Updated: Dec 20, 2021
Metabolic Center for Wellness is the
Only Central Florida Location for Procedure
As an integrative endocrinologist, one of my goals is to help patients improve and maintain proper thyroid function. Contrary to popular belief, the thyroid is not a disposable gland that can easily be replaced with a pill. It’s responsible for hormone receptors throughout the body, controls metabolism and helps regulate mood. It also plays a crucial role in gut regulation, cardiac and pulmonary function, and the health of skin and hair. Unfortunately, one in three people in the United States have thyroid nodules that significantly impact the way this critical organ functions.
Most nodules are harmless masses that require no intervention beyond routine ultrasounds. If left alone, however, some nodules will continue to grow and cause compressive or cosmetic issues; others may become overactive; and some may even be cancerous.
Until recently, the only option for removing part or all of the thyroid has been in-patient, invasive surgical procedures. Fortunately, radiofrequency ablation (RFA) has proven to be an excellent non-surgical option. But surprisingly, there are still very few providers around the country offering RFA, with the Metabolic Center for Wellness being the only one in Central Florida.
How RFA Works
Performed in the office under local anesthesia, RFA is minimally invasive. Using ultrasound guidance to ensure the electrode remains far away from vital structures like nerves, frictional heat is introduced to the unwanted tissue through a process called ionic agitation. It causes immediate tissue coagulation that shrinks and often eliminates the nodule. This highly targeted approach protects the surrounding healthy thyroid tissue. And since thyroid tissue does not have nerves, there is minimal discomfort during the procedure.
The entire process takes about 45 minutes, and any scarring or bleeding is almost negligible. Following the procedure, patients are asked to remain in the office for 30 minutes, then can return to their normal routine with very few restrictions.
Although complications with RFA are very rare, there’s always a risk with associated with any medical procedure. Some of the more common ones include bruising or soreness, skin burn where the probe was inserted and temporary hoarseness. Fortunately, the major risks associated with traditional thyroid surgery—from permanent damage to vocal cord nerves to damage to the parathyroid glands—are all but eliminated with RFA.
RFA is extremely safe and effective, and results can be seen quickly. In fact, most patients have a 60-90% decrease in nodule size within 1 year. Clinical studies have demonstrated that benign, non-functioning thyroid nodules decreased 50-80% by month 6 and by approximately 90% in a year. Those with overactive thyroid nodules generally experienced a 50-70% decreased around 6 months, along with the return of normal thyroid hormone levels in most patients. In rare cases, additional treatment and the use of thyroid hormone therapy is needed.
To be considered for RFA, patients must first have a biopsy to confirm that the thyroid nodule is benign. Additionally, the nodule should be creating some sort of issue for the patient—cosmetically bothersome, causing compressive symptoms and/or rapidly growing. Other potential candidates include those who prefer not to or cannot undergo surgery, or who have a “toxic” nodule that produces unhealthy hormone levels.
RFA is not an option for those with severe heart disease, patients on anticoagulation that cannot temporarily be held, and those with a pacemaker and/or defibrillator. Pregnant patients also should not undergo RFA procedures.
History of RFA
RFA is a minimally invasive technique that has been used for years as a common treatment for small tumors in tissues such as the liver, lung, kidney and prostate. It also has been used for treating heart disease and varicose veins.
In 2002, RFA was first used for the treatment of enlarged benign thyroid nodules in South Korea. Since that time, the procedure has been studied internationally and proven to be a safe and effective therapy for benign thyroid nodules, as well as autonomously or toxic thyroid nodules. The international success of RFA led to FDA approval of the procedure in 2018.
Even with the best thyroid hormone replacement therapies, it is incredibly challenging to regain optimal thyroid function after surgery. Even my surgical colleagues agree that traditional removal of the thyroid is rarely the best option. When it comes to treating thyroid nodules, RFA is a monumental step toward thyroid health by improving the organ’s natural function, as well as reducing complications associated with surgery.
If you’re interested in RFA and believe you’re a candidate for the procedure, schedule an appointment with the Metabolic Center for Wellness today. The screening process is quick and easy, with short wait times for RFA scheduling.