SPEAKER_00: 0:01

Welcome to the Healthy Matters Podcast with Dr. David Hilden, primary care physician and acute care hospitalist at Hennepin Healthcare in downtown Minneapolis, where we cover the latest in health, healthcare, and what matters to you. And now, here's our host, Dr. David Hilden.

SPEAKER_03: 0:19

Hey, everybody, and welcome to episode 21. I am David Hilden, your host, and today we're getting to know one of the most underappreciated and maybe underrated organs in the body, the thyroid. It's small, it's butterfly-shaped, and it packs a huge punch when it comes to how your body functions. If you ever wondered why you're feeling sluggish or moody, hot, cold, or just off... Maybe your thyroid has something to say about it. So joining me today is someone who knows this stuff inside and out, Dr. Srikanth Avila. He's an expert endocrinologist at Hennepin Healthcare in Minneapolis who knows the thyroid like the back of his hand. Srikanth, welcome to the show. Thank you. It's great to have you here. Now start us off. What's the thyroid and what does it do? Our

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body has like many organs and which are very important for our survival. So among them, thyroid is one of the most important organ I would say that it's like a CEO of our organ. It's the CEO of

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the organs? Oh, I haven't heard it called that before. I've heard it called the thermostat

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before. Yeah, thermostat. Like, it's not just about the thermostat. Like, okay, it's just not controlling your heat and cold, but... It's like controlling each and every cell of your body. So, as a CEO, you control each and every system in the organization, and everything runs on the orders of your CEO. In the same way, the thyroid is also like controlling each and every cell of your body and how they respond. So, for the normal functioning of your cells, you need your thyroid. So, you're saying it controls the heart, controls the

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kidneys, controls everything?

SPEAKER_02: 1:57

Yes, territory. indirect it controls

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each and every organ of a body so you're saying we need it it's not like your spleen you kind of need your thyroid

SPEAKER_02: 2:06

yes spleen is something like okay you need it but again if you remove it it's fine but Thyroid is very important. If you don't have thyroid, it's okay. But again, you need the hormones, whatever it produces, for

SPEAKER_03: 2:21

our survival. Yeah. Listeners, that's kind of a running joke in medicine. It's like, what's a spleen? What does that thing do? No, nobody knows. Nobody knows what the spleen does. Let's get rid of that useless thing. That's not true, but it's sort of like this running joke. So, the thyroid makes hormones. Really basic, where is the thing? So,

SPEAKER_02: 2:37

Let me just give us like brief history about thyroid, how the name came in. Okay. So, it dates back to first century AD. That's when like we have some literature on that discussing about thyroid. Ancient Egyptians, Chinese, Greeks, they all talked about thyroid. And they also talked about managing it. So, thyroid. At the time, it was talked about guiter, like a swelling in front of your neck. And they used to treat it with seaweeds. You ate the seaweed or you put it on there? You ate it. So I'll come to that, like why the seaweed's important, like it does make sense. The term thyroid was named in 17th century by Thomas Wharton, derived from the Greek word, which was the meaning for shield. It does kind of look like a shield. Yeah. So it's located. in front of our neck just like we have a prominent spot in our neck in front of our neck called Adam's apple so it just sits below that it's the shape of a butterfly so you have a narrow part in the between and then you have two wings which spread out to one on the left side, on the right side. So we call them as a left lobe and a right lobe. And there is a small bridge which connects these two lobes, and we call that as isthmus.

SPEAKER_03: 4:00

So it sits in your neck. It makes hormones. It's the CEO of the body. And it does kind of look like a shield. I don't think I knew that. That's where the thyroid is. Before we talk about why it happens, what happens when it goes wrong? When someone's thyroid's not working, what symptoms might people experience?

