Endocrinology

Is HPA axis dysregulation causing your chronic insomnia?

Conditions

April 10, 2026

Cortisol. Almost always cortisol. I say this to patients more than almost anything else. And I say it having lived it myself, years of high-output clinical work, late nights, early mornings, and the particular exhaustion of lying in bed completely depleted but unable to actually fall asleep. Tired but wired. It is a real physiological state, and it has a name: hypothalamic-pituitary-adrenal (HPA) axis dysregulation. It is not insomnia in …

What is often overlooked about male factor infertility

Erica Bove, MD

Conditions

March 27, 2026

As a reproductive endocrinologist, I spend a great deal of time trying to answer a deceptively simple question: Why is not this couple getting pregnant? Male factor infertility contributes to at least 40 percent of cases, and most reproductive endocrinologists recognize the importance of evaluating both partners early. In practice, however, the path to that evaluation is not always straightforward. In heterosexual relationships, patients may understandably focus first on the …

Why does sex work seem like a more viable path than medicine in 2026?

Corina Fratila, MD

Physician

March 8, 2026

I’d rather be a sex worker than practice medicine in this broken system (and I’m 53, menopausal, and retired from my hot years).

Let me be clear: This is not a whimsical “maybe I will pivot into OnlyFans” moment. I am 53 years old. I am menopausal. My libido is in witness protection. The bloom is not just off the rose, the whole damn bush was yanked out and replaced with …

The Dozortsev-Diamond paradigm: Is progesterone the true ovulation trigger?

Michael Allon, MD, Lina Villar, MD, and Beata Tralik, MD, PhD

Conditions

March 6, 2026

Every reproductive endocrinologist knows that ovulation is triggered by estradiol. In our textbooks, the sequence is clear: Estradiol rises, triggers an LH surge, and ovulation follows, culminating in the formation of a corpus luteum, which produces progesterone to support implantation and pregnancy. It is straightforward and reassuringly precise, and it forms the backbone of our clinical practice.

Yet, from the very beginning of training, we are instructed to use artificial ovulation …

Insulin resistance is not a disease: a metabolic reframe

Kevin Whitt

Conditions

February 25, 2026

Type 2 diabetes and metabolic disease are now so common that they are treated as an expected part of modern life rather than as a systemic failure. Roughly 90 percent of American adults are now prediabetic or diabetic, and most are unaware of it. This progression quietly opens the door to heart disease, non-alcoholic fatty liver disease, cancer, neurodegeneration, and other chronic illnesses that are then managed downstream.

We are not …

Why “eat less, move more” fails for midlife weight loss

Marsha Shepherd Whitt

Conditions

February 20, 2026

Clinicians often notice a frustrating pattern: Women in midlife follow standard weight-loss advice, eat less and move more, yet see little progress. Calories are reduced, exercise increases, and still the scale barely moves. This is often blamed on motivation, discipline, or compliance. But in many cases, the real issue is not behavior. It’s physiology.

Perimenopause and menopause are not simply estrogen-deficient states; they are states of altered signaling, altered tissue responsiveness, …

Beyond weight loss: the expanding benefits of GLP-1 receptor agonists

Zehra Haider, MD

Meds

February 9, 2026

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) were introduced to help manage type 2 diabetes. They improve glycemic control and promote weight loss, which we all know are essential for long-term outcomes. In practice, I’ve seen that their impact goes beyond these traditional targets. Patients often benefit from cardiovascular protection and kidney improvements, and emerging data show advantages in areas we did not initially anticipate, such as sleep apnea, joint health, …

Oral Wegovy: the miracle and the mess of the new GLP-1 pill

Shiv K. Goel, MD

Meds

February 2, 2026

A patient stopped me in the hallway recently, not in an exam room, not seated, not “ready” for a clinical conversation. Just a human being catching me between visits and asking a question that felt heavier than any lab result:

“Doc, is this finally the thing that will work? Or is it just another trap?”

That question is the GLP-1 era in one sentence. And with the launch of oral Wegovy, it …

Hashimoto’s disease in adolescent girls: Why it’s often overlooked

Callia Georgoulis

Conditions

January 27, 2026

Hashimoto’s disease is the most common cause of hypothyroidism in children and adolescents, yet it remains frequently overlooked, particularly in adolescent girls. Fatigue, mood changes, weight gain, and cognitive slowing are often attributed to mental health conditions or dismissed as normal features of puberty, delaying diagnosis and treatment. This pattern reflects a broader failure to recognize how autoimmune thyroid disease presents during adolescence, and how gendered assumptions shape clinical interpretation …

Why fear-based approaches fail in chronic illness care

Bridgette Johnson, PhD, RN

Conditions

January 9, 2026

In caring for patients with chronic illness, we often assume that if people truly understood the consequences of poor disease management, they would change. We explain complications, cite lab values, outline risks, and sometimes lean into fear in hopes that it will motivate action. When patients do not follow recommendations, we label them as noncompliant or unmotivated. Yet chronic illness is not managed in exam rooms or hospital beds. It …

