Save Your Thyroid with Jennifer Holkem

Jennifer Holkem
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Thyroid nodules impact 70 percent of adults in their lifetime. The standard of care is surgical removal of half or all of the gland. But in recent years, nonsurgical treatment options have become available. Hi, my name is Jennifer Holkem and I advocate for fellow patients suffering with this very common condition. I sit down with patients and physicians and discuss life with thyroid nodules, the journey from diagnosis to treatment, and how to save your thyroid through nonsurgical advances in medicine. Hosted on Acast. See acast.com/privacy for more information.

  1. Sep 9

    A New Option for Thyroid Cancer? (Quick Update)

    Most patients with low-risk papillary thyroid cancer are told there are two paths: surgery, or active surveillance. In this quick update, I'm sharing news of a first-in-human clinical trial that's testing whether there's a third option. Researchers at Sarasota Memorial Health Care System and MD Anderson Cancer Center are evaluating nsPFA (nanosecond pulsed field ablation) — already FDA-cleared for benign thyroid nodules — to see if it can safely treat papillary thyroid microcarcinoma without surgery or thermal damage. The trial is led by Dr. Ralph Tufano (Sarasota Memorial) and Dr. Victoria Banuchi (MD Anderson), who reached out to me personally to help spread the word. You may qualify if you have: ✅ Papillary thyroid microcarcinoma ✅ Tumor smaller than 1.5cm ✅ Cancer confined to the thyroid ✅ No lymph node involvement ✅ No spread beyond the thyroid ✅ Currently a candidate for active surveillance Two enrollment sites: Sarasota, FL and Houston, TX. About 10 of 30 slots remain. Learn more or see if you qualify: 📞 (941) 917-2225 📧 researchinstitute@smh.com 🔗 clinicaltrials.gov/study/NCT07218315 Hosted on Acast. See acast.com/privacy for more information.

    A New Option for Thyroid Cancer? (Quick Update)

  2. Sep 8

    nsPFA: Zero Regrowth at 22 Months! The Durability Data Thyroid Patients Need | Prof. Stefano Spiezia

    The question this community has been asking since nsPFA first appeared on this podcast has finally been answered. Does it last? Professor Stefano Spiezia conducted the first-in-human feasibility study of nsPFA for benign thyroid nodules — and in 2026 he presented the durability data at the NASIT annual meeting in Portland, Oregon. Average 74% volume reduction at up to 22 months. Zero regrowth. Zero serious adverse events. And the nodule continued to shrink throughout the entire follow-up period. Professor Spiezia is the Head of the Division of Endocrine and Ultrasound Guided Surgery at the Sea Hospital in Naples, Director of the Regional Reference Center for Thyroid Treatment, Adjunct Professor at the University of Turin, and Director of the Save Your Thyroid International School for Interventional Thyroid Procedures. In this episode: ✅ Why nsPFA is a paradigm shift — not just another energy source ✅ How it works — programming cells to die, not burning them ✅ The 22-month durability data — 74% volume reduction, zero regrowth, zero serious adverse events ✅ Why the nodule kept shrinking throughout the entire follow-up ✅ 100% patient satisfaction with cosmetic appearance, 95% overall ✅ Why the absence of fibrosis and scarring changes everything ✅ Which nodules benefit most — especially those near critical structures ✅ Why nsPFA and RFA are complementary rather than competitive ✅ The regulatory landscape — FDA cleared in the US, CE mark pending in Europe ✅ The Save Your Thyroid International School — training physicians worldwide If you have been waiting for the durability data on nsPFA before making a decision — this is the episode you have been waiting for. Chapters 00:00 Introduction to Thyroid Nodule Treatments 01:04 New chapter 01:57 The Evolution of Non-Surgical Options 03:56 Understanding NSPFA: A Paradigm Shift 03:56 The Safety and Efficacy of NSPFA 15:39 Navigating Thyroid Nodule Diagnosis 44:09 Introduction to the Podcast and Resources 44:09 Navigating Thyroid Health and Community Support 🔗 Professor Spiezia & the Save Your Thyroid International School: www.sytmedical.com 🔗 nsPFA Trial at MD Anderson & Sarasota Memorial (NCT07218315): clinicaltrials.gov/study/NCT07218315 Contact: (941) 917-2225 or researchinstitute@smh.com 📌 Resources: 👉 Podcast: https://www.saveyourthyroidwithjen.com/ 👉 Patient site: https://www.saveyourthyroid.org/ 👉 Private FB group: https://www.facebook.com/groups/saveyourthyroidnonsurgical 👉 Patient Navigation: https://www.saveyourthyroidwithjen.com/patient-navigation-services/ ⚠️ Disclaimer: This podcast is for informational purposes only and is not a substitute for professional medical advice. No endorsement is given or implied for any specific product, treatment, or physician mentioned. Always consult with a qualified healthcare professional regarding your individual medical needs. 🎵 Music licensed through Soundstripe: 1G4WWNUWW7H8MYH4 VRP5MQM1YSHICQLR 1NSDN1IASZTIWC21 Hosted on Acast. See acast.com/privacy for more information.

