The secretion of DHEA & DHEA-S from the
#adrenal
is dependent on ACTH, therefore in mild autonomous cortisol secretion (MACS) the DHEA & DHEA-S are low (because of relative suppression of ACTH).
#Endocrinology
#EndoTwitter
#MedEd
🎉 Beautiful volunteer appreciation lunch arranged by
#AMWPA
! Wonderful opportunity to meet up with my physician colleagues 🥼
🎙️ Guest speaker, Dr. Sherif Zaafran, president of Texas Medical Board (TMB) spoke on the inner workings of the
#TMB
.
This is why I don’t follow benign
#thyroidnodules
long term. If they are not growing they are not going to be causing a problem.
If they have rapid growth then
#ThyroidAblation
/
#ThyroidRFA
could be considered if it’s symptomatic or has the potential to be.
#ATA2023
Just wrapped up my talk on
#ThyroidRFA
at
#AACE2024
! 🎉 Honored to have had the opportunity to share insights and learn from colleagues.
Thank you everyone who joined and engaged - what a fantastic experience!
#Endocrinology
#WeAreAACE
Meet the professor-trailblazer
@DrIramHussain
Radiofrequency ablation for
#thyroid
disease
-Reduces nodule volume, smaller nodules respond better, bigger nodules may need more than 1 session
-can help treat thyrotoxicosis due to toxic nodules
#AACE2024
@AmThyroidAssn
#endotwitter
Hello 2024! Excited to have our 1st issue of the year & continue to cover the latest in clinical
#thyroid
literature each month. Look for expert reviews from new editorial board members, new topics & features. Follow for updates!
#endotwitter
#medtwitter
#Hyperthyroidism
in pregnancy is sometimes difficult to diagnose because of the normal physiologic changes in
#thyroid
hormone levels during pregnancy causing mild TSH suppression.
Image:
#MedEd
#Endocrinology
🎤Discussing the evolution of sonographic pattern of
#thyroidnodules
in determining risk of
#thyroidcancer
at
#ATA2023
🦋
The algorithmic approach is emphasized, macro-calcifications are addressed and all nodules can now be classified. Expert opinion always helps! 😎
Seeing several people with a suppressed TSH and normal free T4 being diagnosed with "
#hypothyroidism
" instead of
#hyperthyroidism
and getting started on
#thyroid
hormone supplementation.
👉
#Thyroid
function tests involve negative feedback.
Had a great time brainstorming ideas on the uses and pitfalls of
#AI
in thyroidology and medicine/healthcare at the
#ATA2023
!
So much fun hanging out with such a dynamic group of people - the future is in good hands 😎
The
#thyroid
is supplied by the superior and inferior thyroid arteries and their branches.
In ~ 4 – 10% of people the thyroid ima artery may be present.
#Anatomy
Image
@codexanatomicus
🚀 Ready to level up your knowledge in the management of
#thyroidcancer
? 🦋Join the upcoming
#NASOIE
webinar! 💡
🗓️Nov 15, 2023 ⏰6 - 7 pm CST
📌Register:
🔄Repost to spread the word! Let's learn from the experts! 🌟
#InterventionalEndocrinologists
Countdown to
#AACE2024
:
🎤Speaking about
#ThyroidRFA
/
#RFAThyroid
-
✈️flying to New Orleans tomorrow & haven't packed a thing! 🧳
Procrastinating as usual - but can't wait to connect with everyone! And eat beignets! ☕️
Looks like Dr. Mike Tuttle and I agree on keeping the TSH < 3 IU/L in low risk
#thyroidcancer
patients being followed with active surveillance.
I do the same in my low risk partial
#thyroidectomy
patients - start levothyroxine if TSH > 3 IU/L.
The risk of subclinical
#hypothyroidism
is about 8%. It increases with age but not by a significant amount.
Low dose levothyroxine treatment in TPO-Ab positive women didn’t improve adverse outcomes in pregnancy in the data we have.
#ATA2023
#Thyroidcancer
survivorship begins at diagnosis and continues during treatment and through the rest of a person's life.
Patients often face unique challenges related to hormone management and quality of life.
👉Personalized care is key.👈
Image
@codexanatomicus
@DGlaucomflecken
It's funny until you realize you're the only doctor on the plane & then they ask you for your medical license number to prove it.
Me: Who carries a copy of their medical license on a plane?
Flight Attendant: What doctor doesn't remember their medical license number?
😳🫣 🫢
The
#thyroid
gland is located in the upper part the trachea, wrapped around it, with the common carotid arteries just lateral to each thyroid lobe.
#Anatomy
#MedEd
Image
@codexanatomicus
The
#thyroid
ima artery (white arrow) is a variant present in ~ 4% of the adult population.
Check out this case of
#GravesDisease
with
#ThyroidStorm
treated with
#embolization
- probably not something you're going to see every day.
