genuinely are.

🎧 In today’s episode, we’re covering:

• The number nobody hands you on day one — the actual statistical likelihood that your nodule is benign, according to the American Thyroid Association.

• What happens if it is cancer — why the most common type of thyroid cancer is also one of the slowest-growing and most treatable that exists.

• The fact that nodules are so common — and why most people who have one will never even know.

• The incidental finding — how most nodules are actually discovered, and why that makes the news land even harder.

• What your ultrasound is really measuring — risk features, not a diagnosis, and what TIRADS categories mean.

• The Bethesda system — what your biopsy result actually says, and how reliable a benign result is.

• The treatment menu most patients never see — active surveillance, radiofrequency ablation, microwave ablation, and other non-surgical options.

• My own nodule, and what I finally did about it — after years of being told my only options were surgery or nothing.

If you are sitting with a new diagnosis right now, or waiting on a biopsy result, or lying awake with a radiology report you can’t decipher — this episode is for you.

Jennifer Holkem · Founder of Save Your Thyroid

I am not a physician. I am a patient who has been through this, and who has spent years since then learning from some of the world’s leading experts in thyroid nodule treatment. I run a patient community of thousands of people navigating this exact diagnosis, I maintain a physician finder covering specialists in more than 50 countries, and I provide one-on-one patient navigation for people who feel lost in the process.

This episode is a solo one. There is no guest, because the information in it is the information I wish someone had simply sat down and told me on day one.

Six Weeks of Assuming the Worst

When the radiologist finished my biopsy, his exact words to me were: “Well, better get it taken out.”

That was the entire conversation. No context. No numbers. No sense of whether I should be planning a procedure or planning my life. I went home and started researching cancer treatment, because as far as I knew, that is what a thyroid nodule meant.

I called a friend who had just been through lymphoma treatment, hoping she could reassure me. She tried. But she didn’t know the statistics on thyroid nodules either — why would she? That wasn’t her diagnosis. And honestly, she sounded worried for me, which actually made it worse.

But my friend wasn’t the problem. The doctors were.

When my benign results finally came back and I sat down with an ENT, he was dismissive about it. His words were: “So what? You have a lump in your throat. We can take it out or leave it alone, whatever.” He never acknowledged that I had just spent six weeks terrified. When I asked why I had nodules in the first place, he didn’t have an answer, and didn’t seem to think the question mattered.

I never went back to him.

I tell you all of that because I now run a community with thousands of thyroid patients, and I watch that exact spiral happen to someone almost every week. They’re diagnosed, handed a referral, and left to fill in the blanks with fear and Google for weeks on end — because nobody hands them the actual odds.

The Question Nobody Seems to Ask Out Loud

Here is the question everyone actually wants answered but is almost afraid to ask their doctor directly: Is this going to kill me?

So let’s just answer it.

Somewhere between 90 and 95 out of every 100 thyroid nodules found are benign. That is not a hopeful guess. That is the statistical reality for the overwhelming majority of people reading this, according to the American Thyroid Association.

Sit with that for a second, especially if you are in the wait right now.

The most likely outcome — by an enormous margin — is that this turns out to be nothing that threatens your life.

Your fear is still valid. I am not asking you to feel calm. I am asking you to hold the fear and the number at the same time.

And If It Is Cancer

For the smaller group where it does turn out to be cancer, there is a second thing almost nobody tells you up front.

The most common type by far is papillary thyroid cancer, and papillary thyroid cancer is one of the slowest-growing and most treatable cancers that exists. More than 95% of adults diagnosed with it are alive at the five-year mark. When it’s caught while still confined to the thyroid, that number climbs even higher, according to data reported by major cancer centers.

Some doctors will tell you that if you had to choose a cancer diagnosis, this is the one you’d want to pick.

I want to be very careful here, because I am not saying that to minimize anyone’s diagnosis. Cancer is still the C-word. Your fear is real and it deserves to be taken seriously.

I’m saying it because panic causes people to make fast, fear-driven decisions — and this is a disease that almost always gives you time to make a good decision instead.

How You Probably Found Out

Let’s start with the fact that nodules are extraordinarily common in the first place.

By some estimates, if you scanned every adult’s neck with a high-resolution ultrasound, more than half would come back with a nodule somewhere in there. Some estimates go as high as 80%. Most people simply never find out, because many nodules never cause a symptom and never get looked for.

That’s usually how it happens, isn’t it? Rarely does someone find a lump and march into the doctor’s office. It’s the routine physical. The CT scan for back pain. The imaging after a car accident. And there it is — an incidental finding, or what we sometimes call an “incidentaloma.”

It’s one sentence buried in a radiology report that suddenly becomes the only sentence you can think about.

Reading the Report Nobody Explained to You

The first thing that happens after a nodule is found is usually an ultrasound.

Here’s what most people don’t realize: the ultrasound isn’t diagnosing cancer. It’s assessing risk features — size, shape, borders, and calcifications. Based on those features, radiologists sort nodules into risk categories, most commonly using something called the TIRADS system.

This is usually where people start feeling like they’re reading a foreign language. You get a report back with words like hypoechoic and irregular margins and numbers, and no one has explained what any of it means or how worried you should be.

That gap — between getting the report and actually understanding it — is where most of the anxiety lives.

If the risk features and size warrant it, the next step is usually a fine needle aspiration, a biopsy. A small needle sample is taken from the nodule, read by a pathologist, and sorted into what’s called a Bethesda category, numbered one through six. Bethesda II is benign. Bethesda VI is diagnostic of malignancy.

A benign result comes back in up to 80% of biopsies. And according to the American Thyroid Association, the risk of that benign result being wrong — of missing a cancer — is generally less than 3%, and even lower when the biopsy is reviewed by an experienced pathologist at a major medical center.

The biopsy day is usually the hardest day, honestly. Not because the procedure is painful — it’s actually quick — but because it’s when things start to get real. And then there’s a wait. Sometimes days. Sometimes over a week.

If you’re in that wait right now: I see you.

The Menu Nobody Showed You

This is the part I wish people knew on day one.

A thyroid nodule diagnosis — even certain cancer diagnoses — does not automatically mean surgery. It doesn’t mean losing your thyroid. It doesn’t mean a scar, a lifetime of thyroid hormone replacement, and a recovery you didn’t choose.

Depending on the size, the Bethesda category, your symptoms, and how the nodule is behaving, treatment options can include active surveillance — monitoring with regular ultrasounds and doing nothing else unless something changes. For nodules causing symptoms or growth, there are minimally invasive non-surgical treatments like radiofrequency ablation, microwave ablation, and other ablation techniques, where a probe destroys the nodule through the skin with no incision, done on an outpatient basis, and you are home the same day.

These aren’t fringe experimental treatments. Ablation techniques have been used and refined internationally for years and are increasingly available in the US at centers with physicians trained specifically in these procedures. The American Thyroid Association itself has published formal guidance on the safe performance and training standards for thyroid ablation. That’s how firmly it has become part of mainstream, recognized care. There is also a billing code for insurance.

Not everyone qualifies for every option. Your case is genuinely your case, and none of this is a substitute for your own physician’s read on your scans. But too many people are told “thyroid nodule” and immediately assume or are told that surgery is the only road — when for a large number of people, it simply isn’t the only road anymore, and oftentimes shouldn’t be.

What Happened to My Nodule

This part isn’t secondhand for me.

That nodule from my own diagnosis — the one the ENT shrugged off — didn’t stay small. Over the next few years and through a pregnancy, it grew. By the time I finally acted, it measured roughly 4.5 by 7 centimeters, around 65 to 75 milliliters in volume.

I was living with daily trouble breathing. Trouble swallowing. Choking on food. Being unable to lie flat at night. Waking up choking. Dizziness when I turned my head. Exhaustion — and what I’d later learn was actual hypoxia, my body not getting enough oxygen.

I used to describe my quality of life during that stretch as being in the garbage.

The tipping point came after an allergic reaction to antibiotics, which caused the nodule to hemorrhage internally and nearly double in size overnight. That’s when I finally went looking for something other than “take it out or leave it alone.”

That’s how I found radiofrequency ablation.

I had the procedure. I went home the same day. Within a week, my quality of life had already improved dramatically. Over the following months, as the nodule gradually shrank — ultimately by 90% — everything kept getting better. My thyroid stayed intact. My raspy voice improved.

The procedure changed my life. It is the reason I do this.

And I’ve since talked to people with nodules much larger than mine who’ve had the same outcome. This isn’t a fluke. It’s minimally invasive medical innovation, and it is available now.

Watch my first YouTube video here to hear more about my decision to pursue thyroid RFA.

Here’s my full story from the beginning to a few years after treatment.

Final Thoughts

Here’s the honest, full picture stitched back together.

Most thyroid nodules are benign. Of the cancers that are found, the most common type is one of the slowest-growing and most treatable that exists. And even when treatment is needed, surgery is one option on a much longer menu — not the automatic default.

None of that erases the fear of hearing “we found something.” But replacing that fear with facts can be liberating. It’s okay to be scared. But you should know the odds are genuinely in your favor.

If you’re sitting with a new diagnosis right now, you don’t have to figure out the next step by yourself at 2 a.m. with Google. That’s exactly why the Save Your Thyroid community exists — a place built by and for people who have walked this exact path, and a community physicians themselves respect and refer patients to.

I built it because I needed it, and it didn’t exist yet. Now it does. Come join us.

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

[Click the thumbnail above to watch on YouTube!]

Save Your Thyroid with Jennifer Holkem is now available on all major podcast platforms!

To find your favorite way to listen, visit my website, SaveYourThyroidwithJen.com!

Podcast

Key Takeaways from Episode 126:

1. Between 90 and 95 out of every 100 thyroid nodules are benign.
This is the American Thyroid Association’s figure, not an optimistic estimate. For the overwhelming majority of people who receive this diagnosis, the nodule is not a threat to their life.

2. Papillary thyroid cancer is one of the most treatable cancers that exists.
It’s the most common type of thyroid cancer by far, and among the slowest-growing. More than 95% of adults diagnosed are alive at five years, with better outcomes still when it’s confined to the thyroid.

3. Thyroid nodules are extremely common.
More than half of adults would show a nodule on a high-resolution ultrasound, with some estimates as high as 80%. Most people never find out, because most nodules never cause symptoms.

4. Your ultrasound is assessing risk, not diagnosing cancer.
It’s evaluating size, shape, borders, and calcifications, then sorting the nodule into a TIRADS risk category. That report is a risk estimate, not a verdict.

5. A benign biopsy result is highly reliable.
Up to 80% of biopsies return benign, and per the ATA, the chance that result is wrong is generally under 3% — lower still when reviewed by an experienced pathologist at a major medical center.

6. A nodule diagnosis does not automatically mean surgery.
Depending on size, Bethesda category, symptoms, and behavior, options can include active surveillance or minimally invasive ablation. Surgery is one option among several, not a foregone conclusion.

7. Ablation is recognized, mainstream care.
Radiofrequency and microwave ablation have been used and refined internationally for years. The ATA has published formal guidance on safe performance and training standards, and there is an insurance billing code.

8. Panic is the real enemy of a good decision.
This is a diagnosis that almost always gives you time — time to research, to get a second opinion, to understand your options. Use that time rather than deciding in the surgeon’s office.

Sources:

• Large study confirms the 2015 ATA guidelines for classifying small thyroid nodules on ultrasound — Clinical Thyroidology for the Public, Dec 2017

• Clinical Thyroidology for the Public, December 2017 issue index

• Is it appropriate to refer to thyroid cancer as the “good cancer”?

• General Principles for the Safe Performance, Training, and Adoption of Ablation Techniques for Benign Thyroid Nodules: An ATA Statement — Thyroid 2023

• ATA press release: ablation techniques statement

• ATA ablation statement — free full text (PMC)

• Thyroid nodule — MedlinePlus Medical Encyclopedia

• Fine needle aspiration of the thyroid — MedlinePlus

• Thyroid ultrasound — MedlinePlus

• Thyroid cancer — MedlinePlus

For more updates like this, and to explore non-surgical thyroid nodule treatments like RFA, TAE, MWA, and nsPFA, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my website:
👉 SaveYourThyroidwithJen.com

There, you can also sign up for personalized one-on-one patient navigation — because no one should feel alone on their thyroid journey.

Please consider supporting my work. Every donation is sincerely appreciated!

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Disclaimer: None of the statements made in this or any other blog/video/podcast by Jennifer Holkem should be considered medical advice.

Dr. Melanie Goldfarb is an endocrine surgeon. She operates on thyroids for a living. She performs lobectomies and total thyroidectomies. And she also offers in-office RFA — one of the first physicians on the West Coast to do so. She built her entire practice around a single guiding principle: personalized medicine. Give patients options. Let them decide.

And when I asked her what she wishes every thyroid cancer patient could hear before sitting down in a surgeon’s office, she said two things:

This is not urgent.

And we are going to do what is best for you.

Welcome back to Save Your Thyroid with Jennifer Holkem. This is the space where we bridge the gap between the standard of care and what’s actually possible. My mission is to empower you with the knowledge you need to make a truly informed decision — whatever that decision turns out to be.

Dr. Goldfarb is a fellowship-trained endocrine surgeon, Professor of Surgery, and Director of the Center for Endocrine Tumors and Disorders at St. John’s Cancer Institute in Santa Monica, California. She also serves as Medical Director for Cancer Survivorship. She is a researcher in clinical outcomes, secondary malignancies, and the psychosocial needs of adolescent and young adult thyroid cancer patients. She is, in every sense of the phrase, a patient advocate who happens to also be a surgeon.

🎧 In today’s episode, we’re covering:

• What realistic RFA outcomes actually look like — why 50% volume reduction is the published definition of success, why she aims for 70-80%, and how nodule size determines how many sessions you’ll need

• The goiter vs. nodule distinction that changes your treatment options entirely — and why so many patients are confused about which one they have

• Thyroid cancer and ablation — who is actually a candidate, and the 120% concept that explains why location is everything

• The lobectomy + RFA combination — a thinking-outside-the-box approach that removes the dominant side surgically while preserving the other with ablation

• When proactive treatment makes sense — why Dr. Goldfarb draws her line at 3-3.5 centimeters, and why serial ultrasounds showing growth are an automatic reason to act

• Active surveillance is a treatment — how she counsels anxious patients and why choosing to watch is a conscious medical decision, not inaction

• Why thyroid cancer is almost never urgent — and what that means for patients who feel rushed by their surgical consult

• The future — tumor typing, non-invasive technologies, and why she answered “non-invasive” when I asked her to describe the future of thyroid cancer treatment in one word

Dr. Melanie Goldfarb, Endocrine Surgeon · St. John’s Cancer Institute

Dr. Goldfarb is a fellowship-trained endocrine surgeon, Professor of Surgery, and Director of the Center for Endocrine Tumors and Disorders at St. John’s Cancer Institute in Santa Monica, California. As one of the first physicians on the West Coast to offer in-office RFA, she brings a uniquely unbiased perspective — she performs surgery AND ablation, which means her recommendation reflects what’s right for each individual patient rather than the limits of what she’s able to offer.

What Realistic RFA Outcomes Actually Look Like

One of the most important things Dr. Goldfarb does at the beginning of every patient conversation is set expectations honestly. And the honest truth about RFA outcomes is more nuanced than most patients realize.

The published definition of success is 50% volume reduction. Dr. Goldfarb says she achieves that 90-95% of the time. But she also acknowledges that 50% reduction doesn’t relieve symptoms for every patient — which is why she personally aims for 70-80%, and achieves that most of the time.

For nodule size, her framework is straightforward. Under 4 to 4.5 centimeters — one session should be enough. Over six centimeters — you’ll need more than one. Between those numbers, it depends on how you respond and what’s bothering you. And for the really large nodules — she’s done many of them — sometimes three or four sessions are needed.

The critical caveat she gives every patient:

“I am not getting rid of this. I am making it smaller and I will help your symptoms. But we are not getting rid of it.”

That honesty is part of what makes her approach so effective. Patients who understand what they’re signing up for make better decisions and have better outcomes.

One open research question she raised that I found genuinely fascinating: the role of the immune system in how well a patient responds to RFA. The immune system does the cleanup work after ablation — carrying away dead tissue over time. Whether an individual patient’s immune profile predicts their volume reduction outcome is something no one has fully studied yet. She’s ready to set up clinical trials. So am I.

Goiter vs. Nodule — Why It Matters More Than You Think

Dr. Goldfarb said she has this conversation with every other patient who comes in — because someone has told them they have a goiter when they actually have a nodule, or vice versa, and they’ve been given completely wrong information about their treatment options as a result.

A goiter is overgrowth of the entire thyroid gland. There are no distinct demarcations of individual growths — it’s just diffuse enlargement. Thermal ablation is not designed for goiters. There are practitioners who do it, but it’s not what the procedure was built for. The better option for large goiters is thyroid artery embolization.

A nodule is a delineated, distinct growth inside the thyroid. You can see it clearly on ultrasound — it has edges, borders, a defined mass. Thermal ablation kills the tissue within that nodule, and the body carries away the dead tissue over time, shrinking it.

The distinction matters enormously because it determines what treatment is even applicable to you. If you’ve been told you have a goiter and you’re wondering why your RFA consultation went sideways, this may be why.

Thyroid Cancer and Ablation — The 120% Concept

The candidates for thyroid cancer ablation are the same patients who are candidates for active surveillance. Papillary thyroid microcarcinoma — under one centimeter, fully contained within the thyroid, not abutting the trachea, not in a dangerous posterior position near the nerve. For those patients, either active surveillance or thermal ablation is a reasonable option.

The fundamental difference between treating a benign nodule and treating a cancer with ablation is the goal. With a benign nodule, the goal is volume reduction — getting it 70, 80% smaller to relieve symptoms. You’re not trying to get the whole thing. With a cancer, you need 120%. You need the entire tumor plus a margin of surrounding tissue.

“That’s why I say 120%,” Dr. Goldfarb explained. “You don’t just want what’s inside. You want the borders and a little bit outside. If we’re going to do this correctly.”

That’s also why location is everything for cancer ablation. A tiny cancer near the recurrent laryngeal nerve or the trachea may be impossible to treat with that required margin. Which is why the candidates for cancer ablation are specifically those whose tumor location allows for complete treatment without collateral damage.

One more thing worth noting: right after ablation for cancer, the treated area may actually look bigger on the first ultrasound. That’s because you’ve ablated the tumor plus the surrounding margin — so there’s more treated tissue than there was original tumor. It should start shrinking from there. She warns every patient not to panic when the local radiologist sends a report saying it looks bad — because local radiologists often don’t know what post-ablation tissue is supposed to look like. I know this firsthand. My local ENT absolutely flipped after seeing my post-RFA ultrasound. This is one of the biggest education gaps in the field right now.

The Lobectomy + RFA Combination — Saving Half a Thyroid

Dr. Goldfarb has been offering a combination approach for about two years: lobectomy on the dominant side, followed by RFA on the remaining side. It’s for patients who have one side that is just too large, too symptomatic, or too dominant to responsibly address with ablation alone — but who desperately want to preserve something.

Remove the dominant side surgically — get the relief immediately. And then use RFA to address the remaining nodules on the other side over time, preserving as much thyroid function as possible.

After a lobectomy, about 30% of patients end up needing some thyroid medication — but it’s not the full replacement dose that comes with a total thyroidectomy, and many patients whose thyroid was functioning normally before won’t need anything at all. Protecting that remaining lobe matters.

She hasn’t seen published papers on this combination approach — but she’s confident others like her are doing it, because it simply makes sense. For the many patients I see in navigation consults who had a lobectomy years ago and now have growing nodules on their remaining lobe, this is an incredibly relevant conversation to be having with their physician.

Proactive Treatment — Where the Line Is

Dr. Goldfarb draws her personal line at 3 to 3.5 centimeters. At that size, she’ll bring it up as an option even if the patient isn’t symptomatic. Not pushing — just offering. Because if it gets much bigger, the conversation becomes more complicated and the outcomes less dramatic.

Her clearest guidance: serial ultrasounds showing consistent growth are an automatic reason to act. That’s not a slippery slope — that’s data. The nodule is telling you something, and treating it proactively while it’s still manageable is almost always better than waiting until it’s causing serious symptoms.

The slippery slope she’s wary of is practitioners who recommend ablation for every nodule that shows up on an ultrasound regardless of size. As Dr. Tufano has said on this podcast — just because it’s there doesn’t mean we have to treat it. The procedure is not without cost, discomfort, or time. It should be reserved for nodules that actually warrant it.

Active Surveillance — Why Watching IS a Treatment

For anxious thyroid cancer patients who don’t want surgery but also can’t emotionally tolerate watching a cancer, Dr. Goldfarb has a specific way of framing active surveillance that I want every patient in this community to hear.

Active surveillance is not inaction. It is a conscious medical decision made after reviewing all the information, with a physician who has evaluated your specific case and determined that monitoring is appropriate. It is doing something. It is choosing the right intervention — which in this case is thoughtful, structured observation rather than procedure.

For patients who are ridiculously anxious — her words — who will lose sleep over knowing they have a cancer that isn’t being treated, she acknowledges that active surveillance may not be the right choice for them. Their anxiety is itself a clinical variable. In that case, ablation or surgery may be more appropriate — not because the cancer demands it, but because the patient’s quality of life does.

And here’s the data that should reassure every patient on active surveillance: even if a tiny thyroid cancer grows during the surveillance period, or even if ablation doesn’t fully resolve it, your long-term prognosis is no different than if you had treated it immediately. You have not lost anything. The window for excellent outcomes does not close in six months.

This Is Not Urgent

I want to close with this because it’s the thing I most want every thyroid cancer patient to hear.

When a surgeon schedules you for surgery before you leave the consultation, that is not necessarily a signal that your cancer is emergent. It is often simply how surgical practices manage their schedules. Surgeons are busy. Operating rooms require lead time. Getting on the calendar while you’re there is efficient — it is not clinical urgency.

There is such a rare scenario that thyroid cancer actually requires urgent surgery that Dr. Goldfarb uses that word — rare — when describing it. Even for cancers that genuinely need to be removed, she tells patients: we have time. Let’s do this on your schedule. Nothing is going to change in the next couple of months.

For the tiny cancers where active surveillance or ablation is appropriate, the timeline is even more generous. Six months. A year. Three years. None of it changes your prognosis.

“I wish a lot more people told their patients this,” she said.

So do I.

Final Thoughts

I asked Dr. Goldfarb to describe the future of thyroid cancer treatment in one word.

She said: “Non-invasive.”

That’s where we’re going. Tumor typing that tells us in advance which cancers will behave aggressively and which will never hurt anyone. Non-thermal technologies that don’t even require a needle. Thyroid embolization for large goiters. And eventually, perhaps, a way to influence how well a patient’s immune system responds to ablation.

The future is coming. And physicians like Dr. Goldfarb — surgeons who offer ablation, who don’t care which treatment a patient chooses as long as it’s the right one for them — are exactly the people leading us there.

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

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Key Takeaways from my episode with Dr. Melanie Goldfarb:

1. Thyroid cancer is almost never urgent
Even cancer that needs surgery can wait weeks to months. Nothing changes in that time. The rare scenario where thyroid cancer is truly emergent is exactly that — rare. You have time to think, research, and decide.

2. 50% volume reduction is success — but she aims for 70-80%
Nodules under 4 to 4.5 centimeters typically need one RFA session. Larger nodules may need more. Setting realistic expectations from the start leads to better outcomes.

3. Goiter ≠ nodule
Thermal ablation is designed for nodules, not goiters. Knowing which one you have changes your treatment options entirely. Thyroid artery embolization is the better tool for goiters.

4. Cancer ablation requires 120%
For benign nodules the goal is volume reduction. For cancer, you need the entire tumor plus a margin. Location determines whether that’s achievable — which is why candidacy for cancer ablation is specific and selective.

5. The lobectomy + RFA combination saves half a thyroid
Remove the dominant side surgically for immediate relief. Use RFA on the remaining side to preserve thyroid function. An innovative approach for complex multinodular cases that deserves wider awareness.

6. Serial ultrasounds showing growth = automatic reason to act
Proactive treatment at 3 to 3.5 centimeters makes sense. But not every nodule that exists needs to be treated. The growth trend is the signal.

7. Active surveillance is a treatment
Watching is a conscious medical decision — not inaction. And for tiny thyroid cancers, the long-term prognosis is no different whether you treat immediately or monitor first.

8. The future is non-invasive
Tumor typing, non-thermal technologies, thyroid embolization — the field is moving fast. Dr. Goldfarb described the future of thyroid cancer treatment in one word: non-invasive.

For more updates like this, and to explore non-surgical thyroid nodule treatments like RFA, TAE, MWA, and nsPFA, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my website:
👉 SaveYourThyroidwithJen.com

There, you can also sign up for personalized one-on-one patient navigation — because no one should feel alone on their thyroid journey.

Connect with Dr. Melanie Goldfarb:
🔗 St. John’s Cancer Institute — Endocrine Surgery
Telehealth consultations available via Zoom.

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

Andy Manos, PA-C is working to change that path — starting at his community clinic.

As a physician assistant and VP of Internal Growth at North Star Vascular Interventional in Minneapolis, Andy performs thyroid radiofrequency ablation in a community-based interventional radiology clinic. No hospital required. No general anesthesia. Same day in, same day out. And in a field that has historically been housed in the basement of academic medical centers, that distinction matters enormously.

In Episode 124 of Save Your Thyroid with Jennifer Holkem, Andy joins me to talk about how he found his way into this work, what interventional radiology actually is, why patients aren’t being told about nonsurgical options, and what a single question can do to change the entire direction of a thyroid consultation.

Welcome back to Save Your Thyroid with Jennifer Holkem. This is the space where we bridge the gap between the standard of care and the future of medicine. My mission is to empower you with the knowledge you need to avoid unnecessary surgery and keep your thyroid intact for the long haul.

🎧 In today’s episode, we’re covering:

• How interventional radiology is reinventing itself — and why that’s directly good news for thyroid patients who’ve been told their only options are watch it or remove it

• Why patients aren’t being told about nonsurgical options — including the financial realities that can push physicians toward surgery over ablation

• The one question that changes everything — five words that can open a real conversation about ablation even with a physician who doesn’t offer it

• How thyroid artery embolization actually works — explained through the best water balloon analogy you’ve ever heard

• Which nodules TAE is best suited for — including the sub-sternal goiter that makes surgeons nervous and interventional radiology shine

• The nerve risk misconception — why the research shows RFA and surgery carry similar risks to the recurrent laryngeal nerve

• How AI and the internet are becoming legitimate patient advocacy tools — and why Andy Manos is actively feeding them the right information

• Why organ preservation is a movement, not a trend — and how it’s accelerating across thyroid, uterus, and prostate care simultaneously

Whether you’ve just been diagnosed with a thyroid nodule, been offered only surgery or watchful waiting, or simply want to understand what interventional radiology can do that other specialties can’t — this episode is for you.

How Andy Manos Became the Thyroid Ablation Guy

Andy’s path into thyroid ablation started with a mentor — Dr. Jafar Golzarian, a pioneer in interventional radiology and the first physician in the US to perform prostate artery embolization in 2012. When Dr. Golzarian began building North Star Vascular Interventional outside the University of Minnesota hospital system, he invited Andy to come build it with him.

The idea was simple but radical: bring the kind of organ-preserving, minimally invasive care that had previously only been available inside academic medical centers directly to the community. Closer to where patients live. Without the complexity of navigating a hospital system. Without paying to park downtown.

Andy attended his first thyroid ablation conference shortly after and felt immediately at home.

“Everyone was aligned on providing an alternative that no one really knew about. And I just became very passionate.”

The patient follow-ups are what keep him going. Patients walking in and saying they can tell the nodule is gone. That all their symptoms have resolved. That they feel like themselves again. For Andy, that’s the whole point.

What Interventional Radiology Actually Is

Most people have never heard of interventional radiology — and until recently, that was by design. For years, IR existed as a wing of radiology, operating in the background, performing procedures based on orders from other physicians without much patient-facing visibility.

That’s changing fast.

“Interventional radiology used to be in the basement reading images. Now we’re in clinic, seeing patients, doing follow-up. The specialty has completely reinvented itself.”

What IR does, at its core, is use imaging — ultrasound, X-ray, CT — to guide a needle or catheter to the right place inside the body and perform a therapeutic procedure. No large incisions. No general anesthesia in most cases. A band-aid at the end. Back to work the same day or shortly after.

For thyroid patients specifically, that means Andy can evaluate you in clinic, perform a radiofrequency ablation procedure, follow up with you at six months and a year, and track your outcomes — all outside the walls of a hospital. That clinical presence, that continuity of care, is what IR has been building toward — and it’s directly good news for patients who’ve been told their only options are watch it or remove it.

Why Patients Aren’t Being Told About Nonsurgical Options

This is the conversation most clinicians won’t have out loud. Andy had it anyway.

When a patient comes to a surgeon’s office with a symptomatic thyroid nodule, the surgeon’s algorithm is often simple: watch it or remove it. Not because nonsurgical options don’t exist — they do, and the evidence for them is strong — but because of a combination of factors that have nothing to do with the patient’s best interest.

Some of it is awareness. Thyroid nodules may represent a small percentage of a surgeon’s practice. They haven’t been to the conferences. They haven’t read the papers. They don’t know who to refer to.

And some of it, Andy acknowledges candidly, is financial.

“The financial incentive to do surgery is real. It is a thing. And I think patients should know that.”

A surgeon who can do four ablations in clinic in a day and get paid less per case than they would taking those same four patients to the operating room faces a real economic tension. That doesn’t make them a bad physician. But it’s a structural reality that patients deserve to understand when they’re evaluating why they haven’t been offered all their options.

Andy’s goal — and the goal of North Star Vascular — is not to take patients away from surgeons. It’s to make sure patients know they have a choice.

“We’re not trying to take patients from surgeons. We’re trying to make sure patients know they have a choice.”

The One Question That Changes Everything

If you’ve been offered only surgery or watchful waiting and you want to know if there’s another option — Andy has a very specific piece of advice.

Ask five words: “Is there any other option?”

That’s it. That’s the question that breaks a physician out of the routine thyroid nodule visit and into a real conversation. It might get you a referral to someone who does RFA. It might get you the name of a clinic. It might get you an honest “I’ve heard of it but I don’t do it — let me find out who does.”

Any of those answers is progress.

“You’re not being difficult. You’re just being informed. And you’re not going to offend anyone.”

Andy acknowledges it feels uncomfortable. It takes a moment of courage. But he says patients are almost always surprised by the response — because most physicians, even those who don’t offer ablation, are willing to have that conversation once a patient opens the door.

And if your physician doesn’t know where to point you — that’s exactly what saveyourthyroid.org exists for. Go to the top of the page, click Find a Physician, and you’ll find a free, unsponsored list of physicians in the US and abroad who perform thyroid RFA, TAE, and other nonsurgical thyroid procedures.

Thyroid Artery Embolization — The Option for the Nodules Others Can’t Treat

Most people who’ve been following this community have heard of RFA. Fewer have heard of thyroid artery embolization — and even fewer understand how it works.

Andy explained it better than I’ve ever heard it explained before, using an analogy involving a water balloon, a garden hose, and a Costco run.

That’s what Dr. Astani does at North Star Vascular — and it’s exactly why TAE is the treatment of choice for one of the most challenging presentations in thyroid care: the sub-sternal goiter.

A sub-sternal goiter is a thyroid growth that dives beneath the collarbone — sometimes deep into the chest, pressing on nerves, compressing blood vessels, causing symptoms that seem unrelated to the thyroid until someone finally finds the source. Surgeons don’t want to touch these cases. The surgical approach often requires cracking the sternum. Recovery is long and complex.

TAE doesn’t need to reach the nodule directly. It simply cuts off the supply. And for a nodule that’s essentially unreachable any other way, that’s not just a good option — it’s sometimes the only one.

“The sub-sternal goiter is where IR really shines. It’s the nodule that makes surgeons nervous and it’s exactly what TAE was built for.”

What About the Nerve Risk?

One of the most common reasons patients are steered away from RFA by physicians who don’t perform it is the concern about the recurrent laryngeal nerve — the nerve that controls the vocal cords. The implication is that RFA is riskier than surgery for this critical structure.

Andy addressed this directly.

The research shows the risk to the recurrent laryngeal nerve is very similar between RFA and thyroid surgery. It is not meaningfully higher with ablation. The misconception that RFA carries a greater nerve risk than surgery is not supported by the published evidence.

If a physician has told you that surgery is generally safer for the nerve than RFA — it’s worth asking them to point you to the research that supports that claim.

AI and the Internet Are Your Friends

Andy spends time actively feeding AI platforms accurate information about thyroid ablation so that when patients search for alternatives to thyroid surgery, they find real, helpful answers.

“I go on ChatGPT acting like I don’t know what I’m asking — and it feeds me back a lot of my own content. I’m like, good. It’s learning.”

This is patient advocacy in 2026. If your physician doesn’t mention ablation, ChatGPT, Google, and saveyourthyroid.org are all legitimate starting points. The information is out there. And it’s getting better.

The Organ-Preserving Movement Is Bigger Than the Thyroid

One of the things I find most exciting about Andy’s perspective is how he situates thyroid care within a much broader shift in medicine.

The same innovation that brought RFA and TAE to thyroid patients brought uterine fibroid embolization to women who had been told a hysterectomy was their only option. It brought prostate artery embolization to men managing enlarged prostates without surgery. It’s bringing focal therapy to prostate cancer patients who don’t want to sacrifice function.

Across specialty after specialty, the movement is the same: treat the disease without sacrificing the organ.

“Organ preservation is not a trend. It’s a movement. And it’s happening across thyroid, uterus, prostate — everywhere.”

Your thyroid is not expendable. And the movement to prove that — clinically, procedurally, and at the community level — is only accelerating.

How to Find Andy and North Star Vascular

If you’re in or near Minneapolis, or if you’re considering traveling for TAE or thyroid RFA, you can find Andy and the team at northstarir.com. North Star Vascular Interventional is also on social media (Facebook, Instagram).

For a broader list of physicians performing nonsurgical thyroid procedures across the US and abroad, visit saveyourthyroid.org and click FIND A PHYSICIAN at the top of the page. And be sure to check out our new physician map! Free, unsponsored, and updated regularly.

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

[Click the thumbnail above to watch on YouTube!]

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

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Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

Key Takeaways from Episode 124:

1. IR is reinventing itself
Interventional radiology is no longer a behind-the-scenes specialty. It’s building clinical practices, seeing patients, and delivering organ-preserving care directly to communities that previously had no access.

2. You’re not being difficult — you’re being informed
Ask your physician: “Is there any other option?” That one question can open the door to a conversation about ablation — even with a physician who doesn’t offer it.

3. TAE is made for the nodules others can’t treat
Sub-sternal goiters that dive beneath the collarbone are the perfect application for thyroid artery embolization — and exactly the cases where surgical risk is highest.

4. The financial incentives are real
Understanding the economic structure of surgical practice helps patients advocate more effectively for a comprehensive evaluation of all their options.

5. RFA and surgery carry similar nerve risks
The research shows the risk to the recurrent laryngeal nerve is very similar between RFA and thyroid surgery. The misconception that surgery is safer for the nerve is not supported by the published evidence.

6. AI and the internet are legitimate starting points
If your physician doesn’t know about ablation, ChatGPT, Google, and saveyourthyroid.org are all valid tools for finding out what else is available.

7. Organ preservation is a movement
What’s happening in thyroid care is part of a much larger shift across multiple specialties — one that is accelerating and winning.

For more updates like this, and to explore non-surgical thyroid nodule treatments like RFA, TAE, MWA, and nsPFA, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my website:
👉 SaveYourThyroidwithJen.com

There, you can also sign up for personalized one-on-one patient navigation — because no one should feel alone on their thyroid journey.

Connect with Andy Manos and North Star Vascular Interventional:
🔗 northstarir.com

Find a physician near you:
🔗 saveyourthyroid.org

Book a patient navigation consult:
🔗 saveyourthyroidwithjen.com/p/patient-navigation-services

Please consider supporting my work. Every donation is sincerely appreciated!

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Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

The answer, more often than not, is no. They didn’t know what it was. Their doctor didn’t offer it. Or they were already booked for surgery before anyone mentioned it existed.

That conversation is the reason I wanted to record this episode.

Dr. Joshua Klopper is the Medical Director for Endocrinology at Veracyte — and before you read another word, I want to be transparent: he works for the company that makes the Afirma test we’re discussing today. He disclosed that clearly himself in our conversation, and I think it’s important you hear that upfront. With that said, the data behind this technology stands on its own, and he is one of the most knowledgeable people in the country when it comes to explaining what it means for patients.

He was an investigator on the original clinical study that validated the Afirma Genomic Sequencing Classifier. He served on the board of the American Thyroid Association. He spent two decades at the University of Colorado School of Medicine and Kaiser Permanente in Colorado, managing thyroid nodules and thyroid cancer before joining Veracyte.

And in Episode 123, he explained molecular testing in a way I have genuinely never heard it explained before — clearly, honestly, and in language that every patient in this community can understand.

Welcome back to Save Your Thyroid with Jennifer Holkem. This is the space where we bridge the gap between the standard of care and the future of medicine. My mission is to empower you with the knowledge you need to avoid unnecessary surgery and keep your thyroid intact for the long haul.

If you have ever received an indeterminate thyroid biopsy result — Bethesda 3 or Bethesda 4 — this episode was made for you.

🎧 In today’s episode, we’re covering:

• The Bethesda classification — what each category actually means and why the middle categories create so much anxiety

• The human cost of unnecessary surgery — why 70% of thyroid surgeries for indeterminate nodules revealed benign tissue, and what that means for patients who went through them

• How the Afirma test actually works — why it was designed to find the good stuff, not the bad, and what that means for how to interpret a result

• A benign result — what the 96% negative predictive value actually means in plain language

• A suspicious result — why it doesn’t automatically mean cancer and what specific mutations tell us about risk

• The 800-patient multicenter study — the independent research from Brigham and Women’s, UCLA, and University of Nebraska that confirmed Afirma benign nodules behave just like cytologically benign nodules over time

• Why it is almost always safe to take a pause — before agreeing to any surgery for an indeterminate nodule

• Where this technology is heading — including ablation for molecularly benign nodules and better prognostic tools for suspicious results

Dr. Joshua Klopper, Medical Director for Endocrinology, Veracyte

Today’s guest is Dr. Joshua Klopper, a nationally recognized endocrinologist who has spent over two decades specializing in thyroid nodules and thyroid cancer. He was a faculty member in the endocrinology division at the University of Colorado School of Medicine, served as a regional service chief for Kaiser Permanente in Colorado, served on the board of the American Thyroid Association, and was an investigator on the original clinical study validating the Afirma Genomic Sequencing Classifier. He is now Medical Director for Endocrinology at Veracyte.

Disclosure: Dr. Klopper is an employee of Veracyte, maker of the Afirma Genomic Sequencing Classifier discussed in this episode.

What an Indeterminate Result Actually Means

When a thyroid biopsy comes back as Bethesda 3 or Bethesda 4, it means the cytopathologist — the physician trained to read these cell samples — cannot confidently classify what they see as benign or cancerous. It’s not benign. It’s not cancer. It’s somewhere in the middle.

If you take all comers nationally, that gray zone carries approximately a 25% risk of cancer. Which means roughly 75% of those nodules are benign.

For decades, most patients in this category went to surgery to get a definitive answer. The surgeon would remove half or all of the thyroid, a pathologist would examine the tissue, and then the final call would come back. And when it did, more than 70% of the time the answer was benign.

As Dr. Klopper put it: the good news was benign. But the patient didn’t have their thyroid anymore.

That is the problem molecular testing was designed to solve.

How the Afirma Test Was Designed

The founding insight behind Afirma was a question that sounds simple but was genuinely innovative at the time: instead of trying to find the cancer, what if we focused on finding the benign?

Most diagnostic medicine is trained to identify what’s wrong. The cytopathologist learns normal so they can recognize abnormal, and then focuses on the abnormal. The founders of Veracyte flipped that. If the majority of indeterminate nodules are benign, and the goal is to avoid unnecessary surgery, then build a test that is extremely good at identifying benign tissue.

The way the test works at a high level: RNA — not DNA — is extracted from the biopsy sample. RNA is closer to the final cellular phenotype than DNA, which makes it a better target for this kind of classification. Over 21,000 genes are sequenced. Machine learning algorithms evaluate the differential gene expression patterns. And the result comes back as one of two things: benign, or suspicious.

Two-thirds of results nationally come back as benign.

And when the result is benign, the negative predictive value is 96%. That means if you get a benign result from Afirma, your risk of that nodule actually being cancer is approximately 4% — the same risk as if a cytopathologist had looked at the original biopsy and called it benign the first time.

That is the whole value proposition. You went from a 25% risk of cancer to a 4% risk. Without surgery.

What a “Rule Out” Test Means — and Why It Matters

Dr. Klopper explained something in this episode that I found genuinely clarifying — the concept of a rule-out test.

It seems counterintuitive that a test designed to identify benign tissue would be built by making it extremely sensitive to cancer. But that’s exactly how it works. If a test is highly sensitive to cancer, then when it comes back negative — when it doesn’t see cancer — you can trust that result. High sensitivity equals high negative predictive value when the result is negative.

