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October 21, 1988

Decreased Bone Density and Thyroxine-Reply

Author Affiliations

University of Massachusetts Medical School Worcester

University of Massachusetts Medical School Worcester

JAMA. 1988;260(15):2219-2220. doi:10.1001/jama.1988.03410150067029

In Reply.—  We feel that the issues raised by Dr Heath have been addressed in the article itself or the accompanying editorial. Although it is surprising that thyroxine therapy was associated with decreased femoral density without alteration in lumbar spine density, hormone excess or deficiency can have differential effects on cortical and trabecular bone.1 The underlying diagnosis in the thyroxine-treated women did not affect bone mass. Since the study was not prospective, it is not possible to determine when the decrease in bone density occurred. This points out the need for a prospective, long-term, longitudinal study to confirm the findings in our study and in other reported studies. The 31 women in our study who were receiving thyroxine were all premenopausal, with an age range from 24 to 43 years. We cannot comment on differences in bone densities in women in our study and that of Hurley et al,