@AaronGoodman33
We receive emails requesting ‘volunteers’ to write ABIM questions in our speciality. It’s a huge time commitment. It appears to be completely unpaid. I find this bizarre.
Somatic symptom disorder (SSD) is associated with dissatisfaction with
#hypothyroidism
treatment.
@whitsgoldner
presenting a ‘Year in Clinical Thyroidology’ at
#ATA2023
.
Also addressing health disparities, environmental effects and the role of
#AI
for
#thyroidnodules
!
Just read this very nice clinical review on the management of mild autonomous cortisol secretion (MACS) by Dr. Nicholas Yozamp and
@AnandVaidya17
- just in time for grand rounds
@utsw_endocrine
!
I am now an '
#adrenal
expert on occasion' 😝
💉 Hoarseness of voice after
#FNAbiopsy
of a
#thyroidnodule
is extremely rare (< 0.05%), and usually resolves within 6 months. 🎶
🧑🎤Transient vocal cord paresis may be due to inflammation or hematoma.
🦋True incidence is unknown since asymptomatic patients are not screened.
@DGlaucomflecken
This is also how I look when any specialty tries to tell me the patient's symptoms are due to thyroid disease when their thyroid function tests are completely normal...😆
Normal HCG: < 2 mIU/mL
Patient's HCG: > 1,000,000 mIU/mL
So how did this patient end up on the
#endocrinology
consult service❓
👉 Paraneoplastic
#hyperthyroidism
👈
A linear echogenic line is seen on
#thyroidultrasound
; anterior to the longus colli and capitis muscles, posterior to the
#thyroid
gland, medial to carotid artery and lateral to esophagus.
Turns out it's a C-spine surgery implant!
Image and case credit:
@radbaek
@albertodiasf
@Bianco_Lab
Thank you for sharing!
I have several patients on combination T4 + T3 therapy (while maintaining normal thyroid function tests).
It’s interesting… for some patients adding T3 makes no difference and for others it’s life-changing!
🌟Wow! A quick literature search 👀 indicates that this has been reported a lot more than I imagined.
I am a little miffed that I have never found bone in any of my patients’
#thyroidnodules
🦋😝
Congratulations to Dr. Iram Hussain
@DrIramHussain
who shared the closest estimate for our
#ENDO2024
Abstracts Guessing Game () and won free registration to ENDO! The final tally was 2,202. Get ready for the opening of our Late-Breaking Abstract
@DGlaucomflecken
I mean - they probably used our MOC fees to pay a very expensive hot shot marketing person to come up with this. They have to spend the money on something 🤷🏻♀️
A trans-isthmic (medial to lateral) approach and the moving shot technique are used in
#thyroidRFA
to avoid thermal injury to surrounding nerves.
Image taken from article published in
@EuropeanRadiology
by
@radbaek
and colleagues describing complications in
#thyroidablation
.
🎤Very interesting discussion regarding the management of low risk
#thyroidcancer
with panelists Dr. Wendy Sacks, Dr. Carmen Solorzano,
@ir_huber
@leonardograngel
and moderated by Dr. Laura Boucai happening now at
#ATA2023
! 🦋
🦋
#Thyroid
tumors with a malignancy associated gene fusion are likely to be diagnosed as subtype/variant of
#PTC
.
Patients with NTRK fusions have a PTC-FV with more aggressive clinicopathologic findings & will likely have earlier disease recurrence. 🏥
#MedEd
#ThyroidCancer
Insulin secretion is mediated by SST2 and SST5. Glucagon secretion is mediated by SST5.
Pasireotide has a higher affinity for SST5, so insulin is suppressed to greater degree than glucagon resulting in hyperglycemia. Octreotide is more likely to cause hypoglycemia.
#MedEd
Interesting. I’ve always measured the calcitonin in FNA washout in lymph nodes suspected of harbouring medullary
#thyroidcancer
; never thought of measuring it in needle washout from the
#thyroidnodule
!
The
@UTSWInternalMed
annual conference is fast approaching. Attend in-person or virtually on April 13 to learn about new developments, gain advice about chronic conditions, and earn CME credit. Register today:
💥 Exploding
#thyroidnodules
! 💥
#Thyroidnodule
rupture is a rare but known complication of
#thyroidRFA
/thermal ablation.
The nodule bursts through the
#thyroid
capsule into the extra-thyroidal space leading to pain, redness and swelling.
Image from:
“We commonly misinterpret confidence as a sign of competence.”
The article notes men typically display confidence more than woman & this hubris is what ultimately results in leadership failure.
👉 The solution, I think, is to be able to recognise competence (in everyone).
We tend to equate leadership with the very features that make the average man a more inept leader than the average woman. The result is a pathological system that rewards men for their incompetence while punishing women for their competence.
"The majority of
#thyroidnodules
found to be benign at baseline remained so 5 years later."
- Clinical
#Endocrinology
News March 2015
Image from original paper: