Dear Doctor: Calcium is frequently recommended to reduce the risk of bone fractures in the elderly, but I've read that calcium builds in the arteries and heart. So what choice do women have -- die of a hip fracture or die of a heart attack? Personally, I don't know which would be better.

Dear Reader: You highlight an interesting issue. There is no doubt that calcium is beneficial for bones, with supplementation improving bone density and -- at 500 to 1,200 milligrams per day -- leading to a 9 to 19 percent decrease in the rate of hip fractures. But it's true that supplements may have risks as well.

First, for women over 50, supplementation with 1,000 mg of calcium and 400 IU of vitamin D leads to a 17 percent increased risk of kidney stones. Second, calcium supplementation for people with kidney dysfunction or those on dialysis causes increased calcification of blood vessels and a greater risk of heart attacks and strokes.

A 2008 study of 1,471 postmenopausal women in New Zealand compared the effects of 1,000 mg of calcium citrate to those of a placebo. In five years of follow-up, women who took the calcium had an improvement in the ratio of their good to bad cholesterol (HDL/LDL). However, after 2 1/2 years, the group that took the calcium started to show an increased risk of heart attacks; after five years, they had a 49 percent increased risk.

Then there was a 2010 British Medical Journal study that combined data from 11 studies in which women took elemental calcium supplements of 500 mg or more. The studies, which evaluated fracture risk and bone density, weren't intended to assess heart attack and stroke risk, but researchers did gather data on the conditions. In total, the group that took calcium had a 27 percent increased risk of heart attacks and a 12 percent higher risk (not considered statistically significant) of strokes.

In 2011, the same authors tackled data from the Women's Health Initiative (WHI) study in which 36,282 women took 1,000 mg of calcium and 400 IU of vitamin D or a placebo for seven years. The initial study did not reveal an increase in heart attacks among women taking calcium supplements, but as it turned out, 54 percent were taking additional calcium beyond the supplements that were part of the trial. Noting this, the authors of the study compared their data with data from the 46 percent who were not taking additional calcium. They found that the group taking the 1,000 mg of calcium had a 16 percent increase in the rate of heart attacks.

Other grouped studies (using the initial data of the WHI study) have not shown this degree of risk with calcium supplementation.

Confusing, isn't it? Here's the take-home message: If you're otherwise healthy, taking up to 1,000 mg of calcium supplements may be safe. But if you have risk factors for a heart attack or stroke, such as a history of smoking, diabetes, kidney dysfunction or a significant family history of heart disease, I would avoid large doses of calcium and would, in fact, limit calcium supplement intake to no more than 500 mg per day. It's all about balancing bone health with overall health.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: My husband, who is 79, was diagnosed with Grover's disease. I don't know if that's the cause of his depression, but now he just sits in his recliner all day. He's also moody, confrontational and seems to have given up on life. Is there really no hope for us?

Dear Reader: We're very sorry to hear about the struggle you and your husband are now going through. Disease is often more than merely physical, and the distress it causes a patient can have a profound effect on the entire family.

Grover's disease, which is also known as transient acantholytic dermatosis, is a rare skin condition. It is characterized by itchy red bumps, most commonly on the patient's chest or back. Because a feature of the disease is the gradual loss of the "glue" that holds our skin cells together, watery blisters can form. Grover's disease is mostly seen in men over the ages of 40 or 50, though some women have been affected. The cause is not known, and, at this time, there is no cure.

The skin eruptions, which are often unbearably itchy, can last for weeks or months. In some cases, the disease spontaneously resolves within a year. For some individuals, however, it persists indefinitely. Treatment consists of managing the patient's discomfort. Topical high-potency steroids and antihistamines can offer short-term relief. In some cases, light therapy has been found to be helpful.

While depression is not among the symptoms of Grover's disease, it can certainly be a side effect. In fact, depression is among the most common complications of all chronic disease. It's estimated that one-third of patients diagnosed with a chronic illness or a serious medical condition will experience symptoms of depression.

