Save Your Thyroid with Jen

Here's a milestone worth celebrating: ablation has officially appeared in the ATA guidelines.

For years, thyroid ablation has lived in a gray area — talked about by some physicians, dismissed by others, often treated as experimental even when patients were seeing remarkable results. That's changing fast.

Dr. Eren Berber shared in Episode 121 that ablation is now being incorporated into the most recent ATA guidelines as a standard procedure for patients with certain pathologies. He's also preparing to launch a clinical trial on a new non-thermal technology called nanopulse — a heat-free approach that's gaining traction.

"The data is strong, and I think we're going to hear more about ablation and use it more for patients."

This is exactly the kind of progress this community has been advocating for. If you've ever been told ablation is unproven or experimental, the guidelines themselves are starting to say otherwise.

Episode 121: RFA, Robotic Surgery & the Future of Thyroid Care: Dr. Eren Berber — Save Your Thyroid with Jennifer Holkem.

Here's a question worth asking before you agree to any thyroid procedure: what else can this doctor offer me?

Dr. Eren Berber put it perfectly in Episode 121: "If somebody only does one procedure, it's like a hammer and a nail — everybody gets that procedure done."

He performs conventional thyroidectomy, robotic surgery, and thyroid ablation — all at high volume. That matters, because it means his recommendation for you is genuinely about your specific situation, not about what he's limited to offering. He's not steering you toward surgery because that's all he knows how to do. He's not steering you toward ablation because that's his only tool either.

"I'm really providing a custom solution to any given patient without being biased by just being able to do one procedure."

If your provider only offers one option, ask yourself — is that recommendation about you, or about them?

Episode 121: RFA, Robotic Surgery & the Future of Thyroid Care: Dr. Eren Berber — Save Your Thyroid with Jennifer Holkem.

Chelsie Paulson summarized her entire thyroid journey in one breath in Episode 120 — and I haven't been able to stop thinking about it since.

It started with: very likely cancer, but we're not really sure.
Then: this could spread to your body.
Then: you have to take care of this now.
Then: four surgical opinions all pointing the same direction.
Then: a 2 a.m. email, a personal phone call, a cancelled surgery, a plane to New Orleans.
Then: Microwave Ablation with Dr. Emad Kandil.
Then: a benign biopsy.

She points out that there aren't many cases like hers — not because the outcome isn't achievable, but because not enough patients are willing to push back, and not enough doctors are willing to take the road less traveled with them.

"Medicine needs to be personalized. That's where I've landed."

That sentence is the entire point of Save Your Thyroid with Jennifer Holkem. And Chelsie's story is proof of what's possible when a patient refuses to be put in a box.
Episode 120: Canceling Thyroid Surgery: Chelsie's Journey with Indeterminate Nodules & Dr. Emad Kandil — Save Your Thyroid with Jennifer Holkem.

Here's something Jen addresses directly in Episode 120 — because it comes up constantly in the Save Your Thyroid community.

Can lifestyle changes shrink a thyroid nodule?

The honest answer: there's just not enough data to say yes definitively. And here's why that's not a simple question.

The etiology of thyroid nodules is likely different for every individual person.

Chemical exposures. Endocrine disruptors in your environment. The air you're breathing and the water you're drinking. Radioactive material exposures you may not even be aware of. A lifetime of all of these variables — up to the point your nodule was discovered — contributing to its development.

Where do you even begin to untangle that? There are so many variables at play that there is just no consistent lifestyle intervention we can currently point to and say: this is how you definitively shrink a solid thyroid nodule.

That doesn't mean lifestyle doesn't matter. It doesn't mean there aren't things we can do to support our health and potentially prevent nodules from becoming larger and more problematic. And there are absolutely anecdotes of nodules shrinking on their own — Jen loves to hear those stories.

But we can't apply those anecdotes universally. Every person's situation is different. And when you are on a trajectory with growing nodules, lifestyle alone is rarely the answer.

That's why we have intervention. And that's why Chelsie's story matters.

Episode 120: Canceling Thyroid Surgery: Chelsie's Journey with Indeterminate Nodules & Dr. Emad Kandil — Save Your Thyroid with Jennifer Holkem.

Here are Chelsie Paulson's results — six months after Microwave Ablation with Dr. Emad Kandil.

Left nodule: 59% reduction.

Right nodule: 93% reduction.

Reverse T3: normalized completely.

Thyroglobulin: down significantly — because the excess tissue was gone.
All thyroid numbers: completely optimal.

This is the patient who four ENTs told needed surgery. The patient with a 50% malignancy risk on her molecular test. The patient who cancelled her thyroidectomy two nights before it was scheduled and got on a plane to New Orleans instead.
Her thyroid is still hers. And it is working exactly the way it is supposed to.

