Primary Care

Is this recommended TSH target of 7 or higher based on the fact that globally iatrogenic hyperthyroidism is common in older individuals on levothyroxi...

1 Answer available

Outside of teplizumab, what therapies do you recommend for preserving beta cell function in patients with early stage type 1 diabetes mellitus?

Is there strong data for the use of Verapamil, Metformin, Amylin, GLP 1 R agonists or Januvia?

2 Answers available

What is the optimal BP target for patients with diabetes and hypertension to reduce their risk of MI/stroke?

1 Answer available

How do you handle elevated blood calcium levels from lithium?

1 Answer available

When cinacalcet is used to treat hypercalcemia in primary hyperparathyroidism, does it also normalize low serum phosphorus levels?

1 Answer available

Do you recommend adjusting the duration of a drug holiday based on the specific bisphosphonate used when treating osteoporosis?

1 Answer available

Are recurrent UTIs a contraindication to SGLT2i use?

4 Answers available

How do you assess and adjust treatment in patients who develops hypothyroidism after being on lithium for several years?

1 Answer available

Is GLP-1 therapy a viable treatment option for a patient with Type 2 Diabetes complicated by atherosclerotic heart disease and cholelithiasis?

If not, would you consider a prophylactic cholecystectomy?

2 Answers available

In a young male patient with hypogonadotropic hypogonadism and fertility goals, would starting testosterone replacement therapy affect fertility chances?

2 Answers available

How do you approach management of osteoporosis in patients post lung transplant?

1 Answer available

After what time frame off GLP-1 RA therapy should you restart at the lowest starting dose?

Patients may have to stop glp1 a therapy due to supply issues or for other reasons. If they are off for 4 weeks, is it ok to restart at the same dose ...

2 Answers available

How do you approach treatment of depression in Graves' Disease?

1 Answer available

Would you stop denosumab in a patient with chronic kidney disease if they develop asymptomatic hypocalcemia after the injection?

4 Answers available

Is moderate-intensity statin plus ezetimibe just as effective as high-intensity statin monotherapy in preventing major cardiovascular events?

4 Answers available

How do you manage antipsychotic-induced prolactinemia?

1 Answer available

What is your experience with using anabolic therapy for treatment of osteoporosis in patients with EtOH cirrhosis and is one agent preferred over another (PTH analogue vs Evenity)?

Lack of large scale efficacy or safety data for PTh analogue or Evenity in this patient population.

2 Answers available

Is it safe to continue administering Prolia per schedule for osteoporosis treatment shortly after a patient has undergone extensive spinal surgery?

2 Answers available

What patient specific factors outside of health insurance coverage do you use to decide which GLP1 R agonist or dual agonist therapy to start in patients with diabetes?

2 Answers available

How do you counsel patients on the likelihood of resolution of their hypertension post adrenalectomy for primary hyperaldosteronism?

Zarnegar R, et al. The aldsoteronoma resolution score: predicting complete resolution of hypertension after adrenalectomy for aldosteronoma. PMI...

1 Answer available

Should we be more cautious with the use of GLP 1 R agonist therapy in patients with Type 1 diabetes mellitus and obesity given the increased risk of cardiovascular disease with high body weight variability?

Prattichizzo et al., PMID 39468384

1 Answer available

Would you increase or maintain the same initial dose of methimazole for treatment of hyperthyroidism if symptoms and thyroid tests improve but are not normalized?

1 Answer available

What patient-specific factors would influence your decision to initiate semaglutide therapy in patients with HIV-associated lipohypertrophy?

1 Answer available

How do you approach the use of metformin in the management of prediabetes for patients who are neither obese nor have a family history of diabetes?

2 Answers available

Would you recommend statin initiation in a young adult patient (age < 40) with type 1 diabetes mellitus and LDL cholesterol levels greater than 100 without any cardiovascular risk factors?

1 Answer available

Would you continue Forteo treatment past the recommended 2 years if T scores remain low and procollagen (P1NP) is elevated and if so, how would you monitor response?

1 Answer available

Do you routinely check vitamin K levels in post-bariatric surgery patients?

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...

1 Answer available

Does the presence of osteoporosis change the extent of workup that should be performed for an older patient with otherwise serologically low-risk MGUS?

Would your considerations change for a man vs a woman?

1 Answer available

What is the therapeutic role and blood glucose lowering capability of bromocriptine and cholestyramine for the treatment of Type 2 diabetes?

2 Answers available

Would you order a repeat DEXA scan 1 year later for a kidney transplant patient who had an initial DEXA scan within the first 6 months post-transplant showing osteopenia but no history of fractures, and who has been stable on glucocorticoid-free immunosuppressive therapy?

2 Answers available

Is there a role for levothyroxine in managing the symptoms of a patient with euthyroid Hashimoto’s thyroiditis?

3 Answers available

How do you determine osteoporosis treatment response when patients have discrepant DEXA scan results during monitoring (eg improved BMD of the hip and spine but worsening BMD of the femoral neck)?

1 Answer available

How do you approach managing patients with diabetic kidney disease and proteinuria who develop hypoglycemia after initiation of a SGLT2 inhibitor?

1 Answer available

Do oral contraceptives lower bone mineral density in women with hypothalamic amenorrhea by lowering IGF-1?

1 Answer available

How do you counsel patients on semaglutide or tirzepatide in light of potential cancer risks?

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...

1 Answer available

Do you recommend progesterone for endometrial protection in a young woman on estrogen replacement therapy for iatrogenic menopause after definitive radiation therapy for locally advanced cervical cancer?

