A4. It sometimes does, but often we can keep it at bay with careful monitoring and well timed surgery. #AHNSchat

A5. Like most thyroid cancers, external beam radiation does not play a role in most MTCs. Its mostly used for cancers that cannot be removed. Surgery is usually the better option. #AHNSchat

Thank you all for a great chat! #AHNSchat

Hi - Michael Orestes from Walter Reed National Military Medical Center. Excited to join! #AHNSchat

A1. T3 liothyronine is not used very frequently. With regard to thyroid cancer it is sometimes used prior to radioactive iodine therapy instead of T4 to help with the symptoms of being off thyroid medications. #AHNSchat

A2. The answer to this is not well know. Some studies show up to 50%. However, there are some studies that show it can be predicted based on labs before surgery and other factors pubmed.ncbi.nlm.nih.gov/35067900/ #AHNSchat

A3. Generally speaking most patients will be started on thyroid replacement medications the day after surgery. For some cancers RAI needs to be given sooner thyroid replacement needs to be delayed. #AHNSchat

A4. The TSH goals vary based on the risk of recurrence. #AHNSchat

A5. See below #AHNSchat

Having cancer is hard - there are a lot of factors that go into weight changes. Sleep, anxiety, depression, change in exercises habits are just a few! A good evaluation of all these factors is just as important as checking labs and the dose of your thyroid meds. #AHNSchat

This is important - I find that many doctors and patients don't think about the impact of sleep disorders, anxiety and stress on weight. #AHNSchat

Thanks everyone! Great discussion tonight! #AHNSchat

Hello everyone. Excited to be back! Mike Orestes from Walter Reed. #AHNSchat

A2. Removal of an entire lobe at a minimum is important since revision surgery can be challenging. Thyroid cancer often involves multiple parts of the thyroid and RAI requires removal of the entire thyroid to be effective. #AHNSchat

A3. RAI can be used to help treat microscopic cancer that may have spread already or help remove additional benign thyroid tissue to help with monitoring for recurrence. #AHNSchat

A4. This is a great question of our endocrine colleagues. Low iodine diet is required. Thyrogen stimulated causes you to become more hypothyroid so you don't have to stop your thyroid medication beforehand #ahnschat

A5. Thyroglobulin plays a important role in monitoring post RAI ablation, along with thyroid and neck ultrasound. #AHNSchat

Thank you everyone for a great chat! #AHNSchat