Get a Coronary Artery Calcium Score by Age 45
Dr. Gottfried's single most important recommendation for women is a test most conventional doctors never order: a coronary artery calcium score. It is a CT scan of the chest that gives you a concrete number representing plaque buildup in the arteries feeding your heart. A score of zero means low near-term risk. Any elevation is a fork in the road that tells you exactly how seriously you need to treat your cardiometabolic health right now, not in ten years. The reason this matters so much for women specifically is that cardiometabolic disease is the number one killer of women, and the symptoms pointing toward it, hot flashes, night sweats, poor sleep during perimenopause, are routinely dismissed as nuisances rather than read as biomarkers. Dr. Gottfried is direct: hot flashes and night sweats are biomarkers of increased bone loss, cardiometabolic risk, and changes in the brain. Getting a calcium score before or around age 45, and earlier if there is any family history of premature heart disease, turns a vague risk into a number you can actually act on. You can self-order it without a physician's referral.