Episode 120: Canceling Thyroid Surgery: Chelsie's Journey with Indeterminate Nodules & Dr. Emad Kandil — Save Your Thyroid with Jennifer Holkem.

This is the moment that changed everything for Chelsie Paulson.

Two nights before her scheduled thyroid surgery. She had stopped taking her supplements. She had done the surgery prep. She had accepted — or tried to accept — that this was where she was headed.

But something wouldn't let her stop. She felt a tugging. She felt a voice telling her to email Dr. Emad Kandil. So at 2 a.m. she did exactly that.

She typed out her name. Attached her ultrasound reports. Attached her molecular testing. And asked one question: what do you make of this situation? And do I qualify for ablation?

She expected what anyone would expect when they email a doctor's office in the middle of the night. A receptionist calling eventually. An appointment scheduled weeks out. The slow machinery of the medical system doing what it does.

Instead, Dr. Kandil called her personally the next morning.

He said: what are you doing? Cancel your surgery.

She was in tears. She had asked God to show her a clear sign. And there it was.
She got on a plane that day. She had Microwave Ablation. Her follow-up biopsy came back benign.

If you are up in the middle of the night right now, scared and looking for another way — send the email. You never know who's going to call you back.

Episode 120: Canceling Thyroid Surgery: Chelsie's Journey with Indeterminate Nodules & Dr. Emad Kandil — Save Your Thyroid with Jennifer Holkem.

Chelsie Paulson wants to be clear about something: she is not a rebellious person.

Going against four surgical recommendations — canceling a surgery two nights before it was scheduled — getting on a plane to New Orleans instead — none of that came naturally to her. It was genuinely hard. It went against every instinct she had to be cooperative, to trust the system, to do what the doctors said.

But she knew. She knew in her gut that either they didn't know what she knew, or they hadn't read what she had read. And that didn't make them bad people. It just meant they were coming from a different place — maybe specialized in surgery, maybe not current on the latest research, maybe simply following the protocol they were trained to follow.

"You have to be tenacious. You have to have a lot of courage."

Going into a doctor's office is a vulnerable experience. You're emotional. You're scared. The easiest thing in the world is to let that emotion override the rational side of your brain and just say yes to whatever is recommended.

Don't. Do your research. Trust your gut. And be tenacious.

Episode 120: Canceling Thyroid Surgery: Chelsie's Journey with Indeterminate Nodules & Dr. Emad Kandil — Save Your Thyroid with Jennifer Holkem.

This is what an indeterminate thyroid biopsy result actually looks like — and what it feels like to receive one.

Chelsie Paulson read her molecular test results out loud in Episode 120. Suspicious classifier. No variant or fusion detected. No atlas expression. Risk of malignancy: 50%.

Her endocrinologist told her: that means they found something. The report isn't revealing what they found — but they found something.

And then the detail that made it more serious: the associated neoplasm type included follicular thyroid cancer. One of the cancers that can spread to the bones. One that sits outside the more common and more treatable papillary thyroid cancer category. One that no one really wants to touch.

Chelsie sat with that result feeling two things at once — terrified and vindicated. She had known since her first benign biopsy that something wasn't right. And now something had been flagged.

If you are sitting with a result like this right now — uncertain, scared, and not sure which direction to go — please listen to this episode. Chelsie came out the other side with a benign result and her thyroid intact. Her story exists so you know that is possible.

Episode 120: Canceling Thyroid Surgery: Chelsie's Journey with Indeterminate Nodules & Dr. Emad Kandil — Save Your Thyroid with Jennifer Holkem.

Chelsie Paulson thought she didn't have any thyroid symptoms.

Looking back — she had a lot of them.

Two years after having a baby, she couldn't lose weight no matter what she did. She was working out, dieting, doing everything right — and nothing was moving. She had terrible anxiety and enough hair loss to notice her hair was getting thinner.

But the thing that finally got her to the doctor? Her anxiety had become so bad she was having panic attacks.

Her family doctor felt her throat and said: you have a goiter and I can feel nodules.

Chelsie didn't even know what a goiter was. And suddenly she was being sent to an endocrinologist, doing biopsies, and navigating a world she had never thought about before.

If you recognize yourself in any part of this story — the weight that won't move, the anxiety that feels out of proportion, the hair loss, the feeling that something just isn't right — please listen to Episode 120.

Canceling Thyroid Surgery: Chelsie's Journey with Indeterminate Nodules & Dr. Emad Kandil — Save Your Thyroid with Jennifer Holkem.