Background: Hashimoto’s thyroiditis (HT), the most prevalent autoimmune thyroid disorder in reproductive-age women, has been linked to diminished ovarian reserve and subfertility. This study aimed to evaluate the relationship between HT and key fertility parameters, including hormonal markers and reproductive outcomes, while also exploring the potential impact of thyroid hormone replacement therapy. Methods: A retrospective observational study was conducted on 86 women undergoing fertility evaluation. Participants were divided into two groups based on anti-thyroid peroxidase antibodies (ATPO): the HT group (n = 49) and the control group (n = 37). Among women with HT, 57% were receiving levothyroxine (Euthyrox^®) at the time of assessment. Variables analyzed included serum levels of anti-Müllerian hormone (AMH), thyroid-stimulating hormone (TSH), insulin resistance index (HOMA-IR), number of oocytes retrieved, blastocysts formed, pregnancies achieved, and live births. Statistical methods included t-tests, Mann–Whitney U tests, Pearson/Spearman correlations, and linear regression models. Results: Women in the HT group had slightly lower AMH levels and oocyte counts compared to controls, though these differences did not reach statistical significance. TSH values were higher in the HT group and showed a significant negative correlation with blastocyst formation (p = 0.03). Although TSH also showed negative trends with oocyte count, pregnancies, and live births, these correlations did not reach statistical significance. A post-hoc subgroup analysis revealed that HT patients receiving levothyroxine tended to have higher numbers of oocytes retrieved and blastocysts formed compared to untreated HT patients, suggesting a possible beneficial effect of thyroid hormone replacement, although the differences were not statistically significant. Conclusions: HT is associated with subtle but clinically relevant impairments in ovarian reserve and reproductive potential. Thyroid hormone replacement may offer modest benefits and should be considered in the individualized management of fertility in women with thyroid autoimmunity.

Background and Objectives: Hypothyroidism can alter lipid metabolism, vascular resistance, body composition, and myocardial function. Yet the cardiovascular risk engines used in routine practice were developed in general populations and do not include thyroid status. This review examines what contemporary risk models capture, what they omit, and how thyroid dysfunction should influence interpretation without being treated as an unvalidated numerical correction. Materials and Methods: A focused narrative search of PubMed was performed for publications from January 2014 through 6 September 2026, supplemented by earlier landmark cohort studies, risk-model derivation papers, randomized trials, and professional guidelines. Evidence was organized around overt and subclinical hypothyroidism, traditional risk factors, observed cardiovascular events, and the design and validation of major risk equations. Results: SCORE2, SCORE2-OP, Framingham, QRISK3, and PREVENT differ in predicted outcomes, age ranges, geography, and required inputs; their percentages and categories are therefore not interchangeable. Thyroid status is absent from these engines. A prospective community cohort found that adding TSH produced little incremental discrimination beyond conventional scores, whereas cross-sectional studies sometimes found higher calculated risk in women with subclinical hypothyroidism. Individual-participant data suggest that excess coronary and heart-failure risk is concentrated at higher TSH levels, while a large 2025 pooled analysis found only small differences in conventional risk factors between subclinical thyroid dysfunction and euthyroidism. Levothyroxine improves lipids most clearly in overt hypothyroidism, but cardiovascular outcome benefit in older adults with mild subclinical disease remains unproven. Conclusions: Clinicians should use one validated, region- and age-appropriate cardiovascular model, confirm that the patient meets its intended-use criteria, and evaluate thyroid disease in parallel. Cross-model percentage comparisons should be avoided. Persistent TSH elevation, overt hormone deficiency, treatment status, frailty, and severe dyslipidemia belong in clinical judgment and follow-up, not in an improvised score multiplier.

Background/Objectives: Children with neurodevelopmental and neuromotor disabili-ties may be vulnerable to both excess adiposity and undernutrition, while the inter-pretation of simple anthropometric measures can be challenging when functional im-pairment, feeding difficulties, medication exposure, and body-composition differences are present. This exploratory cross-sectional study reports a single clinical assessment performed by the authors between February and April 2023 in a rehabilitation setting. Its objectives were to describe weight-status categories in the assessed children and to examine what practical lessons the assessment provides for disability-sensitive nutri-tional screening. Methods: Twenty children aged 9–15 years with spastic quadriplegia (n = 10), autism spectrum disorder (n = 5), or attention-deficit/hyperactivity disorder (n = 5) underwent a one-time assessment. Weight, height, diagnosis, ongoing rehabilita-tion, medication classes, and maternal anthropometry were recorded. Pediatric BMI was interpreted using age- and sex-specific categories. Given the small heterogeneous sample, analyses were descriptive. Results: Ten children (50%) were classified as hav-ing obesity, three (15%) as overweight, and seven (35%) as healthy weight. Six of the ten children with obesity had mothers with overweight or obesity. The assessment al-so highlighted clinically relevant domains that had not been incorporated systemati-cally, including structured dietary intake, feeding and swallowing difficulties, stand-ardized functional classification, physical activity, body composition, and detailed medication exposure. Conclusions: The findings should be interpreted as lessons from a small real-world clinical assessment rather than as a comprehensive nutrition-al-status evaluation or prevalence estimate. They support the use of a standardized, disability-sensitive screening framework that combines appropriate anthropometry with feeding, dietary, functional, medication, activity, and family-context information.

