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Fri, 14 Mar 2014 13:50:30 -0400 |
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Lisa,
So glad you replied and would love to correspond with you more about this
mom and her history. Her prolactin level was 51.3 at 5 days PP. Her
endocrinologist is fearful about the dopamine antagonist effect of domperidone
but mom is going to try it anyway, so will let you know what happens. (Mom's
endo left it up to mom to make decision on domperidone). I've spent the
whole morning and last night researching, conferring and relaying info to
parents. And in her case it isn't just one possible interference with supply,
it's also PCOS, hypothyroid, ulcerative colitis; so would metformin cause
diarrhea and exacerbate colitis should PCOS cause be ruled out. It seems
to me that the low prolactin level is treatable, with a trial of domperidone
with close follow-up.
Would appreciate hearing about similar cases and outcomes.
Barbara Latterner
<I am aware of a number of similar cases, women with a history of
pituitary adenomas requiring medications to bring down prolactin so that she can
ovulate and conceive. While you would think that this would set a woman up for
lots of milk, that is not necessarily the case. I will be very interested
in hearing the results of the prolactin test. It would be even more useful
if there could be both a baseline and a surge measurement, as a couple of
published case studies found very poor surges. No one has taken the time
to dig into these cases and understand what is going on, but suffice it to
say that when there is a pathology in the picture, it has the potential to
cause problems even if we were able to leapfrog over the fertility impact.
In some cases, stimulating prolactin is the last thing the physician wants
to have happen, at least artificially. But if prolactin comes back low
and a decision is made to try dom, it would be interesting to see what does
or does not happen. Tough situation.
Lisa Marasco>
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