Save Your Thyroid with Jen

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Save Your Thyroid with Jen Podcaster, Founder of Save Your Thyroid https://linktr.ee/itsme_jenagain

10/20/2026

Large nodules creeping under the collarbone present a unique challenge.

Dr. Salem Noureldine explains how patient positioning — even something as simple as a pillow behind the shoulder — can determine whether a compressive nodule can be safely and completely treated with microwave ablation.

Episode 130: Why RFA Sometimes Fails on Toxic Thyroid Nodules — And What Works Instead | Save Your Thyroid with Jen.

10/20/2026

Two ablation technologies, two completely different physics.

Dr. Salem Noureldine explains the real difference between RFA and microwave ablation: RFA generates heat with an electrical current passing through tissue. Microwave generates heat directly at the tip of the probe, through friction — no current traveling through the body at all.

That difference is why microwave can generate heat faster, to a higher temperature, across a larger zone — which matters a lot when you’re treating a big nodule.

Full episode: Ep. 130 with Dr. Salem Noureldine — Save Your Thyroid with Jennifer Holkem.

This week on Save Your Thyroid: why one ablation technology isn’t always enough. 🦋A toxic thyroid nodule doesn’t just si...
10/19/2026

This week on Save Your Thyroid: why one ablation technology isn’t always enough. 🦋

A toxic thyroid nodule doesn’t just sit there — it overproduces hormone and affects your whole body. Dr. Salem Noureldine, endocrine surgeon at George Washington University, joins me to explain why RFA sometimes can’t fully treat these vascular nodules, and what changes at a physics level with microwave ablation.

We cover the “heat sink effect,” why pacemaker patients may be safer candidates for microwave, and a real patient case where a second ablation succeeded where the first one didn’t.

“The patient is the shape sorter box, and my job is to find the shape that fits.”

🎧 Episode 130 DROPS TOMORROW: Why RFA Sometimes Fails on Toxic Thyroid Nodules — And What Works Instead. Search “Save Your Thyroid with Jennifer Holkem” on YouTube or your favorite podcast app.

10/18/2026

Were you told your thyroid nodule is "too small" for ablation? Or "too big"?

Dr. David Goldenberg doesn't use a hard cutoff in either direction: "There is no too small. If I can stick a needle in it and if I believe I can help the patient, I'll do it. Same thing with this, there is not too big."

He has treated nine-centimeter nodules. It took three sessions over two years, and it worked.

What matters is clinical judgment, and whether the procedure can truly help you. "I'm gonna try and stay true to what I think is the right thing to do."

Episode 129: When Thyroid Ablation Isn't the Answer: A Surgeon Who Does Both Explains — Save Your Thyroid with Jennifer Holkem.

"The patients are typically happier before I'm happier… I have to keep on reminding myself it's not about me, it's about...
10/17/2026

"The patients are typically happier before I'm happier… I have to keep on reminding myself it's not about me, it's about how they feel." — Dr. David Goldenberg

A 60–80% volume reduction is a great result on an ultrasound report. But many ablation patients feel relief from their symptoms well before the follow-up scan shows how much the nodule has shrunk.

The numbers matter. How you feel matters more.

Episode 129: When Thyroid Ablation Isn't the Answer: A Surgeon Who Does Both Explains — Save Your Thyroid with Jennifer Holkem.

10/16/2026

What does the perfect thyroid ablation candidate look like, and who needs surgery instead?

Dr. David Goldenberg walks through two real-world examples.

Patient one: a 40-year-old woman with a 15 mL solid, benign, TI-RADS 3 nodule causing neck pressure or cosmetic concern. No other nodules, normal TSH. "She's perfect. She's the perfect candidate."

Patient two: a 55-year-old man with a 35 mL dominant nodule within a multinodular goiter, in a substernal location, with indeterminate cytology. "Well, guess what? This patient needs surgery."

Size, location, how many nodules there are, and how certain we are that the nodule is benign all shape the right answer.

Episode 129: When Thyroid Ablation Isn't the Answer: A Surgeon Who Does Both Explains — Save Your Thyroid with Jennifer Holkem.

"We're not doing this (thyroid ablation) because your thyroid is dying anyway. We're doing this because you have a nodul...
10/15/2026

"We're not doing this (thyroid ablation) because your thyroid is dying anyway. We're doing this because you have a nodule, which is symptomatic, and I can help you by shrinking it." — Dr. David Goldenberg

If you have Hashimoto's and were told there's no point in saving your thyroid, this one's for you. Dr. Goldenberg calls that very old-school thinking. Treatment decisions should be about the nodule causing your symptoms, not the background condition of your gland.

Episode 129: When Thyroid Ablation Isn't the Answer: A Surgeon Who Does Both Explains — Save Your Thyroid with Jennifer Holkem.

10/14/2026

Being referred for ablation doesn't mean you need ablation.

Dr. David Goldenberg describes a conversation he has often: "I have a thyroid nodule and my doctor sent me for ablation. And I say, is it bothering you? No, I didn't even know it was there. You having problems swallowing? Nope. Okay, guess what? Let's just watch it for a while. And they're very happy."

"So not everyone leaves with ablation, not everyone leaves with surgery."

For some patients the best option is observation, for others it's ablation, and for some it's surgery. That's why it's so valuable to see a physician who can walk you through every option.

Episode 129: When Thyroid Ablation Isn't the Answer: A Surgeon Who Does Both Explains — Save Your Thyroid with Jennifer Holkem.

"There is no too small. If I can stick a needle in it and if I believe I can help the patient, I'll do it." — Dr. David ...
10/13/2026

"There is no too small. If I can stick a needle in it and if I believe I can help the patient, I'll do it." — Dr. David Goldenberg

Were you told your nodule was too small, or too big, for ablation? Dr. Goldenberg doesn't use a hard cutoff in either direction. He has seen small nodules sitting in exactly the wrong spot cause real symptoms, and he has treated nine-centimeter nodules over multiple sessions.

What matters most is whether treatment can truly help you.

Episode 129: When Thyroid Ablation Isn't the Answer: A Surgeon Who Does Both Explains — Save Your Thyroid with Jennifer Holkem.

10/12/2026

Did your doctor make a treatment recommendation from a single still image of your thyroid nodule?

One of my favorite quotes from past interviews on this show: an ultrasound is not a picture, it's a movie. A real-time ultrasound shows every side, every angle, and every feature a physician needs to properly evaluate a nodule. A still image shows only a sliver.

Dr. David Goldenberg's response says it all: "Ultrasound is king when it comes to thyroid and thyroid disease."

If you're considering ablation or surgery, ask whether your physician will perform or review a live ultrasound before making a recommendation.

Episode 129: When Thyroid Ablation Isn't the Answer: A Surgeon Who Does Both Explains — Save Your Thyroid with Jennifer Holkem.

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