The trade-off is false positives. Because the test is trained to flag anything that looks remotely suspicious, some nodules that are actually benign will come back as suspicious on the molecular test. That’s the limitation. And it’s what the ongoing research is working to address.

But for the two-thirds of patients who get a benign result? The data is very convincing.

The 800-Patient Study

One of the most important pieces of evidence discussed in this episode is an independent multicenter study — conducted at Brigham and Women’s Hospital, UCLA, and the University of Nebraska — that followed patients with Afirma benign results over time to see what actually happened.

The study: Outcomes of Cytologically Indeterminate Thyroid Nodules Managed With Genomic Sequencing Classifier
Read it here: https://pubmed.ncbi.nlm.nih.gov/38415829/

The findings were reassuring. The majority of patients had no change in their nodule. Of the nodules that grew, only a handful went to surgery and very few were found to be malignant. The overall malignancy rate — assuming all unoperated nodules were true negatives — was less than 4%.

The median follow-up was two years — not the 10 or 20 years that would be most satisfying, Dr. Klopper acknowledged, but meaningful. And the growth behavior of Afirma benign nodules closely mirrored what you would expect from cytologically benign nodules.

That is the durability question being answered. An Afirma benign result isn’t just reassuring right now. It appears to behave like a benign result over time.

What a Suspicious Result Means

For the one-third of patients whose Afirma result comes back suspicious — it’s important to understand what that actually means.

It doesn’t mean cancer. It means the test cannot confidently rule cancer out.

Based on the validation study, a suspicious Afirma result carries approximately a 50% risk of malignancy. In real-world data and meta-analyses, that rises closer to 65%. So you’ve roughly doubled the risk from the baseline indeterminate result — but you still don’t have a definitive answer.

When the result is suspicious, additional mutation data is reported if detected. Specific mutations like BRAF V600E carry a 95%+ risk of cancer — essentially a papillary thyroid cancer diagnosis. But BRAF is actually rare in indeterminate cytology because it tends to produce obvious cytology that’s called Bethesda 5 or 6 in the first place. More commonly, indeterminate nodules carry RAS-like mutations, which shift the risk to somewhere around 50-75%.

And here’s the point Dr. Klopper made that I want every patient to hear: risk of malignancy is not the same as risk of aggressiveness. A nodule with a high probability of being cancer is not necessarily going to be a bad cancer. Most papillary thyroid cancers, even when confirmed, can be managed with a lobectomy — not a total thyroidectomy.

It Is Almost Always Medically Safe to Take a Pause

This was the moment in the episode that I found myself nodding the most.

Dr. Klopper was direct: it is almost never a medically urgent situation when a thyroid biopsy comes back indeterminate. The kind of thyroid cancer that truly requires immediate action is not subtle. It is obvious. It is almost always a Bethesda 5 or 6 result. And even then, it is rarely a true emergency.

For the indeterminate patient — Bethesda 3 or 4 — it is medically safe to take a pause. To get a referral for molecular testing even if it means waiting. To seek a second opinion. To join a community like ours and do research. To make an informed decision.

“Patients should just be fully informed of all their options,” he said.

I have been saying this for seven years. Hearing it from a physician who spent two decades in the clinic makes it land differently.

Where This Is All Heading

Dr. Klopper was genuinely optimistic about the next five to ten years. A few things he’s watching:

Ablation for molecularly benign nodules is already beginning to happen. The ATA’s most recent guidance requires at least one cytologically benign result before ablation — but studies evaluating molecularly benign results as an equivalent are underway, and early data looks similar.

Ablation for molecularly suspicious nodules with low-risk features is also within the realm of possibility — but the bar is very high. The data will need to be very strong before that becomes standard.

Better prognostic tools are coming. The GRID platform — Veracyte’s research database of genomic information from tens of thousands of samples — is being used in collaboration with academic centers to figure out which mutations actually predict aggressive behavior, not just malignancy. The goal is to go from knowing you likely have cancer to knowing whether it’s a cancer that needs aggressive treatment or one that can be managed conservatively.

“We may be able to say with high confidence — greater than 90%, maybe even 95% — that there is no vascular invasion, and you can feel very good about doing a lobectomy only.”

That would be a significant shift. And he believes it’s coming.

Final Thoughts

The single most important message Dr. Klopper wants every indeterminate thyroid patient to hear:

Get the molecular test. If it comes back benign — two-thirds of the time it will — you can trust it. You can watch it. You can avoid surgery. You can move on with your life.

And if you don’t know where to start, the American Thyroid Association website has a physician finder by zip code and state. Veracyte’s patient-facing resources are available here. And our physician directory at saveyourthyroid.org has a list of every thyroid specialist we know of in the US and abroad who performs nonsurgical thyroid procedures.

You don’t have to rush. You don’t have to decide in the surgeon’s office. And you don’t have to lose your thyroid to get an answer.

To hear the full conversation with Dr. Joshua Klopper, listen to Episode 123 on your favorite podcast platform or watch on YouTube at saveyourthyroidwithjen.com.

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

[Click the thumbnail above to watch on YouTube!]

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

Key Takeaways from my episode with Dr. Joshua Klopper:

1. An indeterminate result is not a dead end
Bethesda 3 or 4 is the beginning of a more detailed conversation — not an automatic path to surgery. Molecular testing exists to provide the clarity that cytology alone cannot.

2. 70% of surgeries for indeterminate nodules were unnecessary
Over 70% of removed thyroid tissue in this category came back benign on final pathology. That is the problem molecular testing was built to solve.

3. Two-thirds of Afirma results come back benign
With a 96% negative predictive value, a benign Afirma result takes your risk of cancer from 25% down to approximately 4% — the same as a cytologically benign biopsy.

4. A suspicious result doesn’t mean cancer
It means the test can’t confidently rule cancer out. The risk of malignancy with a suspicious result is approximately 50-65% — meaningful, but not a definitive diagnosis.

5. Risk of malignancy is not the same as risk of aggressiveness
Even a high probability of cancer doesn’t mean it will be an aggressive cancer. Most papillary thyroid cancers can be managed with a lobectomy, not a total thyroidectomy.

6. It is almost always medically safe to take a pause
The indeterminate result is almost never a medical emergency. It is safe to wait, seek a second opinion, get molecular testing, and make an informed decision.

7. The independent 800-patient study confirmed long-term performance
Outcomes of Cytologically Indeterminate Thyroid Nodules Managed With Genomic Sequencing Classifier — conducted across three independent medical centers — showed Afirma benign nodules behave just like cytologically benign nodules over time. Read it: https://pubmed.ncbi.nlm.nih.gov/38415829/

8. Molecular testing and ablation are beginning to intersect
Preliminary data suggests molecularly benign results may qualify patients for ablation — a significant development that is still in early stages but moving forward.

For more updates like this, and to explore non-surgical thyroid nodule treatments like RFA, TAE, MWA, and nsPFA, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my website:
👉 SaveYourThyroidwithJen.com

There, you can also sign up for personalized one-on-one patient navigation — because no one should feel alone on their thyroid journey.

Connect with Dr. Joshua Klopper & Veracyte:
🔗 Afirma: https://www.veracyte.com/tests/afirma-thyroid/providers/
🔗 Study: pubmed.ncbi.nlm.nih.gov/38415829

Additional patient resources:
🔗 American Thyroid Association: thyroid.org
🔗 Clinical Thyroidology for Patients: thyroid.org/patient-thyroid-information/ct-for-patients

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

Dr. Jules Aljammal was the first endocrinologist in the US to perform thyroid RFA for benign thyroid nodules. Dr. Shahzad Ahmad has since performed the highest number of RFA procedures of any endocrinologist in the country. Together, they spent years navigating FDA approvals, publishing the first US clinical data on thermal ablation, and building the North American Society of Interventional Endocrinology — NASOIE — from scratch.

And now they’re doing something that every patient in this community has needed for a long time: they’re setting the standard for what it means to be a qualified RFA provider.

Welcome back to Save Your Thyroid with Jennifer Holkem. This is the space where we bridge the gap between the standard of care and the future of medicine. My mission is to empower you with the knowledge you need to avoid unnecessary surgery and keep your thyroid intact for the long haul.

As RFA grows rapidly in the US, a critical question is emerging: how do you actually know your doctor is qualified to perform this procedure? A general medical license isn’t enough. Standard board certification isn’t enough. And with more and more physicians adopting this technology — some with very limited training — the gap between expert care and general care is becoming a real patient safety issue.

That’s why the new NASOIE certification matters. And in Episode 122, the two people who built it explain exactly what it requires, what it means for you, and what questions to ask right now — whether your doctor is certified or not.

🎧 In today’s episode, we’re covering:

• Why a medical license isn’t enough: The specific training, volume, and outcome standards required to safely perform thyroid RFA

• The 50-case minimum: Why the learning curve is real — and why volume is non-negotiable

• Two levels of certification: What the Certificate of Interventional Endocrinology and the Master level each require

• The three questions to ask any RFA doctor: Straight from the physicians who set the standard

• Thyroid cancer ablation: Why it requires a completely different mindset — and significantly more experience than benign nodule treatment

• Continuity of care: Why finding a physician who will follow you long-term is just as important as finding one who can perform the procedure

• Where to find certified physicians: The map NASOIE is building — and how saveyourthyroid.org will be part of it

• The next five years: Where RFA adoption is headed and what that means for patients

Whether you are actively searching for an RFA provider, trying to evaluate the one you’ve already found, or simply trying to understand what separates an expert from someone who just started offering this procedure — this episode is essential.

Dr. Jules Aljammal & Dr. Shahzad Ahmad, Founders of NASOIE

Dr. Jules Aljammal is an endocrinologist with practices in Utah and Washington state. He is recognized as the very first endocrinologist to perform thyroid RFA for benign thyroid nodules in the United States and has published extensive clinical data on the topic. He is the founder and first president of NASOIE.

Dr. Shahzad Ahmad is an endocrinologist based in Utah who has performed the highest number of RFA procedures of any endocrinologist in the US, achieving several remarkable firsts in North America. He is the president-elect of NASOIE.

Together, they began working toward bringing thermal ablation to the US back in 2012 — years before FDA approval came through in 2018. Their combined ultrasound experience alone represents nearly two decades of imaging before they ever performed their first ablation case.

From the Wild West to the Modern West

For seven years, thyroid RFA in the United States has operated largely without formal standards. Any licensed physician could theoretically offer the procedure — regardless of their training, their volume, or their outcomes.

Drs. Ahmad and Aljammal have watched this play out firsthand. And while they’re careful to note that no physician is intentionally causing harm, the data is clear: complication rates vary significantly between high-volume experienced providers and those still early in their learning curve. Volume reduction results vary. Patient outcomes vary.

Their practice, by comparison, has a complication rate of approximately three in a thousand — voice changes around two in a thousand, nodule rupture one in a thousand. That level of precision comes from a combined volume that dwarfs what most RFA providers in the US have accumulated.

“We wanted to be the modern west,” Dr. Ahmad said. “Not the wild west anymore.”

The NASOIE certification is how they’re making that happen.

What the Certification Actually Requires

The certification is built around three pillars: volume, technique, and outcomes.

Volume: A minimum of 50 cases is required to apply. This isn’t arbitrary — it’s based on published data showing that the learning curve produces meaningfully better results once a provider reaches a certain threshold. Less than 50 cases and the data says you’re still on the steep part of that curve.

Technique: Applicants must submit sample cases demonstrating proper antenna placement, correct safety protocols, treatment of toxic nodules, and appropriate use of advanced techniques. Simply being able to insert an antenna into a nodule is not enough.

Outcomes: Applicants must show their results. Volume reduction benchmarks must be met. Complication rates must be acceptable. Peer review of both technique and outcomes is part of the process — the same way published research is reviewed before it appears in a journal.

There is also a Master level certification that goes further: a higher case volume, published data, and demonstrated proficiency in advanced techniques including hydro dissection — the skill that becomes essential when treating cancers or nodules in challenging locations.

The Three Questions to Ask Your Doctor Right Now

For patients whose provider hasn’t yet achieved certification — or who are evaluating a new provider — Drs. Ahmad and Aljammal offered three direct questions to ask before your procedure:

1. How long have you been doing this, and is this the focus of your practice?
A physician who performs RFA as a small part of a general endocrinology practice will build volume much more slowly than one who has dedicated their practice to thyroid intervention. This isn’t a disqualifier — but it’s important context.

2. Have you published your results?
Publishing outcomes requires tracking outcomes. A physician who has published their RFA results has, by definition, been monitoring their patients closely enough to report on them. That is a meaningful signal.

3. What is your complication rate?
This is the hardest question to ask — and the most important. A physician who can answer it clearly and honestly, including acknowledging that complications do occur, is a physician who is tracking their outcomes. One who deflects or doesn’t know is a red flag.

Thyroid Cancer Ablation: A Different Conversation

One of the most important clarifications in this episode was around thyroid cancer treatment with ablation — a topic our community asks about constantly.

Dr. Ahmad was direct: treating thyroid cancer with ablation requires significantly more experience than treating benign nodules, and it is not something a provider early in their learning curve should be attempting. His recommendation is at least 100 cases before touching thyroid cancer.

The reason is counterintuitive. Cancer doesn’t make the procedure harder because it’s in a “bad location” — it makes it harder because you’re aiming for 100% ablation of the entire tumor, not volume reduction of a large nodule. A small cancer in a small gland is always going to be sitting close to the capsule, close to the edges, close to critical structures. You have almost no cushion. Hydro dissection — the technique of creating separation between the thyroid and surrounding tissue — becomes essential. And that skill takes cases to develop.

“The most important part of being experienced with RFA is not just the technique,” Dr. Ahmad said. “It’s also learning when to say no.”

Continuity of Care Is Non-Negotiable

Dr. Aljammal made a point in this episode that I want every patient to hear clearly: doing the procedure is not enough. Finding a physician who will follow you long-term — monitoring your outcomes, adjusting if needed, and making the call if a surgical approach becomes necessary — is just as important as finding someone who can perform the ablation itself.

This matters especially for thyroid cancer cases, where monitoring needs to span years, not months. Thyroid cancer can recur up to 15 to 20 years after initial treatment. Short-term monitoring is not sufficient.

“Continuity of care is a central point when I recommend someone who is interested in thermal ablation,” Dr. Aljammal said. “It’s very important to find that continuity.”

Where to Find Certified Physicians

NASOIE is currently building a searchable map of certified providers that will be available on their website. The list will also be shared with saveyourthyroid.org so our community can access it directly.

As of this recording, only a small number of physicians have completed the full certification process — the field is still early. But Dr. Ahmad expects that number to grow significantly with each annual NASOIE meeting, with the goal of having certified providers available in most major metropolitan areas across the country.

Final Thoughts: The Progress Is Real

I want to close with something Dr. Ahmad said at the end of our conversation that I’ve been thinking about ever since.

He credited a lot of the growth in patient awareness — and therefore physician adoption — to this community. To the patients who researched RFA themselves, brought it up at appointments, and showed up informed. To the people who shared their stories and encouraged others to advocate for themselves.

“You get a lot of the credit too,” he said. “You’ve helped people get inspiration. Now other people have benefited from that.”

That’s you. That’s this community. Keep asking. Keep sharing. Keep speaking up.

To hear the full conversation, listen to Episode 122 on your favorite podcast platform or watch on YouTube at saveyourthyroidwithjen.com.

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

[Click the thumbnail above to watch on YouTube!]

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

Key Takeaways from my episode with Dr. Ahmad & Dr. Aljammal:

1. Standardization protects patients
A medical license alone isn’t enough to safely perform thyroid RFA. Volume, technique, and outcomes all matter — and now there’s a formal certification to verify them.

2. The 50-case minimum exists for a reason
The learning curve for RFA is real. Complication rates drop significantly as experience builds. Volume is non-negotiable.

3. Two levels of certification
The Certificate of Interventional Endocrinology establishes baseline proficiency. The Master level requires published outcomes and advanced techniques including hydro dissection.

4. Three questions to ask your RFA doctor
How long have you been doing this? Have you published your results? What is your complication rate?

5. Thyroid cancer ablation requires a different mindset
You’re aiming for 100% destruction, not volume reduction. Dr. Ahmad recommends at least 100 cases before a provider attempts thyroid cancer treatment.

6. Continuity of care is non-negotiable
Finding a physician who will follow you long-term — not just perform the procedure — is essential, especially for thyroid cancer cases.

7. The certified physician map is coming
NASOIE is building a searchable list of certified providers that will also be available through saveyourthyroid.org.

8. The next five years
RFA adoption is expected to grow from 1% to 5% of thyroid nodule cases — saving thousands of patients from unnecessary surgery.

For more updates like this, and to explore non-surgical thyroid nodule treatments like RFA, TAE, MWA, and nsPFA, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my website:
👉 SaveYourThyroidwithJen.com

There, you can also sign up for personalized one-on-one patient navigation — because no one should feel alone on their thyroid journey.

Connect with Dr. Shahzad Ahmad:
Endocrinology Center of Utah: thyroidradiofrequencyablation.com

Connect with Dr. Jules Aljammal:
The Thyroid Clinic Utah & The Thyroid Clinic Washington

NASOIE: nasoie.com

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

When we talk about thyroid care, we often talk about what’s possible. But what does it look like when someone at the very top of the surgical world — a pioneer of robotic thyroid surgery, an author of more than 350 scientific papers, a physician who has spent decades at the forefront of innovation — tells you that the most important thing he can offer a patient is not bias?

That’s Dr. Eren Berber. And that’s exactly what he said.

Welcome back to Save Your Thyroid with Jennifer Holkem. This is the space where we bridge the gap between the standard of care and the future of medicine. My mission is to empower you with the knowledge you need to avoid unnecessary surgery and keep your thyroid intact for the long haul.

Dr. Berber is a Professor of Surgery at Cleveland Clinic and Director of Robotic Endocrine Surgery. He performed some of the first robotic thyroid operations in the United States, brought thyroid RFA to Ohio, and continues to lead globally in novel ablation technologies. He is, by any measure, one of the most accomplished thyroid specialists practicing today.

And in Episode 121, he gave one of the most candid, comprehensive assessments of the current thyroid treatment landscape this podcast has ever aired.

Did you know that a surgeon who can perform every major thyroid procedure — conventional surgery, robotic surgery, and ablation — is actually in the best position to tell you which one you truly need? Because when a physician can only do one thing, every patient looks like they need that one thing.

What if you could sit across from someone with no agenda — someone who has mastered all the tools, tracked all the outcomes, and genuinely lets your pathology make the decision?

🎧 In today’s episode, we’re covering:

• The honest truth about robotic surgery: Why the surgeon who pioneered it will tell you it isn’t always the better choice — and when it actually is

• From skeptic to believer: How four years of personally tracking every ablation patient changed Dr. Berber’s perspective on RFA

• The case for treating nodules earlier: Why the most dramatic RFA results happen with smaller nodules — and what that means for patients in the watch-and-wait cycle

• Cleveland Clinic’s first 100 patients: The real outcomes data, complication rates, and what they mean for you

• What’s coming next: Nanopulse ablation trials, AI integration, and why what we’re using today won’t be what we’re using five years from now

• How to navigate a big institution: Why going to the right expert directly — not just the right hospital — makes all the difference

Whether you are a patient comparing your options, someone who has been told they aren’t a candidate for ablation, or simply trying to make sense of a diagnosis that came out of nowhere, this conversation will change how you think about thyroid care.

Dr. Eren Berber, Professor of Surgery · Cleveland Clinic

Today’s guest is Dr. Eren Berber, a Professor of Surgery and Director of Robotic Endocrine Surgery at Cleveland Clinic. He was among the first surgeons in the United States to perform robotic thyroid surgery, brought thyroid RFA to Ohio in 2022, and has authored more than 350 peer-reviewed scientific papers and 30 book chapters. He also performs ablation for liver tumors and other cancers — giving him a broader ablation technology background than most thyroid specialists in the country.

A Pioneer Who Doesn’t Oversell His Own Innovations

One of the most striking things about my conversation with Dr. Berber was his willingness to be honest about the limitations of technologies he helped create.

Robotic thyroid surgery represents one of the most technically demanding procedures in the field. There are only a handful of surgeons in the United States who can perform it at a high level. Dr. Berber is one of them. And he will tell you directly: the only real advantage over conventional surgery is that there is no visible scar on the neck.

Outcomes — including nerve preservation, parathyroid protection, and recovery — are not superior. In fact, robotic procedures can paradoxically be more invasive because of the surgical tunnel required to reach the thyroid without a neck incision. More pain. Longer recovery. And the patient still loses their thyroid and requires lifelong hormone replacement.

“I think their only benefit is that you don’t have an incision in the neck.”

That kind of honesty from someone who pioneered the technology is worth paying attention to.

The Skeptic Who Became a Believer

Dr. Berber didn’t adopt RFA because it was trendy. He adopted it because his patients asked about it, he followed the data carefully, and then he saw the results with his own eyes.

