Endocrine Feedback Loop

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Endocrine Feedback Loop is a monthly journal club podcast series brought to you by the Endocrine Society. Hosted by endocrinologist Chase Hendrickson, MD, from Vanderbilt University, each episode features an expert educator and a topical specialist dissecting recently published journal articles and discussing implications for clinical practice.

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EFL077 - Inflammation vs. Immune-System Dysfunction in PCOS

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.
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EFL076 - Pregnancy Outcomes in PCOS and GDM

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.
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EFL075 - Methimazole Titration and Initial Disease Severity in Graves' Disease

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.
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EFL074 - Taking Levothyroxine Fasting vs. With Breakfast

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.
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EFL073 - Infrequent Zoledronate in Low Fracture Risk

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.
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EFL072 - Pre-Operative Use of Mineralocorticoid-Receptor Antagonists in Primary Aldosteronism

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.
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EFL071 – Taste Changes with Semaglutide

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.
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EFL070 – Dosing Strategies for Remission in Graves Disease

For our 70th episode, we review a paper that tries to improve our understanding of remission in Graves’ disease. Long-term thionamide treatment has long been the preferred approach internationally in Graves’ disease, and only more recently here in the U.S. So, the more we know about dosing and how that might encourage or predict remission, the better. This report is an observational study, as is often the case with the papers we look at, so we will discuss how these authors approach this question and share our thoughts along the way. Host Chase Hendrickson, MD, MPH, MHCC, from Vanderbilt University, talks with regular contributor Andy Crawford, MD, from Dartmouth-Hitchcock Medical Center, and guest expert Giuseppe Barbesino, MD, from Harvard Medical School in Boston. They discuss "Impact of Minimal Dose Strategy Before Antithyroid Drug Discontinuation on Relapse Risk in Graves' Disease" by Miyamura et al., published in the August 2025 issue of JCEM.

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Endocrine Feedback Loop is a monthly journal club podcast series brought to you by the Endocrine Society. Hosted by endocrinologist Chase Hendrickson, MD, from Vanderbilt University, each episode features an expert educator and a topical specialist dissecting recently published journal articles and discussing implications for clinical practice.

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Endocrine Society
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Endocrine Feedback Loop