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Santa Monica Thyroid Diagnostic Center
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Beware of Thyroid Diet Books and Weight Loss Supplements That Are Not Only Good For Making Money for The Authors and Billion Dollar Supplement Corporations. Just Say No Thanks.



This website personality claims to be an expert in thyroid disease. She pushes her books which are not aimed at thyroid patients but on obese people thinking thyroid is why they are fat. The claim on the cover of this book claims 30 Americans have thyroid -based weight problems. This is totally false and leads the unsuspecting person with a weight problem to think thyroid is a major cause of obesity. Thyroid weight gain is small and is reversed with replacement therapy with LT4. If you see a 300 pound person that is hypothyroid and see them 6 months later after full replacement therapy they will weigh 286! They WERE hypothyroid and the thick fluid and some fat due to hypothyroid now is corrected. They are still obese. This type of book fosters the myth that thyroid is a cause of obesity. Thyroid deficiency is a short term slight weight gain problem totally corrected with full thyroid replacement therapy. You don't need supplements or a self serving book to correct your weigh gain from hypothyroid just your doctor' sScript for L Thyroxine. If you are still overweight then look in the mirror and see the real reason you are obese. You will delude yourself thinking it is thyroid when all the research points to other causes.

Comment:

Endocrine societies list this personality as one of the worst on the web for spreading inaccurate information, and selling books.

Save your money and don't buy thyroid support supplements or misleading books touting

"The Thyroid Diet" There is no such thing as a thyroid diet. Only control of iodine intake

by avoiding supplements laced with iodine.

Richard Guttler MD,FACE,ECNU

www.thyroid.com


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Ill Defined Nodule Margins on Ultrasound Can Lead to Poor Volume Reduction with Radiofrequency Ablation RFA

Hye Shin Ahn et al Ultrasonography 2016; 35(3): 244-252.





The mean VRRs were 66.1±18.7% at 6 months and 74.3±16.7% at 1 year. The therapeutic success rate after 6 months and 1 year was 81.8% and 90.9%, respectively. At the 1-year follow-up, the margin of the nodule correlated with therapeutic success. Most of the successfully ablated nodules showed well-defined margins on initial ultrasonography (18/20, 90%) (P=0.026). In addition, nodules with ill-defined margins showed a tendency toward having a low VRR at the 6-month and 1-year follow-up examinations.
RF ablation was effective in decreasing the volume of benign thyroid nodules. Thyroid nodules with well-defined margins tended to show successful outcomes at the 1-year follow-up examination after RF ablation.




Most of the patients (17/19, 89.5%) received RF ablation for one nodule, and the other two patients received treatment for two and three nodules. Among the 22 treated nodules, 12 nodules were treated in one session of RF ablation (12/22, 54.5%), and the other 10 nodules required more than one session (2 sessions, n=9; 3 sessions, n=1). In the cases involving multiple treatment sessions, the second session was performed between 1 to 3 months after the initial procedure and the third session was performed 6 months after the initial session. There were no cases of recurrence or regrowth of the nodules.


In conclusion, RF ablation was effective in decreasing the volume of benign thyroid nodules without complications. Internal factors such as the margin of the nodule can be helpful in predicting therapeutic success. Clinicians should pay particular attention to thyroid nodules with ill-defined margins during RF ablation.

A solid nodule with ill defined margins is a poor candidate for RFA.

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Very Large Microwave Antenna #16 Used to Ablate Micro-Papillary Thyroid Cancer.

Too large for the neck. MWA antennas need to downside to at least #18-19 like RFA probes.



Yue W et al

Int J Hyperthermia. 2014 Mar;30(2):150-7.
Ultrasound-guided percutaneous microwave ablation of solitary T1N0M0 papillary thyroid microcarcinoma: initial experience.




21 patients (six men and 15 women; age range, 29-81 years; mean, 52.1 ± 13.6 years) with 21 nodules of pathologically proven solitary papillary carcinoma < 10.0 mm (T1N0M0) were treated with MW ablation. All tumours were completely ablated at a single session and no serious or permanent complications occurred. No recurrence at the treatment site and no distant metastases were detected, with a mean follow-up of 11 months. Histological examination showed no evidence of a tumour in the treated lesions in eight patients. Follow-up ultrasound examinations showed disappearance of previously detected colour Doppler flow, as well as mass shrinkage, or both.Several cases of temporary hoarseness cleared by 3 montns.

During the short-term follow-up period, ultrasound-guided percutaneous MW ablation appears to be a safe and effective technique for solitary T1N0M0 papillary thyroid micro-carcinoma.

Large antenna too big for most thyroid work.

Ablation seen on left and the antenna probe on the right
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6/23/17
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Demo of Moving Shot Method with Blue Phantom Model for RFA for Thyroid Nodules.

https://youtu.be/fXvgJWvXt5A

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Demo of Lidocaine Injection on the Capsule Before RFA ablation of a Thyroid Nodule


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6/23/17
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Demo of Capsule Injected with Lidocaine Prior to RFA Ablation

https://youtu.be/I4j-3SnVysE

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The 250 Patients Treated with Pig Thyroid in Digby Nova Scotia Are Better off Without Desiccated Animal.