For four years he has personally followed every single ablation patient he has treated. Not delegated, not reviewed in aggregate — tracked individually. He wanted to know firsthand whether it worked.

His first 100 patients answered that question. Over 90% success rate. Less than 5% needed additional treatment. Less than 5% had complications. Hot nodules returned to normal thyroid function within approximately a month.

“Honestly, I was a little bit skeptical initially. But seeing the results in my patients, I’m a big believer.”

His current clinical pathway: benign fine needle biopsy plus symptomatic nodule equals strong ablation candidacy. And today, his patients are bringing up RFA themselves before he even presents it as an option.

The Insight That Should Change How You Think About Timing

Here is something Dr. Berber said that I want every patient in this community to sit with.

The most dramatic RFA results happen with smaller nodules.

When a large nodule is treated with RFA, it shrinks — sometimes dramatically. My own nodule was between 65 and 75 milliliters, and it reduced by 90%, which I am profoundly grateful for. But a remnant remains. When a smaller nodule is treated, it can disappear entirely.

This raises an important question for patients who have been told to watch and wait. If you’re young, if your nodule is growing year over year, if you’re looking at a lifetime of repeat ultrasounds and possible biopsies — why wait?

“Why not even start treating these nodules earlier? The nodule disappears and you’re done with it.”

If that question hasn’t come up in your appointments, it’s worth asking.

What’s Coming Next

Dr. Berber was attending the ISITES conference in Washington DC when we recorded this episode — a gathering focused specifically on innovative endocrine surgery technologies. The conversations happening there give a real preview of where thyroid care is heading.

Nanopulse ablation — a non-thermal approach that doesn’t use heat — is gaining traction, with early clinical experience increasing. A nanopulse trial is being finalized at Cleveland Clinic and expected to launch within months. AI is being incorporated into both thyroid surgery and ablation. New dye-based technologies are improving the visualization and protection of parathyroid glands during surgery.

“What we’re using now is not going to be what we’ll be using five years from now.”

The pace of innovation in this space is accelerating. And physicians like Dr. Berber are at the front of it.

The Insurance Excuse Is Running Out of Road

Thyroid RFA has been FDA cleared since 2018. A CPT billing code went into effect January 1, 2025. The ATA guidelines now formally include ablation as a standard procedure for appropriate patients.

“That excuse is on borrowed time,” I said. Dr. Berber agreed.

If your insurance has denied RFA as investigational, you now have all three of those facts to push back with. Don’t accept that denial without a fight.

Final Thoughts: Be Informed, Be Direct, Be Persistent

Dr. Berber’s advice for patients who have been told they aren’t a candidate for ablation: go directly to a physician who performs the procedure. Don’t rely on a referral from someone who doesn’t offer it to tell you whether you qualify.

And when you find that physician, do your homework. Look them up on PubMed. Find out how many procedures they perform per year. Ask about their outcomes.

“Having these outcomes transparently out there is pretty important — you already know what your surgeon is capable of. I think that has to be more widely adopted.”

You deserve that level of transparency. Ask for it.

To hear the full conversation with Dr. Eren Berber, listen to Episode 121 on your favorite podcast platform or watch on YouTube at saveyourthyroidwithjen.com.

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

[Click the thumbnail above to watch on YouTube!]

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

Key Takeaways from my episode with Dr. Eren Berber:

1. Robotic surgery isn’t always better
The only real advantage of robotic thyroid surgery over conventional surgery is the absence of a neck scar. Outcomes are not superior — and a surgeon who pioneered the technology will tell you that himself.

2. Patient demand drives innovation
Dr. Berber adopted RFA because his own patients started asking about it. When patients speak up, physicians listen. Keep asking. Keep sharing. You are part of how this technology reaches more people.

3. Treat nodules earlier
The most dramatic RFA results happen with smaller nodules. If yours is growing year over year and you’ve been told to watch and wait, ask whether proactive treatment while it’s still small might produce better long-term outcomes.

4. 90%+ success rate in his first 100 RFA patients
With less than 5% needing additional treatment and less than 5% experiencing complications, the real-world data from a high-volume specialist is compelling.

5. At large institutions, see the expert directly
RFA awareness varies significantly even within the same hospital. Going to the right institution is not enough — you need to reach the right physician. Contact Dr. Berber’s office directly, not through the general referral system.

6. The future is non-thermal
Nanopulse ablation, AI integration, and new parathyroid visualization technologies are already in clinical development. The landscape five years from now will look very different from today.

7. Look up your surgeon on PubMed
Dr. Berber publishes every outcome from every procedure he performs. You can search his name and review a decade of results before your first appointment. Every thyroid surgeon should be held to that standard.

8. Insurance calling RFA investigational is on borrowed time
FDA cleared 2018. CPT code active 2025. ATA guidelines updated. Push back on denials — you have the facts on your side.

For more updates like this, and to explore non-surgical thyroid nodule treatments like TAE, RFA, and nsPFA, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my new website:

👉 SaveYourThyroidWithJen.com

There, you can also sign up for personalized one-on-one patient navigation—because no one should feel alone on their thyroid journey.

Connect with Dr. Eren Berber:

🔗 Cleveland Clinic Provider Page
Telehealth consultations available for out-of-state patients.

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

Discover Chelsea Paulson’s inspiring journey through indeterminate thyroid nodules, molecular testing, and microwave ablation. Learn how faith, holistic health, and self-advocacy saved her thyroid.

When it comes to your health, being your own biggest advocate changes everything. Navigating the world of thyroid health can feel isolating and overwhelming—especially when faced with “indeterminate” test results that leave your future hanging in the balance.

In our latest podcast episode, I sat down with Chelsea Paulson, a patient who went from facing the frightening prospect of thyroid surgery to finding healing through personalized medicine. Her story is a powerful testament to the importance of seeking out minimally invasive treatments, integrating holistic health, and holding on to your faith.

Here is a look at Chelsea’s journey from indeterminate nodules to successful ablation.

Welcome back to Save Your Thyroid with Jennifer Holkem. This is the space where we bridge the gap between “standard of care” and the future of medicine. My mission is to empower you with the knowledge needed to avoid unnecessary surgery and keep your thyroid intact for the long haul.

For Chelsie, Microwave Ablation (MWA) was a vital part of her treatment journey. It gave her surgical precision without the surgery—using targeted heat to destroy the nodule while leaving her healthy thyroid tissue completely untouched. Chelsea’s journey is a powerful reminder that even when you’re told surgery is the 'only' option, self advocacy and the right doctor can offer a path to healing that never requires a scalpel.

🎧 In today’s episode, we explore:

• The Power of Molecular Testing: Why Chelsea didn’t stop at an “indeterminate” biopsy and how AFIRMA testing provided the genomic clarity she needed to avoid surgery.

• The Microwave Ablation (MWA) Experience: A step-by-step look at the procedure itself—how it uses targeted heat to neutralize nodules with surgical precision while leaving the thyroid gland intact.

• Navigating the “Standard of Care”: An honest discussion on the decision-making process when choosing between traditional thyroidectomy and minimally invasive ablation.

• The Results & Follow-Up: How Chelsea achieved a 59% and 93% reduction in her nodules and what her journey looks like today, including the holistic strategies she used to support her recovery.

• The Advocacy Roadmap: Practical advice on being “tenacious,” trusting your gut, and finding the right doctors who prioritize thyroid preservation.

Whether you are currently staring at an indeterminate biopsy result or searching for a way to treat your nodules without a scalpel, this conversation is a roadmap for the modern thyroid patient.

Let’s dive in.

The Sneaky Symptoms and the Initial Diagnosis

Chelsea’s journey began with symptoms that are all too easy to brush off. Looking back, she realizes her anxiety levels were unusually high and she was experiencing unexplained hair loss. It wasn’t until a visit to her family doctor, who discovered a goiter during a routine exam, that she realized something deeper was going on.

That revelation sent Chelsea into a whirlwind of research. Ultrasounds revealed two distinct nodules. As Chelsea recalls, “My nodules were 1.8 and 1.7 centimeters.” While small, the characteristics of the nodules raised red flags, launching Chelsea into the next diagnostic step, thyroid biopsies. However, this process would not lead to the answers she was looking for.

Navigating “Indeterminate” Results with Molecular Testing

One of the most frustrating parts of thyroid nodule diagnosis is landing in the gray area of an “indeterminate” biopsy. Instead of panicking or rushing straight to the operating room to have her thyroid removed—which is a common standard of care—Chelsea leaned into personalized medicine.

She utilized advanced molecular testing, specifically the AFIRMA test, to gather more genomic data about her nodules. This crucial step is something many patients aren’t told about, but it plays a massive role in ruling out thyroid cancer and making an informed, confident decision about your body. While Chelsie’s test did not give her a confident “benign” result, it did point to some low suspicion features.

The Decision: Surgery vs. Microwave Ablation

Armed with better data, Chelsea faced a choice. The traditional route often pushes patients toward partial or total thyroidectomy (surgical removal). However, Chelsea wanted a solution that would preserve her thyroid gland and protect her quality of life.

After extensive research and stepping out of the traditional medical referral pattern, she discovered Dr. Emad Kandil, a physician offering microwave ablation—a minimally invasive procedure that uses heat to shrink nodules from the inside out, without the need for a scalpel or lifelong hormone replacement medication.

Incredible Results and the Power of Holistic Health

Chelsea’s experience with the ablation procedure was life-changing. Instead of a long surgical recovery, she was able to return to her life quickly. The results speak for themselves.

“My thyroid nodules shrunk by 59% and 93%,” Chelsea shared, highlighting just how effective this treatment can be for the right candidates.

But Chelsea didn’t stop at the medical procedure. A major part of her healing journey involved integrating holistic health strategies. By making targeted lifestyle changes, supporting her body nutritionally, and leaning heavily on her faith, she created an environment for her thyroid to truly heal.

The Ultimate Takeaway: Trust Your Gut

If there is one major misconception Chelsea wants to clear up, it’s that surgery is your only option for suspicious or growing nodules. Her story is a brilliant reminder that you have choices.

When asked what advice she has for others currently navigating the scary early days of a thyroid nodule diagnosis, her message was simple but powerful: “Be tenacious and trust your gut.”

Don’t be afraid to ask for molecular testing, seek second opinions, and explore minimally invasive options like thyroid ablation. Empower yourself with knowledge, and never hesitate to advocate for the care you deserve.

Looking for more resources to help you on your treatment journey? Join our patient community, Save Your Thyroid: Nonsurgical Nodule Procedures on Facebook. Or, visit our website, saveyourthyroid.org.

Want to hear the full story? Dive deep into the details of the microwave ablation procedure, Chelsea’s holistic health routines, and her journey of faith by listening to the full episode of the podcast!

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

Click the thumbnail above to watch on YouTube!

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

What is this podcast and blog all about?

To my subscribers, welcome back! If you’re new, welcome to Save Your Thyroid with Jennifer Holkem, a podcast and blog all about thyroid nodules. For the past 6 1/2 years, I have advocated for fellow patients suffering with this very common condition.

Thyroid nodules impact 70% of adults in their lifetime, and the standard of care is surgical removal of half or all of the gland. But in recent years, safe and effective non-surgical treatment options have become available.

In this podcast and blog, I sit down with patients and physicians to discuss life with thyroid nodules, treatment options, and how to save the thyroid whenever possible.

Key Takeaways from my episode with Chelsie Paulson:

If you are currently navigating a thyroid diagnosis, let Chelsea’s story be a roadmap. Here are the essential lessons from her journey:

• “Indeterminate” is not a diagnosis—it’s a starting point. Don’t settle for the uncertainty of a gray-area biopsy. Advanced molecular testing like AFIRMA can provide the genomic clarity needed to rule out cancer and avoid unnecessary surgery.

• Surgery is the“Standard of Care,” but the paradigm is shifting. Modern treatments like Microwave Ablation (MWA) can offer surgical precision without the scalpel. You can successfully shrink nodules—in Chelsea’s case by 59% and 93%—while keeping your thyroid gland intact and functioning.

• Trust your gut, but follow up with research. If a treatment plan doesn’t feel right, or if you’re being pushed toward total removal without exploring alternatives, trust that intuition. Be tenacious in doing research and seeking a second (or third) opinion from doctors who specialize in thyroid preserving treatment options.

• Healing is Multi-Dimensional. Successful recovery often goes beyond the procedure. Integrating holistic health strategies and lifestyle changes can support your thyroid health and overall well-being for the long haul.

• Advocacy is Power. Whether it’s navigating insurance hurdles or researching international treatment options, being an active participant in your healthcare can literally save your thyroid.

Chelsea Paulson’s journey from “indeterminate” to “healing” proves that when you combine cutting-edge technology with a relentless spirit, you don’t have to sacrifice your thyroid to regain your health. For more stories like this, and to explore non-surgical thyroid nodule treatments like TAE, RFA, and nsPFA, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my new website:

👉 SaveYourThyroidWithJen.com

There, you can also sign up for personalized one-on-one patient navigation—because no one should feel alone on their thyroid journey.

Watch my previous interviews with Dr. Emad Kandil on this playlist!

https://youtube.com/playlist?list=PL5tSaOk33p79ZDLbJstCQMjFaG31paRue&si=I65529lkfkK6DbYo

Connect with Dr. Emad Kandil:

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

The goal of this podcast and blog

I seek to provide data, resources, and expert opinions on the topic of thyroid nodules, and make it accessible to patients. When I was first looking for thermal ablation treatment, everything that I read was physician-facing material. It was very hard for me to understand. This material is meant to help patients understand what’s going on in their thyroid gland and what an important gland it is. If you can keep your thyroid intact, that’s going to help you live a longer, healthier life, and preserve your quality of life. Thanks for reading this far today! — Jen

Thanks for reading Its me Jen again! This post is public so feel free to share it.

Share

When Emily Saska went in for imaging on a “weird back thing,” she wasn’t expecting to be told she had a significant thyroid nodule. She was 37, a busy lawyer, and a mom of two. But suddenly, she was being told her nodule was “angry,” growing rapidly, and that she needed a referral to general surgery.

For Emily, that recommendation felt like a “needle off the record” moment. Why was she being told to remove a vital, fully functioning organ just because of a benign nodule? Like so many in our community, Emily decided that surgery wasn’t her first choice—it was her last resort.

But Emily did something I encourage every member of the Save Your Thyroid community to do: She paused, she researched, and she advocated for a different path.

Welcome back to Save Your Thyroid with Jennifer Holkem. This is where we bridge the gap between medical expertise and real-life patient journeys to uncover the latest nonsurgical ways to manage thyroid nodules. Our mission is to empower you with the facts so you can choose the best path forward—and keep your thyroid right where it belongs.

Did you know that most adults have thyroid nodules? Up to 70–80% of us will develop them. While many are small, others—like Emily’s—grow quickly and begin to cause visible lumps and physical pressure.

When Emily was referred to surgery, she was told it was just a “consult,” but as she says, “What do you think a general surgeon is going to consult with me about?” She knew she needed to look for an alternative that wouldn’t leave her on hormone replacement for the rest of her life.

What if there was a method that didn’t use heat, didn’t leave a scar, and allowed you to fly to Puerto Rico for vacation just four days later?

🎧 In today’s episode, we’ll cover:

• The “Needle Off the Record” Moment: Hear how Emily felt when she was pushed toward surgery and how she used her “lawyer brain” to research the alternatives.

• The Power of a Second Opinion: Emily’s journey to finding Dr. Emad Kandil and why she trusted him to make the right recommendation for her healthy, working thyroid.

• A “Nothing Burger” Recovery: Emily’s first-hand account of nanosecond pulsed field ablation (nsPFA), the tiny band-aid she received, and her incredible 82% reduction in nodule size.

The Turning Point: A Birthday Gift to Herself

Emily was mentally preparing for the surgical path until she found our community and the name Dr. Emad Kandil. She realized that while her local doctors only offered the scalpel, Dr. Kandil offered a toolbox of options, including the latest non-thermal technology: nsPFA.

On her 37th birthday, Emily gave herself the ultimate gift. She walked into the hospital for a procedure that took about an hour and walked out with nothing but a band-aid.

“I felt like I needed a t-shirt that said: ‘I’ve had weeks of consultations and biopsies, and all I got was this band-aid.’”

Why Emily Chose nsPFA

Every case is unique. For Emily, her nodule had both solid and cystic components. Dr. Kandil used a combination of ethanol ablation and nsPFA to target the nodule without using heat near the delicate structures of her neck.

She wasn’t just choosing a procedure; she was choosing to keep the organ that regulates her heart, her brain, and her energy levels.

What We Can Learn From Emily

Emily’s story is a testament to the fact that you are your own best advocate. She didn’t blindly follow the referral to surgery; she looked for a physician who was passionate about saving the thyroid.

Key Takeaways from Emily’s Experience:

• Don’t wait for permission: Emily sought out a second opinion because she knew her thyroid was worth fighting for.

• Recovery can be easy: With nsPFA, Emily was traveling with her family just days later. There was no “lengthy recovery” or “surgical trauma.”

• Results speak for themselves: Emily saw a 65% reduction in just six weeks, and a staggering 82% reduction by her seven-month follow-up.

Listen to the Full Story

Emily is a voice of encouragement for anyone who feels “rushed” through the surgical pipeline. We talk about her “angry” nodule, the cocktail of medications that helped her feel nothing during the procedure, and her “home run” results.

To hear the full details of Emily’s procedure and her advice for others facing similar diagnoses, listen to the full episode on your favorite podcast platform or watch on YouTube via saveyourthyroidwithjen.com.

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

Click the thumbnail above to watch on YouTube!

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

What is this podcast and blog all about?

To my subscribers, welcome back! If you’re new, welcome to Save Your Thyroid with Jennifer Holkem, a podcast and blog all about thyroid nodules. For the past 6 1/2 years, I have advocated for fellow patients suffering with this very common condition.

Thyroid nodules impact 70% of adults in their lifetime, and the standard of care is surgical removal of half or all of the gland. But in recent years, safe and effective non-surgical treatment options have become available.

In this podcast and blog, I sit down with patients and physicians to discuss life with thyroid nodules, treatment options, and how to save the thyroid whenever possible.

If you are currently navigating a large goiter and have been told surgery is your only option, please listen to this episode and be sure to subscribe. You have choices, and your thyroid is worth saving.

AND, don’t forget to visit my new website:

👉 SaveYourThyroidWithJen.com

There, you can also sign up for personalized one-on-one patient navigation—because no one should feel alone on their thyroid journey.

Watch my previous interviews on nsPFA here!

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

The goal of this podcast and blog

I seek to provide data, resources, and expert opinions on the topic of thyroid nodules, and make it accessible to patients. When I was first looking for thermal ablation treatment, everything that I read was physician-facing material. It was very hard for me to understand. This material is meant to help patients understand what’s going on in their thyroid gland and what an important gland it is. If you can keep your thyroid intact, that’s going to help you live a longer, healthier life, and preserve your quality of life. Thanks for reading this far today! — Jen

Thanks for reading Its me Jen again! This post is public so feel free to share it.

Share

SEO Tags: nsPFA, Nanosecond Pulsed Field Ablation, Thyroid Nodule Treatment, Save Your Thyroid, Dr. Emad Kandil, Thyroidectomy Alternatives, Non-Surgical Thyroid Ablation, Thyroid Patient Stories.

For a long time, thyroid care followed a very predictable, one-way street. If you had a nodule that was growing, causing pressure, or affecting your appearance, you were often told your only real exit was a thyroidectomy. It was a trade-off: you lose the symptoms, but you also lose the gland, the hormones, and a piece of your autonomy. For many, the question wasn’t if you would have surgery, but when.

But today, we are talking about a new frontier. We are moving away from the era of “management” and into the era of “intervention.”

Today’s guest is a board-certified endocrinologist who refuses to accept that surgery is the only answer. Dr. Ian Orozco has become a beacon for patients throughout the Intermountain West seeking non-surgical options like Radiofrequency Ablation (RFA). And he has just taken a massive step to better serve the thyroid community: launching his own private practice, The Thyroid Institute of Utah.

Welcome back to Save Your Thyroid with Jennifer Holkem. This is the space where we challenge the status quo of thyroid treatment and advocate for the preservation of your most vital metabolic engine. My mission is to empower you with the knowledge needed to avoid unnecessary surgery and keep your thyroid intact for the long haul.

Did you know that you don’t have to navigate a massive hospital bureaucracy just to get a second opinion on a thyroid nodule? What if you could walk into a specialized clinic designed entirely around modern, non-surgical thyroid care?

🎧 In today’s episode, we’re going to explore:

• The Big Move: What inspired Dr. Orozco to open The Thyroid Institute of Utah and how a single-focus private practice drastically improves the patient experience.