SPEAKER_02: 4:19

As I said, the thyroid Thyroid affects in each and every system of your body, whether it's directly or indirectly. Let's start with like your brain. Like you feel like mental fog. You can feel depressed. You can feel tired coming down your heart. So if you're producing too much of your thyroid hormone, then it makes your heart beat very fast. Then again, you have symptoms because of that. Like you feel some chest discomfort, some pain. some difficulty in breathing, or it can reduce your heart rate. So if your heart rate is low, then you don't pump enough blood for your body. So there is no enough blood supply in your body. Then again, all the organs start getting tired. They don't function normally. There is no enough energy in generation for them. When it comes down to your stomach, intestines, it's needed for the normal motility of your intestines. So if it is less, then you have constipation. When you are producing too much of the hormone, then you have increased movement of your bowel, then you have diarrhea. It also has effect on your bones. So if you have too much of thyroid hormone producing, it's like an acid. So it starts eating up your calcium

SPEAKER_03: 5:37

from your bone and it starts making It really can affect just about everything. So you've talked about when it's moving too fast or when it's overactive. You've talked about when it's moving too slow and it has symptoms then and they can be quite different. So let's break that down a little bit. Let's start out with the underactive one, otherwise known as hypothyroidism. What causes that?

SPEAKER_02: 5:59

There are many causes for your thyroid to not function well and underperform, but the most common is an autoimmune disease. Autoimmune disease is a condition where your body is producing antibodies and fighting your own organ. For some reason, it just produces these antibodies and starts attacking your thyroid, and it starts destroying the cells, which actually produces a hormone, and then it shuts itself. So that's why now you're not producing any hormone, and then you have underactive thyroid. So that's called Hashimoto's thyroiditis. That's what you will hear very frequently, a lot of people talking about saying, hey, I have Hashimoto's.

SPEAKER_03: 6:44

I suppose that was named after somebody named Hashimoto. Yes. Hashimoto's thyroiditis is the term. And is that what causes all hypothyroidism? Because you mentioned autoimmune disorders. It's an autoimmune disorder. And listeners to the podcast, if you've been listening carefully over the last four years, you've probably heard the word autoimmune, where your own body attacks one of its organs. So that's a common cause of hypothyroidism, probably the most common. How common is that, by the way?

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I'd say it's about 70 to 80% of the chance of your hypothyroidism, like underactive thyroid, is due to Hashimoto's.

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What are the other causes of an underactive thyroid?

SPEAKER_02: 7:22

The other cause would be is like you had some surgery, your thyroid was removed for some reason. Yeah, So that would be the second common cause. Then the other cause would be is when you were treated for overacting thyroid, one of the treatment is radioactive iodine. We give radiation and it destroys your thyroid. And since now your thyroid is destroyed, we are treating for one reason, now you have lined up

SPEAKER_03: 7:46

with another. It's a known consequence. So you said 70-80% of hypothyroidism is due to Hashimoto's or autoimmunities. Who gets this? Who in the population's at risk? Is it everybody equally? Men, women, young, old? Who gets it the most? And how common is it?

SPEAKER_02: 8:02

Right now... or any autoimmune disease, we really don't know exactly why we develop these antibodies. But most of the times when it comes to autoimmune, it's genetic. So it gets transferred from family to family. So you are more prone for autoimmune disease. And if you have any autoimmune disease, any other autoimmune disease, there is high chance that you will develop And this isn't just a thing of older adults, is it? No, it can affect anyone. I would say like around 15, 18 years and it can go up to 20. 80 years, 90 years later in your life, also you can develop these antibodies. So there is no specific time for you to develop these antibodies.

SPEAKER_03: 8:57

And before I move on to an overactive thyroid, so those who are experiencing underactive thyroid, those are the ones having the slowed down symptoms like you mentioned, correct? Yes. They're the ones having the slow heart rate, constipation. What about weight? Is weight involved in an underactive thyroid?

