This is the lecture delivered by Dr. Cady at the Evansville Public LIbrary on February 27, 2013. My apologies for the lateness. I attempted to post this once and it didn't "take." this lecture will be repeated, with some updates, on April 4th, 2013, again at the downtown Evansville Public LIbrary. The room is extraordinarily good in which to present. LIve attendance is encouraged and invited!

1. How to Live Longer Than Your Doctor
Louis B. Cady, MD – CEO & Founder – Cady Wellness Institute
Adjunct Clinical Lecturer – Indiana University School of Medicine
Department of Psychiatry
Child, Adolescent, Adult & Forensic Psychiatry – Evansville, Indiana
This presentation and webinar is © Louis B. Cady M.D. and
may not be reproduced or used without permission.

2. “There are two objects of medical education: to
heal the sick and to advance the science.”
- Dr. Charles H. Mayo, MD
“The glory of medicine is that it is always moving
forward, that there is always more to learn.”
- Dr. William J. Mayo

3. Cady Wellness Institute – July 2005
The Reasons:
• Conventional medical practice had failed me twice.
• A lot of “psychiatric cases” WEREN’T “psychiatric.”
• Nobody was integrated.
• Nobody was looking at ALL of the peer-reviewed
literature.

4. CURRENT PRACTICE OF MEDICINE:
What a patient had to say about her “specialists”:
•“They just monitor
my degeneration.”

5. Differences in life expectancy (2006-
08) – as a function of age

6. “F as in Fat – How Obesity Threatens America’s
Future 2012” – Robert Wood Johnson foundation
Current
and future
IN obesity
rates:
2011 – 25 %
2030 –
49.5%
(if BMI reduced
5%)
2030 – 56%
http://healthyamericans.org/report/100/

7. S
N
O
TI
C
A
BODY
D
IN
M

8. The Functional Medicine component
Dead Doctors Don’t Lie - Joel Wallach, DVM, ND

9. Physicians – what are your betting
odds?
• Population: US physicians, 28 states, 1984-1995
– (Occupation per US Bureau of Census)
• 73.0 years – white; 68.7 years (African American)
– 72.3/62 years of age. – lawyers.  
• 70.9/65.3 – all professionals
• MD’s more likely to die of cerebrovascular
disease, accidents, and suicide.
• [Confounds: old study, more stress now]
Frank E, et al. Mortality rates and causes among U.S. physicians.
Am J Prev Med. 2000 Oct;19(3):155-9.

10. Longevity stats for average
Americans
• 77.9 years of age - in 2007
– Source: Centers for Disease Control and
Prevention.
– http://well.blogs.nytimes.com/2009/08/19/us-life-expectancy-at-all-time-high/
• ½ of deaths due to heart disease and cancer
• Among 15 leading causes of death, mortality rates
dropped for 8 of them.
(c) 2013 Louis B. Cady, M.D. - all
rights reserved

11. Fat Docs
• Positive correlation between BMI and &
mortality
• 85,078 men ages 40 – 84 in Physician’s
Health Study enrollment
– “The relative risks of all cause mortality
increased in a stepwise fashion with increasing
BMI.”
– Alani UA et al. Body mass index and mortality among US male
physicians Ann. Epidemiol. 2004 Nov;14(10):731-9.
(c) 2013 Louis B. Cady, M.D. - all
rights reserved

12. Aging in America: The New Paradigm
•The Oldest Swim Medalist in Olympic History
•41 Year Old Dara Torres
“Don’t put an Age Limit on your Dreams” – Dara Torres

14. Aging in America - 80 – The 3rd Half of Life!
www.bobdelmonteque.com

15. What can you do at 100?
• Rita Levi Montalcini, MD
• Nobel Prize – Medicine 1986
• Birthday – April 18, 1909
• “At 100, I have a mind that is
superior – thanks to
experience – than when I
was 20.”
• “Above all, don’t fear difficult moments. The
best comes from them.”

16. Oxidative stress, and free
radicals….
WHERE DO ALL THE FREE
RADICALS COME FROM?

17. What causes oxidative stress?
• Environmental Toxins
– Heavy metals – including Mercury (fillings!)
– Pesticides/herbicides
– Preservatives
– PCB’s, Dioxins, Phthalates
• Toxins produced in the body
– Yeast and bacteria
– Products of cellular metabolism
• Emotional Stress
– Anxiety/Tension
– Fear
– Anger

19. Oxidative stress in the BRAIN

20. Why is the brain so
susceptible to oxidative stress?
• Burns glucose – generates free radicals.
• Uses 20% of total oxygen and energy consumed
by the body.
• ½ of this is for electrochemical nerve
transmission.
• Contains IRON
• Contains essential fatty acids, which can be
OXIDIZED (“rancid fat”)
• Limited supply of own antioxidants
• Limited ability to regenerate/repair damage

21. What are some consequences of
oxidative stress?
• Impaired cognitive function
• Decreased memory
• Depressed immune system
• Increased inflammation
• DNA damage
• cancer
• Behavioral deterioration

22. - 27,000,000,000,000,000 (27 TRILLION) pounds of chemicals
produced in or imported to US, each year.
- Amer. Acad. Of Pediatrics – note “thousands of chemicals” children
are exposed to daily.