• Understanding RFA: A deep dive into how Radiofrequency Ablation shrinks benign nodules without a scalpel, saving the healthy tissue and often eliminating the need for lifelong thyroid medication.

• The “Fly-In” Patient: How Dr. Orozco’s new Provo-based clinic is perfectly set up for out-of-state patients traveling for expert care.

• Navigating Insurance: An honest look at the hurdles of getting RFA covered, and why insurance companies calling the procedure “investigational” is simply untrue.

Whether you are a patient searching for a surgical alternative or someone tired of the traditional “wait and see” approach, this conversation is a glimpse into the future of interventional endocrinology. Let’s dive in.

Today’s guest returns to the podcast to share an exciting new chapter in his career. Dr. Ian Orozco is a board-certified endocrinologist with extensive experience in thyroid ultrasound, biopsy, and thermal ablation. He has recently established The Thyroid Institute of Utah in Provo, creating a specialized environment tailored specifically to patients looking for cutting-edge, non-surgical thyroid care.

A New Home for Interventional Endocrinology

One of the most compelling parts of my conversation with Dr. Orozco was his explanation of why he went into private practice. In a traditional multi-specialty group or hospital setting, patients often face red tape, long wait times, and rigid referral requirements.

By launching The Thyroid Institute of Utah, Dr. Orozco has gained the agility to treat patients on their terms. From fast-tracking consults for out-of-state patients to personally overseeing every step from the initial ultrasound to the RFA procedure and follow-up, he is providing a level of continuity and excellence that is hard to find in massive healthcare systems.

What the Patients Are Saying: Sparing the Gland

We often hear about the benefits of avoiding a neck scar, but the true victory of RFA is functional. Dr. Orozco highlighted a scenario that brings him the most joy as a physician: successfully treating a hyperfunctioning (”hot”) nodule with RFA and being able to tell the patient to stop taking their anti-thyroid medication the very next day.

By precisely targeting the problematic nodule with thermal energy, the surrounding healthy thyroid tissue is preserved as an innocent bystander. This drastically reduces the risk of hypothyroidism—a common, lifelong consequence of traditional surgery.

Breaking Down Geographic and Insurance Borders

I asked Dr. Orozco the tough questions about access. What if you don’t live in Utah? Because his practice is independent, he can accommodate “fly-in” patients for weekend procedures, allowing them to fly into Provo, receive world-class care, and recover while enjoying the local scenery.

We also tackled the insurance beast. While coverage has improved dramatically since RFA was introduced in the U.S., some companies still push back. Dr. Orozco and his team are dedicated to fighting these denials, armed with data and the new CMS codes established for the procedure.

Final Thoughts: Advice for the Patient Advocate

If you are currently weighing your options for a thyroid nodule and a surgeon has told you they can “put you on the schedule in two weeks,” Dr. Orozco’s advice is simple: hit pause.

Unless you are dealing with an aggressive malignancy, thyroid surgery is rarely an emergency. Take a breath, do your research, and consult with a specialist who actually performs non-surgical techniques before you make a permanent decision.

To hear the full details from my conversation with Dr. Ian Orozco, listen to the full episode on your favorite podcast platform or watch on YouTube via saveyourthyroidwithjen.com.

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

Click the thumbnail above to watch on YouTube!Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

Key Takeaways from my episode with Dr. Ian Orozco:

1. The Power of Private Practice By opening The Thyroid Institute of Utah, Dr. Orozco has removed the bureaucratic hurdles of traditional hospital systems. Patients no longer need to jump through hoops to secure a referral; they can reach out directly for specialized care.

2. RFA Preserves Function Unlike a thyroidectomy, which removes large portions of healthy tissue, Radiofrequency Ablation targets only the nodule. This outpatient procedure protects the gland, avoids a surgical scar, and frequently prevents the need for lifelong thyroid hormone replacement.

3. “Investigational” is a Myth If your insurance company claims RFA is experimental, they are misinformed. The procedure is FDA-cleared and has dedicated CPT codes for billing. Dr. Orozco’s clinic actively helps patients navigate these frustrating insurance appeals.

4. Out-of-State Care is Highly Accessible You don’t have to settle for the standard of care in your hometown if it doesn’t serve you. Dr. Orozco’s independent clinic structure makes it easy for patients to fly into Provo, Utah, have a consultation and procedure in a single weekend, and fly home safely.

5. Thyroid Surgery is Rarely an Emergency When faced with a benign or “hot” nodule, patients often feel rushed into the operating room. Dr. Orozco emphasizes that you have time to research, seek second opinions, and explore minimally invasive options. Don’t let a surgeon’s scheduling convenience dictate your healthcare.

For more updates like this, and to explore non-surgical thyroid nodule treatments like RFA, TAE, and nsPFA, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my website:

👉 SaveYourThyroidWithJen.com

There, you can also sign up for personalized one-on-one patient navigation—because no one should feel alone on their thyroid journey.

Connect with Dr. Ian Orozco:

• Email for Consults: referrals@thyroidutah.com

• Website: https://thyroidutah.com/

  ---

Watch my previous interview with Dr. Ian Orozco here:

This episode is a deep dive comparing and contrasting radiofrequency ablation with radioactive iodine. While these are both nonsurgical in nature, beyond that they couldn’t be more different.

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

The goal of this podcast and blog

I seek to provide data, resources, and expert opinions on the topic of thyroid nodules, and make it accessible to patients. When I was first looking for thermal ablation treatment, everything that I read was physician-facing material. It was very hard for me to understand. This material is meant to help patients understand what’s going on in their thyroid gland and what an important gland it is. If you can keep your thyroid intact, that’s going to help you live a longer, healthier life, and preserve your quality of life. Thanks for reading this far today! — Jen

Thanks for reading Its me Jen again! This post is public so feel free to share it.

Share

When we talk about thyroid nodules, the “standard” path has traditionally pointed in one direction: the operating room. But what happens when the very surgeons trained to remove the thyroid decide there’s a better way? As I always say here, preserving your thyroid is about having the right tool for the right job, and sometimes, the best person to help you avoid surgery is a surgeon.

Today’s guest is a true advocate who refuses to accept that a major surgery is the only answer for the person sitting in front of him. Dr. Jacques Gaudet, a board-certified Otolaryngologist and Head and Neck Surgeon at Southern ENT Associates, has become a pioneer for non-surgical care. He was the second doctor in the entire state of Louisiana to bring Thyroid Radiofrequency Ablation (RFA) to his community.

Welcome back to Save Your Thyroid with Jennifer Holkem. This is the space where we bridge the gap between “standard of care” and the future of medicine. My mission is to empower you with the knowledge needed to avoid unnecessary surgery and keep your thyroid intact for the long haul.

Did you know that your doctor’s background can heavily influence how they treat your nodule? A surgeon has an intimate, 3D understanding of the delicate “danger zones” in the neck—like the recurrent laryngeal nerve and the carotid artery. But what if they could use that surgical knowledge not to cut, but to safely guide a needle that shrinks your nodule from the inside out?

What if there was a way to get world-class, non-surgical treatment right in your local community, without having to travel across the country?

🎧 In today’s episode, we’re getting into the clinical weeds to explore:

• The Post-Katrina Mindset: How Dr. Gaudet’s medical training in the resource-scarce aftermath of Hurricane Katrina shaped his resourceful, patient-first approach to ultrasound and diagnostics.

• The Surgeon-Sonographer Advantage: A deep dive into why an expert understanding of ultrasound is non-negotiable for safe RFA, and why a surgeon’s “eye” makes all the difference when navigating the neck.

• Pioneering in the Bayou: The hurdles Dr. Gaudet cleared to bring this technology to patients in Thibodaux, Raceland, and Houma, and why he chose persistence over the traditional surgical referral patterns.

• Redefining Success: A look at why total disappearance of a nodule isn’t always the goal, and how even a 15% reduction can completely resolve cosmetic and compressive symptoms.

Whether you are a patient searching for a safer alternative or someone feeling stuck in the “watch and wait” cycle, this conversation is a glimpse into what true patient advocacy looks like. Let’s dive in.

Dr. Jacques Gaudet, Head and Neck Surgeon

Today’s guest is Dr. Jacques Gaudet, an ENT surgeon with a passion for helping patients shrink thyroid nodules using non-surgical, thyroid-sparing techniques. Dr. Gaudet practices at Southern ENT Associates and serves patients across Southern Louisiana. He is a recipient of the George G. Lyons Excellence in Otolaryngology Award and a three-time winner of the LSU ENT Resident Research Award.

A Foundation Forged in Persistence

One of the most compelling parts of my conversation with Dr. Gaudet was hearing about his training. Practicing as a medical student and resident in the aftermath of Hurricane Katrina in New Orleans meant traditional hospital systems were fractured. Getting a simple ultrasound-guided fine-needle aspiration was incredibly difficult.

Dr. Gaudet realized that if he wanted to provide the best care for his patients, he couldn’t wait on the system—he had to learn the technology himself. He cross-trained with radiologists and general surgeons, mastering the ultrasound. That early necessity birthed a lifelong passion for ultrasound-guided care, transforming him into a resourceful advocate who doesn’t rely solely on the old ways of doing things.

The Surgeon’s Eye: Why Ultrasound is Everything

We often talk about the heat or the ablation probe, but Dr. Gaudet emphasized that the real magic of RFA is the imaging. For RFA to be safe and effective, the physician must be a master of the ultrasound.

Because he is a trained surgeon who has operated on the delicate structures of the neck, Dr. Gaudet knows exactly where the “land mines” are. “You can always see your knife,” he noted about traditional surgery. But with RFA, “learning to always see the tip of your radio frequency probe... that’s where being a really skilled and practiced sonographer becomes important.” This unique combination of surgical knowledge and ultrasound mastery creates a zone of safety for the patient.

What the Patients Are Saying: Comfort and Trust

We also discussed the “user experience” of having an awake procedure in the office. It’s normal to be anxious, but Dr. Gaudet uses a “friend-not-just-a-patient” approach to build massive trust.

He shared an incredible story of a patient dealing with a scary cancer diagnosis who trusted him so deeply that he promised Dr. Gaudet free shrimp for life once he survived—a promise kept for over a decade! That level of trust translates to the RFA suite. With proper preoperative medication and expert local numbing, Dr. Gaudet noted that the most surprising thing about RFA is how little pain patients actually experience, often feeling completely comfortable while he works.

Final Thoughts: Advice for the Patient Advocate

If you have been told that a total thyroidectomy is your only option, Dr. Gaudet’s advice is simple: Ask questions and get a second opinion. Be as certain as possible about why a surgery is being recommended. Do your homework, find a doctor you trust who is up-to-date on modern thyroid care, and remember: “You’re going to be okay. We just gotta figure out how we win.”

To hear the full details from my conversation with Dr. Jacques Gaudet, listen to the full episode on your favorite podcast platform or watch on YouTube via saveyourthyroidwithjen.com.

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

[Click the thumbnail above to watch on YouTube!]

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

Key Takeaways from my episode with Dr. Jacques Gaudet:

1. Advocacy Over the Scalpel A doctor’s primary role is to be a persistent advocate for the patient. For Dr. Gaudet, this means prioritizing “doing the right thing” over tradition. Even though he is a highly decorated surgeon, he embraces non-surgical options like RFA to preserve his patients’ glands and quality of life.

2. Ultrasound is Non-Negotiable High-level ultrasound expertise is the cornerstone of safe RFA. A Head and Neck Surgeon’s 3D understanding of delicate neck anatomy—combined with masterful ultrasound skills—ensures precision and safety when delivering thermal energy through a needle tip.

3. Louisiana Leads the Way You don’t have to travel to massive medical hubs for world-class care. By putting in the time to study the data and learn the technology, Dr. Gaudet became the 2nd provider in Louisiana to offer Thyroid RFA, bringing advanced, non-surgical treatment to patients in Thibodaux, Raceland, and Houma.

4. Redefining Success and Quality of Life Success with RFA isn’t just about making a nodule completely disappear. Dr. Gaudet notes that even a smaller volume reduction—such as 15% to 25%—can completely resolve cosmetic bulging, eliminate the feeling of a lump in the throat, and restore a patient’s quality of life without the need for lifelong hormone replacement.

5. Confidence in the “Gray Zone” If you have an indeterminate nodule, don’t rush into the operating room. With modern diagnostics and non-surgical tools available, there is time to breathe, get a second opinion, and find a specialist who will partner with you to protect your thyroid.

For more updates like this, and to explore non-surgical thyroid nodule treatments like TAE, RFA, and nsPFA, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my new website:

👉 SaveYourThyroidWithJen.com

There, you can also sign up for personalized one-on-one patient navigation—because no one should feel alone on their thyroid journey.

Connect with Dr. Jacques Gaudet:

• Website: https://southernent.com/

• Locations: Thibodaux, Raceland, and Houma, Louisiana.

  ---

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

Thanks for reading! This post is public so feel free to share it.

Share

When you’re told your thyroid goiter has grown to the size of a grapefruit, the medical system usually gives you one “solution”: Total Thyroidectomy. For Anne Moeller, that wasn’t just a medical recommendation—it felt like an ultimatum. After two pregnancies in 2020 and 2022, her multinodular goiter had become impossible to ignore. It wasn’t just the scarves she wore to hide her neck; it was the fact that she was starting to struggle to breathe as the mass compressed her trachea.

But Anne did something I encourage every member of the Save Your Thyroid community to do: She paused, she researched, and she questioned the “surgery-only” narrative.

Welcome back to Save Your Thyroid with Jennifer Holkem. This is the space where we explore real stories, expert insights, and the nonsurgical options available for treating thyroid nodules—all so you can make confident, informed decisions while preserving your thyroid whenever possible.

Did you know that most adults have thyroid nodules? In fact, up to 70–80% of adults will develop one during their lifetime. For many, these remain small and manageable. However, for others, these nodules can become very, very large, leading to significant physical distress.

When a goiter reaches the size of a grapefruit, like Anne’s did, the only options usually presented are “watch and wait” until it becomes unbearable... or a major, invasive surgery. But what if there were another way for these complex cases? Especially for those massive cervical goiters that compress the trachea and change the very shape of your neck—cases that would typically require a full thyroidectomy and a lifetime of hormone replacement.

What if there was a method that doesn’t require a scalpel, doesn’t require an incision in the neck, and can preserve your thyroid function?

🎧 In today’s episode, we’ll learn about:

• Navigating a Massive Cervical Goiter: Hear Anne’s experience with a massive thyroid growth that was compressing her airway and how she felt the pressure to undergo a total thyroidectomy.

• The Power of Patient Advocacy: Anne’s journey of researching alternatives when she was told her nodules were “too large” for standard nonsurgical treatments like RFA.

• A Patient’s Experience with TAE: Anne’s first-hand account of the procedure and recovery, and how Thyroid Artery Embolization can provide a transformative cosmetic and functional result for goiters previously considered “surgical only.”

The Turning Point: Beyond the Scalpel

Anne was actually scheduled for surgery. She was mentally preparing to lose her thyroid gland until a chance discovery on the British Thyroid Foundation’s website changed everything. She saw two words that the traditional system often overlooks: Radiofrequency Ablation (RFA) and Thyroid Artery Embolization (TAE).

This is where the power of patient community comes in. Anne didn’t just read a brochure; she dove into the research, connected with other patients like Kathy (who many of you know from her own TAE journey), and realized that while her goiter might be “too big” for some ablation techniques, TAE offered a way to “starve” the nodules of their blood supply and shrink them without a single stitch.

Why Anne Chose TAE

Every case is unique. For Anne, the sheer volume of her cervical goiter made her a prime candidate for Embolization. After consulting with Dr. Juan Camacho (whose technical expertise we’ve discussed on the pod before), she made the brave call to cancel her surgery.

She wasn’t just choosing a procedure; she was choosing to keep her thyroid function intact.

What We Can Learn From Anne

Anne’s story isn’t just about a medical procedure; it’s about patient agency. She traveled overseas and sought out one of the best physicians in the field to ensure she got the outcome she wanted—not just the one that was most convenient for the surgeon.

Key Takeaways from Anne’s Experience:

• Size isn’t always a dealbreaker: Even a “grapefruit-sized” goiter can often be managed with an organ-preserving treatment like TAE.

• Symptoms matter: If your goiter is affecting your breathing or swallowing (compression), don’t wait to explore nonsurgical options.

• Community is a resource: Connecting with others who have been in your shoes can provide the clarity and confidence you need to cancel a surgery that doesn’t feel right.

Listen to the Full Story

Anne is a beacon of hope for anyone feeling pressured into a thyroidectomy. We talk about her recovery, the visible changes in her neck, and what it feels like to finally breathe easy again—all while keeping her thyroid.

To hear the full details of Anne’s procedure, recovery, and her advice for others facing similar diagnoses, listen to the full episode on your favorite podcast platform or watch on YouTube via saveyourthyroidwithjen.com.

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

Click the thumbnail above to watch on YouTube!

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

What is this podcast and blog all about?

To my subscribers, welcome back! If you’re new, welcome to Save Your Thyroid with Jennifer Holkem, a podcast and blog all about thyroid nodules. For the past 6 1/2 years, I have advocated for fellow patients suffering with this very common condition.

Thyroid nodules impact 70% of adults in their lifetime, and the standard of care is surgical removal of half or all of the gland. But in recent years, safe and effective non-surgical treatment options have become available.

In this podcast and blog, I sit down with patients and physicians to discuss life with thyroid nodules, treatment options, and how to save the thyroid whenever possible.

If you are currently navigating a large goiter and have been told surgery is your only option, please listen to this episode and be sure to subscribe. You have choices, and your thyroid is worth saving.

Subscribe now

AND, don’t forget to visit my new website:

👉 SaveYourThyroidWithJen.com

There, you can also sign up for personalized one-on-one patient navigation—because no one should feel alone on their thyroid journey.

Watch my previous interview on Thyroid Artery Embolization with Dr. Juan Camacho!

Connect with Dr. Juan Camacho:

precisionimageguided@gmail.com

Learn more about TAE:

https://youtube.com/playlist?list=PL5tSaOk33p7_CcD8KH8AIjB2kNIamAowo&si=JV43ry9oZefSW8b_

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

The goal of this podcast and blog

I seek to provide data, resources, and expert opinions on the topic of thyroid nodules, and make it accessible to patients. When I was first looking for thermal ablation treatment, everything that I read was physician-facing material. It was very hard for me to understand. This material is meant to help patients understand what’s going on in their thyroid gland and what an important gland it is. If you can keep your thyroid intact, that’s going to help you live a longer, healthier life, and preserve your quality of life. Thanks for reading this far today! — Jen

Thanks for reading Its me Jen again! This post is public so feel free to share it.

Share

SEO Tags: Thyroid Artery Embolization, TAE for Goiters, Non-Surgical Thyroid Treatment, Save Your Thyroid, Dr. Juan Camacho, Thyroidectomy Alternatives, Large Goiter Symptoms.

When we talk about thyroid nodules, the “standard” path has shifted from surgery to thermal options like RFA. But what happens when a nodule is too close to a critical nerve? Or when thermal energy just isn’t enough to shrink a stubborn growth? As I always say here, preserving your thyroid is about having the right tool for the right job.

Today’s guest is a true pioneer who refuses to settle for a one-size-fits-all approach. Dr. Emad Kandil, Chief of Endocrine Surgery at Tulane University, has reached a massive clinical milestone: completing over 100 cases using nPulse (nsPFA) technology. This isn’t just another ablation—it’s a non-thermal revolution that is changing the “danger zones” of thyroid care into zones of safety.

Welcome back to Save Your Thyroid with Jennifer Holkem. This is the space where we bridge the gap between “standard of care” and the future of medicine. My mission is to empower you with the knowledge needed to avoid unnecessary surgery and keep your thyroid intact for the long haul.

Did you know that while heat-based treatments like RFA are incredible, they have limits? When a nodule sits right against the nerves that control your voice, using heat can be a high-stakes gamble. But what if we could “program” nodule cells to clear themselves out without using a single degree of heat?

What if there was a method that didn’t rely on burning tissue, didn’t leave behind hard internal scarring, and could potentially reach the nodules that other doctors have turned away? This video explains more about how the technology works.

🎧 In today’s episode, we’re getting into the clinical weeds to explore:

• The 100-Case Milestone: What Dr. Kandil has learned from his first 100 nPulse patients and why this non-thermal approach is a “game-changer” for safety near the laryngeal nerve.

• The Science of “Nanopores”: A deep dive into how ultra-fast electrical pulses trigger apoptosis (natural cell death), allowing the body to clear the nodule without the inflammation of a burn.

• Beyond Benign: An update on the collaborative clinical trial with MD Anderson using this technology for Papillary Thyroid Microcarcinoma (PTMC) and how it’s being used for toxic, hyperfunctioning nodules.

• The Insurance Frontier: An honest look at the current state of coverage for this emerging technology and how these 100 cases are building the data needed for broader patient access.