The risk of ideology in gender medicine

William Malone, MD

Conditions

December 16, 2025

Something unusual is happening in medicine. A once-rare diagnosis (gender dysphoria) has become common among American children and adolescents. An estimated three percent of youth now identify as transgender, and another two percent are questioning their gender identity. That surge should have prompted urgent, transparent scientific inquiry. Instead, the field of pediatric gender medicine has become one of the most ideologically-charged, and least open to critical debate, areas in modern …

Read more…

The risk of ideology in gender medicine

My journey to a type 1 diabetes diagnosis

Beth Thacker

Conditions

November 6, 2025

I was diagnosed with type 1 diabetes mellitus in February 2024. Now it all made sense.

It all started in October 2020 when I passed out cold. I was rushed to the emergency room and 3 days later woke up to find I had a thyroid issue and lost 2 pints of blood. Four days later, after a blood transfusion, I was sent home. At that point, I thought I was …

Are SGLT2 inhibitors safe for type 1 diabetes?

Zehra Haider, MD

Conditions

October 22, 2025

SGLT2 inhibitors have transformed care for people with type 2 diabetes. They not only lower blood sugar but also reduce cardiovascular events and slow the progression of kidney disease. Given these successes, many have asked whether the same benefits extend to people with type 1 diabetes (T1D).

The answer is not straightforward. In T1D, SGLT2 inhibitors remain off-label, and the biggest concern is the increased risk of diabetic ketoacidosis (DKA). Still, …

Life after GLP-1s: How to sustain weight loss

Ricky Bloomfield, MD

Conditions

October 12, 2025

It should come as no surprise that GLP-1 receptor agonists have revolutionized the management of obesity and metabolic syndrome. These drugs have shown extraordinary promise in regulating appetite, promoting weight loss, and improving blood sugar control. Nearly one in eight adults (twelve percent) have taken a GLP-1 agonist, and forty-three percent of adults diagnosed with diabetes have used these therapies, numbers likely to have increased further in the last year …

Why type 1 diabetes screening should be part of back-to-school

Shara Bialo, MD

Conditions

September 24, 2025

Back-to-school season is one of the busiest times of the year for health care providers (HCPs). Doctors’ offices are full of young patients and families preparing for the year ahead, checking off physical exams, immunization forms, and age-based screenings. These visits are more than just routine; they are critical opportunities to talk about risk factors and catch early signs of health issues. Yet too often, one disease slips through the …

How Ukrainian doctors sustained diabetes care during the war [PODCAST]

The Podcast by KevinMD

Podcast

September 6, 2025

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Physician Daryna Bahriy discusses her article “How Ukrainian doctors kept diabetes care alive during the war,” sharing how medical teams in western Ukraine adapted to protect vulnerable patients amid the chaos of …

New surge in misleading ads about diabetes on social media poses a serious health risk

Laura Syron

Conditions

August 16, 2025

A recent surge in misleading ads and AI-generated videos on social media and other online sites promoting bogus diabetes products, treatments and cures – often using fake endorsements, including from my organization Diabetes Canada – poses a serious health risk to people living with diabetes.

So far this year, Diabetes Canada has heard from at least 300 people who saw or bought fake products like smart watches claiming to non-invasively …

Why testosterone matters more than you think in women’s health

Andrea Caamano, MD

Conditions

July 6, 2025

Menopause is finally having its moment in the spotlight, thanks to high-profile women breaking the long-standing taboo around discussing this life stage. Yet, while discussions around hormone replacement therapy (HRT) have increased, one critical component remains largely overlooked — testosterone.

Traditionally seen as a “male hormone,” testosterone is equally vital for women’s health, playing a key role in mood, energy, libido, muscle mass, bone density, and cognitive function. Yet, …

A spoonful of vinegar: Why simple glucose hacks deserve more medical attention

Callia Georgoulis

Conditions

June 10, 2025

In the age of glucose monitors, blood sugar charts, and wearable tech, one of the most effective strategies for stabilizing post-meal glucose levels might already be sitting in your kitchen cabinet: vinegar.

As someone with a strong interest in endocrinology and women’s’ metabolic health, I’ve found myself increasingly drawn to the work of educators like Jessie Inchauspé (popularly known as Glucose Goddess), who break down blood sugar science in ways that …

An effective treatment using an effective care delivery model: Using telehealth to treat adolescents with obesity with GLP-1 medications

Karla Lester, MD

Conditions

June 7, 2025

Will a telehealth model effectively engage adolescents with obesity and their parents to participate in their treatment plan?

Do GLP-1 agonist medications work to improve weight status and reduce or eliminate comorbidities in adolescents?

I’ve worked for over two decades as a community pediatrician to address the childhood and adolescent obesity epidemic. I can say with full certainty, when it comes to adolescents, we aren’t getting anywhere. With the COVID-19 pandemic, the …

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