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. Oct 20

    Why RFA Sometimes Fails on Toxic Thyroid Nodules — And What Works Instead | Dr. Salem Noureldine

    Endocrine surgeon Dr. Salem Noureldine joins the show to break down toxic thyroid nodules — the ones that don't just sit there, but actively overproduce thyroid hormone and drive symptoms like a racing heart, weight loss, anxiety, and insomnia. From there, the conversation opens into the physics-level differences between radiofrequency and microwave ablation, why microwave can outperform RFA on vascular nodules affected by the "heat sink effect," and why patients with pacemakers may be safer candidates for microwave than RFA. Dr. Noureldine is a fellowship-trained endocrine surgeon and assistant professor of surgery at George Washington University, where he founded the university's minimally invasive center and multidisciplinary thyroid tumor board. He holds a focused practice designation in thyroid and parathyroid surgery from the American Board of Surgery and serves as vice chair of NASIT's Guidelines and Statements Committee. Connect with Dr. Salem Noureldine: https://capitalmedicalgroup.com/profile/salem-noureldine This episode is part of our sponsored series with Baird Medical. bairdmed.com If you're dealing with a toxic thyroid nodule, or trying to understand the real differences between ablation technologies before choosing one, this conversation gives you the questions to ask and the physics behind why they matter. 📌 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/ 👉 Find Dr. Noureldine: George Washington University / CMG Group [insert exact link] 💛 Support the channel: PAYPAL 👉 https://www.paypal.com/paypalme/itsmejenagain VENMO 👉 https://account.venmo.com/u/itsme_jenagain 🛍️ Affiliate links: 🌿 TOUPS AND CO: https://toupsandco.com/jen 🎙️ RIVERSIDE: https://www.riverside.fm/?via=itsmejenagain 🧴 VAN MAN: https://vanman.shop/?ref=itsmejenagain 💡 BON CHARGE: https://us.boncharge.com/?rfsn=7843863.50b9fa&shpxid=4137e8a5-8199-46cb-b71c-0f86d29324ff ⚠️ 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: Code: ZST0VC3HMBB4TOLQ, DOKORNPHOY804ITG, TAZR2RVL0DX25NQ5 Chapters 00:00 Introduction to toxic thyroid nodules 01:47 Dr. Noureldine's path into endocrine surgery and ablation 06:38 His role as vice chair of NASIT's Guidelines Committee 08:12 What is a toxic nodule? 09:58 Patient concerns by age group 10:47 Toxic nodules as an overlooked cause of AFib 12:17 RFA vs. microwave: the physics difference 15:23 Comparing ablation zone size 18:00 The heat sink effect in vascular/toxic nodules 20:10 Why RFA needs grounding pads (and microwave doesn't) 22:44 Procedure time and the patient experience 25:21 The "shape sorter" analogy for matching technology to patient 27:52 When ablation isn't the right choice 28:57 What to expect at a consult 32:41 Patient story: retreating a toxic nodule with microwave 37:47 Where to find Dr. Noureldine Hosted on Acast. See acast.com/privacy for more information.

  2. Oct 6

    When Thyroid Ablation Isn't the Answer: A Surgeon Who Does Both Explains | Dr. David Goldenberg

    Most of what we cover on this show is the case FOR thyroid nodule ablation. This episode is the other side of that coin — and it's one every patient considering RFA, microwave, or nsPFA needs to hear. "Just because you have a hammer doesn't mean everything's a nail. Ablation is a tool. It's not a philosophy." Dr. David Goldenberg is Professor and Chair of the Department of Otolaryngology–Head and Neck Surgery at Penn State Health and Penn State College of Medicine. He is a head and neck surgical oncologist who has written more than 275 journal articles, 40 book chapters, and 8 books, and he leads Penn State's hands-on thyroid RFA training course. He performs thyroid surgery, thermal ablation, and nanosecond pulsed field ablation (nsPFA), so he evaluates every patient with all of those options on the table. In this episode: ✅ Why ablation has grown so popular, so fast ✅ Where the evidence is strongest, and where it's still limited ✅ When size, location, or growth pattern points to surgery instead ✅ Why ablating a large thyroid cancer would leave cancer behind ✅ Substernal goiters, airway compression, and the "danger triangle" ✅ Multinodular goiter: when one nodule can be treated and when it can't ✅ Is a nodule ever too small, or too big, to ablate? ✅ Why thermal ablation is done awake, and why that isn't cruel ✅ His decision framework, with two real-world case examples ✅ The questions to ask before you commit (including the one no one asks) ✅ A thorough pre-ablation workup: labs, ultrasound, biopsy, and laryngeal exam ✅ Why Hashimoto's is NOT a reason to remove your thyroid ✅ Why "an ultrasound is a movie, not a picture" If you've been told you're not a candidate for ablation — or you're wondering whether you are — this conversation will help you understand why. Chapters 00:00 Introduction 01:57 Why ablation has grown so fast 03:24 Where enthusiasm has outpaced the evidence 04:29 Offering both surgery and ablation 05:50 When size, location, and growth mean surgery 11:02 Being awake during ablation and tolerating the procedure 14:53 Multinodular goiter 16:04 Why ablating a large cancer leaves cancer behind 18:45 Dr. Goldenberg's decision framework and case examples 22:09 Is a nodule ever too small or too big? 24:20 Questions to ask before you commit 28:02 The complete pre-ablation workup 29:52 Hashimoto's and the "it's dying anyway" myth 32:00 Advice for referring physicians 35:56 Ablation is a tool, not a philosophy 37:22 Why ultrasound is a movie, not a picture 39:36 Where to find Dr. Goldenberg 🔗 Penn State Health Otolaryngology–Head and Neck Surgery (Hershey, PA) — ask about thyroid nodule ablation: https://www.pennstatehealth.org/services-treatments/radiofrequency-ablation 📌 Resources: 👉 Podcast: https://www.saveyourthyroidwithjen.com/ 👉 Patient site & Find a Physician: https://www.saveyourthyroid.org/ 👉 Private FB group: https://www.facebook.com/groups/saveyourthyroidnonsurgical 👉 Patient Navigation: https://www.saveyourthyroidwithjen.com/patient-navigation-services/ 💛 Support the channel: PAYPAL 👉 https://www.paypal.com/paypalme/itsmejenagain VENMO 👉 https://account.venmo.com/u/itsme_jenagain 🛍️ Affiliate links: 🌿 TOUPS AND CO: https://toupsandco.com/jen 🎙️ RIVERSIDE: https://www.riverside.fm/?via=itsmejenagain 🧴 VAN MAN: https://vanman.shop/?ref=itsmejenagain 💡 BON CHARGE: https://us.boncharge.com/?rfsn=7843863.50b9fa&shpxid=4137e8a5-8199-46cb-b71c-0f86d29324ff ⚠️ 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: GKLLAMF1GLKROGMQ UDCFUKGJHFQUE3WA #ThyroidNodule #ThyroidAblation #SaveYourThyroid Hosted on Acast. See acast.com/privacy for more information.