Whether you are a patient searching for a safer alternative or a clinician following the data, this conversation is a glimpse into the next frontier of thyroid preservation. Let’s dive in.

Today’s guest returns to the podcast for a fourth time, Dr. Emad Kandil, an endocrine surgeon with a passion for helping patients shrink thyroid nodules and cancers using various nonsurgical, thyroid-sparing techniques. Dr. Kandil is the Chief of General, Endocrine and Oncological Surgery at Tulane University Medical School in New Orleans, Louisianna.

The Technical Deep Dive: Why “Non-Thermal” is a Safety Frontier

One of the most compelling parts of my conversation with Dr. Kandil was his explanation of the “user experience” behind the nPulse system. When a surgeon performs thermal ablation, they are managing heat. Heat can travel into undesirable, sensitive areas and cause damage. Fighting against this is the “heat sink” effect caused by nearby blood supply, which can sometimes pull energy away from the target.

With nanosecond Pulsed Field Ablation (nsPFA), that struggle disappears. Because there is no heat, the visibility on the ultrasound remains crystal clear. This allows Dr. Kandil to maneuver the probe with extreme precision, reaching nodules that were previously considered “too risky” due to a location near the recurrent laryngeal nerve or the carotid artery.

What the Patients Are Saying: Recovery and Results

We often hear about the “rapid volume reduction” with nsPFA, but seeing it in 100 consecutive cases is where the data becomes real. Dr. Kandil noted that many of his patients are seeing 70% reduction or more in just one month.

But it’s not just about the numbers; it’s about the recovery. Because we aren’t burning tissue, the post-op inflammatory response is significantly lower.

• Less Pain: Patients are reporting a need for fewer NSAIDs and ice packs compared to traditional thermal ablation.

• Faster Bounce-Back: Most of Dr. Kandil’s 100 patients were up and walking immediately after the procedure, returning to their normal lives without the “stiffness” sometimes felt after a thermal burn.

Expanding the Mission: Cancer and Toxic Nodules

Perhaps the most exciting frontier discussed was the use of nPulse for malignant nodules. Dr. Kandil shared details on the collaborative clinical trial with Dr. Victoria Banuchi at MD Anderson for Papillary Thyroid Microcarcinoma (PTMC).

🔗 MD Anderson Clinical Trial (PTMC): Contact the study team directly to ask about the "nPulse PTMC Trial":

Principal Investigator: Dr. Victoria Banuchi Phone: 346-217-8668 General MD Anderson Trials Line: 1-877-632-6789

The ability to trigger regulated cell death (apoptosis) in a cancerous nodule—without the collateral damage of surgery—could redefine “Active Surveillance” for thousands of patients. Furthermore, we discussed how nPulse is effectively “shutting down” toxic, hyperfunctioning nodules, providing a non-surgical answer for patients who were previously told their only options were radioactive iodine or a thyroidectomy.

The Insurance Frontier and Future Access

I asked Dr. Kandil the tough question: How do we get this to more people? While RFA now has established Category I CPT codes, nsPFA is still navigating the insurance landscape. However, the data from these first 100 cases is the “fuel” needed for broader advocacy. Dr. Kandil is currently transitioning into several new treatment locations to help expand access to this technology, ensuring that more patients have the option to choose preservation over the blade.

Final Thoughts: Advice for the Patient Advocate

If you are currently weighing your options for a thyroid nodule, Dr. Kandil’s advice is simple: Don’t rush into surgery until you’ve explored the full spectrum of non-surgical care. Whether it’s RFA, Microwave, or this new non-thermal frontier of nsPFA, the goal is to keep your thyroid intact and your quality of life high.

To hear the full details from my conversation with Dr. Emad Kandil, listen to the full episode on your favorite podcast platform or watch on YouTube via saveyourthyroidwithjen.com.

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

Click the thumbnail above to watch on YouTube!

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

What is this podcast and blog all about?

To my subscribers, welcome back! If you’re new, welcome to Save Your Thyroid with Jennifer Holkem, a podcast and blog all about thyroid nodules. For the past 6 1/2 years, I have advocated for fellow patients suffering with this very common condition.

Thyroid nodules impact 70% of adults in their lifetime, and the standard of care is surgical removal of half or all of the gland. But in recent years, safe and effective non-surgical treatment options have become available.

In this podcast and blog, I sit down with patients and physicians to discuss life with thyroid nodules, treatment options, and how to save the thyroid whenever possible.

Key Takeaways from my episode with Dr. Emad Kandil:

1. A Non-Thermal Paradigm Shift

Unlike RFA or Microwave ablation, which use heat to “burn” tissue, nsPFA uses ultra-fast electrical pulses to trigger apoptosis (regulated cell death). This allows the body to clear the nodule naturally without the inflammation, “heat sink” effects, or internal scarring (fibrosis) often associated with thermal energy.

2. Enhanced Safety in “Danger Zones”

Because there is no heat involved, nsPFA is uniquely suited for nodules located near critical structures like the recurrent laryngeal nerve or the carotid artery. Dr. Kandil’s 100-case milestone demonstrated that the lack of thermal spread provides a new level of precision, reducing the risk of voice changes or collateral tissue damage.

3. Rapid and Durable Volume Reduction

The data shows that this “heat-free” method is both fast-acting and permanent:

• Speed: Patients often see nearly a 50% reduction in just 14 days and over 70% within the first month.

• Durability: Long-term follow-up at 22 months showed an average 74% reduction with zero cases of regrowth.

4. Superior Patient Experience

The non-thermal nature of the procedure translates to a significantly easier recovery:

• Reduced Pain: Patients reported using fewer NSAIDs and ice packs post-procedure.

• Immediate Recovery: Most patients were mobile immediately after the 15-minute procedure and returned to normal activities the next day.

• High Satisfaction: 100% of patients in the durability study were highly satisfied with the cosmetic results (no surgical scars).

5. Expanding to Cancer and Complex Cases

The technology is moving beyond benign nodules:

• Malignancy: A collaborative trial is underway at MD Anderson to evaluate nsPFA for Papillary Thyroid Microcarcinoma (PTMC).

• Toxic Nodules: It is being used to “shut down” hyperfunctioning nodules that cause hyperthyroidism.

• Non-Responders: nsPFA is a viable option for patients who did not see significant shrinkage after previous thermal treatments (RFA/MWA).

6. The Path to Access

While nsPFA is currently navigating the insurance and CPT code landscape, the clinical success of these first 100 cases is building the foundation for broader coverage. Dr. Kandil is expanding access through new treatment locations to ensure more patients can choose preservation over surgery.

For more updates like this, and to explore non-surgical thyroid nodule treatments like TAE, RFA, and nsPFA, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my new website:

👉 SaveYourThyroidWithJen.com

There, you can also sign up for personalized one-on-one patient navigation—because no one should feel alone on their thyroid journey.

Watch my previous interviews with Dr. Emad Kandil on this playlist!

https://youtube.com/playlist?list=PL5tSaOk33p79ZDLbJstCQMjFaG31paRue&si=I65529lkfkK6DbYo

Connect with Dr. Emad Kandil:

Learn more about nsPFA (nPulse):

• YouTube Playlist: https://youtube.com/playlist?list=PL5tSaOk33p79ae_HG6gIc7SCVySjfjWEd&si=5Pn5c_LrFiZSqO6M

• Pulse Biosciences Website: https://www.pulsebiosciences.com/patients/

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

The goal of this podcast and blog

I seek to provide data, resources, and expert opinions on the topic of thyroid nodules, and make it accessible to patients. When I was first looking for thermal ablation treatment, everything that I read was physician-facing material. It was very hard for me to understand. This material is meant to help patients understand what’s going on in their thyroid gland and what an important gland it is. If you can keep your thyroid intact, that’s going to help you live a longer, healthier life, and preserve your quality of life. Thanks for reading this far today! — Jen

Thanks for reading Its me Jen again! This post is public so feel free to share it.

Share

At the recent NASIT 2026 (North American Society of Interventional Thyroidology) conference in Portland, Oregon, the energy was electric. As the founder of Save Your Thyroid, I was there to capture the advancements in non-surgical treatments for thyroid nodules and cancers, as well as spread awareness of our continuously growing patient community.

This year’s meeting wasn’t just about the technology; it was about a global shift in how we approach thyroid nodule care.

About NASIT

NASIT is the premier gathering for healthcare professionals—surgeons, endocrinologists, and interventional radiologists—dedicated to non-surgical thyroid treatments. With over 150 global experts in attendance, the event showcased the latest research and emphasized that the demand for non-invasive therapies is at an all-time high.

Key Takeaways from the Conference

1. The Power of Patient Advocacy

• Insights: I was incredibly moved by how many physicians expressed gratitude for the advocacy work we do. As I introduced myself, many doctors already knew about our community’s impact. Your voices are changing the clinical landscape, ensuring that patients are no longer just “recipients” of care, but active partners in decision-making.

  

2. Innovative Treatment Options

The conference highlighted a massive expansion in the “toolbelt” available to doctors:

• Radiofrequency Ablation (RFA) and Microwave Ablation (MWA): Still cornerstones of heat-based ablation, but with more refined data on long-term success.

  

• Thyroid Artery Embolization (TAE): Technologies like TriSalus’s Pressure-Enabled TAE are showing incredible promise for treating massive goiters without traditional surgery.

  Watch this demo of how the PED-TAE procedure works!

• Nanosecond Pulse Field Ablation (nPulse/nsPFA): Pulse Biosciences shared 22-month data showing a 75% volume reduction with no regrowth—a non-thermal game-changer.

  

3. Collaborative Learning & Breaking Silos

One of the most refreshing aspects of NASIT is the collaboration. We saw surgeons, endocrinologists, and interventional radiologists debating the best protocols for treating thyroid cancers and parathyroid adenomas. Using real-time QR code feedback, the audience engaged in live debates, proving that the medical community is hungry to learn from the collaborative experience of these safe non-surgical protocols.

The Future of Non-Surgical Treatments

We are witnessing a significant shift. As Rudy Garay from RGS Healthcare noted, the U.S. medical system is like a “coal-powered train”—it takes a moment to get moving, but once it gains momentum, it’s unstoppable. With growing evidence and rising patient demand, the medical community is responding with faster adoption of these life-changing technologies. Watch that clip here.

Conclusion

The NASIT 2026 conference was a pivotal moment. It proved that when patients and doctors work together, we can move away from “surgery-first” mentalities toward more personalized, organ-sparing solutions.

I encourage you to stay informed and talk to your healthcare providers about these options. Together, we are saving thyroids!

For more information or to find a physician specializing in these treatments, please visit Save Your Thyroid.

Watch the full recap video here!

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

What is this podcast and blog all about?

To my subscribers, welcome back! If you’re new, welcome to Save Your Thyroid with Jennifer Holkem, a podcast and blog all about thyroid nodules. For the past 6 1/2 years, I have advocated for fellow patients suffering with this very common condition.

Thyroid nodules impact 70% of adults in their lifetime, and the standard of care is surgical removal of half or all of the gland. But in recent years, safe and effective non-surgical treatment options have become available.

In this podcast and blog, I sit down with patients and physicians to discuss life with thyroid nodules, treatment options, and how to save the thyroid whenever possible.

Frequently Asked Questions

What is NASIT? NASIT stands for the North American Society of Interventional Thyroidology. It is a multidisciplinary organization focusing on minimally invasive and non-surgical treatment methods for thyroid and parathyroid conditions. Learn more about NASIT at nasit.org.

What are the benefits of non-surgical treatments? Non-surgical treatments, like RFA or nsPFA, typically offer shorter recovery times, no scarring, and a significantly lower risk of permanent hypothyroidism compared to traditional surgery.

How can patient advocacy influence treatment options? By asking for these options and sharing your experiences, you signal to the medical industry that there is a demand for innovation. This encourages more doctors to get trained and more hospitals to invest in the necessary technology.

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

The goal of this podcast and blog

I seek to provide data, resources, and expert opinions on the topic of thyroid nodules, and make it accessible to patients. When I was first looking for thermal ablation treatment, everything that I read was physician-facing material. It was very hard for me to understand. This material is meant to help patients understand what’s going on in their thyroid gland and what an important gland it is. If you can keep your thyroid intact, that’s going to help you live a longer, healthier life, and preserve your quality of life. Thanks for reading this far today! — Jen

Thanks for reading Its me Jen again! This post is public so feel free to share it.

Share

When we talk about massive thyroid goiters, the conversation often feels like it only has one destination: the operating table. But as I always say here, your thyroid gland is worth fighting for.

Today’s guest didn’t just face a routine thyroidectomy; he was told he needed a sternotomy—a highly invasive procedure where surgeons crack open the chest—in order to remove his massive multinodular goiter. His journey is a masterclass in patient advocacy and a testament to the power of looking beyond the standard “cut it out” advice.

Welcome back to Save Your Thyroid with Jennifer Holkem. This is the space where we explore real stories, expert insights, and the nonsurgical options available for treating thyroid nodules—all so you can make confident, informed decisions while preserving your thyroid whenever possible.

Did you know that most adults have thyroid nodules? In fact, up to 70–80% of adults will develop one during their lifetime. For many, these remain small and manageable. However, for others, these nodules can become very, very large, leading to significant physical distress.

When a goiter reaches a certain size, the only options usually presented are “watch and wait” until it becomes unbearable... or a major, invasive surgery. But what if there were another way for these complex cases? Especially for those “deep diving” goiters that have migrated into the chest—cases that would typically require a sternotomy, where the chest bone is surgically opened to reach the gland.

What if there was a method that doesn’t require a scalpel, doesn’t require an incision in the neck, and can preserve your thyroid function?

🎧 In today’s episode, we’ll learn about:

• Navigating a Massive Goiter: How Tosin handled the physical weight of a thyroid growth that was diving into his chest and the intense pressure to undergo a total thyroidectomy and a sternotomy.

• The Power of Patient Advocacy: Tosin’s journey of researching alternatives when he was told his nodules were “too large” or “too deep” for standard nonsurgical treatments like RFA or ethanol ablation.

• A Patient’s Experience with TAE: Tosin’s first-hand account of the procedure and recovery, and how this specific approach may shrink goiters that were previously considered “surgical only.”

The Slow Burn: From Routine Check to Major Growth

Tosin’s story started back in 2016 with a small thyroid growth. Like many of us, he was initially asymptomatic, but he knew one thing for certain: he didn’t want to be tied to a synthetic hormone pill for the rest of his life.

“Taking it out means you get to take the pill for the rest of your life,” Tosin recalled.

He chose to watch and wait, but eventually, his body started sending signals he couldn’t ignore. What started as a “small thing” had grown significantly, eventually pressing against his windpipe and lungs.

The Turning Point: “We Need to Crack Your Chest”

When the doctors told Tosin that his goiter had become substernal (growing down into the chest cavity), the surgical recommendation became extreme. They weren’t just talking about a neck incision anymore; they were talking about a sternotomy.

For Tosin, the fear wasn’t just about the surgery itself—it was about the recovery, the potential complications, and the loss of his thyroid gland. He knew there had to be another way, even if his local physicians hadn’t mentioned it.

Discovering the TAE Difference

Tosin’s curiosity served him well. His research eventually led him to Thyroid Artery Embolization (TAE). Unlike thermal ablation (like RFA), which uses heat to destroy tissue from the inside, TAE works by blocking the blood supply to the goiter, causing it to shrink naturally over time.

In Tosin’s case it was much less invasive, had a lower risk profile, and—most importantly—it kept his functioning thyroid intact.

Why Curiosity is Your Best Medical Tool

If there is one thing Tosin wants you to take away from his experience, it’s this:

Be curious. Ask the hard questions. If a doctor says surgery is the “only” way, ask “Why?”

• Validate the data. Don’t be afraid to seek second and third opinions from other specialists.

• Listen to your gut. If a procedure feels too invasive, keep looking.

The Result: A New Lease on Health

Post-procedure, the results were nothing short of miraculous for Tosin. Not only did the size of his thyroid decrease significantly, but his TSH levels actually normalized. He was back to work almost immediately, avoiding the months of recovery a sternotomy could have required.

Tosin’s journey reminds us that we are the CEOs of our own health. When we choose knowledge over fear, we can find options we never knew existed.

To hear the full details of Tosin’s procedure, recovery, and his advice for others facing similar diagnoses, listen to the full episode on your favorite podcast platform or watch on YouTube via saveyourthyroidwithjen.com.

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

Click the thumbnail above to watch on YouTube!

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

What is this podcast and blog all about?

To my subscribers, welcome back! If you’re new, welcome to Save Your Thyroid with Jennifer Holkem, a podcast and blog all about thyroid nodules. For the past 6 1/2 years, I have advocated for fellow patients suffering with this very common condition.

Thyroid nodules impact 70% of adults in their lifetime, and the standard of care is surgical removal of half or all of the gland. But in recent years, safe and effective non-surgical treatment options have become available.

In this podcast and blog, I sit down with patients and physicians to discuss life with thyroid nodules, treatment options, and how to save the thyroid whenever possible.

Key Takeaways from Tosin’s journey:

1. “Too Big” is Often a Matter of Perspective

The most significant takeaway is that size and location do not automatically mandate surgery. Tosin was told his goiter was too large and had “dived” too deep into his chest for standard treatments. His success with TAE proves that even complex, substernal goiters—those traditionally requiring a cracked chest (sternotomy)—can often be managed nonsurgically by cutting off the blood supply rather than cutting out the gland.

2. Thyroid Preservation Supports Hormonal Balance

A major win in Tosin’s story is the normalization of his TSH levels. Often, the surgical narrative suggests that a diseased or enlarged gland is “broken” and needs to be removed. Tosin’s journey shows that if you preserve the tissue and reduce the mass, it’s possible that the remaining gland can find its equilibrium, sparing the patient from a lifetime of synthetic hormone replacement.

3. TAE fills the “Ablation Gap”

While Radiofrequency Ablation (RFA) or Ethanol Ablation are a miracle for many, Tosin’s case highlights where Thyroid Artery Embolization (TAE) shines. For nodules that are exceptionally large or positioned dangerously close to other structures, TAE offers a “global” shrinkage method by targeting the internal plumbing (the arteries) rather than using a needle probe to heat the tissue.

4. Curiosity is a Survival Skill

Tosin’s phrase, “Knowledge is power,” isn’t just a cliché—it was his roadmap. His experience emphasizes that patients must:

• Look beyond the Endocrinologist or Surgeon: Sometimes the most innovative solutions come from Interventional Radiologists (IRs).

• Question the “Only Option”: If surgery is presented as the only path, it is a signal to seek a second or third opinion from a specialist in thyroid-preserving technologies.

5. Recovery can be Measured in Days, Not Months

The contrast in recovery is staggering. A sternotomy involves a long hospital stay and months of physical restriction. By choosing TAE, Tosin was back to work and his normal life almost immediately. This underscores the potential quality of life benefit that nonsurgical options provide, which can be downplayed in traditional surgical consultations.

For more stories like Tosin’s, and to explore non-surgical thyroid nodule treatments like TAE, RFA, and nsPFA, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my new website:

👉 SaveYourThyroidWithJen.com

There, you can also sign up for personalized one-on-one patient navigation—because no one should feel alone on their thyroid journey.

Watch my previous interview on Thyroid Artery Embolization with Dr. Juan Camacho!

Connect with Dr. Juan Camacho:

precisionimageguided@gmail.com

Learn more about TAE:

https://youtube.com/playlist?list=PL5tSaOk33p7_CcD8KH8AIjB2kNIamAowo&si=JV43ry9oZefSW8b_

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

The goal of this podcast and blog

I seek to provide data, resources, and expert opinions on the topic of thyroid nodules, and make it accessible to patients. When I was first looking for thermal ablation treatment, everything that I read was physician-facing material. It was very hard for me to understand. This material is meant to help patients understand what’s going on in their thyroid gland and what an important gland it is. If you can keep your thyroid intact, that’s going to help you live a longer, healthier life, and preserve your quality of life. Thanks for reading this far today! — Jen

Thanks for reading Its me Jen again! This post is public so feel free to share it.

Share

Have you ever felt like you were doing everything “right”—eating organic, avoiding gluten, taking your supplements—yet your thyroid labs still look like a roller coaster and your energy is non-existent?

If you have been in the thyroid community for any length of time, you know there are plenty of opinions on how to heal. But my guest today, Morley Robbins, deals in facts. Morley is the creator of the Root Cause Protocol and the author of Cu-RE Your Fatigue. While many know him as a challenger of the medical status quo, I see him primarily as a dedicated historian of medical literature.

In this episode, we tackle a fundamental question: Is your thyroid actually broken, or is it simply starving for the minerals it needs to function?

Welcome back to Save Your Thyroid with Jennifer Holkem, the podcast where we explore real stories, expert insights, and the deep-level science of thyroid health—so you can make confident, informed decisions while preserving your thyroid function whenever possible.

