Dr.guttler @thyroid.com. Contact email. 

Clinical Thyroidologist is an endocrinologist who is a procedural thyroid endocrinologist.

When you know about clinical thyroidologists, it is in your best interest to seek one out in your area, or insist that one is recruited soon. Modern clinical procedural thyroid endocrinology is a full time job. General endocrinologists are extremely involved in caring for diabetes patients, and many decide to not get involved in learning all the tools needed to practice this new endocrine sub-speciality. While internal medicine and diabetes is a big job that needs to be done, a number of fellows and young endocrinologists are now entering this new field.

Thyroidologists.com r.guttler@thyroidis dedicated to supplying information on modern procedural thyroid endocrinology to physicians and patients.A clinical thyroidologist can be certified in thyroid nuclear medicine so they can treat you with radioiodine for Graves' hyperthyroidism, large simple goiters, and thyroid cancer in their office without the need to go into a hospital. They are certified by the American College of Endocrinology in Thyroid/Parathyroid ultrasound, and the American Institute of Ultrasound Medicine certifies their ultrasound lab.A Clinical thyroidologist keeps a scorecard on the pathologists that interpret their thyroid biopsies. If the ratio of indeterminate to cancer at surgery( Ideal < 2/1 ) is > 2-4 to 1, it results in an increase in unnecessary thyroidectomies. The scorecard method can help decrease the estimated 35,000 unnecessary surgeries due to over-diagnosis of suspicious follicular lesions. The ability to see cancer or a microfollicular pattern while doing the on-site adequacy assesment during the USGFNA procedure for follicular cells, can result in adding molecular markers such as BRAF, Inform Thyroid(R) by Asuragen, or Afirma(R) Veracyte, by needle washout technique during the actual biopsy procedure.This saves a repeat biopsy just to obtain the marker studies after the fact. BRAF can be positive in more aggressive cancer. Afirma can change an indeterminate result into a low risk < 4% one needing follow up rather than surgery, or a high risk needing surgery, with a 50% risk of cancer at surgery. The On-Site Adquacy assessment by the endocrinologist can decrease inadequate biopsy results, from 10-20 % to 1-6%. This saves the patient the need to have bad slides read as adequate by pathologists and decreases the costs that occur when a repeat biopsy is needed.