Save Your Thyroid with Jennifer Holkem

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 Problem01:55 Meet Dr. Joshua Klopper — Medical Director for Endocrinology at Veracyte02:34 Understanding the Bethesda Classification System05:38 The Human Cost of Unnecessary Thyroid Surgery07:37 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 Cancer14:28 What Is a "Rule Out" Test and Why Does It Matter?16:04 Oncocytic (Hurthle) Cells — Why They're Challenging19:00 How Two-Thirds of Indeterminate Nodules Come Back Benign21:27 Why It's Almost Always Safe to Pause Before Surgery22:42 The Surgeon Bias Problem — Patients Deserve Options25:37 How Patients Encounter Molecular Testing on Their Journey29:43 What Happens to the Sample at Veracyte?33:52 The 800-Patient Study — Long-Term Afirma Performance41:24 What Does a Suspicious Afirma Result Actually Mean?46:17 Risk of Malignancy — What the Numbers Really Mean48:00 BRAF, RAS and Other Mutations Explained53:30 The GRID Research Platform and Future Discovery56:35 Molecular Testing and Ablation — What's Coming58:33 One Message for Every Indeterminate Thyroid Patient1:02:38 How to Learn More1:05:56 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/itsmejenagainVENMO 👉 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.

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 yearsIf 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.CHAPTERS00:00 Introduction01:00 Meet Dr. Ahmad & Dr. Aljammal — The Pioneers Behind US Thyroid RFA03:38 The Birth of NASOIE & Bringing RFA to the United States08:05 The Wild West Problem — Why Standardization Is Urgently Needed09:37 Patient Safety & the Real Risks of Untrained Providers12:30 The 50-Case Minimum & What Certification Requires16:08 How New Providers Can Build Toward Certification17:45 Ongoing Education & What Happens After Certification20:20 How Patients Can Find Certified Physicians24:15 Why Anecdotes Aren't Enough — The Case for Verifiable Standards26:32 Top 3 Questions to Ask Your RFA Doctor Before Your Procedure31:32 Volume, Published Outcomes & PubMed Transparency33:09 Treating Thyroid Cancer with Ablation — A Different Mindset38:45 Knowing When NOT to Perform Ablation41:50 Continuity of Care — Why Follow-Up Is Non-Negotiable42:35 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.comThyroid 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.

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.

Navigating an Indeterminate Thyroid Nodule Diagnosis with Chelsie PaulsonWhat do you do when your thyroid biopsy results leave you with more questions than answers? In this episode of Save Your Thyroid, I am joined by Chelsie Paulson, a vocal advocate and active member of our patient community. After an Afirma molecular test came back with a 50/50 inconclusive result, Chelsie was told that removing her thyroid was her only option.Instead of accepting lifelong thyroid hormone replacement, Chelsie took her health into her own hands. She shares her incredible journey of advocating for herself, canceling her surgery just days before, and traveling to New Orleans for Microwave Ablation with Dr. Emad Kandil. We also discuss how she integrated holistic lifestyle changes with a specialist in California to support her body's natural healing process, ultimately leading to massive nodule shrinkage and a benign pathology result!If you are sitting in the waiting room of uncertainty with an indeterminate nodule, this episode is here to give you hope and remind you that you have choices.Learn more about Dr. Emad Kandil and his practice:🔗 https://kandilablationcenter.com/⏱️ Episode Chapters:0:00 - Welcome to Save Your Thyroid02:05 - Discovering the Nodule: Symptoms & First Biopsy07:27 - The 50/50 Afirma Result & The Push for Surgery15:07 - A 2 AM Email: Finding Dr. Kandil & Canceling Surgery19:19 - Experiencing Microwave Ablation in New Orleans27:27 - Holistic Healing & Integrative Oncology in California28:52 - Post-Procedure Nodule Shrinkage & Benign Results38:59 - How Chelsie is Feeling Today44:32 - Misconceptions About Ablation & Final Advice for PatientsEnjoyed this episode? Subscribe to Save Your Thyroid for more interviews with the world’s leading experts in thyroid-saving technology.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/itsmejenagainVENMO👉 https://account.venmo.com/u/itsme_jenagainAffiliate 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-0f86d29924ff⚠️ 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.