If so, what do you typically prescribe?

2 Answers available

How do you reduce the risk of contralateral fracture in a patient with atypical femur fracture from prolonged bisphosphonate use?

Do anabolic agents have a role?

1 Answer available

Do you recommend checking both TSI and TBII antibodies for Graves' disease diagnosis and monitoring?

1 Answer available

How frequently do you monitor for hypocalcemia in patients on romosozumab?

1 Answer available

Would you consider using Evenity in an elderly patient with rate controlled atrial fibrillation without history of MI or CVA?

1 Answer available

What workup do you recommend for patients requiring higher-than-expected levothyroxine doses for their weight?

2 Answers available

How often should TSH levels be monitored in patients with a history of Graves' disease who are in remission with negative TSI/TBII antibodies and off medical therapy?

1 Answer available

How do you counsel patients with elevated Thyroglobulin Peroxidase antibody levels, diffuse thyroiditis features on ultrasound, non-specific symptoms of fatigue, but normal biochemical thyroid function labs?

1 Answer available

Which patient population would most benefit from inhaled insulin (Afrezza)?

1 Answer available

Do you recommend adding low-dose Aspirin for primary prevention in patients with Type 2 Diabetes on Eliquis for another indication?

1 Answer available

Does oral semaglutide provide similar cardiovascular risk reduction benefits as injectable semaglutide?

1 Answer available

How do you approach mild prolactin elevations (20-80) in women with galactorrhea on nipple stimulation but regular menses and no plans for pregnancy?

1 Answer available

How do you manage osteoporosis treatment following parathyroidectomy for primary hyperparathyroidism?

1 Answer available

How should patients time the ingestion of their alendronate and levothyroxine given issues with food/drug interactions?

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

1 Answer available

Should all kidney transplant patients be started on statin therapy post operatively given their increased risk of CVD?

At what doses do you start? and how do you titrate therapy?

1 Answer available

How soon after radioactive iodine therapy for hyperthyroidism should Methimazole be resumed?

1 Answer available

Would you consider PTH analogue in a patient with mildly elevated PTH?

2 Answers available

Does vitamin D supplementation in primary hyperparathyroidism increase the risk of kidney stones?

Is this seen more with high dose vitamin D supplementation?

1 Answer available

Have you been able to safely use other bisphosphonates in patients who developed an allergic reaction (angioedema) to fosamax?

1 Answer available

What factors guide you in adjusting the dose of fludrocortisone in a patient with primary adrenal insufficiency?

1 Answer available

How do the results of the ESPRIT trial, which evaluated the impact of an SBP target of <120 mmHg on preventing major cardiovascular events, influence your blood pressure management goals for hypertensive patients with diabetes or a history of stroke?

ESPRIT Trial

1 Answer available

Is there any evidence that spironolactone or finasteride therapy increase blood levels of testosterone?

2 Answers available

Do you recommend the use of Korlym (Mifepristone) for patients with difficult to control diabetes and evidence of mild endogenous hypercortisolism of unknown source?

1 Answer available

Do you recommend the use of bempedoic acid (Nexletol) for treatment of hyperlipidemia in patients with elevated baseline uric acid levels?

Should uric acid levels be monitored regularly while on therapy?

1 Answer available

Which brand/preparation of levothyroxine do you recommend to treat hypothyroid patients with alpha-gal allergy?

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

1 Answer available

When do you recommend using trabecular bone score (TBS) for managing osteoporosis?

1 Answer available

When managing patients with suspected MASLD, what specific criteria or findings would prompt you to refer them to hepatology?

1 Answer available

What work up do you recommend in post bariatric surgery patients who are slowly gaining back the weight despite no changes in diet?

1 Answer available

Would you order a fibroscan to screen for MASLD in patients with insulin resistance but normal LFTs?

1 Answer available

How do you approach the use of GLP-1 receptor agonists for the management of patients with metabolically healthy obesity?

1 Answer available

Do you recommend the use of GLP1 R agonist therapy in patients with T1DM for weight loss?

3 Answers available

When would you treat mild anemia from low testosterone in an older male?

Would you consider testosterone therapy if he is otherwise asymptomatic?

2 Answers available

What strategies do you employ for adjusting the dosage of levothyroxine in hypothyroid patients who experience significant weight loss or are initiated on GLP-1 receptor agonists?

How often do you recommend monitoring thyroid function tests in these situations?

1 Answer available

Should low-intensity statins be favored to minimize the risk of diabetes onset while still offering cardiovascular benefit for patients with prediabetes where a statin is indicated?

Cholesterol Treatment Trialists' (CTT) Collaboration

2 Answers available

When do you recommend screening patients with T2DM for heart failure?

2 Answers available

For patients with metabolic syndrome, is it reasonable to wait for the effect of tirzepatide therapy on their lipid profile prior to starting statin therapy?

4 Answers available

When do you recommend the use of oral testosterone replacement over injectable testosterone?

Ahmad et al., PMID 36106278

1 Answer available

What is the optimal anti androgen dose of spironolactone when treating female hirsutism?

1 Answer available

Are there any concerns with live vaccine innoculation and patients who are on denosumab?

1 Answer available

How long does it take the hypothalamic-pituitary-gonadal axis to recover from secondary amenorrhea in the setting early onset and chronic use of oral combined contraceptive pills?

1 Answer available

Do you recommend the use of automated insulin delivery systems (such as Control IQ with Tandem insulin pumps) for managing gestational diabetes?

1 Answer available

Is adequate BP control sufficient enough when titrating spironolactone therapy for primary hyperaldosteronism treatment?

