The Journal of Clinical Endocrinology and Metabolism

Dose matters more with melatonin than people realize because the effect of dose is tiny.

In a randomized trial in the Journal of Clinical Endocrinology and Metabolism, researchers gave older adults with insomnia three different doses of melatonin and a placebo.

The dose that worked best was 0.3 milligrams or 300 micrograms, which incidentally is roughly what the body produces on its own.

It restored sleep efficiency and normalized nighttime melatonin levels.

The single most important input, as we discussed earlier, is light, and it works in both directions.

In the evening, even ordinary room light is enough to suppress your own melatonin.

A study in the Journal of Clinical Endocrinology and Metabolism compared people living in normal indoor lighting before bed to people in dim light and found that room light delayed melatonin onset in ninety-nine percent of participants and cut the total duration of melatonin production by about ninety minutes.

That's the overhead light in your kitchen, not your phone.

The best data we have on timing comes from a study called SWAN, the Study of Women's Health Across the Nation, which has followed a large group of women right through the menopause transition for nearly two decades.

In one analysis published in the Journal of Clinical Endocrinology and Metabolism in 2020, the researchers looked at a measure of bone microarchitecture called the trabecular bone score.

What they found was that it held steady, no decline at all until about 18 months before a woman's final period.

Then it began falling by more than 1% per year.

This is a slow building, compounding problem, and catching it early is worth the effort.

On the treatment side, there's a thoughtful review in the Journal of Clinical Endocrinology and Metabolism making the case for what the authors call precision medicine-guided treatment of acromegaly.

Their argument is that the traditional approach, put everyone on a first-generation somatostatin receptor ligand and see what happens, leaves a lot of patients exposed to hormone excess for too long while doctors trial and error their way to an effective drug.

Instead, they describe three biologically distinct groups of patients, younger patients with aggressive, treatment-resistant tumors, older patients with smaller tumors that usually respond well, and a middle group that often needs combination therapy.

And we submitted this to, of course, New England Journal, and they wanted nothing to do with it.

It finally got published in the Journal of Clinical Endocrinology and Metabolism, which is a respectable endocrine journal.

It really went nowhere.

I mean, if it would have been a drug that a drug company had, it would have been worth billions.

It is highly efficacious.

A network meta-analysis published in the Journal of Clinical Endocrinology and Metabolism showed denosumab reduces the risk of glucocorticoid-induced vertebral fractures with a risk ratio of 0.21.

Wow.

Yeah, meaning a massive seventy-nine percent relative risk reduction.

It was published-

2019, The Journal of Clinical Endocrinology.

Yes, and so-

Davis was the lead-

But they're saying now that the long-term damage in the intestines can could raise the risk of hip fractures in people with celiac disease, a new study says.

So at the Journal of Clinical Endocrinology and Metabolism, they were talking about gluten and people who ate it and how...

When they avoided it, it allowed their digestive tract to begin to heal.

And they're saying now that the research confirmed that patients that had a higher rate of hip fractures when tissue damage persisted over time became quite the challenge.