TODAY'S AJENDA #103

Today's Ajenda:

• The Hidden Cost of “Just to Be Safe” Testing

• Steady Energy for the Season Ahead

• Invitation: Smart Human Health Summit

The Hidden Cost of “Just to Be Safe” Testing

I’m suddenly on the other side of the conveyor belt I know so well professionally — this time, as the patient.

Recently, a large thyroid nodule was found incidentally, and now I’m staring down the familiar sequence: more imaging, more interpretation, biopsy discussions, the phrase “it may be nothing,” followed quickly by the implication that it also may not be nothing.

Here’s how it started.

I recently switched to a new doctor, who also happens to be my husband’s physician. I made the change because I’ve been genuinely impressed with the care he’s given my husband (and trust me when I tell you my standards are HIGH).

At my first visit, as part of getting established in the practice, he ordered a thyroid ultrasound. I had never had one before and, honestly, hadn’t thought much about my thyroid. I’ve never had symptoms that suggested a problem.

During the scan, I could see the screen as the technician moved the probe across my neck. Years of looking at medical images have trained my eyes in a way that’s hard to turn off. And pretty quickly, something caught my attention.

There it was: a large thyroid cyst, also called a nodule — and it wasn’t subtle. In that moment, I felt the quiet shift that so many patients experience: the realization that a routine check can suddenly open the door to a whole new set of questions.

And there’s a very specific kind of psychological whiplash that comes from going in search of reassurance — and instead being handed uncertainty. This is the part of modern medicine we do not talk about enough.

We love the language of “proactive”; we praise vigilance; we celebrate early detection as if more information is always better information, and more testing is always better care. Sometimes that is true, and sometimes it is lifesaving. But sometimes what starts as a non-standard scan, a “just to check,” or a body-peeking expedition uncovers an incidental finding that is real enough to demand follow-up, but ambiguous enough to disrupt your peace, your sleep, your concentration, and frankly, your identity.

That gray zone is expensive, not only financially, but psychologically.

Let me be very clear: I am not anti-testing or anti-imaging, and I am certainly not anti-medicine. I am deeply pro-evidence, pro-good judgment, and pro-using the right test for the right patient at the right time. My motto is: don’t do a test unless you know what you will do with the RESULTS of that test.

But I am also increasingly aware of the hidden cost of testing that is not truly standard, not clearly indicated, or marketed more as emotional insurance than sound medical strategy.

Because here is what can happen: You feel fine, then you get a ‘procedural’ test, something is seen (which it often is), now you are no longer “fine.” Not because you are necessarily sick, but because you have now entered a new category: person under evaluation.

That is not a small shift.

A thyroid nodule is actually a perfect example of this. Thyroid nodules are common, very common, and most are benign. Although many are found accidentally, once they are discovered, they often trigger a cascade of ultrasounds, recommendations, measurements, surveillance, sometimes biopsies, and an unavoidable question hanging in the air: could this be cancer?

Even when the statistical odds remain reassuring, the emotional experience is anything but. 

In my case, several features are suspicious for malignancy: its size, appearance, and shape. Last week, I had an FNA (fine needle aspiration) with four relatively painless needle aspirations of this nodule, and now I await the results. The endocrinologist did not love the way it looked, and because I understand the correlation between ultrasound characteristics and malignancy risk, I am trying to prepare myself for whatever the pathology report may show. 

But this is where I think the conversation needs to get more sophisticated.

We tend to talk about testing in binary terms: good or bad, responsible or neglectful, early detection or dangerous avoidance. Real life is messier. Some tests save lives, some tests create noise. Some findings matter urgently, some create months of medical theater before ultimately meaning very little. And some findings fall into that maddening middle where follow-up is reasonable, but the psychological toll starts long before the pathology report does. 

It’s the late-night Googling, the sudden awareness of your body and your mortality. It is the bizarre emotional speed with which the brain can go from “routine” to “what if this is the beginning of something terrible?” And the part that’s worth sitting with is the loss of innocence that comes from becoming a patient, even temporarily.