2 Answers available

For hypothyroid patients on dual replacement therapy (levothyroxine & liothyronine), do you recommend monitoring TSH while holding off on the morning T3 dose?

3 Answers available

What is your approach to management of hyperlipidemia in patients taking JAK inhibitors?

1 Answer available

How do you counsel patients on the use of compounded weight loss medications?

3 Answers available

Would you recommend changing a patient from the pill form of levothyroxine to Tirosint-SOL if they are started on a proton pump inhibitor?

Yue et al., PMID 38554774

1 Answer available

Which patients would benefit most from teplizumab therapy to delay the onset of T1DM?

Herold et al., PMID 31180194

2 Answers available

Do you recommend the use of GLP 1 R agonist therapy for obese women with PCOS who are actively trying to conceive?

Dao et al., PMID 38663923

2 Answers available

Do you recommend a particular antiresorptive/anabolic agent for patients who are at high risk for fractures but have high risk of osteonecrosis of the jaw?

3 Answers available

Would you recommend cinacalcet for patients with recurrent nephrolithiasis who have hypercalciuria despite thiazide diuretic use and who also have an elevated PTH level without localizing parathyroid adenoma on imaging?

1 Answer available

What is the typical timeline for remission of autoimmune hypoglycemia?

1 Answer available

What is the clinical importance of differentiating between impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) states?

Bergman et al., PMID 38458916

2 Answers available

What evaluation do you do in patients with hypertension and persistently elevated aldosterone/renin ratio (over 20) but without an elevated aldosterone level (under 10 ng/dL)?

1 Answer available

Is Metformin contraindicated in patients using long term oxygen therapy at home?

Liang et al., PMID 35900801

1 Answer available

Is a history of provoked DVT a contraindication to starting testosterone replacement therapy in a middle aged man with symptomatic hypogonadism who is on anti-coagulation?

1 Answer available

How do you choose between antithyroid drugs, RAI, and surgery for hyperthyroidism patients with existing cardiovascular disease, given their varying effects on cardiovascular outcomes?

Chiung-Hui Peng et al., PMID 38436957

3 Answers available

Do you adjust the dose or the timing of levothyroxine ingestion in patients on anti-acid medications?

2 Answers available

Would you transition from denosumab to anabolic agents in patients who are in urgent need for extensive dental work?

2 Answers available

Is active smoking a contraindication to starting menopausal hormone therapy (HRT) in a post-menopausal woman with severe vasomotor symptoms and no other cardiovascular risk factors?

1 Answer available

Should fasting C-peptide levels be used to guide T2DM management?

2 Answers available

Given the cardioprotective and renoprotective effects of SGLT2 inhibitors, should we consider administering to patients with well controlled type 1 diabetes despite the risk of DKA?

3 Answers available

What is your approach to a patient on long-term denosumab who now requires multiple invasive dental procedures?

2 Answers available

Do you recommend using anastrazole in men developing gynecomastia while on testosterone replacement treatment for hypogonadism depending on pre-treatment estradiol level?

1 Answer available

Do you recommend stopping a SGLT2i indefinitely if a patient with chronic kidney disease and diabetes develops euglycemic diabetic ketoacidosis?

1 Answer available

Do you use the homeostatic model assessment (HOMA) to assess for insulin resistance and change your clinical management of patients?

3 Answers available

What is your approach to managing patients with recurrent nephrolithiasis and nephrocalcinosis in the setting of hypoparathyroidism?

1 Answer available

Does your decision to start or continue Ozempic therapy in patients with diabetic retinopathy depend on the severity of the retinopathy?

1 Answer available

Do you prioritize dietary modifications and exercise over early pharmacologic interventions, such as metformin or insulin, for women diagnosed with gestational diabetes?

1 Answer available

Should dopamine agonist treatment stop in pregnant patients with recurrent prolactinoma despite prior surgery?

1 Answer available

When and how do you taper off cabergoline therapy for treatment of microprolactinoma?

1 Answer available

Under what circumstances would you test for hypercortisolism in a patient with insulin resistance?

1 Answer available

How reliable is the FRAX score for assessing risk of osteoporotic fractures?

1 Answer available

Is there any role for 25-OH Vitamin D testing in patients older than 75 years old in the general population?

Demay, et al., PMID 38828931

2 Answers available

Do you avoid empagliflozin in patients with history of amputation?

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

1 Answer available

How would you approach a finding of osteoporosis (Z score -4.5) in a recently postpartum patient who had DEXA sent for long-term low-dose glucocorticoid use?

The patient is actively breastfeeding.

1 Answer available

Are you offering GLP-1 agonists to patients with CKD and diabetes mellitus?

4 Answers available

Do you recommend Alpha Lipoic Acid to patients with diabetic polyneuropathy?

6 Answers available

Is there any evidence regarding bone density gains/fracture reduction in the setting of treatment with romosozumab after a two year course of teriparatide?

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

1 Answer available

Which screening method for diabetes do you consider to be the most sensitive?

Bergman et al., PMID 38458916

1 Answer available

Do you recommend continuous glucose monitoring for patients with Type 2 diabetes who are not on insulin?

5 Answers available

Should weight loss medications be used in women who are gaining excessive weight during pregnancy?

1 Answer available

What range of musculoskeletal complaints have you seen with romosozumab use?

1 Answer available

What work-up should be considered in patients with significantly worsening A1c despite steady diet, lifestyle, and medication adherence?

1 Answer available

When and for whom should we consider adding bempedoic acid to the lipid lowering regimen?