Thyroid. It causes too many complications especially elderly hypothyroid patients. Before synthetic T4 qand modern TSH testing, it was a silent killer causing cardiac disease and osteoporosis. The powerful T3 in Pig thyroid is the cause of the problem. Humans are not designed to ingest T3 but should get it from conversion for T4. Spikes in T3 in the blood occur when T3 is ingested in pig thyroid. It is almost never used by endocrinologists in 2017. Even though some will say pig is better than synthetic in the long run 95% will be better off not taking that outdated drug from pigs. The first use was with sheep thyroid injected into a hypothyroid patient in England in 1870s.


We did not know until the 70s how many patients were injured by these animal products with no hormone content measurements. Without a TSH test that could detect an overdose, many died of heart or bone disease but the the cause was not detected by testing. We do not use this anymore. It is advised for those that are upset about the closure and lack or pig thyroid should actually be happy they will be at lower risk of pig thyroid complications.



Richard Guttler MD,FACE,ECNU

www.thyroid.com



DIGBY, NS – A thyroid clinic has been closed in Digby and its patients are looking for answers.

The clinic’s doctor, Dr. Ronald Matsusaki, received a cease and desist letter last week from the Ethics Review Board division of the Nova Scotia Health Authority.

Many if not most of the patients are treated using desiccated thyroid medication, also known as ‘pig thyroid,’ instead of the more commonly used synthroid.

The clinic operated on Wednesdays out of the Digby General Hospital and treated around 250 patients.
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6/23/17
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USA Lagging Behind Europe and Asia in Alternative Treatments for Benign Thyroid Nodules.

Negro R et al Eur Thyroid J. 2017 Apr;6(2):75-81.
A 2016 Italian Survey about Guidelines and Clinical Management of Thyroid Nodules.

"Laser/radiofrequency ablation RFA and percutaneous ethanol injection PEI were commonly considered as alternatives to surgery (46.2 and 71.4%, respectively). Nonsurgical procedures are favorably embraced."

Comments: What a disgrace that big companies making radiofrequency equipment for other uses in the USA do not have a ThyroidRF miniprobe suitable for thyroid use.

Half the endocrinologists in Europe consider RFA as an alternative to surgery.71% consider ethanol ablation as an alternative.

It is a disgrace that endocrinologists and others refer few of their patients for ethanol ablation in the US, while they continue to fill their local hospitals for surgery for this benign condition.With half of all thyroid surgeries done by low volume surgeons the risk is too high for treating these benign conditions.



The patient must find a physician doing PEI or willing to refer you to a center in Europe or Asia for RFA on their own through the a Google search.

Treat cysts with ethanol in the USA now!



To Prevent a surgery have me refer you to Europe or Asia for either RFA or HIFU for spongiform or solid benign nodules.


Least invasive is HIFU for solid nodules. It does not insert a probe into your neck.The US probe just sits on your neck to deliver the heat needed to ablate.








Richard Guttler MD,FACE,ECNU

310-393-8860 for details on PEI, RFA and HIFU treatments.



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6/22/17
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Can Focused Ultrasound Destroy Benign Thyroid Nodules without Surgery and Preserving Thyroid Function? The Answer is YES

Localized Thyroid Tissue Ablation by High Intensity Focused Ultrasound: Volume Reduction, Effects on Thyroid Function and Immune Response


Abstract

Purpose: The aim of this study was to assess the effectiveness of high intensity focused ultrasound (HIFU) in reducing thyroid nodule volume while preserving thyroid function as measured by immunological response.

Materials and Methods: 12 patients (9 females) whose average age was 56.9 years (37 – 81) were treated with HIFU in an ambulatory setting. All patients had a single benign thyroid nodule treated in one HIFU session. The median nodular outline volume (NOV) was 3.4 ml (range 0.6 – 5.0 ml). The therapeutic ultrasound probe (Echopulse® THC900 888-H) used works with a frequency of 3 MHz, reaching temperatures of 80 – 90° C and a mean output between 87.6 and 192.8 W. To assess possible effects of HIFU on thyroid function, serum levels of triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), thyroglobulin (hTg) and antibodies against thyroglobulin (TAbs), thyrotropin receptors (TRAbs) and thyroid peroxidase (TPOAbs) were measured at enrollment, 24-hours post-HIFU treatment and at 3-month follow-up.Pre- post thyroglobulin reduction was measured to evaluate the success of ablation and the nodular outline volume (NOV) was evaluated at baseline and the 3-month follow-up to assess effectiveness.

Results: All measured hormone levels were within normal ranges and remained stable (p > 0.05). No clinically meaningful immune reaction was induced (p > 0.05). Thyroglobulin serum levels increased significantly at 24 hours after ablation (p < 0.05) and decreased significantly at the 3-month follow-up (p < 0.05), returning to pre-ablative levels. The median reduction in nodular outline volume (NOV) was 55 % (p < 0.05).

Conclusion: HIFU is a safe and effective alternative for treating benign thyroid nodules, while preserving thyroid function. Further investigations with multiple treatments should be conducted to evaluate whether additional treatments can achieve greater volume reduction.

Key points:

• HIFU is a safe and effective method to treat thyroid nodules.

• HIFU does not interfere with thyroid gland function.

• HIFU does not induce any immune response like Graves’ disease.





• Korkusuz H, Sennert M, Fehre N et al. Localized Thyroid Tissue Ablation by High Intensity Focused Ultrasound: Volume Reduction, Effects on Thyroid Function and Immune Response. Fortschr Röntgenstr 2015; 187: 1011 – 1015

Comments: We have connections to top HIFU centers in Europe to take my referral patients after my initial evaluation for a quick 2 day visit for just the treatment.Call Matt for details 310-393=-8860.
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6/22/17
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