23. Age-related changes in total blood mercury levels for
females 16 – 49 years of age, 1996-2006.
Source: 4th National Report on Human Exposure to Environmental Chemicals. CDC 2009.

24. “The results show that America’s pets are serving as
involuntary sentinels of the widespread chemical
contamination that scientists increasingly link to a growing
array of health problems across a wide range of animals –
wild, domesticated, and HUMAN.”
(c) 2013 Louis B. Cady, M.D. - all
Nadenko,O et al. High levels of toxic industrial chemicals contaminate cats and dogs.
rights reserved
April 2008. Environmental Working Group. www.ewg.org/reports/pets - accessed 2/13/2013

25. • 46 total pollutants
– 9 carcinogens
• 35 total pollutants – 40 reproductive toxins
– 11 carcinogens – 34 neurotoxins
– 31 reproductive toxins – 15 endocrine disruptors
– 24 neurotoxins • (inc. thyroid toxins)
• Epidemiology • Epidemiology
– Thyroid disease increasing
– 35X more skin cancer
– Correlation between eating
– 4X more breast tumors canned food and developing
– 8X more bone cancer hyperthyroidism later in life.
– 2X risk of leukemia • Self grooming: lick off
– 20-25% die of cancer accumulated dust (PBDE’s and
pthalates)
Nadenko,O et al. High levels of toxic industrial chemicals contaminate cats and dogs.
April 2008. Environmental Working Group. www.ewg.org/reports/pets - accessed 2/13/2013

26. Environmental working group (baby)
cord blood study - 2009
• 10 minority newborns from five states – tests were for > 300 chemical
sat a cost of $10,000 per baby. Two year study (2007 – 2008)
• 232 toxic chemicals found
– Bisphenol A (estrogen like chemical in plastics – linked to early
puberty & childhood obesity, neuro and behavioral changes (found
in 9/10 babies)
• Aggression in little girls
• Sexual problems in men
– Tetrabromobisphenol A (toxic flame retardant for computer circuit
boards)
– Perfluorobutanoic acid (Teflon family – for non-stick cooking)
Ref: http://www.mnn.com/health/fitness-well-being/blogs/232-toxic-chemicals-found-in-10-newborns
(c) 2013 Louis B. Cady, M.D. - all rights reserved

27. 1976 – 2009
METASTATIC breast cancer:
- Compounded increase of 2.07% per
year over 34 year period
(c) 2013 Louis B. Cady, M.D. - all
rights reserved

28. Observational study of randomly selected men –
Boston
3 cohorts of men: 1987-1989; 1995-1997; 2002
-2004.
1374, 906, and 489 men, respectively.
“Age independent decline in T that does not appear to
be attributable to observed changes in explanatory
factors, including lifestyle characteristics such as
smoking and obesity.”
“Recent years have seen a SUBSTANTIAL, and as
yet UNRECOGNIZED age-independent population-
November 2009
level decrease in T in American men.”
“Alpha Male” issue
Travison, Araujo, et al. Jrnl of Clin. Endocrinol & Metabol 92:1; 196-202.

29. Mitochondrial Damage:
Loss of Energy
Mitochondria
Free radical
damage alters
their energy
production
capability. Plus,
they “breathe
their own
exhaust.”

30. WHAT TO DO?

31. Modern Medicine’s Paradigm:
Two Standard Deviations – “if you are not
sick, then you must be well.”
“NORMAL”
OPTIMAL?
OPTIMAL

32. Average (normal) or optimal?
• Would you like an normal wife (husband) or
an optimal one?
• Would you like a “normal” marriage or an
exciting and optimal one?
• Would you like a “normal” sex life or would
you like to have an optimal (!!) stimulating
one?
• Would you like “normal” labs or
OPTIMAL ones?

33. LEVEL III RESULTS:
Per HDRS – 17, remission in:
15.9% on Li
24.7% on T3
Per QIDS-SR16, remission in:
13.2% on Li
24.7% for T3 *
* Fava & Covino: Augmentation/Combination Therapy in STAR*D Trial,
Medscape Psychiatry

34. 63 patients with “subclinical hypothyroidism”
HAM-D and MADRS scales with serum TSH Free T4, free T3
TPO AB and Tg-AB levels
Prevalence of depressive symptoms in this
population was 63.5%
“This study suggests the importance of a psychiatric
evaluation in patients affected by subclinical
hypothyroidism.” Hunh?