  3. Sep 22

    60% Goiter Reduction Without Surgery or Ablation? An IR Explains TAE | Dr. Sean Golden

    Interventional radiologist Dr. Sean Golden joins the show to talk through thyroid artery embolization (TAE) — a minimally invasive treatment that cuts off blood supply to an enlarged thyroid gland instead of removing or ablating it, with patients home the same day. Dr. Golden co-built the TAE program at UW Health alongside Dr. Matthew Niemeyer, and brings a distinct perspective as a physician who came to TAE independently rather than through the more established training pathway. In this episode: ✅ What TAE is and how it compares to surgery and ablation ✅ Step-by-step: what actually happens during the procedure ✅ Recovery — what to expect in the days and weeks after ✅ UW's hybrid CT angiography suite and why it matters ✅ GE's EmboAssist technology, explained ✅ Current research: contrast deposition, shrinkage timelines, and hormone changes post-procedure ✅ Who is (and isn't) a good candidate for TAE ✅ What Dr. Golden wishes every endocrinologist knew If you've been researching non-surgical options for an enlarged thyroid or goiter, this conversation covers the clinical detail patients are usually not given. Chapters: 00:00 Introduction to TAE & Dr. Sean Golden 01:29 What Is Interventional Radiology? 04:07 From Prostate to Thyroid: How Dr. Golden Got Into TAE 07:36 Building the UW TAE Program 09:47 Expanding Access in the Midwest 11:30 Walking Through the TAE Procedure Step-by-Step 14:10 How Fluoroscopy & Contrast Guide the Procedure 16:03 Choosing the Right Embolization Particles 19:09 Recovery: What to Expect After TAE 21:11 UW's Hybrid CT Angiography Suite 23:09 What Is GE's EmboAssist Technology? 27:35 Does the Roadmap Change Patient Selection? 28:17 Research: Can Contrast Predict Shrinkage? 29:48 Thyroid & Parathyroid Hormone Changes Post-TAE 31:42 Publishing Research & the PROTECT Trial 32:32 Who Is a Good Candidate for TAE? 34:03 Who Isn't a Candidate (and Stroke Risk) 36:42 The Multidisciplinary Care Team 37:50 Treating Graves' Disease with TAE 38:44 How Patients Find This Program 39:36 Results: 60% Volume Reduction Explained 42:06 Long-Term Follow-Up (5-Year Monitoring) 42:42 Where TAE Is Headed as a Field 43:37 What's Needed for Wider Physician Adoption 44:48 What Dr. Golden Wishes Endocrinologists Knew 46:33 Next Steps for Patients Considering TAE 📌 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/ 💛 Support the channel: PAYPAL 👉 https://www.paypal.com/paypalme/itsmejenagain VENMO 👉 https://account.venmo.com/u/itsme_jenagain 🛍️ Affiliate links: 🌿 TOUPS AND CO: https://toupsandco.com/jen 🎙️ RIVERSIDE: https://www.riverside.fm/?via=itsmejenagain 🧴 VAN MAN: https://vanman.shop/?ref=itsmejenagain 💡 BON CHARGE: https://us.boncharge.com/?rfsn=7843863.50b9fa&shpxid=4137e8a5-8199-46cb-b71c-0f86d29324ff ⚠️ 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: LWEQ1ULKFKSZCJAI 1V2EQXECZBOZ1GND Hosted on Acast. See acast.com/privacy for more information.

  4. 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)

  5. 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.

  6. 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.

  7. 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.

  8. 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.

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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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