Endocrine Feedback Loop

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,” [https://doi.org/10.1210/clinem/dgaf569] 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.

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," [https://doi.org/10.1210/clinem/dgaf545] published in the April 2026 issue of JCEM, and consider how these findings may inform perioperative management and surgical decision-making in clinical practice.

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," [https://academic.oup.com/jcem/article-abstract/111/1/e270/8127627] published in the January 2026 issue of JCEM.

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" [https://doi.org/10.1210/clinem/dgaf433] by Miyamura et al., published in the August 2025 issue of JCEM.

EFL069 - The Gut Microbiome in Type 1 Diabetes and Obesity

For our 69th episode, we review a paper in The Journal of Clinical Endocrinology & Metabolism on the gut microbiome of adolescents with type 1 diabetes, which hopes to understand differences between those with a normal body mass index compared to obesity. Studying gut microbiomes has been a “hot topic” for several years now, and we are excited to take the opportunity to unpack this work and see how it helps us better understand our patients. We both work through the challenges that come with any observational study and learn more about the specific techniques used by these investigators in this study. Host Chase Hendrickson, MD, MPH, MHCC, from Vanderbilt University talks with regular contributor Ashok Balasubramanyam, MD, from Baylor College of Medicine, and guest expert Åke Lernmark, MD, PhD, professor emeritus from Lund University in Malmö, Sweden. They discuss “Gut Microbial Changes Associated With Obesity in Youth With Type 1 Diabetes” [https://doi.org/10.1210/clinem/dgae529] by Ismail et al, published in the February 2025 issue of JCEM.