DEAR DR. ROACH: I have been taking 1,000-1,200 mg of calcium daily for a long time now — more than 12 years. I am 46.

I don’t get much, if any, dairy in my diet, but I am a good vegetable eater.

Should I be concerned about calcium supplements and kidney stones or other places calcium supplements might deposit? Should I continue with my 1,000 mg? I am still premenopausal. — M.T.

ANSWER: Several new studies have been released that call into question the advice that all women should be taking supplemental calcium.

One was a study in 2006 that showed calcium plus vitamin D supplementation did not reduce a risk of hip fracture, but did increase a risk of kidney stones. Many studies have shown previously that calcium from diet did not increase kidney stone risk, whereas supplements did.

More concerning was a study from 2013 that showed an increase in heart disease risk among women taking calcium supplements, especially among those who already were getting adequate calcium in their diet.

At this point, except for women with osteoporosis, I am recommending that women try to get calcium from diet rather than supplements. Leafy vegetables have good amounts, and you can take a glass a day of calcium-fortified juice if you don’t like dairy.

DEAR DR. ROACH: I have been diagnosed with benign essential tremor. I have seen several experts and tried many medications, none of which have been very helpful. I recently read about focused ultrasound. Can you tell me anything about it? I have no desire for brain surgery for deep brain stimulation. — A.M.

ANSWER: Benign essential tremor is a common movement disorder. The word “essential” just means we don’t really understand what causes it, although a genetic mutation is postulated.

Although it is called “benign,” the effects of the tremor can be significant. The tremor most commonly is in the hands, but can be in the head or voice as well, and less commonly in the legs or trunk. It runs very strongly in families, and although it can occur at almost any age, it is usually diagnosed about age 45, and tends to worsen over time.

It can be confused for Parkinson’s disease. Many people notice that alcohol temporarily improves the tremor, which is helpful for diagnosis, but not treatment.

Treatment can include medications, including beta blockers and anti-seizure medicines. They help many people with this condition. However, as many as 30 percent of people do not get better with medication.

There are several surgical treatments. They involve the thalamus, a deep area of the brain involved IN motor function. Surgery on the thalamus was shown back in the 1950s to improve the tremor, but in the 1990s, deep brain stimulation — a wire placed into that area of the brain — was shown to be as effective, with fewer side effects.

More recently, radiation and ultrasound have been studied. They can direct energy precisely to the thalamus, and can, in theory, provide the same benefits without surgery. Ultrasound may be better because the benefits show up immediately, as opposed to radiation, which takes several weeks to work. The initial studies are very promising, but it is a very new technique, and studies are ongoing that will need to be completed before the procedure can be routinely recommended.

I found a very helpful website at: www.essentialtremor.org. It’s from the International Essential Tremor Foundation and discusses treatments in greater detail.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

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