Endocrine Feedback Loop

For our 66th episode, we review a recent Journal of the Endocrine Society article that looks at the frequency of positive islet antibodies in a population of adults without diabetes. While that may initially seem like an unusual article choice, we found it to be quite helpful in an era where we now have a therapeutic option to delay the onset of clinical type 1 diabetes when we can identify people early enough. That treatment option naturally raises questions about how we can find such patients and the risk of false-positive results with these antibodies. 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 Raghu G. Mirmira, MD, PhD, from the University of Chicago. They discuss “Prevalence of Islet Autoantibodies in Adults Without Diabetes” by Pauley et al, published in the August 2025 issue of JES. Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl066 — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series.

For our 65th episode, we go to The Journal of Clinical Endocrinology & Metabolism to look at a report of two different studies that investigate the relationship between MACS (mild autonomous cortisol secretion) and vertebral fractures. MACS has been of increasing interest to endocrinologists over the past few years, with a greater recognition of its health impact and new guidelines on its assessment and treatment. As this topic continues to evolve, we thought that this paper has a high likelihood of impacting our clinical care and so is well worth discussion. Host Chase Hendrickson, MD, from Vanderbilt University talks with regular contributor Jill Wagoner, MD, from the University of Nebraska Medical Center, and guest expert Oksana Hamidi, DO, from the University of Texas Southwestern Medical Center. They discuss “Adrenalectomy Reduces the Risk of Vertebral Fractures in Patients With Mild Autonomous Cortisol Secretion” by Morelli et al, first published online in JCEM in April 2025. Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl065 — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series.

For our 64th episode, we return to The Journal of Clinical Endocrinology & Metabolism to review a recent paper that attempts to elucidate the connection between subclinical thyroid disease and cardiovascular disease. Any of you listeners who see patients with thyroid conditions likely frequently encounter people with mild thyroid abnormalities and need to figure out if those abnormalities may have a clinical impact. So, given the many unanswered questions in this area, we thought this article well worth discussing. Not only do these authors use an observational study design, but their work is a pooling of multiple observational investigations, necessitating a careful thinking through of the methodology. Host Chase Hendrickson, MD, from Vanderbilt University talks with regular contributor Anupam Kotwal, MD, from the University of Nebraska Medical Center, and guest expert Jennifer S. Mammen, MD, PhD, from Johns Hopkins University School of Medicine. They discuss “Associations Between Subclinical Thyroid Dysfunction and Cardiovascular Risk Factors According to Age and Sex” by Baretella et al, published in the May 2025 issue of JCEM. Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl064 — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