Because one of the hidden costs of incidental findings is that they can change the way you relate to your own body. A body that felt familiar and trustworthy on Monday can feel suspect by Wednesday. You start listening, interpreting, and watching differently. And that shift, even before any diagnosis, is real, powerful, and sometimes all-consuming.

Sometimes the most medically intelligent question is not “what else can we scan?” but rather “was this test truly necessary in the first place, and if it reveals something incidental, am I prepared for the emotional and medical cascade that may follow?”

That is not fear-mongering.
That is informed consent.
And frankly, I think we deserve a lot more of it.

So this is where I am landing, at least for now: more testing is not automatically better care, more detection is not automatically better health, and more information is not automatically more wisdom. Sometimes, additional testing can detect something dangerous before it produces symptoms or causes harm, and only time will tell if that will ultimately be my story.

For now, I’m staying anchored in the grounding practices that help steady me. This experience has changed me in ways I am still processing, but it has also sharpened my gratitude for every moment and experience I get to have. I’m not perfect at it, and I still feel the pull toward rabbit holes and overwhelming worst-case-scenario thinking, but I am trying, as intentionally as I can, to focus on joy and strength rather than fear of the uncertain. (With the understanding that doctors tend to swing from overt denial to full-blown emergency mode)!

I can feel spring knocking at the door, and I am so ready! The days are getting a little longer, and a quiet momentum is building excitement for the summer of ‘26. This transition is a perfect time to focus on small rituals that support steady energy and grounded clarity rather than overstimulation. Spring is a season of transition, and transitions often call for habits that feel supportive and sustainable.

Spring is also a season when many people return to more consistent movement routines or increase their workouts, and having energy that feels clean and balanced can make those efforts feel more sustainable. Energy that feels steady matters whether you are tackling a morning strength session, a brisk walk, or simply staying focused through a busy day. Coffee works well for many people, but it can sometimes cause spikes and crashes, or a jittery edge that does not pair well with exercise. This is where I turn to matcha tea, which offers a different approach to energizing the body. (Plus, I really get a powerful reaction to its green color, which is synonymous with health…for me!) 

What gives matcha its clean energy: 

Matcha is a finely ground powder made from specially grown green tea leaves. Unlike regular green tea, where the leaves are steeped and then discarded, matcha involves consuming the entire leaf in powdered form. That means you get a more concentrated dose of nutrients and antioxidants compared to traditional brewed tea. Matcha has become popular worldwide as a daily beverage and ingredient in smoothies, lattes, and baked goods. Because you consume the powdered leaves rather than an infusion, matcha contains higher levels of certain compounds, including catechins like EGCG, which are studied for their antioxidant properties. 

Matcha for post-workout recovery: 

Uniquely, the tea plants used for matcha are typically shaded for several weeks before harvest. This shading process increases chlorophyll levels and boosts amino acid production, including L-theanine, which promotes calm focus and sustained alertness. This synergy allows you to feel awake and energized without the sharp highs and lows that can interfere with concentration or post-workout recovery. According to analysis from Harvard Health Publishing, the combination of caffeine and L-theanine may encourage a gentler form of stimulation that supports mental clarity, which can be helpful when you are preparing for movement or tackling challenging tasks.

Matcha and your metabolic health: 

Spring is also a time when many people think about metabolic health and cellular renewal. Matcha is rich in antioxidants called catechins, including EGCG, which are studied for their role in supporting oxidative balance. While no single beverage is a substitute for medical care or a comprehensive nutrition plan, antioxidant-rich foods and drinks complement a lifestyle that prioritizes resilience. They work alongside hydration, movement, and adequate sleep to support the body’s natural ability to adapt and recover. 

