Dear Dr. Roach: I have calcium buildup throughout my vascular system. My legs were operated on, and the surgeon had to drill through the calcium to open up the blood flow. I am now told that there is calcium buildup on my aortic valve, which I had replaced four years ago.

I also have prostate cancer and have been prescribed Orgovyx, along with 1,000 mg of calcium due to Orgovyx weakening the bones. What is your opinion? Does the calcium supplement add to the calcium buildup more than it benefits my bones? Would my vascular system stop building up calcium if I stopped taking the calcium supplement?

-WH.

Answer: There is some evidence that calcium supplements increase the risk of calcium deposition in blood vessels, but evidence is mixed. There are strong studies showing that there is no risk from supplements.

Without a consensus, I can't say for sure whether stopping the calcium supplement will protect your arteries. Stopping calcium supplements would not stop the calcium buildup in the blood vessels, as this process happens in many people who do not take calcium supplements. But stopping supplements may slow it down.

It is clear that calcium is necessary for bones. Orgovyx blocks the body's ability to make testosterone. Without testosterone, prostate cancer cells have a much harder time growing, but the bones will get weaker as well. However, there are other ways to protect your bones, with standard treatments for osteoporosis like Fosamax or Prolia if the bones are already affected.

Calcium is still needed, even with a medicine to reduce the loss of mineral from the bones. Dietary calcium does not increase the risk of calcium in the blood vessels in the same way that calcium supplements do.

It is not hard to get enough calcium in the diet through dairy; almonds; lentils; leafy, green vegetables; and small fish with the bones still intact, such as canned sardines and salmon. This is the best way to get the benefits of calcium for your bones without potential harm to your blood vessels.

Dear Dr. Roach: If someone has already had meningitis, are they less likely to get it in the future?

-S.G.

Answer: The most common causes of meningitis vary dramatically by age. Neisseria meningitidis, the bacteria that is the target of the meningitis vaccine, is most commonly found in adolescents and young adults. For middle-aged and older adults, the most common is Streptococcus pneumoniae, which causes pneumonia as its name suggests. This is the target of pneumonia vaccines such as PCV20 or PCV21. There are less-common bacteria, including Staphylococcus and Listeria.

Some infections lead to immunity from future infections, so I understand your question. Unfortunately, since there are so many causes, getting meningitis once does not protect you from getting it again.

In the case of Neisseria, the risk of developing a recurrence of the same meningitis is more than 50 times the average risk. There are immune deficiencies that can predispose a person to recurrent infections and anatomical abnormalities, which similarly put a person at a higher risk.

A person with prior meningitis should take preventive maneuvers, such as getting a vaccination. A person with an anatomical issue, like a cerebrospinal fluid leak, should have it repaired if possible. All adults are recommended for the pneumonia vaccine, mostly to prevent pneumonia, but it helps prevent other types of pneumococcal disease, including meningitis.

Contact Dr. Roach at: ToYourGoodHealth@med.cornell.edu.