SPEAKER_02: 9:14

Yes. Because it's the main hormone which controls your metabolism. And that energy is driven from your thyroid. It's like a spark plug where it's igniting your fuel to produce that energy. If you don't burn your calories. Then you accumulate those calories and then you land up having increased weight. So, underactive thyroid will make you to gain

SPEAKER_03: 9:39

weight. I've heard the metaphor of like your thyroid sort of like the gas pedal and the brake on your car. And when it's overactive, someone's standing on the gas pedal. And when it's underactive, someone's standing on the brake. So, you can't go fast. You can't move. Everything's sluggish. You gain weight. Your heart's slow. You have constipation. Everything's in low gear. Okay. So, shift to hyper hyperthyroidism. And in medicine, folks, hypo means low, hyper means high. So hyperthyroid is it's overactive. What causes that?

SPEAKER_02: 10:09

Again, the most common cause when it comes to hyperthyroidism, again, that's again, it's an autoimmune disease. So again, your body is producing antibodies, which here, it's not destroying your thyroid. So We talked about Hashimoto's where your body is producing antibody. It destroys your thyroid. Here, it's actually stimulating, overstimulating your thyroid to produce more hormone than what is required. So usually our thyroid is under control of your brain. So there is a muscle gland called pituitary. So it produces a hormone called TSH. The name itself, it's thyroid stimulating hormone. TSH, yeah. Yeah. So that, stimulates your thyroid and controls how much you need to produce and when to stop and when to start. But here, your body is producing antibodies which doesn't listen to anyone and it just does its own job.

SPEAKER_03: 11:06

It's out of control thyroid. Yeah. Producing its own hormones without that signal from the brain. Yes. Dang it. So those of you whose thyroid's working right in the normal range, you know, you got something to be thankful for because it can go either direction. It can be a little bit rogue and producing too much hormone. What's that called? What's an overactive one called?

SPEAKER_02: 11:27

The overactive thyroid, because of the autoimmune condition, we call it as a Graves' disease. Again, it's named after the person who actually first described. Grave. It's called as Graves' disease.

SPEAKER_03: 11:39

Somebody, Dr. Grave or Mrs. Grave, I don't know who it was,

SPEAKER_02: 11:43

Graves' disease. Graves' disease, but don't go by the name, like saying Graves' means, okay, do I go to Graveyard? Yeah, exactly. I

SPEAKER_03: 11:50

thought that too. You know, here's another little sidebar. We've stopped naming things after people and places kind of in medicine because it's not helpful. It's not helpful to name it after some guy named Graves who stuck his name on it. I assume it's a guy because, frankly, that's what happened. Unfortunately, it could have been his wife that found it. He put his name on it. So we're getting away from that. So it doesn't mean you're going to the grave. It was named after somebody named Dr. Graves. Okay, so that's one cause of it. Are Are there other causes for an overactive thyroid besides this autoimmune Graves disease?

SPEAKER_02: 12:25

The other causes for overactive thyroid is when you have some inflammation because of some viral infection. So when you have some inflammation, it destroys. So here your body is not, like your thyroid is not producing. Your thyroid already has produced some hormone and it has stored and it's just releasing when you need it. It's like a dam, right? Like where you have your water reserves, but when you need, you just open the gates. Here, during the inflammation, the gates get damaged and then the whole hormone which was stored is just released. Just flooded into your body. Yeah. So that's transient. So it's temporary because it just empties whatever the hormone is there. And it has a shelf life. After some time, it just have to be excreted and metabolized from your body. So it disappears. So initially, you will have the symptoms of like hyper-functioning thyroid. Then once the inflammation settles down, your thyroid levels comes to normal. But there is a possibility because if there was too much of inflammation or too much of destruction, then you can land up having an underactive thyroid. So that's the other cause. The other cause is pregnancy. So after pregnancy, like after delivery, we call it as postpartum thyroiditis. After delivery up to one year, there is a chance that your Thyroid gets inflamed and produces more thyroid harm.

SPEAKER_03: 13:50

So it occurs after pregnancy, Shikhat. It's not the pregnancy didn't cause it, but it is some consequence of some women's pregnancies?

