This is a question that maybe anybody could answer, but mostly directed to head and neck surgeons or general surgeons who do parathyroidectomies. I know that brown fat is a problem for us when interpreting FDG PET scans. When we pre-administer beta blockers (usually propranolol, 1hr prior to radiopharmaceutical administration), the brown fat's sugar requirements reduce and we thus get better images in the areas where brown fat is prominent (esp. neck and upper chest in slim or young people).
As part of my role in nuclear medicine I attend thyroid cancer MDMs. I recently learned while listening to a discussion regarding hypoparathyroidism as a result of total thyroidectomies and LND that intraoperatively brown fat can actually look a lot like parathyroid glands. This means that it is much more difficult to avoid hypoparathyroidism in young patients as a parathyroid gland could be mistaken for brown fat.
This brings me to my shower thought: could the colour of the fat be changed by administering beta-blockers for a period of time (I have no idea how long it would take to be effective) prior to thyroidectomies? Or have you noticed whether young/skinny people who you would ordinarily expect to have a lot of brown fat have normal coloured fat if they take beta blockers? I did a quick look on pubmed but most articles about brown fat and beta blockers are about pet scans so I thought I'd ask the reddit brains trust!
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