3 Answers available

Do you recommend obtaining a DEXA scan for patients with recurrent nephrolithiasis and hypercalciuria of unknown etiology?

2 Answers available

What is your approach to differentiating diabetes insipidus from primary polydipsia in the outpatient setting?

1 Answer available

In patients with hypertension and suspected primary aldosteronism who have undergone negative confirmatory testing, what follow-up and monitoring strategies would you recommend to ensure early detection of potential aldosteronism?

1 Answer available

Which patient population would benefit most from cellulose and citric acid (Plenity) therapy for weight loss?

1 Answer available

Would you consider GLP1 R agonist therapy in a patient with a history of severe gallstone pancreatitis that is now post cholecystectomy?

1 Answer available

How do you time Evenity after completion of Forteo?

1 Answer available

How do you adjust your HbA1c goal for managing diabetes in elderly patients with multiple chronic illnesses but no limitations in performing self-care tasks?

1 Answer available

Would you use romosozumab in a patient with a cardiovascular event more than 2 years prior?

4 Answers available

Would you refer a patient for parathyroidectomy if they have normal calcium levels, mild hyperparathyroidism, and evidence of osteopenia?

2 Answers available

Do you recommend osteoporosis medication in postmenopausal females on anastrozole with very low Vitamin D (4.5)?

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...

1 Answer available

How do you counsel patients with non-statin associated inflammatory myopathies about statin use?

1 Answer available

Following abaloparatide use for osteoporosis treatment, how long do you consolidate with bisphosphonates before considering a drug holiday?

1 Answer available

Should patients with hypothyroidism hold their morning levothyroxine dose before going to the lab to check free T4/TSH?

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...

3 Answers available

Is there a role for Vitamin D supplementation in the treatment of Hashimoto’s thyroiditis?

1 Answer available

After completing 12 months romosozumab, what is the next best treatment option for patients with severe osteoporosis, high risk for fracture, and normal kidney function?

1 Answer available

How do you monitor risk of erythrocytosis from testosterone use for female to male transgender patients?

1 Answer available

How do you counsel a patient with hypothyroidism who complains of persistent hypothyroid symptoms despite achieving normal TSH values with levothyroxine?

1 Answer available

Does norethindrone suppress FSH, LH completely?

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? ...

2 Answers available

Would you consider anabolic osteoporosis therapy in a young adult male with multiple non-traumatic vertebral compression fractures and low bone density for age (Z-score -2.6)?

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...

1 Answer available

When do you consider stopping denosumab when a patient with osteoporosis is otherwise tolerating it without issues?

Assuming follow-up IV bisphosphonate x2 infusions to prevent rebound fractures

5 Answers available

Would you recommend switching a diabetic CKD patient on oral semaglutide to the subcutaneous form since the benefits in CKD have primarily been reported in studies using subcutaneous GLP-1 receptor agonists?

1 Answer available

How long do you wait before reassessing a 24 hour urine calcium level in patients with recurrent nephrolithiasis, hypercalciuria, and osteoporosis who are initiated on bisphosphonate therapy?

3 Answers available

Under what circumstances would you refer a patient with mild autonomous cortisol secretion without features of Cushing syndrome for adrenalectomy?

1 Answer available

Should Orlistat be considered in the management of hypertriglyceridemia?

1 Answer available

What is your approach to treating osteoporosis in patients post bariatric surgery?

Are oral bisphosphonates contraindicated with all types of bariatric procedures?

3 Answers available

Is intermittent fasting effective for weight loss?

3 Answers available

Would you treat an isolated elevated total cholesterol in a post-menopausal patient who is otherwise healthy and has no significant CV risk factors?

2 Answers available

When do you refer a patient with MODY3 to GI/Hepatology for monitoring/management of hepatic adenomas?

1 Answer available

Can anabolic agents be used in a patient with history of radioactive iodine treatment for hyperthyroidism?

1 Answer available

Would you switch a patient with glucocorticoid induced osteoporosis to romosozumab if a patient sustained a fragility fracture 1 year into treatment with teriparatide?

1 Answer available

How long should T3 be continued in hypothyroid patients who received no symptomatic benefit after starting T3/T4 combination therapy?

2 Answers available

Do you treat hypercalciuria in post menopausal osteoporosis with normal serum calcium and PTH?

2 Answers available

Aside from lifestyle measures such as calcium intake, vitamin D repletion, and weight-bearing exercises and ruling out all secondary causes, what is the preferred approach to managing osteoporosis in young women with Z score of less than -2.5 and planning to get pregnant soon?

2 Answers available

When do you start bisphosphonates empirically, irrespective of DEXA results, in patients going on chronic glucocorticoids?

1 Answer available

Where do you place romosozumab in your treatment sequence for osteoporosis management?

4 Answers available

What are the potential causes for significant discrepancies between predicted A1c by Dexcom CGM and standard serum A1c by lab draw?

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

1 Answer available

Is there enough evidence now to use injectable semaglutide as a foundational therapy for symptomatic heart failure with preserved ejection fraction in the setting of overweight or obesity?

1 Answer available

Should testosterone replacement be stopped in elderly men who suffered acute stroke even when testosterone levels have been stably in the low-to-mid normal range?

1 Answer available

Would you recommend prescribing testosterone replacement therapy to reduce osteoporosis fracture rates in men with hypogonadism?

1 Answer available

Have the results of the ancillary study of the VITAL trial, demonstrating that Vitamin D3 supplementation did not reduce the incident rate of fractures in generally healthy midlife and older adults, changed how you prescribe Vitamin D?