SPEAKER_02: 13:59

Yeah, so... During pregnancy, you know, like a lot of physiological changes happen. So your body needs more of thyroid hormone during pregnancy than what you required in like a normal life. You deliver a baby. So now your thyroid has to readjust to the new- To the new metabolic requirements. Requirements. So your thyroid just is trying to get adjusted to it. And that time, whatever the hormone it's producing, it's like it's more than what's required. And again, that's transient. So slowly- It starts settling down, and then it just comes back

SPEAKER_03: 14:33

to normal. We're going to talk about treatments of these conditions after the break. But before we do that, I want to talk just for a moment or two about thyroid nodules. We're not going to get into depth about that, but they can be a big nothing. They could be producing hormone, making you hyperthyroidism, or they can even be cancer, right?

SPEAKER_02: 14:55

Yes.

SPEAKER_03: 14:55

Okay, so let's talk for a moment. If you do have a thyroid nodule, so your doctor told you or you felt a lump in the front of your neck, could you just talk us briefly through thyroid nodules and what people should know about them?

SPEAKER_02: 15:10

Yeah. You actually are asking one of the favorite topics in thyroid for me. So I do a lot of, see a lot of thyroid nodules patients. I actually do biopsies also. Yeah, this

SPEAKER_03: 15:21

guy puts needles in your neck, folks. For a good reason. For a good reason. Not very far. That's a little bit of kind of like maybe humor that the public doesn't do. We talk about stuff like this. So you're going to put a needle where? It's just in the front. It's not very deep. Okay, so you do that a lot in your clinic. Talk about that.

SPEAKER_02: 15:40

Thyroid nodules, the name itself, it's a nodule. Nodule is something, an abnormal growth in your thyroid. So that's what's called a thyroid nodule. Why they grow, we don't have any clear answers. The most common hypothesis is like because of a hormonal imbalance where there is a difference in the growth of one particular area in your thyroid and the other one. So one is outgrowing the other part. and outgrow and form nodules, they're usually non-functional. And they're not doing anything. Yes, they're usually non-functional. I just like to frame, put it as an usually because I'll tell you sometimes they do produce hormones or they can affect your thyroid to produce less harm. So these nodules, again, whenever we listen, oh, there is something growing in my thyroid, we all panic thinking, oh, something is growing. Is it a cancer or something? Let me put it in a very simple way. These thyroid nodules are very common. As your age increases, the incidence of these nodules increase. So just to put it very simple, at the age of 30, It's about 30% chance. Like if you scan anyone who is in 30s, there is a 30% chance that you might find an audio.

SPEAKER_03: 16:59

30%? That's a lot.

SPEAKER_02: 17:00

Yeah. So that's why it's a pretty common. It's common. It's not uncommon.

SPEAKER_03: 17:03

Yeah.

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At the age of 50, it's a 50% chance. Age of 80, it's an 80% chance. Anyone is 90 and above, there's a 100% chance. If you're

SPEAKER_03: 17:11

90 years old, you probably got a nodule in your

SPEAKER_02: 17:13

thyroid. Yes. So- That's that common. That's fascinating. I didn't know that. Yeah. Yeah. So that's why we don't, again, they don't grow. They grow very slow. Like, you don't know when you have developed a snordial. You probably haven't. You don't feel it. Yeah, you don't feel it unless it becomes very big and obvious. You don't feel it. Most of the times, these snordials show up when you went for some scan for some reason. We see in your thyroid, there is some snordial. You had

SPEAKER_03: 17:39

a CAT scan of your lungs because you were short of breath. Some totally different reason. Totally different. And it's what they call it in Incidental finding. Yes. Oh yeah, we saw this too.

SPEAKER_02: 17:49

So that's 70% to 80% of the times we find this incidentally because you have gone for some other scan and we found this that there is a thyroid nodule. But again, when we see a nodule, we always want to make sure that, okay, is this a cancer or not? So does all nodule need our attention? No. There are criterias which have been set in line by American Thyroid Association and then the radiology, they have their own association. So they have set in guidelines and Based on the guidelines, we decide, okay, this nodule seems a little concerning. Let's do some further workup. This nodule doesn't seem concerning. It's okay. Let it live. We don't need to do anything. Let it be there. Or there are some other nodules we just say, okay, it's not concerning, but let's watch for it if they grow or not. So that's the

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take-home message, I think, from this whole little segment about nodules. They're common most of the time, or at least a lot of the time, you don't have to worry about them. But we do have to look into it and see if it's one of the concerning ones to see if it happens to be one of those thyroid cancers. We are talking with Dr. Srikanth Avila. We've covered the basics and the common thyroid disorders. When we return from a short break, we're going to discuss how these conditions are diagnosed and treated, and importantly, how you can manage your daily life if your thyroid is acting up or maybe I should say acting down. Stay with us. We'll be right back.

