Thyroid No Surgery 2017

Thyroid No Surgery 1 : The Art of Refusing a Screening Thyroid Ultrasound


Since the 1990’s ultrasound imaging has become so easy, and inexpensive that every primary care physician sees a source of extra income adding a thyroid ultrasound to the yearly physical examination. Thyroid ultrasound is not like a urine analysis. The patient is at risk from an ultrasound that is not mandated by a history of thyroid disease in the family,radiation exposure, or a physical finding of an enlarged thyroid,a nodule or function abnormalities of hypothyroidism or hyperthyroid by TSH testing. The finding of small nodules can trigger a referral to radiology for a needle biopsy. The results of suspicious can trigger the surgery. The surgery has many risks including loss of voice,calcium problems, pain and loss of work time. The number of clinically significant cancers in the general population is small, but the exposure to unnecessary search of them by screening ultrasound is too risky for you without an indication.

What to Do if asked to have an ultrasound by your physician?

  1. Ask why is it needed.
  2. If the answer is it is a routine part of the examination, and there is no other reason you can refuse to allow it.
  3. If the answer is you have a family history of thyroid disease, or cancer, or other thyroid related conditions, and you have an enlarged thyroid on examination then the ultrasound is not screening or routine but medically indicated. You need to go ahead with the ultrasound.
  4. Finally if it is office  based find out about who is doing the ultrasound and who is reading the images.
  5. Ask to be referred out to an expert in thyroid neck ultrasounds. A list of endocrine neck certified ultrasound thyroidologists can be found on under ECNU certified endocrinologists.
  6. Your medical health depends on avoiding screening or routine ultrasound imaging, and if you clinically need an ultrasound get referred to an expert endocrinologist in neck and thyroid ultrasound.
  7. Modern Thyroid imaging with ultrasound has gone too far and now is a threat to your health by exposing you to the potential of a thyroid biopsy and surgery for no reason if it is done as a routine or screening procedure.
  8. If your daughter is an ultrasound tech and she offers a free imaging of your thyroid and you have no indication of a thyroid problem, nicely as possible SAY NO.                 
  9. It is never wrong to get a second opinion to determine if the ultrasound is indicated.