PMID 35939577

2 Answers available

How would you approach choosing osteoporosis treatment in a patient with a T score -3.3 in lumbar spine and no prior fracture history who has squamous cell cancer and received radiation therapy?

1 Answer available

How do you manage osteoporosis in patients with anorexia nervosa (who often are young women < 40)?

2 Answers available

Should metformin be used in women with PCOS for weight loss?

1 Answer available

Should patients with mild subclinical hypothyroidism (TSH < 10 mIU/L) be treated with thyroid hormone replacement to improve their lipid profile?

2 Answers available

What would be your next step in treating a patient with osteoporosis who developed AFF on denosumab and who then completed one year of romosozumab?

3 Answers available

Is it possible for certain individuals with osteoporosis to be a denosumab "non-responder"?

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...

1 Answer available

For a patient with osteopenia or osteoporosis, how long can intravenous zoledronic acid be maintained if there are not adverse events?

1 Answer available

What is your approach to tapering chronic steroids in patients who are at high risk of HPA suppression?

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

1 Answer available

Should lipid lowering therapy be started in patients with isolated elevation in lipoprotein (a) and minimal cardiovascular risk?

2 Answers available

Despite low T scores (-2.5 or worse), what is the actual fracture risk in relatively younger patients (early 50s to mid 60s) with low BMD?

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

1 Answer available

Would you start osteoporosis treatment in patients with low FRAX scores but have T scores lower than -2.5?

1 Answer available

What is the best treatment of isolated elevated DHEA-S in a woman with clinical androgen excess (without PCOS, neoplasm, etc)?

1 Answer available

Would you order a DEXA scan for a cervical cancer patient with osteoporosis?

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

1 Answer available

Should insulin be started early (prior to optimization of other anti-hyperglycemic medications) in patients with mild-to-moderate diabetes and hypertriglyceridemia refractory to statin and fibrates?

2 Answers available

Should thyroxine hormone be started in women having fertility concerns with high-normal TSH and negative TPO antibody?

2 Answers available

Would atypical fractures of the hip in a parent (treated with bisphosphonate) be considered when calculating the FRAX score for a patient with osteopenia?

2 Answers available

How should very low T scores (worse than -3) be interpreted in very thin patients (BMI < 18)?

1 Answer available

Should GLP-1 agonists be weaned in patients who have achieved goal weight loss and glycemic control?

1 Answer available

Would you give transdermal hormone replacement therapy to a woman with remote history of provoked pulmonary embolism?

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

1 Answer available

Should a short trial of androgen therapy be used in patients with primary adrenal insufficiency suffering from persistent fatigue and hypoactive sexual desire despite sufficient glucocorticoid and mineralocorticoid replacement?

1 Answer available

What is the next best anti-hypertensive medication to start after mineralocorticoid receptor antagonists in patients with primary aldosteronism?

1 Answer available

How do you manage calcium and vitamin D replacement in scleroderma and myositis patients with dysphagia and malabsorption?

1 Answer available

What is your approach to treating premenopausal woman with OI with a new compression fracture?

2 Answers available

Should patients with asymptomatic GH deficiency be treated with GH replacement therapy if they have prior known severe CAD?

1 Answer available

Should a toe-brachial index be obtained in lieu of resting ABI as an initial screen for PAD in high-risk patients such as those with longstanding diabetes or advanced age with stiffened vessels?

1 Answer available

What treatment would you use in a patient with osteoporosis on denosumab for 10 years who develops ONJ at a site of an old implant?

1 Answer available

In a young female with severe osteoporosis due to congenital estrogen deficiency, can estrogen be prescribed if genetic testing for congenital disorders reveals a heterozygous Factor V Leiden mutation?

No prior thrombosis; no family history of thrombosis. As per endocrine, the only useful therapy for the osteoporosis is estrogen.

1 Answer available

How do you approach long term management of glucocorticoid-induced osteoporosis in patients who develop osteonecrosis of the jaw on antiresorptive agent?

2 Answers available

Do you recommend stopping Vitamin D supplementation in a patient with hypercalcemia and a low 25(OH)D level?

1 Answer available

When tapering moderate to high doses of long term steroids do you routinely monitor for adrenal insufficiency?

Do you attempt to taper fully or maintain at a low dose?

2 Answers available

How would you manage a patient with osteoporosis on denosumab who develops significant renal insufficiency where it is difficult to continue denosumab due to increased risk of hypocalcemia (i.e. eGFR in the low 20’s)?

1 Answer available

In which patients with chronic kidney disease and low 25-OH vitamin D levels do you prefer weekly ergocalciferol to daily cholecalciferol supplementation?

1 Answer available

Do you treat low 25-OH vitamin D levels in those with end stage kidney disease?

1 Answer available

What kinds of dental work do you particularly worry about and try to avoid in patients on bisphosphonates?

2 Answers available

In a patient who fractures after several years of denosumab therapy, would you wait 6 months after the last denosumab injection to start an anabolic agent or could start an anabolic agent sooner?

1 Answer available

Would you avoid the entire class of bisphosphonates if a patient develops an allergic reaction, or would you consider the use of an alternative bisphosphonate?

2 Answers available

For a patient who would benefit from an anabolic agent for osteoporosis, do you prefer romosuzumab over teriparatide in the absence of contraindications to either agent?

3 Answers available

How do you approach a potential drug holiday in a patient with osteoporosis who has had improvement in BMD after several years of denosumab therapy?

1 Answer available

How do you approach treatment of osteoporosis in patients with CKD who develop a fragility fracture while on denosumab?

1 Answer available

What recommendations do you have for a transgender female patient with history of prothrombin gene mutation who is interested in starting gender affirming hormone therapy?