SPEAKER_01: 19:19

When Hennepin Healthcare says, we're here for life, they mean here for you, your life, and all that it brings. Hennepin Healthcare has a hospital, HCMC, a network of clinics in the metro area, and an integrative health clinic in downtown Minneapolis. They provide all of the primary and specialty care you'd expect to find, as well as services like acupuncture and chiropractic care. Learn more at hennepinhealthcare.org. Hennepin Healthcare is here for you and here for life.

SPEAKER_03: 19:56

And we're back talking with Srikanth Avila about thyroid disorders. And in that first half, we covered a lot of ground. So our break came a little bit later. Now what I'm going to do is ask you to talk about the conditions that we started with. Hypothyroid, Hashimoto's, hyperthyroid, Graves' disease, and related disorders. How were they

SPEAKER_02: 20:15

diagnosed? It's a basic, simple blood test. So you are... It's called a thyroid function test. So the name itself describes it. So we are trying to look about the function of your thyroid. So it's the TSH, the thyroid stimulating hormone. And the thyroid hormone which your thyroid produces is called T4 and T3, which always bug me.

SPEAKER_03: 20:40

It is T4 and T3. They don't come sequentially. Your body changes one to the other. They go in opposite order. And where the heck are T1 and T2? I always wanted to know that in med school. Anyway, T4 and T3 are the hormones that circulate through your body and do their job.

SPEAKER_02: 20:55

Yes. That's what we're going to check when initially looking for your thyroid functions, whether normal or abnormal. And when they are abnormal, so when we say like underactive thyroid, So we would expect your thyroid hormone to be low. Obviously, since your thyroid is not producing enough hormone, then your brain is sensing that, hey, your thyroid is not producing enough hormone as it's supposed to produce. So then your brain, the pituitary, is producing this TSH in more, trying to stimulate, trying to override and say, hey, try to produce. It's cracking the whip a little harder,

SPEAKER_03: 21:33

isn't it? Yes. So high TSH means a low underactive thyroid. Yes. And the opposite is also true, I assume?

SPEAKER_02: 21:41

Yes. in the hyperactive thyroid, we would expect your thyroid to produce too much of hormone, but your pituitary is sensing that, saying, hey, you're producing too much of a hormone. Let me not stimulate you. So that's why you will expect your TSH to go down and you will see your T3 and T4 levels going up. So now we know that, okay, you have an underactive thyroid and you have an overactive thyroid, but we need to establish what's causing this. So we need to find the reason so that is there any particular reason which we can prevent, treat that, remove that cause, then your thyroid would normalize.

SPEAKER_03: 22:26

One thing I like about thyroid disease and maybe a lot of endocrinology in general is that there's a blood test. You know, a lot of things there isn't. or there's blood tests that are supportive, you can diagnose pretty accurately with a TSH, a T3, and a T4 as the initial tests. Yes. As the initial tests. And then if they're abnormal, there's additional tests. And endocrinologists can get pretty specific about what's wrong. They can check antibodies, and you can check other hormone levels, and you can figure out, do you have Graves' disease? Do you have Hashimoto's? Do you have all these things? So this is something you can get diagnosed relatively readily. Very common one, underactive hypothyroidism. Autoimmune, Hashimoto's, hypothyroidism. There's jillions of people, and jillion is the correct term, running around with that. How is it treated?