  3. Sep 1

    Just Diagnosed With a Thyroid Nodule? What They Don't Tell You on Day One

    "Well, better get it taken out." That was the entire conversation after my thyroid biopsy. Then I waited six weeks for pathology — six weeks so frightening I didn't tell my own parents, and spent researching cancer treatments for a disease I didn't have. Not one person told me that most thyroid nodules are benign. If you've just been told you have a thyroid nodule, this episode is the information nobody handed me. No guest this week — just the conversation I wish someone had sat down and had with me on day one. In this episode: ✅ The number nobody gives you — 90 to 95 out of every 100 thyroid nodules are benign, according to the American Thyroid Association ✅ What happens if it is cancer — why papillary thyroid cancer is one of the slowest-growing and most treatable that exists ✅ Why more than half of adults have a thyroid nodule and never know it ✅ What your ultrasound is actually measuring — risk features and TIRADS categories, not a diagnosis ✅ The Bethesda system explained, and how reliable a benign biopsy result really is ✅ Why a nodule diagnosis does not automatically mean surgery ✅ Active surveillance, radiofrequency ablation, microwave ablation, and other non-surgical options ✅ My own story — the nodule that grew to 4.5 x 7 cm, the years I lost to "take it out or leave it alone," and the outpatient procedure that shrank it by 90% and left my thyroid intact It's okay to be scared. But you should know the odds are genuinely in your favor. 📚 Sources referenced: American Thyroid Association — Clinical Thyroidology for the Public, December 2017 American Thyroid Association — Statement on ablation techniques for benign thyroid nodules, Thyroid, 2023 MedlinePlus Medical Encyclopedia 📌 Resources: 👉 Podcast: https://www.saveyourthyroidwithjen.com/ 👉 Patient site: https://www.saveyourthyroid.org/ 👉 Physician Finder — specialists in 50+ countries: https://www.saveyourthyroid.org/find-a-physician/ 👉 Private FB group: https://www.facebook.com/groups/saveyourthyroidnonsurgical 👉 Patient Navigation: https://www.saveyourthyroidwithjen.com/patient-navigation-services/ 💛 Support the show: PAYPAL: https://www.paypal.com/paypalme/itsmejenagain VENMO: https://account.venmo.com/u/itsme_jenagain ⚠️ This podcast is for informational purposes only and is not a substitute for professional medical advice. No endorsement is given or implied for any specific product, treatment, or physician mentioned. Always consult with a qualified healthcare professional regarding your individual medical needs. Hosted on Acast. See acast.com/privacy for more information.

  4. Aug 18

    Your Thyroid Cancer Is Not Urgent — An Endocrine Surgeon Explains | Dr. Melanie Goldfarb

