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November 17, 1993

Changes in Bone Density With Lactation-Reply

JAMA. 1993;270(19):2300. doi:10.1001/jama.1993.03510190054020

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In Reply.  —In response to Dr Klahr's letter, we agree that our observation of bone loss during a period of high prolactin levels (lactation), coupled with a similar observation in women with prolactin-secreting adenomas, suggests the importance of further exploration of calcium metabolism in high prolactin states. Antipsychotic drugs are indeed a major cause of hyperprolactinemia that may cause galactorrhea and amenorrhea and, ultimately, bone loss. This is an important group for further study as available data are limited. However, based on our current data in lactating women, we cannot determine whether hyperprolactinemia is solely or partially responsible for bone demineralization.Naylor and Newman chastise us for providing what is, in their view, an insufficient explanation as to why bone mass might not have returned to baseline at 12 months in the group that breast-fed at least 6 months. They correctly point out that this group included some women who