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

1 Answer available

In a patient who completed 5 years of oral bisphosphonate and has a T score persistently in osteoporotic range, what factors help you decide whether it is appropriate to start a drug holiday vs. switch to an alternative agent?

1 Answer available

Do you change management in patients that are taking bisphosphonates and develop atrial fibrillation?

1 Answer available

In postmenopausal osteoporosis, would you switch to romosozumab (rather than a PTH/PTHrP analog) if a patient fractures while on denosumab?

1 Answer available

How do you approach the use of bisphosphonates in reproductive-aged women?

1 Answer available

Would you consider using teriparatide beyond a cumulative maximum of two years now that the black box warning regarding osteosarcoma has been removed?

1 Answer available

How do you counsel patients about the risk of osteonecrosis of the jaw with anabolic agents such as teriparatide or romosozumab ?

Would you hold these agents in the setting of invasive dental procedures?

1 Answer available

What strategy do you use to determine the appropriate timing to resume osteoporosis therapy after a drug holiday?

2 Answers available

How do you counsel male-to-female transgender patients on the VTE risk of hormonal therapy?

1 Answer available

Would you consider use of an oral bisphosphonate (such as alendronate liquid) in a patient with eosinophilic esophagitis?

1 Answer available

How would you approach osteoporosis management in a patient who fractures while on denosumab therapy?

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

1 Answer available

How do you approach prophylaxis against glucocorticoid-induced osteoporosis in patients with end-stage renal disease on dialysis?

1 Answer available

Is there a role for starting an anabolic agent in a patient that developed an atypical femoral fracture while on denosumab sooner than 6 months after the last denosumab dose?

Is there a role for earlier use of anabolic agents to promote bone healing in patients that develop AFFs?

2 Answers available

How do you transition to an anabolic agent in a patient who develops an atypical fracture while on denosumab?

1 Answer available

Do you approach therapy differently for patients with a diagnosis of osteoporosis based on a fragility fracture rather than based on bone mineral density on DXA (assuming no secondary causes of osteoporosis)?

1 Answer available

How do you approach therapy for severe osteoporosis after an initial 12 months of romosozumab?

1 Answer available

What agent would you choose for a patient who needs osteoporosis therapy after a bisphosphonate holiday?

2 Answers available

For patients on a bone-modifying agent for osteoporosis/severe osteopenia in the context of adjuvant AI therapy, how do you manage the bone-modifying agent once their AI course is complete?

1 Answer available

How do you manage post-menopausal osteoporosis in a patient with stable bone density and no fractures after three years of holiday after giving zoledronic acid?

1 Answer available

How do you manage osteopenia, osteoporosis and calcium / Vit D supplementation in a patient with calcinosis?

1 Answer available

Is romosozumab an option in a patient who has completed 2 years of teriparatide therapy and has a fracture while on denosumab?

1 Answer available

When treating patients with low bone mineral density, when/how do you monitor bone turnover markers (NTX, CTX, etc)?

1 Answer available

Would you consider an osteoporosis medication in a pre-menopausal/young patient with a low Z score and an ongoing risk factor for secondary osteoporosis such as chronic antiepileptic treatment?

1 Answer available

In which osteoporosis patients would you consider starting with anabolic therapy over antiresorptive therapy?

1 Answer available

Do you regularly do bone density testing to screen for osteoporosis in men with rheumatoid arthritis without any other risk factors?

2 Answers available

Following oral cavity radiotherapy, how do you advise patients on ongoing bisphosphonate therapy and the risk for osteonecrosis?

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...

1 Answer available

How common is hypothyroidism in postradiation head and neck cancer patients?

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

3 Answers available

Papers discussed in this category

Cancer, 2001-12-01

Hypothyroidism: a frequent event after radiotherapy and after radiotherapy with chemotherapy for patients with head and neck carcinoma.

Arthritis Rheumatol, 2017 Aug

2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis.

Current opinion in rheumatology, 2015-05

Current approaches to osteoporosis treatment.

Am J Med, 2012 Nov 20

Bisphosphonate therapy for osteoporosis: benefits, risks, and drug holiday.

Arthritis Care Res (Hoboken), 2017 Aug

2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis.

JAMA, 2006-12-27

Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial.

BMJ, 2008 May 20

Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis.

Circulation,

Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens: the ESTHER study.

J Clin Oncol, 2019 Sep 18

Management of Osteoporosis in Survivors of Adult Cancers With Nonmetastatic Disease: ASCO Clinical Practice Guideline.

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

Denosumab and teriparatide transitions in postmenopausal osteoporosis (the DATA-Switch study): extension of a randomised controlled trial.

N Engl J Med,

Bisphosphonate use and atypical fractures of the femoral shaft.

Semin Dial, 2010 May 10

Why dialysis patients need combination therapy with both cholecalciferol and a calcitriol analogs.

The lancet. Diabetes & endocrinology, 2017-07

10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension.

Post reproductive health, 2022 Dec 27

Hormone replacement therapy in women with history of thrombosis or a thrombophilia.

JAMA, 2021 Apr 13

Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial.

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

A Practical Review of C-Peptide Testing in Diabetes.

Journal of the American Heart Association, 2015 Jun 26

Effects of Exercise Training on Cardiorespiratory Fitness and Biomarkers of Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Mayo Clinic proceedings, 2023 Jun 29

Progression to Insulin Therapy in Patients With Type 2 Diabetes According to Cardiorespiratory Fitness, Body Mass Index, and Statin Therapy.

