For our 64th episode, we return to to review a recent paper that attempts to elucidate the connection between subclinical thyroid disease and cardiovascular disease. Any of you listeners who see patients with thyroid conditions likely frequently encounter people with mild thyroid abnormalities and need to figure out if those abnormalities may have a clinical impact. So, given the many unanswered questions in this area, we thought this article well worth discussing. Not only do these authors use an observational study design, but their work is a pooling of multiple observational investigations, necessitating a careful thinking through of the methodology. Host Chase Hendrickson, MD, from Vanderbilt University talks with regular contributor Anupam Kotwal, MD, from the University of Nebraska Medical Center, and guest expert Jennifer S. Mammen, MD, PhD, from Johns Hopkins University School of Medicine. They discuss “Associations Between Subclinical Thyroid Dysfunction and Cardiovascular Risk Factors According to Age and Sex” by Baretella et al, published in the May 2025 issue of JCEM. Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl064 — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series