Thyroid No Surgery or Radiation for Autonomous Functioning Thyroid Nodules: Radiofrequency Ablation is the treatment of choice in 2021.

Thyroid No Surgery or Radiation for Autonomous Functioning Thyroid Nodules AFTN: Radiofrequency Ablation should be the treatment of choice in 2021.

Dr.Guttler’s Comments:

1. Until recently the treatment for toxic or AFTN’s was surgery or radioiodine.
2. Ethanol ablation was tried but was not effective. Laser is also used for AFTN’s.
3. Thyroid RFA has been studied and found to be a safe and effective alternative to surgery or radioiodine.
4. Many prospective studies have been done.
5. The presence of a nodular goiter and a suppressed TSH is the clue to get thyroid I/123 image and uptake.
6. Consensus statements and guidelines support the notion that thyroid RFA should be regarded as first line therapy for benign thyroid nodules.
7. RFA therapy for AFTN’s  is available for anyone but especially if they do not want surgery, or radiation therapy.
8. Early RFA therapy of AFTNs that are small <12 ml will result with more nodule reduction 84% vs 68% and a higher rate of normalization of the TSH. 86% for small nodules and 45% for larger nodules.
9. Patients wait to be treated because they are not sick from clinical hyperthyroidism.They want to avoid surgery or radioiodine.
10. This is not a good idea because subclinical hyperthyroidism has some bad effects.
11. Also,thyroid RFA is more successful if done early when the nodule is small.
12. Please call me at 310-393-8860 or email thyroid.manager@thyroid.com for evaluation for Thyroid RFA for your AFTN.
13. Ask for Alicia.
14. Dr.G.