The Journal of clinical endocrinology and metabolism, 2011 Dec 28

Update in lipid alterations in subclinical hypothyroidism.

The New England journal of medicine, 2022 Apr 21

Calorie Restriction with or without Time-Restricted Eating in Weight Loss.

The lancet. Diabetes & endocrinology, 2019 Aug 22

Combination denosumab and high dose teriparatide for postmenopausal osteoporosis (DATA-HD): a randomised, controlled phase 4 trial.

The New England journal of medicine, 2019 Mar 23

Levothyroxine in Women with Thyroid Peroxidase Antibodies before Conception.

BMC medicine, 2019-07-10

The TABLET trial: limitations and implications.

JAMA, 2017 Dec 12

Effect of Levothyroxine on Miscarriage Among Women With Normal Thyroid Function and Thyroid Autoimmunity Undergoing In Vitro Fertilization and Embryo Transfer: A Randomized Clinical Trial.

The lancet. Diabetes & endocrinology, 2022 Mar 14

Levothyroxine in euthyroid thyroid peroxidase antibody positive women with recurrent pregnancy loss (T4LIFE trial): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial.

The New England journal of medicine, 2023 Jun 16

Cardiovascular Safety of Testosterone-Replacement Therapy.

BMC endocrine disorders, 2024 Nov 18

Risk of Hepatocellular Carcinoma with Glucagon-like Peptide-1 receptor agonist treatment in patients: a systematic review and meta-analysis.

International urology and nephrology, 2024 Nov 04

Effect of GLP-1 receptor agonists on prostate cancer risk reduction: a systematic review and meta-analysis.

Cancers, 2024 Sep 22

Risk of Esophageal and Gastric Cancer in Patients with Type 2 Diabetes Receiving Glucagon-like Peptide-1 Receptor Agonists (GLP-1 RAs): A National Analysis.

The New England journal of medicine, 2018 Oct 01

Fracture Prevention with Zoledronate in Older Women with Osteopenia.

JBMR plus, 2021 Aug 30

New Insights Into Osteoclast Biology.

The New England journal of medicine, 2023 Aug 25

Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity.

Kidney international, 2022 Nov

Executive summary of the KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease: an update based on rapidly emerging new evidence.

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

The rationale, design and baseline data of FLOW, a kidney outcomes trial with once-weekly semaglutide in people with type 2 diabetes and chronic kidney disease.

Cardiovascular diabetology, 2024 Feb 08

Cardiorenal effectiveness of empagliflozin vs. glucagon-like peptide-1 receptor agonists: final-year results from the EMPRISE study.

The New England journal of medicine, 2024 May 24

Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes.

Diabetes care, 2011-09

Efficacy and safety of antioxidant treatment with α-lipoic acid over 4 years in diabetic polyneuropathy: the NATHAN 1 trial.

Nutrients, 2023 Aug 18

Effects of Oral Alpha-Lipoic Acid Treatment on Diabetic Polyneuropathy: A Meta-Analysis and Systematic Review.

Endocrine reviews, 2019 Feb 01

Emerging Biomarkers, Tools, and Treatments for Diabetic Polyneuropathy.

Blood advances, 2017 Dec 21

Bone disease in monoclonal gammopathy of undetermined significance: results from a screened population-based study.

Arteriosclerosis, thrombosis, and vascular biology, 2019-07

Cardiovascular Outcomes of Romosozumab and Protective Role of Alendronate.

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

Low Bone Density and Bisphosphonate Use and the Risk of Kidney Stones.

Endocrine, 2019 Nov 21

Primary hepatocellular adenoma due to biallelic HNF1A mutations and its co-occurrence with MODY 3: case-report and review of the literature.

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

An Online Survey of Hypothyroid Patients Demonstrates Prominent Dissatisfaction.

Nature reviews. Endocrinology, 2022 Jan 18

Primary hypothyroidism and quality of life.

International journal of radiation oncology, biology, physics, 2024 Oct 23

Hormone Replacement Therapy in Patients with Gynecologic Cancer and Radiation-Induced Premature Ovarian Insufficiency.

Curr Rheumatol Rep, 2020 Aug 26

Lipid-lowering Therapies in Myositis.

JMIR diabetes, 2023 Sep 11

Impact of a Combined Continuous Glucose Monitoring-Digital Health Solution on Glucose Metrics and Self-Management Behavior for Adults With Type 2 Diabetes: Real-World, Observational Study.

JAMA network open, 2024 Mar 04

MACE and Hyperthyroidism Treated With Medication, Radioactive Iodine, or Thyroidectomy.

The lancet. Diabetes & endocrinology, 2019 Feb 28

Primary therapy of Graves' disease and cardiovascular morbidity and mortality: a linked-record cohort study.

BJS open, 2022 Jul 07

Attaining biochemical euthyroidism early after total thyroidectomy in Graves' disease may lower long-term morbidity risk.

N Engl J Med, 2023 Mar 02

Hydrochlorothiazide and Prevention of Kidney-Stone Recurrence.

Joint bone spine, 2021 May 19

Effects of prior osteoporosis treatment on 12-month treatment response of romosozumab in patients with postmenopausal osteoporosis.

The New England journal of medicine, 2016 Sep 15

Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes.

The American journal of cardiology, 2004-02-01

Safety and tolerability of simvastatin plus niacin in patients with coronary artery disease and low high-density lipoprotein cholesterol (The HDL Atherosclerosis Treatment Study).

Nature medicine, 2024 Feb 19

A terminal metabolite of niacin promotes vascular inflammation and contributes to cardiovascular disease risk.