Can you shrink a thyroid nodule by 82% while keeping your thyroid intact? In today’s episode, I am joined by Emily Saska, a patient who refused to accept a total thyroidectomy as her only option. When Emily discovered an "angry," rapidly growing 3.8cm thyroid nodule, she was steered toward the operating room. Instead, she chose a "needle off the record" moment and sought out nsPFA (nanosecond Pulsed Field Ablation).Join us as Emily walks us through her experience with this cutting-edge, non-thermal technology performed by Dr. Emad Kandil. From a "nothing burger" recovery to stunning clinical results, Emily’s story is a powerful testament to the importance of patient advocacy and the life-changing potential of thyroid-saving technology.In this episode, we explore:The Surgery Referral: Why Emily questioned the "standard of care" and how she found the courage to seek a second opinion.What is nsPFA? An inside look at nanosecond Pulsed Field Ablation—a non-thermal alternative for those who want to avoid the risks of heat-based treatments.The "Birthday Band-Aid": Emily’s step-by-step account of the procedure day and why her recovery was so incredibly fast.Proven Results: How Emily achieved a 65% reduction in just six weeks and an 82% reduction by her seven-month follow-up.Empowering Advice: Why you should never "blindly trust" a surgical referral without exploring the latest nonsurgical tools first.If you’ve been told that surgery is your only path, this episode is for you. Your thyroid is a vital organ—learn how you can save it.Connect with Our Guest & Expert:Dr. Emad Kandil’s Practice: https://kandilablationcenter.com/Previous episodes on nsPFA (nPulse): Dr. Tufano: https://youtu.be/ihkp3tmLqXI?si=xGrWeS4OavCM59qF Dr. Harding: https://youtu.be/1eG6x0W9CW0?si=wl1maW_QS5SEwNP_ Dr. Kandil: https://youtu.be/GWa-xs9iO-s?si=vR_ZRcDN0WuBqK1aResources: 👉 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 Show:Paypal: https://www.paypal.com/paypalme/itsmejenagainVenmo: 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.Keywords: Thyroid Nodule, nsPFA, Nanosecond Pulsed Field Ablation, Thyroid Ablation, Dr. Emad Kandil, Thyroidectomy Alternative, Non-Surgical Thyroid Treatment, Save Your Thyroid, Thyroid Nodule Shrinkage, Patient Advocacy. Hosted on Acast. See acast.com/privacy for more information.

Are you being told that a thyroidectomy is your only option for a growing thyroid nodule? Dr. Ian Orozco is here to change that with the launch of his new private practice, The Thyroid Institute of Utah.In this episode of Save Your Thyroid, we are challenging the status quo of traditional thyroid care and exploring the minimally invasive revolution of Interventional Endocrinology. Join host Jennifer Holkem as she sits down with board-certified endocrinologist Dr. Ian Orozco, a leading expert in Radiofrequency Ablation (RFA) in the Intermountain West.Together, they discuss his transition to a specialized private clinic in Provo, Utah, and how non-surgical options like RFA are helping patients shrink benign nodules, preserve their thyroid function, and avoid lifelong hormone replacement. Whether you are actively navigating a new diagnosis, seeking alternatives to the scalpel, or considering traveling out-of-state for expert care, this conversation is packed with the insights you need to make an informed, empowered decision.In this episode, we cover:  The Thyroid Institute of Utah: Why Dr. Orozco opened a single-focus practice dedicated entirely to modern thyroid care.  Understanding RFA: How Radiofrequency Ablation works to treat symptomatic hot and cold thyroid nodules without surgery.  Navigating the Hurdles: The truth about insurance coverage, Medicare codes, and how to advocate for yourself.  The Future of Treatment: Emerging technologies, ethanol ablation for cysts, and why the "wait and see" approach is becoming a thing of the past.Enjoyed this episode? Subscribe to Save Your Thyroid for more interviews with the world’s leading experts in thyroid-saving technology.⏱️ Episode Chapters:00:00 Introduction to a New Era in Thyroid Care02:35 Dr. Ian Orozco's Journey and Philosophy06:57 The Importance of Collaboration in Thyroid Treatment10:35 Understanding Radiofrequency Ablation (RFA)20:17 The Benefits of RFA Over Traditional Surgery27:52 Expanding Treatment Options and Innovations in Thyroid Care33:52 How to Connect with Dr. Orozco for Treatment35:49 Empowerment in Patient Care36:45 Navigating Insurance Challenges39:45 The Future of Interventional Endocrinology42:49 Emerging Technologies in Thyroid Treatment48:24 Lightning Round: Insights and Advice53:52 Final Thoughts on Patient EmpowermentResources:👉 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/itsmejenagainVENMO👉 https://account.venmo.com/u/itsme_jenagainAffiliate 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-0f86d29924ff⚠️ 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.