For our 63rd episode, we returned to the Endocrine Society’s annual meeting and recorded before a live audience at ENDO 2025 in San Francisco. We look at a study from The Journal of Clinical Endocrinology & Metabolism that suggests that we can substantially alter our diagnostic approach to adrenal insufficiency. This study and others have already led to a shift in recommendations from some experts, so we thought it would be of great interest to you all as our listeners. Host Chase Hendrickson, MD, from Vanderbilt University talks with regular contributor Katie Guttenberg, MD, from the University of Texas Health Science Center at Houston, and guest expert Anand Vaidya, MD, from Brigham and Women’s Hospital and Harvard Medical School in Boston. They discuss “Performance of Dehydroepiandrosterone Sulfate and Baseline Cortisol in Assessing Adrenal Insufficiency” by Han et al, first published online in JCEM in December 2024. We have four senior fellows joining us to help analyze the article. They each submitted questions in advance, and we called on them throughout the episode to ask those questions. Those fellows are Natalia Fretes Oviedo, MD, from the Cleveland Clinic; Nikola Gligorijevic, MD, from the University of Pittsburgh; Rinki Pandya, MD, from Oregon Health & Science University; and Aye Khine, MD, from University of California San Francisco. Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl063 — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a recently published article in The Journal of Clinical Endocrinology & Metabolism that investigates the impact of primary hyperparathyroidism on fertility and pregnancy outcomes. Those who take care of primary hyperparathyroidism will have encountered the challenge of managing it around pregnancy and will be familiar with how little data we have to guide us there. The authors utilize an observational methodology, so we will do our usual, careful walk through the study design to highlight those intrinsic limitations. Dr. Hendrickson talks with Alyson K. Myers, MD, from the Albert Einstein College of Medicine, and guest expert Shonni J. Silverberg, MD, from Columbia University. The article featured this month, by Sant et al, was published in the May 2025 issue of JCEM: “Fertility and Pregnancy Outcomes in Primary Hyperparathyroidism: Observations From a Large Insured Population.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl062 — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Welcome to our 61st episode and the beginning of our sixth season! Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a recently published clinical trial in The Journal of Clinical Endocrinology & Metabolism that tries to understand the impact of genetics on the benefits of a lifestyle program in reducing the risk of developing type 2 diabetes. Personalized or precision medicine has been a hot topic for several years now, and this podcast has recently reviewed a few studies that fit that description. The authors of this investigation try to answer the question of how we can decide in advance which patients are particularly likely to benefit from a given intervention. Dr. Hendrickson talks with Ashok Balasubramanyam, MD, from Baylor College of Medicine, and guest expert Miriam Udler, MD, PhD, from Massachusetts General Hospital. The article featured this month, by Lankinen et al, was published in the January 2025 issue of JCEM: “Effects of Genetic Risk on Incident Type 2 Diabetes and Glycemia: The T2D-GENE Lifestyle Intervention Trial.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl061 — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a recent study in The Journal of Clinical Endocrinology & Metabolism that reports on the benefits of older weight-loss medications in a population of women with polycystic ovary syndrome (PCOS). Much of the attention today in obesity medicine focuses on GLP-1 receptor agonists. However, these medications are not treatment options for many of our patients, so we thought this paper asked important questions that we would want to know the answers to. Dr. Hendrickson talks with Na Shen, MD, from the University of California, Los Angeles, and guest expert Stanley G. Korenman, MD, also from UCLA. The article featured this month, by Bandeira Marchesan et al, was first published in JCEM in September 2024: “Topiramate Added to Metformin for Obesity Control in Women With Polycystic Ovary Syndrome.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl060 — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a recent investigation in The Journal of Clinical Endocrinology & Metabolism that tries to illuminate the relationship between serum testosterone and fractures in men. Ever since the release of the TRAVERSE fracture findings last year, we as endocrinologists have been uncertain in how to think about testosterone and bone health, as that trial made us question what we thought we already knew. So we thought that this article would be an important one to review and are eager to discuss it. Dr. Hendrickson talks with Anna Goldman, MD, from Harvard Medical School and guest expert Peter J. Snyder, MD, from the University of Pennsylvania. The article featured this month, by Grahnemo et al, was first published in JCEM in October 2024: “Associations of Serum Testosterone and SHBG With Incident Fractures in Middle-Aged to Older Men.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl059-testosterone-levels-and-fracture-risk-in-men — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a study in The Journal of Clinical Endocrinology & Metabolism that reports the relationship between body mass index and percent body fat in terms of defining overweight and obesity. He talks with Andrew Kraftson, MD, from the University of Michigan and guest expert Beverly Tchang, MD, from Weill Cornell Medicine in New York City. The article featured this month, by Potter et al, was first published in JCEM in May 2024: “Defining Overweight and Obesity by Percent Body Fat Instead of Body Mass Index.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl058-bmi-vs-percent-body-fat-in-defining-obesity — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a study in The Journal of Clinical Endocrinology & Metabolism that gives insight into how we should wean patients off long-term glucocorticoid use and how successful that typically is. He talks with Salila Kurra, MD, from Columbia University and guest expert Felix Beuschlein, MD, from University Clinic Zurich in Switzerland. The article featured this month, by Arshad et al, was published in the November 2024 issue of JCEM: “A Retrospective Study on Weaning Glucocorticoids and Recovery of the Hypothalamic-Pituitary-Adrenal Axis.