Internal Medicine

Endocrinology   

Questions discussed in this category



There seems to be little guidance on vitamin replacement in these patients. Vitamin K level < 50 yet PT/INR is normal. Is the vitamin K assay usefu...

A female in her early 70s, total thyroidectomy, left 1.4 cm and right 0.7 cm tall cell variant papillary thyroid cancer with clear margins and negativ...

For a patient whose sodium remains 142 despite water deprivation from 8 pm to 8 am, with urine osm of about 500, is further testing needed?

Clinical scenario where an indeterminate pathology on initial FNA was followed by a “benign” result on a 2nd FNA.

Do you avoid using these agents only in patients with history of medullary thyroid cancer or pancreatic cancer? Are there other cancer risks we should...

Patient had intolerance to methimazole and then developed agranulocytosis with PTU. FT4 is 2.9 (upper normal range is 1.7). I have started the patient...

Some data showed early enteral nutrition improves outcomes in DKA. Some thought that enteral nutrition could counteract the insulin gtt.

The new SCCM guidelines suggest an upper limit of 200 compared to the conventional 180.

With the time intervals recommended after taking each medicine, I am wondering how patients should be counseled.

If they are already on a preparation that contains animal products, would you change it?

Would you consider testosterone therapy if he is otherwise asymptomatic?

What is your evaluation approach for RAI response?  What cumulative dose do you use in practice for deciding a patient is RAI refractory?

Do treatments for osteoporosis have a large enough effect on tooth movement to make Invisalign less effective?

Many patients are interested in romosozumab for "maximizing bone gain" and preventing future fractures. Some have had anabolic therapy with teriparati...

The patient has very low urinary calcium despite calcium supplements, vitamin D used to be low now normal. Continues to have elevated PTH with normal ...

After replacing Vitamin D, what will be your first treatment of choice? Labs including ALP and calcium levels are normal. T scores are -3 or above. Th...

There is literature showing small changes in both free T4 and TSH (despite steady state) in the first few hours after ingestion of L-T4. In occasional...

If not, what can be possible causes for a postmenopausal woman to have FSH, LH < 0.3 with low E2, and being asymptomatic and doing well otherwise? ...

A male patient in his 30s with two lumbar compression fractures (non-traumatic) and a Z-score of -2.6 in the spine, Z-score -0.5 in hips. History of 3...

Can a diagnosis of acromegaly be made with just an elevated IGF-1 level in patients with features of acromegaly?

If so, how long should OCPs be held to reliably trust the dex suppression test results?

Young, previously healthy male with normal growth presenting with two syncopal episodes. Currently, only symptom is mild fatigue. Labs showed: Cortiso...

And is there a preferred diagnostic test? Whenever cyclic hypercortisolemia is suspected, it is advised that evaluation should be repeated for months,...

I’ve seen several such patients who have no secondary causes for bone loss, on adequate calcium/vitamin D, and compliant with denosumab who do n...

Female is in her later 40s with surgical oophorectomy taking Sertraline 50 mg daily and prn Trazodone and Lamotrigine. Has some weight loss and fatigu...

Should this patient population be treated differently? At our institution, we have started using EPIC to screen many patients for osteoporosis and ou...

The female patient is in her late 70s with cardiac disease (likely due to chronic hyperthyroidism that was missed due to non-suppressed TSH). I’...

Elderly male with primary hypothyroidism, HTN, and progressive worsening cognition over several months. PCP has been increasing LT4 dose as outpatient...

Is patch or gel HRT with ASA prophylaxis a reasonable option after counseling? Or do you add a prophylactic DOAC? 

The patient has no personal history of VTE, but has positive family history of VTE.  Any prophylactic anticoagulation options? How would manage...