    What if the surgeon sitting across from you told you that your thyroid cancer is not urgent — and that you have time to think, research, and explore all your options before committing to anything? That's exactly what Dr. Melanie Goldfarb tells her patients. And she's an endocrine surgeon. 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 genuinely unbiased perspective — she performs surgery AND ablation, so her recommendation reflects what's right for each patient, not the limits of what she can offer. In this episode she joins Jennifer Holkem to cover the full landscape of thyroid nodule and cancer treatment — from realistic RFA expectations to a combination approach that could save half your thyroid. In this episode: What realistic RFA outcomes look like: The published definition of success is 50% volume reduction — Dr. Goldfarb achieves that 90-95% of the time but personally aims for 70-80%. Nodules under 4 to 4.5 centimeters typically need one session. Larger nodules may need more. Goiter vs. nodule — why the distinction changes everything: A goiter is diffuse thyroid overgrowth. A nodule is a distinct, delineated growth. Thermal ablation is designed for nodules, not goiters. Getting this wrong leads to the wrong treatment conversation entirely. Thyroid cancer and the 120% concept: Candidates for cancer ablation are the same patients who qualify for active surveillance — tiny papillary thyroid microcarcinomas under one centimeter, fully contained. The critical difference from benign treatment: you need 120% — the entire tumor plus a surrounding margin. Location is everything. The lobectomy + RFA combination: For patients with one dominant side that is too large for ablation alone, Dr. Goldfarb removes that side surgically while using RFA to preserve the other. An innovative approach that saves half a thyroid for the right patient. When proactive treatment makes sense: Her threshold is 3 to 3.5 centimeters. Serial ultrasounds consistently showing growth are an automatic reason to act. But not every nodule that exists needs treatment. Active surveillance is a treatment: Watching is a conscious medical decision — not inaction. And the data is clear: even if a tiny thyroid cancer grows during surveillance, long-term prognosis is no different than treating it immediately. Why thyroid cancer is almost never urgent: When a surgeon books you for surgery before you leave the office, that is scheduling efficiency — not a clinical emergency signal. True urgent thyroid cancer scenarios are genuinely rare. You have time. The future of interventional thyroidology — in one word: non-invasive. Find Dr. Goldfarb: stjohnscancer.org/endocrine — telehealth consultations available via Zoom Resources: Podcast: saveyourthyroidwithjen.com Patient site: saveyourthyroid.org Private FB group: facebook.com/groups/saveyourthyroidnonsurgical Patient Navigation: saveyourthyroidwithjen.com/patient-navigation-services Support the channel: PayPal: paypal.com/paypalme/itsmejenagain Venmo: account.venmo.com/u/itsme_jenagain Affiliate links: TOUPS AND CO: toupsandco.com/jen RIVERSIDE: riverside.fm/?via=itsmejenagain VAN MAN: vanman.shop/?ref=itsmejenagain BON CHARGE: us.boncharge.com/?rfsn=7843863.50b9fa&shpxid=4137e8a5-8199-46cb-b71c-0f86d29824ff Disclaimer: This podcast is for informational purposes only and is not a substitute for professional medical advice. No endorsement is given or implied for any specific product, treatment, or physician mentioned. Always consult with a qualified healthcare professional regarding your individual medical needs. Hosted on Acast. See acast.com/privacy for more information.

  5. Aug 4

    The PA Who's Bringing Thyroid Ablation to Your Community | Andy Manos & North Star Vascular

    Most patients diagnosed with a thyroid nodule are offered two options: watch it or remove it. Andy Manos, PA-C is on a mission to make sure a third option reaches every community in the country. 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 and same day out. In this episode he joins Jennifer Holkem to pull back the curtain on why so many patients are never told about nonsurgical options, how financial incentives can push physicians toward surgery, and what a single question can do to change the entire direction of a thyroid consultation. He also breaks down thyroid artery embolization using the most accessible analogy I've ever heard — a water balloon, a garden hose, and a Costco run — and explains why the sub-sternal goiter that makes surgeons nervous is exactly the case where TAE shines. In this episode: Why interventional radiology is reinventing itself as a patient-facing clinical specialtyThe financial realities that can push physicians toward surgery over ablationThe five words every thyroid patient should ask their physicianHow thyroid artery embolization works — and which nodules it's best suited forWhy RFA and surgery carry similar risks to the recurrent laryngeal nerveHow AI and the internet are becoming legitimate tools for thyroid patient advocacyWhy organ preservation is a movement happening across thyroid, uterus, and prostate care Find Andy and North Star Vascular: northstarir.com Hosted on Acast. See acast.com/privacy for more information.

  6. Jul 21

    Indeterminate Thyroid Nodule? Up to 70% of Surgeries Weren't Necessary | Dr. Joshua Klopper