Journal of clinical lipidology, 2024 Mar 29

A focused update to the 2019 NLA scientific statement on use of lipoprotein(a) in clinical practice.

Journal of the American College of Cardiology, 1986-12

Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin.

The New England journal of medicine, 2011-12-15

Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy.

Current opinion in lipidology, 2007 Aug

Niacin in cardiovascular prevention: mechanisms, efficacy, and safety.

The American journal of cardiology, 2005 Jun 01

Influence of extended-release nicotinic acid on nonesterified fatty acid flux in the metabolic syndrome with atherogenic dyslipidemia.

Trials, 2018 Mar 05

Improved adherence adjustment in the Coronary Drug Project.

The New England journal of medicine, 2014 Jul 17

Effects of extended-release niacin with laropiprant in high-risk patients.

JAMA, 1975 Jan 27

Clofibrate and niacin in coronary heart disease.

BMJ (Clinical research ed.), 2007 Feb 19

Effects of antithyroid drugs on radioiodine treatment: systematic review and meta-analysis of randomised controlled trials.

European journal of endocrinology, 2003 Dec

Resumption of methimazole after 131I therapy of hyperthyroid diseases: effect on thyroid function and volume evaluated by a randomized clinical trial.

Current osteoporosis reports, 2021 Feb 01

Approaches to Fracture Risk Assessment and Prevention.

The Journal of clinical endocrinology and metabolism, 1974 Nov

Serum thyroid hormone and thyrotropin concentrations during thyroxine and triiodothyronine therapy.

Diabetes Care, 2024 Jan 1

15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes-2024.

The New England journal of medicine, 2013 Sep 12

Gonadal steroids and body composition, strength, and sexual function in men.

Journal of thrombosis and haemostasis : JTH, 2019 Sep 13

Transgender patients and the role of the coagulation clinician.

The Journal of clinical endocrinology and metabolism, 2024 Jan 18

Approach to the Patient: Hormonal Therapy in Transgender Adults With Complex Medical Histories.

Diabetes care, 1999-08

Glucose intolerance and 23-year risk of coronary heart disease and total mortality: the Honolulu Heart Program.

Diabetes research and clinical practice, 1994 Jan

Insulin autoimmune syndrome (Hirata disease): clinical features and epidemiology in Japan.

Clinical endocrinology, 2020 Feb 26

Management of Insulin Autoimmune Hypoglycaemia: Single-centre experience from Western India with systematic review of world literature.

Journal of the Endocrine Society, 2022 Dec 02

Perioperative Evaluation and Management of Patients on Glucocorticoids.

Diagnostics (Basel, Switzerland), 2021 Apr 20

Glucocorticoid Withdrawal-An Overview on When and How to Diagnose Adrenal Insufficiency in Clinical Practice.

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

Proton Pump Inhibitors Do Not Affect the Bioavailability of a Novel Liquid Formulation of Levothyroxine.

Journal of general internal medicine, 2021 Jan 19

Concomitant Use of Levothyroxine and Proton Pump Inhibitors in Patients with Primary Hypothyroidism: a Systematic Review.

Frontiers in pharmacology, 2023 Mar 16

Glucagon-like peptide-1 receptor agonists as add-on therapy to insulin for type 1 diabetes mellitus.

Nutrition & diabetes, 2019 Nov 04

Double or hybrid diabetes: A systematic review on disease prevalence, characteristics and risk factors.

Diabetes, obesity & metabolism, 2019 Aug 19

Double diabetes: A distinct high-risk group?

BMC endocrine disorders, 2021 Sep 16

The association between overweight/obesity and double diabetes in adults with type 1 diabetes; a cross-sectional study.

The Journal of clinical endocrinology and metabolism, 2023 Sep 18

Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome.

European journal of endocrinology, 2018 Apr 27

Liraglutide increases IVF pregnancy rates in obese PCOS women with poor response to first-line reproductive treatments: a pilot randomized study.

BMJ open, 2024 Apr 24

Use of GLP1 receptor agonists in early pregnancy and reproductive safety: a multicentre, observational, prospective cohort study based on the databases of six Teratology Information Services.

The New England journal of medicine, 2023 Oct 18

Teplizumab and β-Cell Function in Newly Diagnosed Type 1 Diabetes.

N Engl J Med,

Cardiovascular and Cancer Risk with Tofacitinib in Rheumatoid Arthritis.

Autoimmunity reviews, 2023 Dec 20

Implementation of regulatory guidance for JAK inhibitors use in patients with immune-mediated inflammatory diseases: An international appropriateness study.

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

Update on the clinical use of trabecular bone score (TBS) in the management of osteoporosis: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), and the International Osteoporosis Foundation (IOF) under the auspices of WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging.

Lancet (London, England), 2024 Jun 27

Lowering systolic blood pressure to less than 120 mm Hg versus less than 140 mm Hg in patients with high cardiovascular risk with and without diabetes or previous stroke: an open-label, blinded-outcome, randomised trial.

Diabetes care, 2021 May 05

High Burden of Subclinical and Cardiovascular Disease Risk in Adults With Metabolically Healthy Obesity: The Atherosclerosis Risk in Communities (ARIC) Study.

Hospital & community psychiatry, 1983 Dec

The dexamethasone suppression test: promises and problems of diagnostic laboratory tests in psychiatry.

Clinical endocrinology, 1978 Nov

Endocrine effects of spironolactone in man.

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

Effect of finasteride on serum levels of androstenedione, testosterone and their 5α-reduced metabolites in men at risk for prostate cancer.

The Journal of clinical endocrinology and metabolism, 2007-05