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This week we respond to questions about late diagnosis of cancer and treating hypertension with supplements.

Dear HOUSE Calls,

My aunt was just diagnosed with Stage 4 cancer, and I want to know why she didn’t find it sooner. It’s always been a problem in my family that people don’t like to go to the doctor for check-ups.

Why is that, and how can I help the younger members of my family?

We are so sorry for your aunt’s diagnosis. This must be a difficult time for her and your family.

There are a lot of reasons that people don’t go to the doctor. Maybe they don’t trust doctors. Maybe they prefer just not to know. Maybe they can’t afford to see the doctor, or it is just too far away or otherwise inconvenient. Maybe they don’t think they need to go unless there is a problem. Maybe they are scared there is a problem.

We share your sadness and frustration when we see patients too late. All of these problems are surmountable. But perhaps the hardest two issues to address are lack of trust and just not wanting to know if something is wrong.

The medical community in this country did some things in the early 20th century in terms of unethical research on poor people, prisoners, children with developmental disabilities, and African Americans. Most of these things we now consider grossly unethical and even deplorable, but the mistrust over those events lingers, even as ethical standards for research have changed to protect the rights of patients.

As far as your family members, perhaps the most important thing you can do is encourage that they develop a relationship with a trusted personal primary care clinician. Good luck.

Dear HOUSE Calls,

What alternative supplements can you recommend for high blood pressure?

You will find a variety of products available if you just start searching on the internet, but as with all supplements, the quality and consistency of these products are a challenge. In general, the volume and quality of the research literature is limited. On the upside, most of these things are safe.

We should be clear that we are not trained as naturopaths or homeopaths.

Certainly there is a lot of information on supplements such as omega-3 fatty acids, calcium, and co-Q 10. We could quickly find 30 supplements promoted for treatment of hypertension, but the question is, what works well? That’s harder to answer.

The most promising alternative to medicines for high blood pressure is a special diet called the DASH diet (stands for Dietary Approaches to Stopping Hypertension), which is a low saturated fat, high fiber, low sodium diet. Weight loss and exercise are important additions to diet that are proven to reduce blood pressure.

Also, treating sleep apnea if you have it is very important in reducing blood pressure. Hopefully that will get you started.

HOUSE Calls is a weekly column by Dr. Cristy Page, Dr. Adam Zolotor, and Dr. Adam Goldstein on behalf of YOUR HEALTH™ and the UNC Department of Family Medicine.

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