EFL074
For our 74th episode, recorded live at ENDO 2026 in Chicago, we review a recent JCEM study that addresses a common clinical question: does levothyroxine need to be taken on an empty stomach?
This randomized clinical trial evaluates a dose-adjusted, non-fasting regimen and finds that a 15% increase with breakfast ingestion achieves TSH stability similar to that with standard fasting dosing. The results also suggest potential improvements in adherence and patient-reported well-being, while highlighting variability in dose adjustments and limitations in generalizability.
Host Chase Hendrickson, MD, MPH, MHCC, from Vanderbilt University, is joined by regular contributor Andy Crawford, MD, from Dartmouth-Hitchcock Medical Center, and guest expert Matt Edelson, MD, from the University of Chicago. Together, they discuss “Fasting versus non-fasting dose-adjusted levothyroxine ingestion in hypothyroidism,” published in the April 2026 issue of JCEM, and consider how these findings may inform patient-centered approaches to medication timing and management.
Regular Contributor
Andrew Crawford, MD
Dartmouth-Hitchcock Medical Center
Dr. Crawford earned both his ScB in Biology and his MD from Brown University. He completed his Internal Medicine residency and Endocrinology, Diabetes, and Metabolism fellowship training at the Hospital of the University of Pennsylvania. Dr. Crawford is an Assistant Professor of Medicine and Medical Education and serves as Program Director of the Endocrinology Fellowship at Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire. His clinical work focuses on the evaluation and management of thyroid disorders, with particular expertise in thyroid nodules, thyroid cancer, and hyperthyroidism.
Guest Expert
Matthew Ettleson, MD
University of Chicago
Dr. Ettleson is an Assistant Professor of Medicine at the University of Chicago, Section of Endocrinology, Diabetes & Metabolism. He received his undergraduate and medical degrees from Northwestern University and completed clinical training at the University of Michigan and the University of Chicago. His research interests include epidemiology and health services research in the diagnosis and treatment of thyroid disease. Specifically, his research aims to evaluate and improve the quality of care for patients with hypothyroidism. He has investigated patterns in hypothyroidism treatment, medical decision-making, and clinical outcomes. Dr. Ettleson maintains a general endocrinology outpatient practice, with a focus on thyroid diseases, parathyroid disease, and male hypogonadism.
Chase Hendrickson, MD, MPH, MMHC, practices general endocrinology at the Vanderbilt University Medical Center, where he is an associate program director for the endocrinology fellowship program. His interests include endocrine education, teaching inferential methods, and quality improvement.
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