SPEAKER_02: 23:17

It's an underactive thyroid, so you're not producing enough thyroid hormone. So we have a synthetic thyroid hormone, which is nothing but your T4, and that's all you need. T4. T4. You don't need T4. T3 replacement. So there are some instances where we can give T3 replacement, but otherwise it's just a

SPEAKER_03: 23:38

T4 you need. And that's the levothyroxine. But I want to delve into that a little bit more. There's, like I said, a whole bunch of our listeners are taking levothyroxine right now. If your body has T3 and T4 running through it, why when we treat it, do we only give T4? Why don't we also give T3 more often? Because that is asked of us. People want to take ground up thyroid or they want to take thyroid from some animal or whatever because it's more Thank you for

SPEAKER_02: 24:07

asking that because that's the most common question we get. Reason is very simple. So your thyroid produces, yes, your thyroid produces of T3 and T4, but the ratio amount of your T4, which your thyroid produces, is actually 16 is to 1. So it's 16 times more than you're producing. 16 molecules of T4, then you're just producing one molecule of T3. And what your thyroid produces as a T3 is actually around 5 to 10% of what actually your body needs. The other organs, like your liver, muscles, also produces T3. Tatooine. your body cells take up T4 and they convert your T4 into T3. So that's why you don't need T3 because your other organs, it's not just thyroid. They take

SPEAKER_03: 24:55

care of it. They take care of it. People think that when I tell them, you don't need to take T3, they think that I've got like some stake in the pharmaceutical company that makes T4. Believe me, folks, I don't. It's been around forever. I don't. Doctors don't. It's just that it's unnecessary. So when you're You're taking all these pain out of your pocket, all these expensive things, and you're going and you're taking all these extra thyroids. Almost certainly. There's always exceptions, but you almost certainly don't need that. So I'm just trying to save your wallet that when I tell you, just take your T4, you'll be okay. So that's underactive thyroid. And there's loads of people who take their thyroid med every day and they're doing just fine. What about the overactive thyroid? Because in that case, you're producing too much thyroid hormone. So you don't want to take more. What do you do in that case?

SPEAKER_02: 25:44

Yes. Now you are producing too much of a thyroid hormone. So now we need to calm your thyroid. So we have a which act inside your thyroid and prevent the excess production of your thyroid hormone. Is that the only way to treat? No, we have other options, but that's the most common and easy way to treat. There are some people who don't tolerate. It's a medicine. It's a chemical, right? So when you take some medication, you always have some side effects. So some people don't tolerate because of the side effects. When they develop those side effects, then we... stop that medication. We try other forms of that medication and see if they tolerate. If they don't tolerate, then we have other treatment options like radioactive iodine.

SPEAKER_03: 26:30

Yeah, that sounds like a walk in the park. What's radioactive iodine? And don't let me forget, I'm going to ask you about seaweed. I'm going to ask you about seaweed.

SPEAKER_02: 26:38

The name itself suggests it's a radioactive iodine. Iodine is a molecule and that's a radioactive one. That's what we give to treat your hyperactive thyroid. Why iodine? The reason is because Because your thyroid hormone is made up from iodine. So, it's nothing but iodine. It's iodine, yeah. Yeah. So, it's nothing but iodine. Your thyroid is the only organ, major organ, which utilizes your iodine to produce this hormone. It's the reason it's in salt. So, that's why we give this radioactive iodine because it's mainly taken up by your… It doesn't go to

SPEAKER_03: 27:11

any

SPEAKER_02: 27:11

other organ. There are some… place where it's secreted in minute quantities, like in your saliva and your lacrimal glands. But otherwise, it's major concentration

SPEAKER_03: 27:22

is in your thyroid. I actually love this about medicine. So your thyroid is kind of the only place in your body that uses iodine. So let's nuke it. That's what we're doing. Yes. Let's make the iodine radioactive. It only goes, it doesn't, you know, the rest of your body is relatively unaffected. And we basically blast the crud out of your thyroid with this little, but it's safe, folks. It's safe. It is one way to ablate your thyroid with a chemical method, and then it's not overactive anymore. But then you get to take medicine to replace the hormone after you've had that done, right?