That recovery piece matters for workouts as well. Exercise works by creating beneficial stress on the body, and proper recovery allows muscles to rebuild and grow stronger. A beverage that provides steady energy without excessive stimulation can fit neatly into that recovery cycle.

One ritual that aligns with this approach is Sun Goddess Matcha from Pique Tea*. I have one every single day, and it now occupies a different ritual in my day than my early-morning coffee.

This matcha is ceremonial-grade and organic, crafted using traditional stone-grinding methods that preserve the tea's vibrant green color and nutrient profile. These qualities make it a supportive option for morning routines, pre-workout energy, or an afternoon reset when you want focus, without overstimulation.

Should you make the switch? 

I view matcha as a simple tool for clean, steady energy that can complement an active lifestyle. It is not a replacement for medical care or personalized nutrition guidance, and it does not solve every symptom or challenge. But it can support workouts by providing sustained alertness and hydration-friendly energy, and it can support daily life by offering a moment of calm focus. There is something centering about preparing a cup, whisking the powder into a smooth, bright green liquid, and taking a brief pause before the day begins or a workout session starts. It is a small ritual that honors both the science of nutrition and the human need for moments of presence and care.

While Spring invites forward movement, it also invites intention. Choosing habits that support the nervous system and provide sustainable energy can make this season feel more balanced and manageable. Movement, nutrition, and recovery work together to build strength and vitality, and Pique’s Sun Goddess Matcha is a practical daily addition with many benefits for everyday wellness that meets you where you are and helps you move forward with clarity and resilience.

To celebrate the shift into spring, Pique is offering Ajenda subscribers a special, limited-time seasonal offer: up to 20% off + free gifts! 

If you’re interested in a deep, evidence-based conversation about women’s health right now, I wanted to share an event I’ll be part of next month.

On April 25, 2026, I’ll be speaking at the Smart Human Health Summit 2026, a full-day integrative women’s health conference taking place in person in Princeton, New Jersey, and virtually for those joining from elsewhere.

The focus this year is women’s health across the lifespan — and the goal is simple: bring together physicians and experts who are doing meaningful work in this space and create room for the thoughtful, science-driven conversations women deserve to hear.

What I’ll be discussing

My session will focus on menopause and hormone therapy, a topic that continues to generate a lot of questions and confusion for many women.Specifically, I’ll be covering:

• What the current evidence actually tells us about hormone replacement therapy (HRT)

• Why the conversation around menopause treatment became so complicated over the past two decades

• Who may benefit from hormone therapy, who may not, and how physicians think about risk versus benefit

• The broader health implications of menopause — including bone health, cardiovascular health, and sleep

My goal is always the same: to help women understand the science well enough to make informed, confident decisions about their own health.

The summit is hosted by Dr. Aly Cohen, who wrote the book DETOXIFY, and the speaker lineup includes an exceptional group of experts, including:

• Tieraona Low Dog on integrative and herbal medicine

• Gayatri Devi on Alzheimer’s and dementia in women

• Adi Benito-Herrero on thyroid disease and Hashimoto’s

• Vivian Kominos on women’s heart health

• Ashley Koff on weight management and GLP-1 medications

There will also be a panel discussion on the current state of women’s healthcare, featuring OB-GYNs Maria Sophocles and Christopher Naraine, moderated by health journalist Meghan Rabbitt and author Deborah Copaken.

The summit is designed for both healthcare professionals and anyone who wants a deeper understanding of women’s health, with expert presentations, panel discussions, and opportunities for questions and conversation.

If this is a topic that interests you, you can learn more about attending the event and register here. Whether you attend in person or virtually, it should be a thoughtful and informative day focused entirely on women’s health, and I’d love to fill the room with incredible ‘Ajenders’ like you! 

Space is limited, especially for in-person attendance. We encourage you to register soon to secure your spot. I would love to see you there!

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ABOUT DR. JEN

In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—has shared the latest health news and information with millions of viewers nationwide. As an OBGYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time. And she has gone through menopause…

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^{This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.}