    If your thyroid biopsy came back inconclusive — Bethesda 3 or 4 — you may have been told surgery is your only option. But for decades, over 70% of those surgeries revealed nodules that were actually benign. There's a better way. It's called molecular testing. And today's guest literally helped prove it works. Dr. Joshua Klopper is the Medical Director for Endocrinology at Veracyte and a nationally recognized thyroid specialist with over two decades of experience managing thyroid nodules and thyroid cancer. He was an investigator on the original clinical study that validated the Afirma Genomic Sequencing Classifier — the test that has since helped millions of patients avoid unnecessary thyroid surgery. He served on the board of the American Thyroid Association and previously served as faculty at the University of Colorado School of Medicine. ⚠️ Conflict of Interest Disclosure: Dr. Klopper is an employee of Veracyte, maker of the Afirma Genomic Sequencing Classifier discussed in this episode. In this episode, Dr. Klopper breaks down everything a patient needs to know about molecular testing — in plain language, without the jargon. If you or someone you love has been told their thyroid biopsy is inconclusive — this episode could change the conversation with your doctor. Chapters: 00:00 Introduction — The Indeterminate Thyroid Nodule Problem 01:55 Meet Dr. Joshua Klopper — Medical Director for Endocrinology at Veracyte 02:34 Understanding the Bethesda Classification System 05:38 The Human Cost of Unnecessary Thyroid Surgery 07:37 What Was the Patient Experience Before Molecular Testing? 10:18 What Is the Afirma Genomic Sequencing Classifier? 12:00 Why the Test Was Designed to Find Benign — Not Cancer 14:28 What Is a "Rule Out" Test and Why Does It Matter? 16:04 Oncocytic (Hurthle) Cells — Why They're Challenging 19:00 How Two-Thirds of Indeterminate Nodules Come Back Benign 21:27 Why It's Almost Always Safe to Pause Before Surgery 22:42 The Surgeon Bias Problem — Patients Deserve Options 25:37 How Patients Encounter Molecular Testing on Their Journey 29:43 What Happens to the Sample at Veracyte? 33:52 The 800-Patient Study — Long-Term Afirma Performance 41:24 What Does a Suspicious Afirma Result Actually Mean? 46:17 Risk of Malignancy — What the Numbers Really Mean 48:00 BRAF, RAS and Other Mutations Explained 53:30 The GRID Research Platform and Future Discovery 56:35 Molecular Testing and Ablation — What's Coming 58:33 One Message for Every Indeterminate Thyroid Patient 1:02:38 How to Learn More 1:05:56 Closing 📄 Study referenced in this episode: Outcomes of Cytologically Indeterminate Thyroid Nodules Managed With Genomic Sequencing Classifier: https://pubmed.ncbi.nlm.nih.gov/38415829/ 🔗 Learn more about Afirma molecular testing: https://www.veracyte.com/tests/afirma-thyroid/providers/ 🔗 American Thyroid Association patient resources: https://www.thyroid.org 🔗 Clinical Thyroidology for Patients (ATA): https://www.thyroid.org/patient-thyroid-information/ct-for-patients/ 📌 Resources: 👉 Podcast: https://www.saveyourthyroidwithjen.com/ 👉 Patient site: https://www.saveyourthyroid.org/ 👉 Private FB group: https://www.facebook.com/groups/saveyourthyroidnonsurgical 👉 Patient Navigation: https://www.saveyourthyroidwithjen.com/p/patient-navigation-services/ 💛 Support the channel: PAYPAL 👉 https://www.paypal.com/paypalme/itsmejenagain VENMO 👉 https://account.venmo.com/u/itsme_jenagain ⚠️ Disclaimer: This podcast is for informational purposes only and is not a substitute for professional medical advice. No endorsement is given or implied for any specific product, treatment, or physician mentioned. Always consult with a qualified healthcare professional regarding your individual medical needs. 🎵 Music: Y4XYU0XSPNNR5RI3 Hosted on Acast. See acast.com/privacy for more information.

  7. Jul 7

    Is Your RFA Doctor Certified? A New Standard for Thyroid Ablation | Dr. Ahmad & Dr. Aljammal