In your husband's case, he is dealing with a disease that's mysterious, incurable and profoundly uncomfortable. It comes at a stage of life when, with a career behind them, children grown and gone, and friends and siblings beginning to pass away, many elderly people become prone to depression. It's not at all surprising that his response has been to withdraw. But depression brings its own set of health challenges. People who are chronically depressed have higher rates of heart disease and stroke. A new study has linked it to dementia.

Your first challenge is to persuade your husband that he can benefit from medical help. Unlike Grover's disease, depression can be successfully treated with medication, if he's open to it, and talk therapy. Since he has become moody and confrontational, it's a good idea to consider who is the best person to broach the idea with him. If you're comfortable having the discussion, we urge you to do so. Perhaps a trusted friend or a family member can lend a hand. Early diagnosis and treatment can reduce distress and head off complications.

Even with treatment, it can take weeks and even months for depression to loosen its grip. If your family can be supportive and understanding, it will be a big help. And as your husband is working his way back, be sure to take care of yourself. Stay engaged with the world, spend time with friends and family, and perhaps consider joining a support group.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: How important is radon as a cause of lung cancer? Should I get my home tested?

Dear Reader: Just a few years ago, radon was the topic of seemingly limitless public and media fascination. Times may have changed, but the presence of radon has not. To answer your question, let's take a closer look at this radioactive element.

A colorless, odorless gas that can be inhaled, radon is produced normally in our environment from the radioactive decay of the elements uranium, radium and thorium. Radon is not a stable element, and its many isotopes are subject to rapid radioactive decay, leading to the release of radioactive particles. This decay also produces solid radioactive elements that can attach to dust particles, which can also be inhaled.

The problem with radon is that exposure to its radioactive particles may lead to cancer, specifically lung cancer. A 2006 study of 59,001 uranium miners followed for 30 years in Germany found a much higher number of lung cancers in those with greater exposure to radon. The highest incidence of lung cancer was seen 15 to 24 years after exposure. Uranium miners in the Colorado Plateau also appear to have an increased risk of lung cancer.

Those who don't mine uranium can't ignore the issue, however. The Iowa Radon Lung Cancer Study, published in 2000, looked at 413 lung cancer cases in Iowa women, ages 40 to 84. The study measured amounts of radon in the homes of those patients who had lived in the same house for more than 20 years. It also measured radon levels in the homes of women with similar ages, smoking histories and work histories who didn't have cancer.

The authors found that 60 percent of the home basements of women with lung cancer exceeded the Environmental Protection Agency limits for radon levels; and 30 percent of the first-floor spaces exceeded those limits. Based on an analysis of radon levels in the control group, the study concluded that increased radon levels led to increased rates of lung cancer.

Subsequently, a combined analysis of 13 European studies evaluated radon levels in the homes of lung cancer patients who had lived there for a minimum of 15 years. For every quantile increase in radon levels, the rate of lung cancer increased by 8.4 percent. Note, however, that smoking played a large part in this increase. When smoking was removed from the equation, the level of increased risk was only 2.3 percent per quantile increase in radon. The authors theorized that, out of all the causes of lung cancer, radon is responsible for 9 percent.

Radon exposure is higher for some people than for others. It enters homes and other buildings through the soil and can build up inside, especially in structures that don't have good ventilation. This is more problematic in winter months when windows are more likely to be closed.

Further, some areas of the country, such as Iowa and the Appalachian Mountains of Pennsylvania, have naturally higher levels of radon. New homes in these areas are constructed to prevent radon from entering and building up inside, and the EPA recommends that all houses be tested. If you're curious about your own area, the EPA has maps showing which zones of the country have more radon.

The take-home message: Radon exposure is considered a substantial risk factor for lung cancer. If you live in a part of the country where radon levels are high, you should have your home tested.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)