Most adults have thyroid nodules; in fact, they are one of the most common findings in clinical practice today. While most remain small and benign, many patients eventually face a crossroads: “watch and wait” until the nodule becomes symptomatic, or undergo invasive surgery. But what if we are asking the wrong questions? What if the nodule isn’t just a random growth, but a metabolic symptom of a deeper mineral crisis?

What if these “zombie cells” that refuse to die are simply starving for the minerals they need to function? What if the “rust” of iron toxicity in the gland is the very thing driving the growth of these masses? Today, we are stepping outside the surgical suite and into the mitochondria to explore a paradigm-shifting approach to thyroid nodules—one that doesn’t involve a scalpel, but instead focuses on the “spark plugs of life” to restore your body’s innate ability to heal.

🎧 In today’s episode, we’ll learn about:

• The Iron-Thyroid Trap: Why “low ferritin” on a blood test often masks iron toxicity in the tissues, and how this “rust” leads to hypothyroidism.

• The “Zombie Cell” Theory of Nodules: The fascinating science of how a lack of copper prevents cells from dying (apoptosis), leading to the formation of thyroid nodules.

• The 90/90 Rule: Why focusing on thyroid hormones (the gas pedal) is useless if your mitochondria (the engine) are broken.

• The Vitamin D Paradox: How high-dose Vitamin D supplementation can inadvertently block Vitamin A and crash your bioavailable copper levels.

• The “Mailroom Metaphor”: Why modern medicine’s focus on 20,000 different “keys” for symptoms misses the singular mineral “workspace” where all healing happens.

• The Roots of Mineral Depletion: How glyphosate and “hollow food” have made it impossible to get what we need from a standard diet alone.

  ---

Meet our Guest: Morley Robbins

Morley Robbins is the founder of The Root Cause Protocol. He received his BA in Biology from Denison University in Ohio and holds an MBA from George Washington University in healthcare administration.

Morley has trained in wellness coaching, nutritional counselling, and functional diagnostic nutrition. He is known as the “Magnesium Man” due to his extensive research into and the understanding of magnesium’s pivotal role in the body, and its deficiency due to the spectrum of stress that dominates our lives, today. Currently he is researching the intricate relationship between copper, iron, and oxidative stress and its impact upon magnesium status and ATP production. As a certified health coach (IIN), Morley has performed over eighty-five hundred one-on-one consults, trained almost 1,000 RCP consultants into these core metabolic principles, and is helping a growing populous feel better by empowering them to get to the root cause of their symptoms and to regain metabolic homeostasis.

The “Unlearning” Curve

I have a confession: When I first heard Morley speak on the Jesse Chappus Podcast, I was offended. His statements about vitamin supplements and iron contradicted everything I “knew” to be true about thyroid health. But curiosity led me to his book, Cure Your Fatigue, and ultimately, it shifted my entire paradigm.

As Morley explains, “You can’t heal in the sympathetic nervous system.” To heal, we have to release the fear that we are “broken” and look at the hard science of how our bodies actually work.

Why “Clean Eating” Isn’t Enough

Many of my listeners eat a pristine, whole-foods diet. So why are we still mineral depleted?

• The Glyphosate Factor: Glyphosate is a chelator—it binds to copper in the soil so plants can’t take it up. We are essentially eating “hollow” food.

• The 90/90 Rule: Mitochondria produce 90% of our energy and 90% of our “exhaust.” Think of the thyroid as the gas pedal and the mitochondria as the engine. You can’t fix a broken engine by pressing the gas pedal harder.

The Iron Myth: Distribution vs. Deficiency

One of the most controversial topics we cover is the “Iron Myth.” The body is a closed loop that recycles about 24mg of iron daily while losing only 1mg. We are designed to hoard iron, not excrete it.

On page 68 of Morley’s book, he lists conditions linked to iron overload—and hypothyroidism is right at the top.

The Data: Men with Hemochromatosis have an 80x higher risk of thyroid dysfunction (Edwards et al., 1983).

This proves that when iron accumulates in the gland, the thyroid fails. Many patients are told they have “low ferritin” and need iron supplements. But if you haven’t bled that iron out, where is it? It’s likely trapped in your tissues, “rusting” your cells because you lack the Copper Doorman (ferroportin - the only known mammalian cellular iron exporter, essential for moving iron from inside cells to the blood) to move it back into your blood.

Thyroid Nodules: The “Zombie Cell” Theory

I’ve long had a theory that nodules are just cells that cannot die. Morley and I dive into the science of Apoptosis (programmed cell death).

• The Mechanism: Cytochrome C is the enzyme that triggers cell death, and it requires copper.

• The Result: If mitochondria are too weak (low copper), the cell refuses to die. It becomes a “Zombie Cell.” These cells clump together, and we call them a nodule.

Recent research supports this: A 2024 study in Frontiers in Endocrinology found a positive association between iron levels and the risk of developing thyroid nodules.

Actionable Solutions from Morley’s book: The “Stops” and “Starts”

How do we stop the oxidative stress “rusting” and start the healing?

The Stops:

• Iron Supplements: Stop adding fuel to the fire unless medically necessary for acute loss.

• Synthetic Vitamin C & Zinc: These common supplements can inadvertently disrupt your copper levels.

The Starts:

• Real Vitamin C: Look for whole-food sources like Camu Camu or Acerola Cherry.

• Copper-Rich Foods: Grass-fed beef liver and bee pollen are nature’s mineral powerhouses.

• Cod Liver Oil: This provides the critical Vitamin A (Retinol) needed to make copper bioavailable.

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

Click the thumbnail above to watch on YouTube!

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

This conversation is just the beginning. We need to stop looking at the front of the “mailbox” (the symptoms) and start looking at the “work side” (the minerals).

Stay Tuned for Part 2: Morley and I will be doing a “Live Lab Interpretation” of a Full Monty panel to show you exactly how this looks on paper!

What is this podcast and blog all about?

To my subscribers, welcome back! If you’re new, welcome to Save Your Thyroid with Jennifer Holkem, a podcast and blog all about thyroid nodules. For the past 6 years, I have advocated for fellow patients suffering with this very common condition.

Thyroid nodules impact 70% of adults in their lifetime, and the standard of care is surgical removal of half or all of the gland. But in recent years, safe and effective non-surgical treatment options have become available.

In this podcast and blog, I sit down with patients and physicians to discuss life with thyroid nodules, treatment options, and how to save the thyroid whenever possible.

For more interviews on thyroid health, and to explore non-surgical thyroid nodule treatments like RFA, nsPFA, and TAE, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my new website:

👉 SaveYourThyroidWithJen.com

There, you can also sign up for personalized one-on-one patient navigation—because no one should feel alone on their thyroid journey.

Watch the Jesse Chappus podcast episode that sparked my curiosity to read Morley’s book!

Connect with Morley Robbins:

Purchase Morley’s book

If you found Morley’s information refreshing and take a deeper dive at the Root Cause Protocol Institute, here is the link.

Join the Premium Community which includes two live Q&A zoom meetings monthly. Morley will answer your questions and engage in a very lively conversation for $9.97 a month. Far less than the monthly cost of your cup of Joe and this is good for your health! Here is the link.

INSTAGRAM - https://www.instagram.com/therootcauseprotocol?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw%3D%3D

FACEBOOK -

https://www.facebook.com/RootCauseProtocol

https://www.facebook.com/groups/MagnesiumAdvocacy/

YOUTUBE - https://www.youtube.com/@TheRootCauseProtocol/featured

TIKTOK - https://www.tiktok.com/discover/root-cause-protocol-morley-robbins#:~:text=The%20Root%20Cause%20Protocol%20(RCP,minerals%20have%20in%20our%20bodies

X (Twitter)- https://x.com/RCPCopper

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

The goal of this podcast and blog

I seek to provide data, resources, and expert opinions on the topic of thyroid nodules, and make it accessible to patients. When I was first looking for thermal ablation treatment, everything that I read was physician-facing material. It was very hard for me to understand. This material is meant to help patients understand what’s going on in their thyroid gland and what an important gland it is. If you can keep your thyroid intact, that’s going to help you live a longer, healthier life, and preserve your quality of life. Thanks for reading this far today! — Jen

Thanks for reading Its me Jen again! This post is public so feel free to share it.

Share

Finding out you have thyroid nodules often happens by surprise. For many, the discovery doesn’t come from a visible lump, but from subtle, creeping symptoms that are easy to dismiss until they begin to impact daily life. In my latest podcast episode, I sat down with Matthew to discuss his personal patient journey—from the initial shock of diagnosis to finding a non-surgical treatment that changed his trajectory.

If you’ve ever felt the quiet frustration of symptoms that start off subtly but become impossible to ignore, Matthew’s journey is a powerful reminder that looking beyond the "standard" advice may lead to the relief you’ve been searching for.

Welcome back to Save Your Thyroid with Jennifer Holkem, the podcast where we explore real stories, expert insights, and nonsurgical options for treating thyroid nodules—so you can make confident, informed decisions while preserving your thyroid whenever possible.

Most adults have thyroid nodules. In fact, up to 70–80% of adults will develop one during their lifetime. For many, these remain small and manageable. However, for others, these nodules can become very, VERY large, leading to significant physical distress. When a goiter reaches a certain size, the only options usually presented are "watch and wait" until it becomes unbearable... or a major, invasive surgery.

But what if there were another way for these complex cases? Especially for those “deep diving” goiters that have migrated into the chest—cases that would typically require a sternotomy, where the chest bone is surgically opened to reach the gland.

What if there was a method that doesn’t require a scalpel, doesn’t require an incision in the neck, and can preserve your thyroid function?

🎧 In today’s episode, we’ll learn about:

• Navigating a Massive Goiter: How Matthew handled the physical weight of a thyroid growth that was diving into his chest and the pressure to undergo a total thyroidectomy and sternotomy.

• The Power of Patient Advocacy: Matthew’s journey of researching alternatives when he was told his nodules were “too large” or “too deep” for standard non-surgical treatments.

• A Patient’s Experience with TAE: Matthew’s account of the procedure and recovery, and how this specific approach may shrink goiters that were previously considered “surgical only.”

  ---

Meet Our Guest: Matthew Ashby

Matthew found himself facing a daunting medical crossroad. Like so many in our community, Matthew wasn’t looking for a “quick fix,” but rather a way to address a rapidly growing health concern while honoring his body’s natural function.

Matthew’s nodules were not obvious to him, because he had no symptoms. His first clue came when someone pointed out to him that he was taking breaths while speaking. As the nodules had grown, they didn’t just expand outward; they began to migrate downward into his chest cavity. This “diving” goiter started to create physical symptoms—most notably the breathing and swallowing difficulties —that could no longer be ignored.

When Matthew sought medical advice, he was met with the standard recommendation: a total thyroidectomy. Because of the size and depth of his goiters, he was even told he might require a sternotomy to reach the tissue in his chest. Unwilling to accept such an invasive path without exploring every alternative, Matthew stepped into the role of his own advocate. His research led him to the work of Dr. Juan Camacho and an alternative approach called Thyroid Artery Embolization (TAE).

TAE is a procedure that focuses on the blood supply to the thyroid. By strategically reducing flow to specific areas, this procedure may shrink goiters and nodules over time, potentially relieving the pressure on the airway and esophagus without the need for a scalpel.

The TAE Experience and Recovery

Matthew’s decision to choose TAE was rooted in a desire to preserve the thyroid gland. Keeping the thyroid intact is a major goal for many in the Save Your Thyroid community, as it allows the body to continue its natural hormone production and may help patients avoid lifelong dependence on thyroid medication.

Matthew described his experience with the TAE procedure as straightforward, with a recovery process that involved minimal discomfort. In just 3-4 months after the treatment, he noticed significant improvements in his quality of life. The distressing breathing issues began to dissipate, allowing him to return to his normal activities with a renewed sense of health.

Advocating for Your Thyroid Health

Matthew’s story is a powerful reminder of why patient advocacy is so important. If you are struggling with the symptoms of thyroid nodules, Matthew wants you to remember:

• You have options: Surgery is not the only path. Procedures like TAE are viable non-surgical treatments that may offer relief.

• Seek multiple opinions: Not every doctor is trained in the latest interventional radiology techniques. It is okay to look for a specialist who aligns with your goals.

• Do your research: Understanding the “natural history” of your nodules can help you make an informed decision before symptoms become debilitating.

To hear the full details of Matthew’s procedure, recovery, and his advice for others facing similar diagnoses, listen to the full episode on your favorite podcast platform or watch on YouTube via saveyourthyroidwithjen.com.

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

Click the thumbnail above to watch on YouTube!

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

What is this podcast and blog all about?

To my subscribers, welcome back! If you’re new, welcome to Save Your Thyroid with Jennifer Holkem, a podcast and blog all about thyroid nodules. For the past 6 years, I have advocated for fellow patients suffering with this very common condition.

Thyroid nodules impact 70% of adults in their lifetime, and the standard of care is surgical removal of half or all of the gland. But in recent years, safe and effective non-surgical treatment options have become available.

In this podcast and blog, I sit down with patients and physicians to discuss life with thyroid nodules, treatment options, and how to save the thyroid whenever possible.

Key Takeaways from Matthew’s Journey:

Matthew’s experience serves as a roadmap for anyone navigating a complex thyroid diagnosis. Here are the most significant lessons from his story:

• Goiters Can Grow “Inward”: Not all thyroid issues are visible from the outside. Multinodular goiters can grow downward into the chest cavity (substernal), which may lead to serious breathing and pressure issues.

• A Sternotomy is Not Always Required: Traditional surgery for “deep-diving” goiters often requires cracking the chest bone (sternotomy) to reach the tissue. TAE may offer a way to treat these areas through a tiny access point in the wrist, potentially avoiding major orthopedic surgery.

• The Importance of Preserving the Gland: By choosing a non-surgical treatment like TAE, Matthew was able to keep his thyroid intact, allowing his body to continue producing natural hormones and avoiding the need for lifelong thyroid replacement medication.

• Symptoms Can Be Silent: Breathing issues and anxiety can develop so gradually that you might not realize they are caused by your thyroid until the pressure is finally lifted.

• Advocacy Changes the Outcome: Matthew was told surgery was his only option. His commitment to researching alternatives like Thyroid Artery Embolization (TAE) allowed him to find a less invasive path with a much faster recovery.

• Recovery is Quicker Than You Think: Unlike the weeks of recovery required for a thyroidectomy or sternotomy, Matthew found that the recovery from TAE involved minimal discomfort and a rapid return to his daily quality of life.

For more stories like Matthew’s, and to explore non-surgical thyroid nodule treatments like TAE, RFA, and nsPFA, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my new website:

👉 SaveYourThyroidWithJen.com

There, you can also sign up for personalized one-on-one patient navigation—because no one should feel alone on their thyroid journey.

Watch my previous interview on Thyroid Artery Embolization with Dr. Juan Camacho!

Connect with Dr. Juan Camacho:

precisionimageguided@gmail.com

Learn more about TAE:

https://youtube.com/playlist?list=PL5tSaOk33p7_CcD8KH8AIjB2kNIamAowo&si=JV43ry9oZefSW8b_

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

The goal of this podcast and blog

I seek to provide data, resources, and expert opinions on the topic of thyroid nodules, and make it accessible to patients. When I was first looking for thermal ablation treatment, everything that I read was physician-facing material. It was very hard for me to understand. This material is meant to help patients understand what’s going on in their thyroid gland and what an important gland it is. If you can keep your thyroid intact, that’s going to help you live a longer, healthier life, and preserve your quality of life. Thanks for reading this far today! — Jen

Thanks for reading Its me Jen again! This post is public so feel free to share it.

Share

But what if you could shrink the goiter without a scalpel? What if you could target the blood supply of the enlargement, allowing your thyroid to return to a manageable size while keeping the organ—and its vital functions—intact?

In the rapidly advancing world of interventional radiology, Pressure-Enabled Thyroid Artery Embolization (PED-TAE) is emerging as an alternative for those with large goiters. While traditional treatments have limitations, this innovative approach is changing the narrative for patients who thought surgery was their only path.

If you are struggling with a large goiter or complex thyroid nodules, this conversation will introduce you to a potential solution that may help your quality of life.

Welcome back to Save Your Thyroid with Jennifer Holkem, where we explore the latest advancements in thyroid health and patient-centered care.

Large goiters can be more than just a cosmetic concern; they often cause difficulty swallowing, shortness of breath, and significant discomfort. Historically, the “gold standard” for a large goiter was a thyroidectomy, sometimes with the necessity of a sternotomy.

But what if there was another way? A method that uses a tiny catheter instead of a blade, requires no general anesthesia, and in a recent study* boasts a 73% volume reduction in just six months?

🎧 In today’s episode, we’ll learn about:

• What is PED-TAE: How pressure-enabled delivery may transform thyroid artery embolization into an effective, minimally invasive tool.

• Overcoming the “Size Problem”: Why traditional ablation methods sometimes struggle with massive goiters and how embolization may fill that gap.

• The Scientific Data: Insights into the recent clinical data demonstrating 100% technical success.

  ---

Meet Our Guest: Dr. Juan Camacho

Interventional Radiologist

In this groundbreaking episode, I sit down with Dr. Juan Camacho to discuss the shift from “scalpel to catheter.” Dr. Camacho is at the forefront of thyroid innovation, specializing in techniques that preserve the thyroid gland while treating even the most complex cases.

As Dr. Camacho explains, we are entering a new era of thyroid care. For patients with massive goiters that aren’t ideal candidates for RFA or surgery, PED-TAE offers a middle ground. By using a specialized device to deliver embolic agents directly into the thyroid’s blood supply, doctors can “starve” the goiter, causing it to shrink significantly without the need for invasive neck surgery.

“TAE offers a way to shrink even the largest goiters while preserving the organ.”

---

A 73% Reduction in Just Six Months

This isn’t just a theoretical alternative—the data backs it up. Dr. Camacho shares findings from a recent published study, which showed that patients experienced a staggering 73% reduction in goiter volume within half a year.

One of the most exciting aspects of PED-TAE is its potential impact on Quality of Life. Success isn’t just measured by a smaller number on an ultrasound; it’s measured by a patient being able to breathe easier, swallow without discomfort, and feel confident in their appearance again. By avoiding surgery, patients may also avoid the risks of vocal cord paralysis and the need for daily thyroid medication.

Exploring Every Option

The core message of Dr. Camacho’s work is simple: “There are always options.” Not every treatment is perfect for every person, but the days of a “one-size-fits-all” surgical approach are over. Whether it’s Graves’ disease or a massive multinodular goiter, the goal is a multidisciplinary approach that puts the patient’s choices first.

Want to hear Dr. Camacho’s full breakdown of how PED-TAE works and the future of non-surgical thyroid care? Watch the full episode below!

Watch this episode on YouTube, or download for offline viewing on YouTube Music!

Click the thumbnail above to watch on YouTube!

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

What is this podcast and blog all about?

To my subscribers, welcome back! If you’re new, welcome to Save Your Thyroid with Jennifer Holkem, a podcast and blog all about thyroid nodules. For the past 6 years, I have advocated for fellow patients suffering with this very common condition.

Thyroid nodules impact 70% of adults in their lifetime, and the standard of care is surgical removal of half or all of the gland. But in recent years, safe and effective non-surgical treatment options have become available.

In this podcast and blog, I sit down with patients and physicians to discuss life with thyroid nodules, treatment options, and how to save the thyroid whenever possible.

Key Takeaways:

• Innovative Alternative: PED-TAE is a non-surgical option for shrinking large goiters while preserving thyroid function.

• Clinical Results: Recent studies show a 73% volume reduction in six months with a 100% technical success rate.

• Pressure-Enabled Delivery: This specific technology can enhance how embolic agents reach the thyroid.

• Quality of Life: The primary goal is relieving symptoms like neck pressure and swallowing difficulties without the scars of surgery.

• Patient Advocacy: Dr. Camacho emphasizes the importance of exploring all alternatives and seeking multidisciplinary care.

  ---

To further explore non-surgical thyroid nodule treatments like RFA, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my new website:

👉 SaveYourThyroidWithJen.com There, you can also sign up for personalized one-on-one patient navigation—because no one should feel alone on their thyroid journey.

Patient Navigation

Watch my previous videos with Dr. Camacho on this playlist!

https://youtube.com/playlist?list=PL5tSaOk33p7_CcD8KH8AIjB2kNIamAowo&si=hVTlSKxTsBa0CHX2

Connect with Dr. Juan Camacho:

• precisionimageguided@gmail.com

Learn more about the PROTECT Registry:

https://clinicaltrials.gov/study/NCT06868459?cond=thyroid&intr=embolization&rank=3

Connect with a PROTECT Registry PED-TAE Physician:

https://docs.google.com/spreadsheets/d/1p0FfNAjnwYB75FdSA4Af6WTFouHh5FNQXEUbJfatkB8/edit?usp=sharing

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by “Its me Jen again” should be considered medical advice.

