Reader Questions
DEAR DR. ROACH: I’m a 67-year-old man who had a calcium score test recently, and I was taken aback to see my score at 513. I’ve always been active and maintain a healthy weight. My cholesterol and blood pressure have never been high, but I do have diabetes.
I’m scheduled to see a cardiologist soon, but I’ve been wondering if the results might be inaccurate or misinterpreted in any way. Should I consider taking the test again? Could you clarify what this test really means? — S.C.
ANSWER: A coronary calcium score is derived using a fast CT scanner that images the blood vessels supplying the heart. Typically, there isn’t much room for misinterpretation. Unless there was a mix-up in identifying the person being scanned, the results should be reliable.
Interestingly, many heart attack patients don’t exhibit the classic risk factors like high cholesterol or blood pressure. Unfortunately, diabetes is indeed a risk factor, but effectively managing it can significantly reduce the chances of complications.
A high calcium score doesn’t definitively indicate the presence of heart artery blockages, but it certainly increases the likelihood. You and your doctor might want to use a decision analysis tool, like the MESA calculator, to discuss whether medication could help lower your risk of heart attack or stroke.
It’s worth noting that medications such as statins may still lower heart attack risks—even in individuals with normal cholesterol and blood pressure levels.
DEAR DR. ROACH: I’m a 56-year-old male in decent health, but I’ve been struggling to sleep well over the past few years. I’ve tried various methods, but nothing worked until I started using legally available THC drinks. They help me sleep without any side effects. Are these drinks safe for long-term use, or should I hold back on how often I consume them? — Anon.
ANSWER: Unfortunately, I can’t provide a definitive answer regarding the long-term safety of THC for sleep. Reliable long-term data are lacking. However, there is information about heavy marijuana users, and they tend to have a higher rate of psychiatric issues, including psychosis and cognitive decline.
There’s also the possibility of developing cannabis use disorder, which occurs when individuals consume more than intended, impacting various areas of their lives. This condition shares similarities with opioid use disorder and alcohol dependency. That said, taking a single dose at bedtime, particularly a small amount, is unlikely to lead to serious mental health issues or dependency.
Since you’re not experiencing side effects now, it seems unlikely that you will, but it can depend on how much THC each drink contains. Some could have as low as 2-5 mg, while others might go up to 100-200 mg. It’s best to start with the lowest effective dose, perhaps even using it every other day if you’re concerned about dependency.
Additionally, some cannabis drinks combine THC with CBD, which can help reduce anxiety. If what you’re using has CBD, you might consider switching to a CBD-only product or a lower THC dose to find the minimal effective amount. Just make sure you know what you’re getting; a third-party analysis would be ideal.