    How do you know if the doctor performing your thyroid RFA is truly qualified? It's the question every patient asks — and until now, there hasn't been a clear answer. A medical license isn't enough. General board certification isn't enough. And with RFA growing rapidly in the US, the gap between trained specialists and general providers is becoming a real patient safety issue. That's exactly why two of the most accomplished names in thyroid ablation have spent years building a solution. Dr. Jules Aljammal is the very first endocrinologist to perform thyroid RFA for benign thyroid nodules in the United States. Dr. Shahzad Ahmad has performed the highest number of RFA procedures of any endocrinologist in the country, achieving multiple North American firsts along the way. Together, they are the founder and president-elect of NASOIE — the North American Society of Interventional Endocrinology — and the architects of the first formal certification program for RFA providers in the US. In this episode, they break down exactly what that certification requires, what it means for patients, and what questions you should be asking your provider right now — whether they're certified or not. In this episode: ✅ Why a standard medical license is not enough to safely perform thyroid RFA ✅ What the new NASOIE certification requires — including the 50-case minimum and outcome review ✅ The two certification levels: Certificate of Interventional Endocrinology and Master of Interventional Endocrinology ✅ The three questions to ask any prospective RFA physician before your procedure ✅ Why treating thyroid cancer with ablation requires a different mindset — and significantly more experience ✅ Why continuity of care after ablation is non-negotiable ✅ Where to find certified physicians and how NASOIE is building that map ✅ Where RFA adoption is headed in the next five to ten years If you are currently searching for an RFA provider — or you want to verify that the one you've already found is truly qualified — this episode is essential listening. CHAPTERS 00:00 Introduction 01:00 Meet Dr. Ahmad & Dr. Aljammal — The Pioneers Behind US Thyroid RFA 03:38 The Birth of NASOIE & Bringing RFA to the United States 08:05 The Wild West Problem — Why Standardization Is Urgently Needed 09:37 Patient Safety & the Real Risks of Untrained Providers 12:30 The 50-Case Minimum & What Certification Requires 16:08 How New Providers Can Build Toward Certification 17:45 Ongoing Education & What Happens After Certification 20:20 How Patients Can Find Certified Physicians 24:15 Why Anecdotes Aren't Enough — The Case for Verifiable Standards 26:32 Top 3 Questions to Ask Your RFA Doctor Before Your Procedure 31:32 Volume, Published Outcomes & PubMed Transparency 33:09 Treating Thyroid Cancer with Ablation — A Different Mindset 38:45 Knowing When NOT to Perform Ablation 41:50 Continuity of Care — Why Follow-Up Is Non-Negotiable 42:35 Where Is RFA Headed in the Next Five Years? 45:36 How to Find Dr. Ahmad & Dr. Aljammal 🔗 Find Dr. Shahzad Ahmad: Endocrinology Center of Utah: thyroidradiofrequency.com 🔗 Find Dr. Jules Aljammal: Thyroid Clinic Utah: thyroidclinicutah.com Thyroid Clinic Washington: thyroidclinicwashingon.com 🔗 NASOIE — North American Society of Interventional Endocrinology: nasoie.com ⚠️ Disclaimer: This podcast is for informational purposes only and is not a substitute for professional medical advice. No endorsement is given or implied for any specific product, treatment, or physician mentioned. Always consult with a qualified healthcare professional regarding your individual medical needs. 🎵 Music: Y4XYU0XSPNNR5RI3 Hosted on Acast. See acast.com/privacy for more information.

  8. Jun 23

    RFA, Robotic Surgery & the Future of Thyroid Care: Dr. Eren Berber

    What does the future of thyroid care look like when the person describing it helped build the present? Dr. Eren Berber is a Professor of Surgery and Director of Robotic Endocrine Surgery at Cleveland Clinic. He performed some of the first robotic thyroid operations in the United States, brought thyroid RFA to Ohio, and has authored more than 350 scientific papers. He has spent his entire career at the forefront of thyroid innovation — and in this episode, he gives one of the most candid, comprehensive assessments of the current treatment landscape that Save Your Thyroid with Jennifer Holkem has ever aired. He's not selling any single approach. He performs conventional thyroidectomy, robotic surgery, and RFA — all at high volume. And his honest take on all three will surprise you. On robotic surgery: the only real advantage is avoiding a scar in the neck. Outcomes are not superior to conventional surgery. He pioneered it and he'll tell you that himself. On ablation: he was skeptical initially. Four years of personally following every patient he treated changed his mind entirely. Over 90% success rate in his first 100 patients, less than 5% complications, and hot nodules returning to normal thyroid function within a month. On the future: ablation technologies are evolving faster than most patients realize. A nanopulse ablation clinical trial is launching. AI is being incorporated into thyroid surgery. And the ATA guidelines now formally include ablation as a standard procedure for appropriate patients. On insurance calling RFA investigational: FDA cleared since 2018, CPT billing code active since 2025, guidelines updated. That excuse, in his words, is on borrowed time. In this episode: Why robotic thyroid surgery is not necessarily better than conventional surgery — from the surgeon who pioneered itHow Dr. Berber counsels patients between ablation and surgeryWhy treating nodules earlier — while they're still small — produces dramatically better outcomesCleveland Clinic's outcomes from their first 100 RFA patientsHow to navigate a large institution and get to the right expertThe nanopulse ablation trial coming to Cleveland ClinicWhy 98% of thyroid surgeons in the US are not high volume — and why that mattersHow to look up your surgeon's published outcomes on PubMed before your appointmentFind Dr. Berber: clevelandclinic.org — search Dr. Eren Berber and contact his office directly. Telehealth consultations available for out-of-state patients. Hosted on Acast. See acast.com/privacy for more information.

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About

Thyroid nodules impact 70 percent of adults in their lifetime. The standard of care is surgical removal of half or all of the gland. But in recent years, nonsurgical treatment options have become available. Hi, my name is Jennifer Holkem and I advocate for fellow patients suffering with this very common condition. I sit down with patients and physicians and discuss life with thyroid nodules, the journey from diagnosis to treatment, and how to save your thyroid through nonsurgical advances in medicine. Hosted on Acast. See acast.com/privacy for more information.

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