SPEAKER_02: 27:54

Yes, because now we are destroying your thyroid. So then there is no functional thyroid tissue left because your thyroid is still there. It doesn't disappear. It's there, but it's not working. We microwaved it. Yeah.

UNKNOWN: 28:10

I'm kidding.

SPEAKER_03: 28:11

Okay, before I let you go, Dr. Avila, Egyptians or somebody was feeding seaweed to people.

SPEAKER_02: 28:17

What the heck? So, seaweed, there are good stores of iodine. In seaweed. Seaweed, yes. So, as I talked about at the time, we talked about a term called goiter. Goiter is nothing but there is enlargement of your thyroid. Goiter is simply an enlarged thyroid. Yeah. So, that happens if you don't consume enough iodine. And that happens in people who are in hilly areas where... Usually, your soil is deficient in iodine because of the rainwater. It just washes off. So, hilly areas are deficient in iodine. Yes.

SPEAKER_03: 28:54

Who knew? Sorry, folks in Denver.

SPEAKER_02: 28:57

That was like an earlier thing. But right now, the simple source of iodine is your salt.

SPEAKER_03: 29:03

Yeah, around here, at least in the Western Hemisphere, they stick it in salt.

SPEAKER_02: 29:07

Yeah, so almost everywhere now, that's the easiest way where all the salt is iodinized. And that's where you get enough iodine from your salt. So in ancient times, we don't have this. all this manufacturing unit where we could separate iodine and salt and mix them and sell this iodinized salt. So at that time, the good source of your iodine was your seaweed. Your seawater is a good source of iodine. It has really good quantity. So I'm not telling, okay, go and drink seawater. You don't need to. But you are saying next time you go to your

SPEAKER_03: 29:41

sushi restaurant, get the seaweed salad.

SPEAKER_02: 29:43

I wouldn't definitely say that. But yeah, because again, you need to eat tons of seaweed. Okay. So here in sushi, when we go there, it's just very little seaweed there. That's not enough. Like you have to eat a great quantity, good quantity of seaweed every day.

SPEAKER_03: 30:02

So maybe that isn't your sole solution. But if you like the seaweed salad, get it anyway. Okay, Dr. Srikanth Avila, we've been talking about thyroid disease. If you could leave us with one message for listeners, what would it be?

SPEAKER_02: 30:13

I would like to tell our listeners, if you see any thyroid nodule, don't freak out. As I said, it's pretty common. Just talk to your doctor to get that evaluated and see if it is concerning or not. If you also notice any symptoms, like if you feel very tired, mental clouding, you don't feel right, get your thyroid checked and see if it is normal. If it is abnormal, then obviously we do have very simple measures to treat it and so that you can feel better and you can be what you were before that.

SPEAKER_03: 30:48

Yeah, it's reassuring. You don't have to freak It's common. There's things to be done. Dr. Srikanth Avila, thanks for joining me today.

SPEAKER_02: 30:55

Thank you, Dr. Hillen. And this was a wonderful session and it was nice talking to you.

SPEAKER_03: 31:00

It's been great chatting with you. We have been talking about your thyroid. It's sort of endocrinology month. We've covered diabetes. We've covered your thyroid. We got your hormones covered, listeners. Thanks for tuning in. I hope you'll join us in two weeks' time for our next episode. And in the meantime, be healthy and be well.

SPEAKER_00: 31:17

Thanks for listening to the Healthy Matters Podcast with Dr. David Hilden. To find out more about the Healthy Matters Podcast or browse the archive, visit healthymatters.org. Got a question or a comment for the show? Email us at healthymatters at hcmed.org or call 612-873-TALK. There's also a link in the show notes. The Healthy Matters Podcast is made possible by Hennepin Healthcare in Minneapolis, Minnesota and engineered and produced by John Lucas at Highball. Executive producers are John Lucas, and Christine Hill. Please remember, we can only give general medical advice during this program and every case is unique. We urge you to consult with your physician if you have a more serious or pressing health concern. Until next time, be healthy and be well.