Background/Objectives: Biochemical control and radiological response may follow different trajectories during dopamine agonist treatment of a cystic prolactinoma. We describe this discordance in a woman with longitudinal endocrine and imaging assessments and two subsequent pregnancies. Case Presentation: A 28-year-old woman presented in 2015 with menstrual irregularity, headache, and prolactin of 88.76 ng/mL (reference interval, 1.9–25 ng/mL). Twenty-one prolactin measurements and six written pituitary magnetic resonance imaging reports were reviewed alongside medication and reproductive histories. A right-sided pituitary lesion contained solid and cystic components. Despite persistent prolactin elevation during several cabergoline and bromocriptine regimens, the reported solid component decreased from approximately 7 × 6 mm in 2017 to 3 × 2 mm in 2021, with a residual 3 × 3 mm cystic component. Post-polyethylene glycol results remained above the interval recorded by the laboratory. Following treatment interruption associated with a pregnancy in 2019, prolactin remained elevated in 2021 without reported lesion regrowth. It subsequently normalized to 22.8 ng/mL during cabergoline treatment. A second pregnancy occurred in 2023. Conclusions: This probable cystic microprolactinoma illustrates the need to assess hormonal, structural, and reproductive outcomes separately. Persistent modest hyperprolactinemia in a shrinking lesion does not, by itself, establish dopamine agonist resistance. Interpretation requires attention to drug exposure and the distinction between persistent disease and recurrence after documented remission.

Background/Objectives: Bone mineral density (BMD) is fundamental to osteoporosis assessment, but fracture risk is also shaped by fracture history, falls, frailty, secondary causes, age, sex, and treatment context. This narrative review examines clinically relevant information that modifies adult endocrine decision-making beyond the T-score. Methods: PubMed/MEDLINE was searched through 28 June 2026; recent guidelines, consensus statements, systematic reviews, meta-analyses, and pivotal fracture-endpoint trials were prioritized. The exact search strings, filters, eligibility criteria, selection process, and prioritized guidance documents are provided in PubMed MEDLINE search strategies. Results: BMD should be interpreted with fracture history and clinical risk factors, while the applicability of T-scores differs by age and sex. FRAX, vertebral imaging, and trabecular bone score can refine assessment in selected patients. Very-high-risk patients may warrant early osteoanabolic or dual-action therapy followed by antiresorptive treatment, whereas antiresorptives remain appropriate for many high-risk patients. Denosumab requires planned continuity and a follow-on strategy; advanced chronic kidney disease requires particular attention to mineral metabolism and hypocalcemia risk. Conclusions: Contemporary osteoporosis care expands rather than replaces densitometry. Endocrine management should integrate valid DXA interpretation, fracture-risk urgency, reversible contributors, drug-specific safety, treatment feasibility, monitoring, and the next treatment phase.

Background/Objectives: Bone mineral density (BMD) is fundamental to osteoporosis assessment, but fracture risk is also shaped by fracture history, falls, frailty, secondary causes, age, sex, and treatment context. This narrative review examines clinically relevant information that modifies adult endocrine decision-making beyond the T-score. Methods: PubMed/MEDLINE was searched through 28 june 2026; recent guidelines, consensus statements, systematic reviews, meta-analyses, and pivotal fracture-endpoint trials were prioritized. Results: BMD should be interpreted with fracture history and clinical risk factors, while the applicability of T-scores differs by age and sex. FRAX, vertebral imaging, and trabecular bone score can refine assessment in selected patients. Very-high-risk patients may warrant early osteoanabolic or dual-action therapy followed by antiresorptive treatment, whereas antiresorptives remain appropriate for many high-risk patients. Denosumab requires planned continuity and a follow-on strategy; advanced chronic kidney disease requires particular attention to mineral metabolism and hypocalcemia risk. Conclusions: Contemporary osteoporosis care expands rather than replaces densitometry. Endocrine management should integrate valid DXA interpretation, fracture-risk urgency, reversible contributors, drug-specific safety, treatment feasibility, monitoring, and the next treatment phase.