Papers discussed in this category


JAMA oncology, 2018-02-01

BMJ, 2008 May 20

Circulation,

Cancer,

Blood, 2013-10-24

The Lancet. Oncology, 2011-08

The Lancet. Oncology, 2018-03

The Journal of clinical endocrinology and metabolism, 2022 Jun 16

Semin Dial, 2010 May 10

The Journal of clinical endocrinology and metabolism, 2016-05

Clinical journal of the American Society of Nephrology : CJASN, 2019-05-07

Curr Opin Cell Biol, 1995 Aug

Post reproductive health, 2022 Dec 27

Journal of the American Heart Association, 2015 Jun 26

Mayo Clinic proceedings, 2023 Jun 29

The Journal of clinical endocrinology and metabolism, 2011 Dec 28

The New England journal of medicine, 2022 Apr 21

The lancet. Diabetes & endocrinology, 2019 Aug 22

The New England journal of medicine, 2019 Mar 23

BMC medicine, 2019-07-10

JAMA, 2017 Dec 12

The lancet. Diabetes & endocrinology, 2022 Mar 14

The New England journal of medicine, 2020 Sep 24

The Journal of clinical endocrinology and metabolism, 2010 Jan 15

The New England journal of medicine, 2023 Jun 16

BMC endocrine disorders, 2024 Nov 18

International urology and nephrology, 2024 Nov 04

Cancers, 2024 Sep 22

The Journal of clinical endocrinology and metabolism, 2005-04

European journal of cancer (Oxford, England : 1990), 2012-07

The New England journal of medicine, 2015 Sep 17

The New England journal of medicine, 2020 Sep 24

The American journal of medicine, 2016-05

Clinical journal of the American Society of Nephrology : CJASN, 2018-07-06

Journal of critical care, 2023 May 13

The Journal of urology, 1992-06

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2019-02

European journal of endocrinology, 2023 Jul 20

JBMR plus, 2021 Aug 30

World journal of surgery, 2004 Apr 19

The New England journal of medicine, 2023 Aug 25

Kidney international, 2022 Nov

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2023 Jan 18

Cardiovascular diabetology, 2024 Feb 08

The New England journal of medicine, 2024 May 24

The lancet. Diabetes & endocrinology, 2021 Oct 20

Blood advances, 2017 Dec 21

Arteriosclerosis, thrombosis, and vascular biology, 2019-07

The New England journal of medicine, 1980-04-17

International journal of endocrinology, 2015 Oct 20

Clinical journal of the American Society of Nephrology : CJASN, 2017-08-07

American journal of kidney diseases : the official journal of the National Kidney Foundation, 2013-04

Thyroid : official journal of the American Thyroid Association, 2018 Apr 05

Nature reviews. Endocrinology, 2022 Jan 18

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2020 Sep

European journal of endocrinology, 2022 Nov 22

Journal of cardiovascular development and disease, 2022 Sep 08

Curr Rheumatol Rep, 2020 Aug 26

JAMA network open, 2024 Mar 04

The lancet. Diabetes & endocrinology, 2019 Feb 28

BJS open, 2022 Jul 07

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2018-10-05

Pituitary, 2022 May 26

Clinical endocrinology, 2018-01

N Engl J Med, 2023 Mar 02

The New England journal of medicine, 2024 Apr 06

Joint bone spine, 2021 May 19

Genes, 2022 Oct 17

JAMA, 2007-01-24

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2017-07

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2019 Dec 01

JAMA network open, 2022 Oct 03

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2022 Oct 17

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2020 Mar 16

The American journal of cardiology, 2004-02-01

Nature medicine, 2024 Feb 19

Journal of clinical lipidology, 2024 Mar 29

BMJ (Clinical research ed.), 2007 Feb 19

European journal of endocrinology, 2003 Dec

Current osteoporosis reports, 2021 Feb 01

The Journal of clinical endocrinology and metabolism, 1974 Nov

The New England journal of medicine, 2013 Sep 12

Journal of thrombosis and haemostasis : JTH, 2019 Sep 13

The Journal of clinical endocrinology and metabolism, 2024 Jan 18

Diabetes research and clinical practice, 1994 Jan

Clinical endocrinology, 2020 Feb 26

Journal of the Endocrine Society, 2022 Dec 02

Diagnostics (Basel, Switzerland), 2021 Apr 20

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2024 Mar 28

Journal of general internal medicine, 2021 Jan 19

Frontiers in pharmacology, 2023 Mar 16

Nutrition & diabetes, 2019 Nov 04

Diabetes, obesity & metabolism, 2019 Aug 19

BMC endocrine disorders, 2021 Sep 16

Frontiers in endocrinology, 2022 Aug 18

The Journal of clinical endocrinology and metabolism, 2023 Sep 18

European journal of endocrinology, 2018 Apr 27

BMJ open, 2024 Apr 24

N Engl J Med,

Autoimmunity reviews, 2023 Dec 20

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2020 Apr 24

Stroke, 2007-12

The New England journal of medicine, 2006 Aug 10

European heart journal, 2020 Jan 01

Journal of the American Heart Association, 2023 Sep 08

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2023 Jul 01

Diabetes care, 2021 May 05

Clinical endocrinology, 1978 Nov

The Journal of steroid biochemistry and molecular biology, 2013 Mar 06

The Journal of clinical endocrinology and metabolism, 2007-05

The Journal of clinical endocrinology and metabolism, 1975 Oct

Clinical endocrinology, 1978 Dec

The New England journal of medicine, 1980-02-21

The New England journal of medicine, 2018 Sep 13

The Journal of clinical endocrinology and metabolism, 2018 May 01

The Journal of urology, 2022 Jan 20

Haematologica, 2009 Oct 14

American journal of hematology, 2023 Jul 20

Kidney360, 2022 Aug 25

Circulation, 2019-06-18

Thyroid : official journal of the American Thyroid Association, 2020 May 07

Journal of thyroid research, 2020 Apr 14

Frontiers in endocrinology, 2023 Dec 04

Diabetes care, 2024 Aug 01

European journal of endocrinology, 2008 Jan

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 2019 Jun 05

Nutrients, 2016 Jan 02