The goal of this podcast and blog

I seek to provide data, resources, and expert opinions on the topic of thyroid nodules, and make it accessible to patients. When I was first looking for thermal ablation treatment, everything that I read was physician-facing material. It was very hard for me to understand. This material is meant to help patients understand what’s going on in their thyroid gland and what an important gland it is. If you can keep your thyroid intact, that’s going to help you live a longer, healthier life, and preserve your quality of life. Thanks for reading this far today! — Jen

We’re closing out 2025 with a look straight into the future of healthcare! For my final video of the year, I traveled to Salt Lake City, Utah, to go behind the scenes with PIUR IMAGING’s groundbreaking 3D Ultrasound technology at the clinic of Dr. Alireza Falahati.

This isn’t just another tech review; it’s an up-close look at the innovations that will fundamentally change how doctors diagnose and treat thyroid nodules, offering a massive benefit to patients globally.

Subscribe now

The Challenge: Why 2D Ultrasound Can Fall Short

For years, doctors have relied on traditional 2D ultrasound to examine the thyroid gland and assess nodules. While effective, 2D imaging has significant limitations when dealing with complex or irregularly shaped nodules:

1. Limited Perspective: Standard ultrasound only provides a cross-sectional view, making it challenging to accurately determine the nodule’s true shape and size in three dimensions.

2. User Dependency: The accuracy of the scan is highly dependent on the skill and consistency of the technician operating the probe, leading to variability in results.

3. Accuracy Gaps: In the critical process of volumetric measurement—determining the nodule’s mass and growth—2D methods can introduce errors, which is crucial information for deciding on treatment.

The Solution: Precision in Three Dimensions

Enter PIUR IMAGING with a Tomographic 3D Ultrasound solution that revolutionizes the process.

The Solution: Precision in Three Dimensions

Enter PIUR IMAGING with a Tomographic 3D Ultrasound solution that revolutionizes the process.

At its core, this technology turns existing ultrasound machines into powerful 3D imaging tools. Instead of relying on manual 2D slices, the PIUR system automates the scan to generate a precise, three-dimensional volume of the thyroid gland.

This breakthrough delivers several key advantages for both doctors and patients:

• Seeing the Whole Picture: The system allows doctors to see the thyroid nodule from all angles, including a vital “front-to-back” view that is impossible with standard 2D scans. This “whole picture” view helps doctors understand the nodule’s true shape and its relationship to other tissues.

• Consistent Results: Because the 3D process is automated, the results are highly consistent, no matter who performs the scan. This reduces the risk of human error and ensures that the diagnosis is reliable and repeatable every time.

• Smarter Risk Assessment: The much clearer and more detailed images allow physicians to better categorize the nodule using the established ACR TI-RADS risk system. This boosts confidence in the diagnosis and dramatically improves the ability to spot potential thyroid cancer early.

• More Accurate Treatment: With better 3D maps and precise volume data, doctors can move beyond diagnosis to plan targeted treatments—like minimally invasive procedures (such as RFA)—with a much higher degree of accuracy.

Go Behind the Scenes in Salt Lake City

In the video, we witness Dr. Alireza Falahati demonstrating this technology and discussing its impact on his practice. Dr. Falahati provides expert insights into how this shift from 2D to 3D ultrasound will benefit both the medical community and, most importantly, the patients receiving care.

If you are a medical professional, a patient interested in the latest diagnostic methods, or simply a fan of health innovation, this is a video you cannot miss.

Watch the full video now to see PIUR IMAGING’s 3D Ultrasound in action!

What are your thoughts on this medical breakthrough? Let us know in the comments below!

Leave a comment

What is this podcast and blog all about?

To my subscribers, welcome back! If you’re new, welcome to Save Your Thyroid with Jennifer Holkem, a podcast and blog all about thyroid nodules. For the past 6 years, I have advocated for fellow patients suffering with this very common condition.

Thyroid nodules impact 70% of adults in their lifetime, and the standard of care is surgical removal of half or all of the gland. But in recent years, safe and effective non-surgical treatment options have become available.

In this podcast and blog, I sit down with patients and physicians to discuss life with thyroid nodules, treatment options, and how to save the thyroid whenever possible.

To further explore non-surgical thyroid nodule treatments like RFA and holistic thyroid health, be sure to subscribe!

AND, don’t forget to visit my new website: 👉 SaveYourThyroidWithJen.com There, you can also sign up for personalized one-on-one patient navigation—because no one should feel alone on their thyroid journey.

🔗 Connect and Learn More!

Learn more about Dr. Alireza Falahati:

https://www.utendocrinology.com/

Learn more about Piur Imaging:

https://www.piurimaging.com/

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by Jennifer Holkem or “Its me Jen again” should be considered medical advice.

The goal of this podcast and blog

I seek to provide data, resources, and expert opinions on the topic of thyroid nodules, and make it accessible to patients. When I was first looking for thermal ablation treatment, everything that I read was physician-facing material. It was very hard for me to understand. This material is meant to help patients understand what’s going on in their thyroid gland and what an important gland it is. If you can keep your thyroid intact, that’s going to help you live a longer, healthier life, and preserve your quality of life. Thanks for reading this far today! — Jen

But what if there was an alternative that prioritized organ preservation, minimized downtime, and maximized convenience?

Welcome back to Save Your Thyroid with Jennifer Holkem, the podcast dedicated to bringing you the newest breakthroughs in thyroid health and patient-first advocacy.

Thyroid nodules and the options for treatment can feel overwhelming, often leading patients directly to the operating room. However, the world of thyroid treatment is rapidly evolving, moving beyond traditional surgery to embrace minimally invasive options like Radiofrequency Ablation (RFA). This week, we’re cutting through the confusion by looking thousands of miles across the globe to see how experts in Taiwan are not only making RFA the norm, but also mastering advanced techniques to ensure safety, minimize complications, and preserve your thyroid gland.

🩺 Meet Our Guest: Dr. Chan Jung Chang

In this vital episode, I sit down with Dr. Chan Jung Chang, an internationally recognized expert in thyroid health and advanced Radiofrequency Ablation (RFA) techniques. Dr. Chang serves as an Otolaryngologist (ENT) and Attending Physician at Taichung Tzu Chi Hospital in Taiwan.

Dr. Chang brings a unique and highly advanced perspective, showcasing why RFA has become so widely adopted in Taiwan—not just for benign thyroid nodules, but also for treating papillary thyroid microcarcinoma under specific criteria.

His expertise centers on innovations that prioritize patient safety and organ preservation, including the crucial use of hydrodissection (often enhanced with hyaluronic acid) and arterial ablation to ensure long-term success without the need for traditional surgery. Dr. Chang’s insights into Taiwan’s streamlined, “one-stop shop” patient journey offer a glimpse into the future of efficient and patient-centered thyroid care.

🇹🇼 In This Week’s Episode, We’re Exploring:

• The Taiwan Model: The cultural and logistical reasons that have led to the widespread adoption of Radiofrequency Ablation (RFA) as a primary non-surgical treatment for thyroid nodules.

• Streamlined Patient Journey: How Taiwan’s “one-stop shop” care model provides patients with efficient diagnosis and treatment, often within just two weeks.

• Advanced Safety Techniques: The necessity and implementation of sophisticated methods like Hydrodissection (using hyaluronic acid) to safeguard the delicate structures around the thyroid, such as the vocal cord nerve, during RFA.

• Preventing Regrowth: The cutting-edge use of Arterial Ablation to treat highly vascularized tumors and minimize the risk of nodule or tumor recurrence.

• RFA for Cancer: The specific patient selection criteria and evolving landscape for using RFA to manage papillary thyroid microcarcinoma as a non-surgical alternative to preserve the gland.

• Patient Empowerment: The importance of respecting patient choice in deciding between surgery and advanced ablation techniques, and the essential role of consistent follow-up care post-RFA.

Why Taiwan is Leading the RFA Revolution 🧑‍⚕️

The widespread adoption of RFA as a non-surgical option in Taiwan isn’t just about medical advancement—it’s driven by cultural preferences.

• Minimizing Scarring: There’s a strong cultural emphasis on avoiding visible scarring, especially on the neck. RFA, which involves only a tiny pinprick and no incision, offers a powerful, scar-free solution.

• Preserving the Gland: Across all cultures, patients deeply value the ability to preserve their thyroid gland. RFA achieves this by only destroying the abnormal tissue (the nodule or small cancer) while leaving the healthy surrounding tissue intact.

For patients exploring RFA, Dr. Chang notes that the journey in Taiwan is exceptionally efficient. They employ a “one-stop shop” model, where patients can receive their diagnosis, consultation, and treatment planning in a single, streamlined visit. This drastically cuts down the time from initial check-up to treatment, often completing the diagnosis and treatment process within just two weeks.

Advanced RFA: Protecting What Matters Most

While RFA is a minimally invasive procedure performed under ultrasound guidance, treating complex or large tumors near vital structures requires specialized skill. Dr. Chang details two key advanced techniques that are crucial for maximizing safety and success:

1. Hydrodissection

The thyroid is surrounded by critical structures, including the windpipe (trachea) and the recurrent laryngeal nerve (which controls your voice). To safely perform RFA on a nodule that is close to these structures, Hydrodissection is used.

• The Technique: A sterile solution is carefully injected to create a protective buffer—a water cushion—between the nodule and the nearby critical organ. This pushes the nerve or trachea away from the treatment zone, ensuring the radiofrequency energy only hits the target tissue.

• Hyaluronic Acid Advantage: Dr. Chang notes that using hyaluronic acid can further improve the hydrodissection process, making the protective barrier more stable and effective.

2. Arterial Ablation

For some large or highly vascularized nodules, there’s a risk of the tumor attempting to regrow by forming new blood vessels. Dr. Chang and his team employ arterial ablation to preemptively address this:

• Preventing Regrowth: By ablating the small arteries that supply blood to the tumor, they cut off the tumor’s nutrient source. This step is key to ensuring the nodule shrinks permanently and prevents the regrowth of the tumor.

Navigating Thyroid Cancer: RFA for Microcarcinoma

While surgery remains the primary treatment for most thyroid cancers globally, RFA is playing an increasingly important role in managing small malignant tumors.

• Papillary Thyroid Microcarcinoma (PTMC): RFA can be considered a highly effective non-surgical option for patients with small, low-risk papillary thyroid microcarcinoma that meets specific criteria (e.g., small size, location away from vital structures).

• Patient Choice: Dr. Chang stresses that patient choice is respected. If a patient prefers to avoid surgery and its associated risks, RFA offers a safe, non-invasive alternative that can effectively treat the lesion while preserving the thyroid gland.

As Dr. Chang wisely states, “We are open-minded to treatment modalities.” This open approach ensures patients have access to the full spectrum of options, leading to better outcomes and life-changing experiences.

The Importance of Follow-Up Care

The RFA journey doesn’t end when you leave the clinic. Regular follow-up care is crucial for monitoring the ablated tumor site and ensuring the treatment was fully effective.

• Monitoring Success: Follow-up protocols involve routine imaging to monitor the reduction in the nodule’s size.

• Managing Long-Term Health: This ongoing check-up ensures the patient’s long-term thyroid health is maintained, confirming the non-surgical approach delivered the desired result.

The future of RFA in treating thyroid cancer is bright, with ongoing advancements in diagnostic techniques poised to further increase its acceptance and use. By combining cutting-edge technology with a patient-first, streamlined model, experts like Dr. Chang are truly revolutionizing thyroid treatment and ensuring patients worldwide have access to these life-changing procedures.

🔑 Key Takeaways from This Episode

• Non-Surgical Preference: Radiofrequency Ablation (RFA) has become widely preferred in Taiwan, driven by a cultural attitude to avoid visible scarring on the neck.

• Streamlined Care: Taiwan utilizes a “one-stop shop” patient journey for thyroid treatment, allowing efficient diagnosis and treatment planning to occur within approximately two weeks.

• Organ Preservation: Across cultures, there is a shared value for preserving the thyroid gland, which RFA achieves by only treating the tumor/nodule.

• Advanced Safety: Hydrodissection is a crucial technique used to protect vital organs, like the recurrent laryngeal nerve, during RFA, and is often improved by adding hyaluronic acid.

• Preventing Recurrence: Arterial ablation is an advanced technique that can be used to prevent tumor regrowth by cutting off the blood supply to the ablated area.

• RFA for Cancer: RFA can be considered a valid non-surgical option for patients with papillary thyroid microcarcinoma under specific, strict criteria.

• No Size Ceiling: RFA can be performed on tumors of various sizes, indicating no strict ceiling for treatment dimensions, depending on technique and location.

• Patient Empowerment: Patient choice is respected in deciding between RFA and traditional surgery, reinforcing the importance of being open-minded to treatment modalities.

• Post-Procedure Management: Consistent follow-up care is essential for monitoring treatment effectiveness, managing patient health, and ensuring long-term success post-RFA.

  ---

Watch this episode on YouTube, or download for offline viewing on YouTube Music!Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

(Click the thumbnail above to watch on YouTube!)

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

What is this podcast and blog all about?

To my subscribers, welcome back! If you’re new, welcome to Save Your Thyroid with Jennifer Holkem, a podcast and blog all about thyroid nodules. For the past 6 years, I have advocated for fellow patients suffering with this very common condition.

Thyroid nodules impact 70% of adults in their lifetime, and the standard of care is surgical removal of half or all of the gland. But in recent years, safe and effective non-surgical treatment options have become available.

In this podcast and blog, I sit down with patients and physicians to discuss life with thyroid nodules, treatment options, and how to save the thyroid whenever possible.

To further explore non-surgical thyroid nodule treatments like RFA and holistic thyroid health, be sure to subscribe!

AND, don’t forget to visit my new website: 👉 SaveYourThyroidWithJen.com There, you can also sign up for personalized one-on-one patient navigation—because no one should feel alone on their thyroid journey.

🔗 Connect with DR. CHAN JUNG CHANG (Via International Medical Service Center):

Dr. Chan Jung Chang practices at Taichung Tzu Chi Hospital in Taiwan. For inquiries related to international medical services, including RFA treatment, please use the following contact details for the International Medical Service Center (TCIMSC):

• IMSC Email: tcimsc@tzuchi.com.tw

• IMSC Contact Number: +886-4-36060666 #3013

• Official LINE ID (Messaging App): @814xrlvr (or use the Official LINE Link below)

• IMSC Official LINE Link: https://lin.ee/HR4gdM7

Please add the official LINE account of the “Taichung Tzu Chi Hospital, International Medical Service Center (TCIMSC)” and leave your inquiry message. They will respond to ensure that no messages are missed.

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by Jennifer Holkem or “Its me Jen again” should be considered medical advice.

The goal of this podcast and blog

I seek to provide data, resources, and expert opinions on the topic of thyroid nodules, and make it accessible to patients. When I was first looking for thermal ablation treatment, everything that I read was physician-facing material. It was very hard for me to understand. This material is meant to help patients understand what’s going on in their thyroid gland and what an important gland it is. If you can keep your thyroid intact, that’s going to help you live a longer, healthier life, and preserve your quality of life. Thanks for reading this far today! — Jen

Save Your Thyroid with Jen is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

Subscribe now

These are valid, critical questions. And to answer them, you need to speak with a specialist who is an expert not just on the thyroid, but on the entire anatomy of the neck.

Welcome back to Save Your Thyroid with Jennifer Holkem, the podcast dedicated to bringing you the newest breakthroughs in thyroid health and patient-first advocacy.

Thyroid nodules are incredibly common, but the path to treatment can be confusing. It often involves a team of specialists, and one of the most crucial members of that team is an Otolaryngologist, or ENT. Today, we explore why their perspective is so vital.

🎧 In today’s episode, we’ll learn about:

• The ENT’s Role: Why otolaryngologists are crucial for thyroid care and their expertise in neck anatomy.

• The Diagnostic Process: What to expect from imaging, biopsies, and understanding your results.

• The “Big Two” Risks: A surgeon’s perspective on protecting the voice and parathyroid glands during surgery.

• A Non-Surgical Alternative: How Radiofrequency Ablation (RFA) fits into the treatment landscape as a minimally invasive option.

• Patient Empowerment: The importance of patient education, advocacy, and making informed decisions.

  ---

Meet Our Guest: Dr. Michael J. Wolfe

In this vital episode, I sit down with Dr. Michael J. Wolfe, an expert in otolaryngology (ENT) and head & neck surgery. Dr. Wolfe brings a unique and critical perspective to our show, bridging the world of traditional surgical treatment with emerging, minimally invasive techniques.

For many patients, the journey starts with symptoms like a lump in the throat, a cough, or difficulty swallowing. Dr. Wolfe walks us through the diagnostic process, from imaging to biopsy, and what those results mean for your treatment plan.

Understanding the Risks of Surgery

A key part of our conversation focuses on the “gold standard” treatment: thyroid surgery. Dr. Wolfe provides a surgeon’s candid insights into the primary risks—potential damage to the recurrent laryngeal nerve (which controls your voice) and the parathyroid glands (which regulate calcium).

This discussion is essential for any patient facing a surgical decision, as it highlights the importance of understanding the full scope of the procedure.

The Non-Surgical Option: RFA

So, what if there’s another way? We dive deep into Radiofrequency Ablation (RFA), a minimally invasive, non-surgical alternative for treating symptomatic, benign thyroid nodules. RFA offers a way to shrink the nodule without an incision, without general anesthesia, and—most importantly—while preserving the healthy thyroid gland and the delicate structures around it.

Dr. Wolfe and I discuss how RFA is changing the game, why access is still limited, and the importance of patient advocacy in exploring all available options. This episode is all about empowering you to collaborate with your specialists and make the best, most informed decision for your thyroid health.

Want to hear Dr. Wolfe’s full insights on RFA, surgery, and protecting your voice? Watch the full episode below!

Watch this episode on YouTube, or download for offline viewing on YouTube Music!Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

(Click the thumbnail above to watch on YouTube!)

Save Your Thyroid with Jennifer Holkem is now available on more podcast platforms!

• RSS Feed

• Spotify

• iHeartRadio

• Audible

• Amazon Music

• Acast

• Pocketcasts

Visit my new podcast website, SaveYourThyroidwithJen.com!

Visit now!

What is this podcast and blog all about?

To my subscribers, welcome back! If you’re new, welcome to Save Your Thyroid with Jennifer Holkem, a podcast and blog all about thyroid nodules. For the past 6 years, I have advocated for fellow patients suffering with this very common condition.

Thyroid nodules impact 70% of adults in their lifetime, and the standard of care is surgical removal of half or all of the gland. But in recent years, safe and effective non-surgical treatment options have become available.

In this podcast and blog, I sit down with patients and physicians to discuss life with thyroid nodules, treatment options, and how to save the thyroid whenever possible.

Key Takeaways:

• Thyroid surgery is often driven by patient symptoms and biopsy results.

• Otolaryngologists play a crucial role in thyroid care due to their expertise in neck anatomy.

• The diagnostic process for thyroid nodules includes imaging and biopsies to determine treatment options.

• Radiofrequency ablation (RFA) is a minimally invasive alternative to traditional surgery for thyroid nodules.

• Patient education and advocacy are essential in making informed decisions about thyroid health.

• Collaboration between specialists, including endocrinologists and surgeons, enhances patient care.

• The risk of thyroid surgery includes potential damage to the voice and parathyroid glands.

• Patients should seek second opinions and explore all treatment options available to them.

• Understanding the nature of thyroid cancer can alleviate patient anxiety about diagnoses.

• Access to RFA is still limited, and patients may need to travel for treatment.

To further explore non-surgical thyroid nodule treatments like RFA and holistic thyroid health, be sure to subscribe!

Subscribe now

AND, don’t forget to visit my new website: 👉 SaveYourThyroidWithJen.com There, you can also sign up for personalized one-on-one patient navigation—because no one should feel alone on their thyroid journey.

Connect with DR. MICHAEL J. WOLFE:

• Website: https://proliancesurgeons.com/doctor/michael-j-wolfe-md-facs/

Please consider supporting my work. Every donation is sincerely appreciated!

Venmo

Paypal

Find a physician, explore treatment options, and join our patient community here:

Save Your Thyroid

Disclaimer: None of the statements made in this or any other blog/video by Jennifer Holkem or “Its me Jen again” should be considered medical advice.

The goal of this podcast and blog

I seek to provide data, resources, and expert opinions on the topic of thyroid nodules, and make it accessible to patients. When I was first looking for thermal ablation treatment, everything that I read was physician-facing material. It was very hard for me to understand. This material is meant to help patients understand what’s going on in their thyroid gland and what an important gland it is. If you can keep your thyroid intact, that’s going to help you live a longer, healthier life, and preserve your quality of life. Thanks for reading this far today! — Jen