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl057-weaning-glucocorticoids-and-hpa-recovery — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a recent article in Journal of the Endocrine Society assessing plasma renin in the management of individuals with primary adrenal insufficiency. He talks with Jill Wagoner, MD, from the University of Nebraska and guest expert Irina Bancos, MD, from Mayo Clinic. The article featured this month, by Piazzola et al, was published in the November 2024 issue of JES: “Plasma Renin: A Useful Marker for Mineralocorticoid Adjustment in Patients With Primary Adrenal Insufficiency.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl056-renin-measurements-in-primary-adrenal-insufficiency — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a recent systematic review and meta-analysis in The Journal of Clinical Endocrinology & Metabolism about the role for T3 replacement in the treatment of people with hypothyroidism. He talks with Andrew Crawford, MD, from Dartmouth-Hitchcock Medical Center and guest expert James Hennessey, MD, from Beth Israel Deaconess Medical Center. The article featured this month, by Esberard de Lima Beltrão et al, was first published online in JCEM in September 2024: “Treatment Preferences in Patients With Hypothyroidism.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl055-t3-replacement-in-the-treatment-of-hypothyroidism — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a recent article in The Journal of Clinical Endocrinology & Metabolism providing data in support of metformin being renal protective. He talks with Steven D. Wittlin, MD, from the University of Rochester Medical Center and guest expert Silvio Inzucchi, MD, medical director of the Yale Medicine Diabetes Center. The article featured this month, by Wang et al, was first published online in JCEM in July 2024: “Renal Protective Effect of Metformin in Type 2 Diabetes Patients.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl054-renal-protection-of-metformin — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a recent article in The Journal of Clinical Endocrinology & Metabolism about the impact of molecular testing for indeterminate thyroid nodules. He talks with Anupam Kotwal, MD, from the University of Nebraska Medical Center, and guest expert Sarah Mayson, MD, from the University of Colorado School of Medicine. The article featured this month, by Lévesque et al, was first published online in May 2024: “Publicly Funded Molecular Testing of Indeterminate Thyroid Nodules: Canada’s Experience.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl053-the-cost-effectiveness-of-molecular-testing-for-indeterminate-thyroid-nodules — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a recent article in The Journal of Clinical Endocrinology & Metabolism about the benefits of surgical cure of primary hyperparathyroidism in women with osteopenia. He talks with Alyson Myers, MD, from Albert Einsten College of Medicine, and guest expert Natalie Cusano, MD, from the Zucker School of Medicine at Hofstra University and the Lenox Hill Hospital in New York. The article featured this month, by Frey et al, was published in the June 2024 issue of JCEM: “Parathyroidectomy Improves Bone Density in Women With Primary Hyperparathyroidism and Preoperative Osteopenia.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl052-osteopenia-as-a-surgical-indication-in-primary-hyperparathyroidism — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a recent article in The Journal of Clinical Endocrinology & Metabolism about polycystic ovarian syndrome. He talks with Anna Goldman, MD, from Harvard Medical School, and guest expert David Ehrmann, MD, from the University of Chicago. The article featured this month, by van der Ham et al, was first published online in JCEM in May 2024: “Clustering Identifies Subtypes With Different Phenotypic Characteristics in Women With Polycystic Ovary Syndrome.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl051-pcos-subtypes-redux — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion recorded in front of an audience at ENDO 2024 in Boston. He talks about a recent article in The Journal of Clinical Endocrinology & Metabolism with Amal Shibli-Rahhal, MD, from University of Iowa Carver College of Medicine, and guest expert Ghada El-Hajj Fuleihan, MD, from the American University of Beirut, along with four fellows who submitted questions ahead of time. The article featured this month, by Bauer et al, was first published online in JCEM in January 2024: “Bisphosphonate Use and Risk of Atypical Femoral Fractures: A Danish Case-Cohort Study With Blinded Radiographic Review.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl050-bisphosphonates-and-atypical-femoral-fractures — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, as we begin our fifth season of the podcast with a discussion about a recent article in The Journal of Clinical Endocrinology & Metabolism with Katie Guttenberg, MD, from UTHealth Houston, and guest expert Odelia B. Cooper, MD, from Cedars-Sinai Medical Center. The article featured this month, by Demir et al, was first published online in JCEM in March 2024: “Machine Learning May Be an Alternative to BIPSS in the Differential Diagnosis of ACTH-dependent Cushing Syndrome.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl049-artificial-intelligence-in-the-diagnosis-of-cushing-syndrome — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series. Announcement: If you will be at ENDO 2024 in Boston, come to a live recording of the podcast at 10 a.m. on Saturday, June 1, in the ENDO Expo Theater.

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a recent article in The Journal of Clinical Endocrinology & Metabolism with Anupam Kotwal, MD, from the University of Nebraska, and guest expert Megan Haymart, MD, from the University of Michigan. The article featured this month, by Altshuler et al, was first published online in JCEM in February 2024: “Nonoperative, Active Surveillance of Larger Malignant and Suspicious Thyroid Nodules.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl048-active-surveillance-for-larger-malignant-thyroid-nodules — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a recent article in The Journal of Clinical Endocrinology & Metabolism with Alyson K. Myers, MD, from Albert Einstein College of Medicine and guest expert Leonor Corsino, MD, from Duke University School of Medicine. The article featured this month, by Frías et al, was published in the February 2024 issue of JCEM: “Tirzepatide in Hispanic/Latino Patients With Type 2 Diabetes: A Subgroup Analysis of the SURPASS Program.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl047-the-benefits-of-tirzepatide-in-hispanic-latino-individuals — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series