Endocrinology   

Questions discussed in this category



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?

Trial has included diazoxide, decadron, verapamil and pasireotide with ongoing overnight lows.

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

We know canagliflozin is not given to patients with amputations, what about other SGLT2 inhibitors

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 ...

Would you recommend aiming for the postmenopausal range as per the lab reference range or do you have a specific goal?

Or other therapy - e.g., tolvaptan? Free water restriction may hinder QOL. Salt tablets may raise levels more quickly but have risks of edema and hype...

Only the mCRPC population was included in the Fizazi et al. study, but the FDA approval is for prevention of skeletal related events from any solid tu...

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...

Would you consider it for a patient with good PS but with limited metastatic disease? What dose fractionation would you prefer?

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?

Are oral bisphosphonates contraindicated with all types of bariatric procedures?

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...

What level or additional signs/symptoms trigger a workup? What does your workup typically consist of?

I have a longstanding patient with diabetes and a consistently significant difference between CGM average and that predicted by serum A1c. The CGM avg...

Does it depend on location of radiation, length of radiation, and time since radiation?

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...

For example, patients who have been maintained on 5mg of prednisone for years without previous tapering attempts and the rheumatic disease is not acti...

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

There is a current recommendation from the anesthesia society to hold one dose of GLP-RA prior to general anesthesia. Given the long half-life of the ...

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’...

NCCN cervical cancer guidelines added a new statement - Patients who have received prior pelvic radiation therapy and have osteoporosis may benef...

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? 

With studies showing non inferiority to zoledronic acid q 3 months in support of bone metastatic disease, would you consider extrapolating this data a...

Do you look into their stage/risk to decide? Since patients can experience bone loss after stopping denosumab, how do you plan to discontinue?

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

If a patient has been treated sucessfully for Graves but has persistent symptoms of diplopia, is radiation therapy helpful? Or is this just a dry and ...

Would you consider omitting treatment if small tumor and early stage? Or would you use tamoxifen?

Would you consider keeping the patient on denosumab or would switch to an anabolic agent?

Are there specific features that suggest drug-induced uveitis versus de novo uveitis?

Does denosumab effect knee replacement or hip replacement? Should replacement occur right before or after injection? 

Do you encourage patients to take a break from/stop taking Fosamax or similar medications for their osteopenia or osteoporosis in order to prevent dev...

My understanding is that this risk is exceedingly rare even with treatment in and around the stalk and hypothalamus. 

Is there any evidence that this improves outcomes over a more simple and cost effective follow up of careful physical examination and checking a perio...

Does it matter whether the intracranial lesions have been treated with whole brain or SRS/SRT?

Do you extrapolate the results of OPTIMIZE-2 and CALGB 70604 showing that an every 12 week dosing of zolendronic acid is noninferior to ever...

Do you treat patients who are clinically hypothyroid but biochemically euthyroid?

If a patient had a recurrence that was pathologically proven despite negative idodine scans, what imaging scans would you follow up with for surveilla...

In the case of a partial resection with focal perineural invasion, but no lymphadenectomy due to severe fibrosis from prior radio-ablation for hyperth...


Papers discussed in this category


Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2014-04-10

Lancet, 2016 Mar 19

Eur. Urol.,

Cancer, 2001-12-01

Neuro-oncology, 2011 Jun 10

The Journal of clinical endocrinology and metabolism, 2001-12

J. Clin. Endocrinol. Metab.,

J. Clin. Endocrinol. Metab.,

Lancet,

Metab. Clin. Exp.,

J. Neurosurg., 2018 Nov 09

Clin Endocrinol (Oxf), 2009 Jul 24

Nat Clin Pract Endocrinol Metab,

Neurosurgery, 2008-01

Clinical neurology and neurosurgery, 2013-02

Ann. Endocrinol. (Paris),

Ann. Endocrinol. (Paris), 2013 Nov 25

JAMA oncology, 2018-02-01

Lancet,

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013-07-20

Curr Treat Options Oncol, 2019 Mar 14

Leuk. Lymphoma, 2011 Feb 08

Cancer,

Arthritis Rheumatol, 2017 Aug

Current opinion in rheumatology, 2015-05

Am J Med, 2012 Nov 20

Arthritis Care Res (Hoboken), 2017 Aug

JAMA, 2006-12-27

Annals of surgery, 2014-01

Perioper Med (Lond), 2018 Jun 08

BMJ, 2008 May 20

Circulation,

Cancer discovery, 2015-07

J Immunother Cancer,

J Clin Oncol, 2019 Sep 18

Blood, 2013-10-24

The Lancet. Oncology, 2011-08

The Lancet. Oncology, 2018-03

Lancet (London, England), 2015-09-19

Int J Part Ther, 2021 Summer

N Engl J Med,

J Clin Oncol, 2022 Jan 18

The Journal of clinical endocrinology and metabolism, 2022 Jun 16

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-12-10

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

The lancet. Diabetes & endocrinology, 2017-07

Post reproductive health, 2022 Dec 27

Cancer Chemother Pharmacol, 2021 Mar 31

J Bone Miner Metab, 2020 Jul 12

Endocrine reviews, 2019-02-01

Eur J Endocrinol, 2022 Apr 21

Pediatr Hematol Oncol, 2023 Mar 20

JAMA, 2021 Apr 13

Diabetes therapy : research, treatment and education of diabetes and related disorders, 2017 May 08

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

Clinics (Sao Paulo, Brazil), 2018 Dec 10

Metabolites, 2020 Jul 11

Protein & cell, 2014 Jul 12

Trends in biochemical sciences, 2016 Jan 05

The Journal of clinical endocrinology and metabolism, 2005-04

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

The New England journal of medicine, 2018 Oct 01

The New England journal of medicine, 2015 Sep 17

The New England journal of medicine, 2020 Sep 24

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2018-05

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

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-05-10

The New England journal of medicine, 2018-07-12

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-05-10

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-04-10

Clinical breast cancer, 2023 Mar 28

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2010 Jun 14

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

Diabetes care, 2011-09

Nutrients, 2023 Aug 18

Endocrine reviews, 2019 Feb 01

The lancet. Diabetes & endocrinology, 2021 Oct 20

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

Endocrine, 2019 Nov 21

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

Calcified tissue international, 2022 Oct 26

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

JMIR diabetes, 2023 Sep 11

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

Annals of oncology : official journal of the European Society for Medical Oncology, 2022 Mar 14

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 New England journal of medicine, 2016 Sep 15

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

Diabetes Care, 2024 Jan 1

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 care, 1999-08

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

The New England journal of medicine, 2023 Oct 18

N Engl J Med,

Autoimmunity reviews, 2023 Dec 20

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

Hospital & community psychiatry, 1983 Dec

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

Annals of surgery, 2008-10

Kidney360, 2022 Aug 25

Circulation, 2019-06-18