Endocrine Feedback Loop

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.

For our 73rd episode and the start of the seventh season, we review a recent study examining the long-term anti-fracture efficacy of infrequent zoledronate dosing in women with osteopenia. While current clinical approaches typically focus on treating individuals at higher fracture risk, this study explores whether earlier intervention in lower-risk populations may help reduce fracture risk over time.
This secondary analysis of a randomized clinical trial evaluates the effects of zoledronate administered at extended intervals, with outcomes assessed over a 10-year period. The findings suggest that infrequent dosing may be associated with meaningful reductions in vertebral, major osteoporotic, and overall fracture risk, particularly in the later years of follow-up. The study also examines how fracture risk relates to baseline risk factors and changes in bone mineral density, raising questions about the role of routine monitoring and the timing of preventive therapy.
Host Chase Hendrickson, MD, MPH, MHCC, from Vanderbilt University, talks with regular contributor Amal Shibli Rahhal, MD, from the University of Iowa, and guest expert Thomas Weber, MD, from Duke Health. Together, they discuss “Anti-fracture efficacy of 5 or 10 yearly zoledronate in women aged 50 to 60 years,” published in the April 2026 issue of JCEM, and consider how these findings may inform decisions around early treatment strategies, risk assessment, and long-term fracture prevention in clinical practice.

For our 72nd episode and the final episode of the sixth season, we review a recent study examining the perioperative medical management of primary aldosteronism, with a focus on the use of mineralocorticoid receptor antagonists before adrenalectomy. Primary aldosteronism is increasingly recognized as a common and clinically important cause of secondary hypertension, yet questions remain about optimal preoperative treatment strategies. This study explores whether pretreatment with mineralocorticoid receptor antagonists influences postoperative outcomes and longer‑term biochemical cure in patients undergoing surgery.
Host Chase Hendrickson, MD, MPH, MHCC, from Vanderbilt University, talks with regular contributor Salila Kurra, MD, from Columbia University, and guest expert Jun Yang, MD, PhD, from Monash Health in Melbourne, Australia. Together, they discuss "Mineralocorticoid Receptor Antagonist Pre-Adrenalectomy in Primary Aldosteronism," published in the April 2026 issue of JCEM, and consider how these findings may inform perioperative management and surgical decision-making in clinical practice.

For our 71st episode, we review a randomized, placebo-controlled clinical trial that explores how semaglutide may influence taste perception in women with obesity and polycystic ovary syndrome. While GLP‑1 receptor agonists are widely used for weight loss, the mechanisms underlying changes in food preference remain less well understood. This study takes a multimodal approach to examine whether semaglutide alters taste recognition, tongue gene expression, and brain responses to food-related cues. Host Chase Hendrickson, MD, MPH, MHCC, from Vanderbilt University, talks with regular contributor Na Shen, MD, from UCLA, and guest expert Kalpana Muthusamy, M.B.B.S., MD, from Mayo Clinic in Rochester, Minnesota. Together, they discuss "Semaglutide and Taste in Women With Obesity and Polycystic Ovary Syndrome: A Randomized Placebo-Controlled Study," published in the January 2026 issue of JCEM.