Please subscribe to this podcast and support my advocacy: https://podcasters.spotify.com/pod/show/itsmejenagain/subscribeDr Jagdish Dhingra has been in practice at ENT Specialists Inc. for the last 20 years. For the last 10 years he has focused his practice on diseases of thyroid and parathyroid glands. He has performed over 3000 office-based ultrasound-guided procedures on the thyroid gland. For the last 2 years he has extended his practice of ultrasound guided treatments to include Radiofrequency Ablation (RFA). He performs these in an office setting at his practice in Plainville, MA. In today’s discussion, we’ll cover topics such as the prevalence of thyroid nodules, molecular testing, comparing thyroid procedure costs, and much more.Timestamps:00:00 Introduction music00:51 Dr. Dhingra introduction01:44 Choosing Thyroid RFA03:09 Prevalence of thyroid nodules06:24 TIRADS scoring of ultrasound09:17 Categorizing thyroid nodules with Bethesda Categories12:30 Molecular testing18:27 RFA candidacy32:07 Comparing procedure costsContact Dr. Dhingrahttps://www.entspecialists.com/Preoperative Diagnosis of Benign Thyroid Nodules with Indeterminate Cytologyhttps://www.nejm.org/doi/full/10.1056/nejmoa1203208Disclaimer: None of the statements made in this or any other video by "Its me Jen again" should be considered medical advice.👉Find a thyroid thermal ablation provider: https://www.saveyourthyroid.org/👉Join our FB community, Save Your Thyroid:  https://www.facebook.com/groups/saveyourthyroidnonsurgical👉Follow me on Spotify: https://spoti.fi/3ZbeDCU👉Subscribe to my Substack: https://itsmejenagain.substack.com/👉Follow me on IG/FB for more patient focused information (I'm a patient too!): FB: https://www.facebook.com/itsmejenagain IG: https://www.instagram.com/itsme_jenagain/👉Subscribe to this channel, Its me Jen again: https://www.youtube.com/itsmejenagain👉If you value this content, please consider donating to my efforts to spread this message: https://www.paypal.com/paypalme/itsmejenagain#saveyourthyroid #thyroidnodule  #thyroidsurgery #nonsurgical  #thermalablation #thyroidectomy #patient #advocate #itsmejenagain  #thyroidrfa #surgery #surgeon #geneticmarkers #moleculartesting #endocrinologistNew Electric Intro Credits: Syn Cole - Feel Good [NCS Release] Connect withNCS: Snapchat: ncsmusic • http://soundcloud.com/nocopyrightsoun... • http://instagram.com/nocopyrightsound... • http://facebook.com/NoCopyrightSounds • http://twitter.com/NCSounds • http://spoti.fi/NCS Syn Cole • https://soundcloud.com/syncole • https://www.facebook.com/SynCole • https://twitter.com/SynColeOfficial •https://www.instagram.com/SynCole/  Music Credits: *All Night Long by Vendredi https://soundcloud.com/vendrediduo Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: https://bit.ly/3cXdkSv Music promoted by Audio Library https://youtu.be/l210g5PbV9c Hosted on Acast. See acast.com/privacy for more information.