Podcast Summary: Ologies with Alie Ward – Episode: Thyroidology (Thyroid Gland) with Keppel Patel

Release Date: January 29, 2025

In this engaging episode of Ologies with Alie Ward, host Alie Ward delves deep into the fascinating world of the thyroid gland with expert guest Dr. Keppel Patel, a division chief at NYU Langone Hospital’s Endocrine Surgery Department. Together, they explore the complexities of thyroid function, disorders, treatments, and the broader implications on overall health.

1. Introduction to Thyroidology

Alie Ward introduces the topic by highlighting common misconceptions and the significance of the thyroid gland in regulating metabolism and overall bodily functions. She sets the stage for a comprehensive discussion with Dr. Patel, emphasizing the thyroid’s pivotal role in maintaining bodily health.

Notable Quote:

Alie Ward [00:00]: "Maybe that's too many numbers for you. What I'm saying is that ritual is essential for women 18 plus."

2. Understanding the Thyroid Gland

Dr. Keppel Patel explains the anatomy and primary functions of the thyroid gland, likening thyroid hormone to the "gas for your engine" that regulates metabolism, temperature, digestion, and energy levels.

Notable Quote:

Dr. Keppel Patel [04:54]: "The thyroid gland is ... shaped like a butterfly... Its sole purpose is to make thyroid hormone... it regulates your metabolism."

3. Measuring Thyroid Function

The conversation transitions to how thyroid function is assessed, focusing on Thyroid Stimulating Hormone (TSH) levels and the roles of T4 (thyroxine) and T3 (triiodothyronine). Dr. Patel clarifies the inverse relationship between TSH and thyroid activity.

Notable Quote:

Alie Ward [05:44]: "Do you know a lot of women ... not getting enough vitamin D?"

4. Hypothyroidism and Hashimoto's Thyroiditis

Dr. Patel discusses hypothyroidism, its symptoms, and its common cause—Hashimoto's thyroiditis, an autoimmune disorder. They differentiate between general hypothyroidism and its autoimmune form, explaining how the latter involves the immune system attacking the thyroid gland.

Notable Quote:

Dr. Keppel Patel [07:22]: "The most common cause for hypothyroidism in this country is Hashimoto's."

5. Treatment Options for Hypothyroidism

Various treatment modalities are explored, including synthetic levothyroxine (Synthroid) and natural desiccated thyroid from pigs. Dr. Patel emphasizes the importance of individualized treatment plans and discusses the pros and cons of each option.

Notable Quote:

Dr. Keppel Patel [28:17]: "Most of us really prefer using levothyroxine... It's a known quantity that you're giving them."

6. Thyroid Nodules and Cancer

The discussion shifts to thyroid nodules—growths within the thyroid gland—and their evaluation. Dr. Patel explains the diagnostic process, including physical examinations and ultrasounds, and the high likelihood of nodules being benign. The segment also covers thyroid cancer, its types, and treatment approaches.

Notable Quote:

Dr. Keppel Patel [34:00]: "Thyroid nodules are basically growths in the thyroid gland... over 95% of them are going to be benign."

7. Iodine Deficiency and Goiter

Alie and Dr. Patel recount the historical prevalence of goiter in the Midwest’s "goiter belt" during the 1920s and the successful public health intervention of iodizing salt. They discuss current global iodine deficiency issues and their geographic correlations.

Notable Quote:

Dr. Keppel Patel [25:51]: "The most common cause for goiter are still iodine deficiency worldwide."

8. Graves Disease and Hyperthyroidism

Exploring the opposite of Hashimoto's, Graves disease is introduced as an autoimmune disorder that leads to hyperthyroidism. Dr. Patel outlines its symptoms, diagnostic markers, and treatment options, including antithyroid medications, radioactive iodine, and surgery.

Notable Quote:

Dr. Keppel Patel [55:43]: "Graves disease is ... making the thyroid overactive... causing weight loss, tremors, anxiety."

9. Impact of Infections on Thyroid Health

The episode examines how viral infections like Epstein-Barr Virus (EBV) and COVID-19 can trigger or exacerbate thyroid disorders through autoimmune responses.

Notable Quote:

Dr. Keppel Patel [32:00]: "Viral pathogens in general have been known to trigger autoimmune responses... COVID has been linked to transient hyperthyroidism."

10. Diet and Lifestyle Influences on Thyroid Function

Alie and Dr. Patel discuss the role of diet in managing thyroid conditions. While diet alone may not cure thyroid disorders, certain dietary adjustments can help reduce inflammation and support thyroid health. They also touch on the importance of lifestyle factors like stress management.

Notable Quote:

Dr. Keppel Patel [65:24]: "Anything that you can do to decrease that kind of stress and your immune response can be potentially beneficial."

11. Gender Differences in Thyroid Disorders

The conversation highlights the higher prevalence of thyroid disorders in women, exploring possible links to hormonal differences and environmental factors. Dr. Patel addresses how hormonal therapies, including those for gender-affirming care, can impact thyroid function.

Notable Quote:

Dr. Keppel Patel [70:56]: "Females are more prone to autoimmune diseases, including thyroid disorders."

12. Thyroid Issues in Pets

A unique segment covers thyroid disorders in cats, addressing hyperthyroidism and its prevalence in certain geographic regions. Dr. Patel explains the similarities and differences between feline and human thyroid conditions.

Notable Quote:

Dr. Keppel Patel [52:06]: "Feline hyperthyroidism is usually benign and related to thyroid enlargement as cats age."

13. Listener Questions

Alie addresses numerous listener-submitted questions, allowing Dr. Patel to provide expert insights on topics such as:

• Thyroid Function with Normal Lab Results: Understanding why some individuals feel unwell despite normal thyroid tests.

  Notable Quote:

  Dr. Keppel Patel [62:42]: "TSH is probably the best test for thyroid function... but we have to treat each patient individually."

• Thyroid and Physical Symptoms: Linking symptoms like eyebrow loss (Queen Anne sign) and hives to thyroid disorders.

  Notable Quote:

  Dr. Keppel Patel [68:30]: "Loss of the outer third of the eyebrows is called the Queen Anne sign and is an uncommon manifestation of hypothyroidism."

• Preventing Thyroid Nodules: Strategies (or lack thereof) to prevent nodules from forming.

  Notable Quote:

  Dr. Keppel Patel [73:43]: "Unfortunately, there's nothing you can do to prevent thyroid nodules from developing."

• Thyroid and Libido: Exploring how thyroid function affects sexual health.

  Notable Quote:

  Dr. Keppel Patel [76:06]: "If you're hypothyroid, you'll probably have a decreased libido."

14. Conclusion and Key Takeaways

Alie Ward and Dr. Patel wrap up the episode by reinforcing the importance of understanding thyroid health, seeking specialized medical advice, and the benefits of individualized treatment plans. They encourage listeners to pay attention to their bodies and consult healthcare professionals when experiencing symptoms related to thyroid dysfunction.

Notable Quote:

Dr. Keppel Patel [81:18]: "If you do have a thyroid problem, you should go see an expert who specializes in this."

Final Thoughts

This episode of Ologies with Alie Ward offers a thorough exploration of thyroid health, demystifying complex concepts and providing actionable advice for listeners. Dr. Keppel Patel’s expertise, combined with Alie’s relatable hosting style, makes intricate medical information accessible and engaging.

For more detailed insights and professional guidance, listeners are encouraged to consult healthcare providers and refer to reputable sources on thyroid health.