Endocrine Feedback Loop

For our 78th episode, we review a recent Journal of the Endocrine Society (JES) article reporting results from a Phase 2, single-dose trial of an SGLT1 inhibitor for post-bariatric hypoglycemia. This condition can be particularly difficult to diagnose and manage, and current treatments are not uniformly effective or well tolerated, with no FDA-approved therapy currently available. The study explores whether targeting intestinal glucose absorption could offer a new oral treatment option, while raising important questions about patient selection, clinically meaningful outcomes, and what a larger Phase 3 trial will need to demonstrate. Host Chase Hendrickson, MD, MPH, MHCC, from Vanderbilt University talks with regular contributor Steven D. Wittlin, MD, from the University of Rochester Medical Center, and guest expert Sangeeta Kashyap from Weill Cornell Health. They discuss a study by Lawler et al., published in the August 2026 issue of JES titled, “A single dose trial of mizagliflozin for the treatment of postbariatric hypoglycemia.”

For our 77th episode, we discuss a study in the Journal of Clinical Endocrinology & Metabolism investigating the role of immune signaling in polycystic ovary syndrome (PCOS), now renamed polyendocrine metabolic ovarian syndrome (PMOS). Using a multiracial case-control design, the authors examined whether PCOS is characterized by chronic inflammation or whether immune dysregulation plays a more central role in its pathophysiology.
Host Chase Hendrickson, MD, MPH, MHCC, from Vanderbilt Health, is joined by regular contributor Anna Goldman, MD, from Harvard Medical School, Brigham and Women's Hospital, and Atrius Health, along with guest expert Corrine Welt, MD, Chief of Endocrinology at the University of Utah, to discuss "Multiracial Cytokine Profiling Reveals Immune Dysregulation not Chronic Inflammation in Polycystic Ovary Syndrome." Together, they explore the implications of the syndrome's recent name change, review the study's unexpected findings of lower circulating inflammatory markers in women with PCOS, and discuss the challenges of disentangling the effects of adiposity, metabolism, and immune function. The conversation highlights what these results reveal about the evolving understanding of PCOS and whether they have implications for current clinical practice.

For our 76th episode, we discuss a recent Journal of Clinical Endocrinology & Metabolism secondary analysis examining pregnancy outcomes among women with polycystic ovary syndrome (PCOS) and gestational diabetes mellitus (GDM). Drawing on data from the DiGest randomized clinical trial, the study explores whether PCOS influences maternal and neonatal outcomes and whether a reduced-calorie dietary intervention benefits women with these coexisting metabolic conditions.

Host Chase Hendrickson, MD, MPH, MHCC, from Vanderbilt University, is joined by regular contributor Alison Myers, MD, from Albert Einstein College of Medicine and Montefiore Medical Center, along with guest expert Ellen Seely, MD, from Brigham and Women's Hospital and Harvard Medical School, to discuss "Association between polycystic ovary syndrome and pregnancy outcomes in GDM: A secondary analysis of the DiGest trial" . Together, they examine the challenges of interpreting secondary analyses, the role of PCOS in pregnancy risk, the potential effects of dietary intervention in gestational diabetes, and what these findings mean for the clinical care of women with PCOS and GDM.

How does the severity of Graves disease at presentation affect subsequent methimazole dose titration? Find out more in this month's episode!
For our 75th episode, we review a forthcoming Journal of Clinical Endocrinology & Metabolism study examining whether the severity of Graves disease at presentation influences methimazole titration and treatment management. Drawing on a retrospective longitudinal cohort of 152 patients, the study provides a real-world look at antithyroid drug dosing and monitoring practices.
Host Chase Hendrickson, MD, MPH, MMHC, from Vanderbilt University, is joined by new regular contributor Jonea Lim, MD, from the University of Oklahoma, and guest expert Elizabeth Pearce, MD, MSc, from Boston University. Together, they discuss “Initial disease severity and methimazole titration for Graves' disease: a retrospective longitudinal cohort study” and explore its implications for the clinical management of Graves disease.
Want to learn more? Visit the Episode 75 webpage for additional resources and information about our guests and host.

For our 74th episode, recorded live at ENDO 2026 in Chicago, we review a recent JCEM study that addresses a common clinical question: does levothyroxine need to be taken on an empty stomach?
This randomized clinical trial evaluates a dose-adjusted, non-fasting regimen and finds that a 15% increase with breakfast ingestion achieves TSH stability similar to that with standard fasting dosing. The results also suggest potential improvements in adherence and patient-reported well-being, while highlighting variability in dose adjustments and limitations in generalizability.
Host Chase Hendrickson, MD, MPH, MHCC, from Vanderbilt University, is joined by regular contributor Andy Crawford, MD, from Dartmouth-Hitchcock Medical Center, and guest expert Matt Edelson, MD, from the University of Chicago. Together, they discuss “Fasting versus non-fasting dose-adjusted levothyroxine ingestion in hypothyroidism,” published in the April 2026 issue of JCEM, and consider how these findings may inform patient-centered approaches to medication timing and management.