35. (permission granted to use photos & data)

36. (permission granted to use photos & data)

37. • Early 20’s college student
• Weight gain, fatigue, brain fog
• Saw “numerous” MD’s asking for help
• Told “nothing is wrong with your thyroid;
your labs are fine.”
(permission granted to use photos & data)

38. (permission granted to use photos & data)

39. (c) 2013 Louis B. Cady, M.D. - all
rights reserved

40. “Low thyroid”
So what do most doctors check?!
TSH
T4 T3
In the presence of cortisol…
Reverse T3 = NOT
USEFUL thyroid
hormone

41. Consequences of untreated
hypothyroidism
• Central nervous system:
– Fatigue!
– Drowsiness
– Poor memory and concentration
• Decreased metabolism:
– Body weight increases
– Heat production goes down
– Basal metabolic rate goes down
• Gut: decreased activity; constipation
• Cardiovascular – decreased cardiac
output; blood pressure falls
• INEXORABLE WEIGHT GAIN –
INCREASED BMI.

42. OK – how do we stack the odds
• Wear your seatbelt.
– (reduces risk of serious injury or death by 50%)
– CDC statistics http
://www.cdc.gov/motorvehiclesafety/seatbelts/index.html
• Don’t smoke, and if you do smoke, STOP.
– More deaths each year from smoking than HIV, illegal drug use, alcohol
use, motor vehicle injuries, suicides and murders combined.
• CDC. Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses-
United States, 2000-2004. Morbidity and Mortality Weekly Report 2008;57(45):122-8.
• Lose weight. If you can’t, find out WHY and do something
about it.
• Get appropriate cancer screenings.
(c) 2013 Louis B. Cady, M.D. - all
rights reserved

43. “Excess body weight is correlated with excess morbidity
and mortality. In particular, Grade 2 or higher obesity
(BMI>35) significantly increases the risk of death.”
(c) 2013 Louis B. Cady, M.D. - all
(www.cdc.gov/nchs/data/hus/hus11_InBrief.pdf)
rights reserved

44. Health maintenance screens - women
source: American Cancer Society
• Breast exams every 3 years – women, 20’s and
30’s
– Every year for women 40 and over
– MRI screening appropriate in some women (<2%)
– Yearly mammograms > age 40
• Cervical screening
– Age 21
– “PAP smear every 3 years.” ages 21 – 29.
– “30 – 65 years of age PAP plus HPV every 5 years”

45. “Do you feel
lucky?”
(c) 2013 Louis B. Cady, M.D. - all
rights reserved

46. Further screening guidelines
• After 50:
– colonoscopy (the best) – every 10 years
– Flex sig, “DCBE”, CT scan- every 5 years
– EVERY YEAR – “fecal occult blood test.”
• Prostate cancer:
– Former – DRE of the prostate every year > 40
– Current: “men make an informed decision about
whether or not to be tested for prostate cancer.”
• My recommendation: every year after 40
– Digital rectal exam and PSA with % Free PSA if over 4

47. Addresses Nutrient Deficiencies
Get ADEQUATE nutrients, not just the
bare minimum from “RDA”
Optimal nutrient
level supported by
safety and efficacy
studies
RDA level
critical level
deficiency syndrome
Rx: Any “MVI” used should have its results
MEASURED

49. The Physicians’ Health Study II
• Take a multivitamin!
CONCLUSIONS: “Daily multivitamin
supplementation modestly but
significantly reduced the risk of total
cancer.”

50. The Critical Tests
You(& your doc!!!)
Need to Have…
But THAT YOUR DOCTOR IS
NOT ORDERING…
(c) 2013 Louis B. Cady, M.D. - all
rights reserved

51. The tests that we do at CWI
that I recommend:
• SEX HORMONES:
– Estradiol
– Free and total testosterone
– Progesterone (women)
– Sex hormone binding globulin
• Adrenal: DHEA-S, 2 –4 cortisols
• Thyroid:
– TSH, FREE T4, FREE T3, and REVERSE T3
– If autoimmune thyroid disease (family or self):
• Antithyroid antibodies
• Antithyroglobulin antibdoies
(c) 2013 Louis B. Cady, M.D. - all rights reserved

52. The tests that we do at CWI
that I recommend:
• CBC CBC CBC CBC
– Anemia is rampant!
• PSA PSA PSA PSA
• Inflammatory markers:
– Homocysteine, (highly sens)-C-reactive protein
• Nutrient markers:
– RBC Mg, RBC Zn, MMA (for B12)
• Salivary and urine testing – for adrenal panel,
hormones and NEUROTRANSMITTERS.
(c) 2013 Louis B. Cady, M.D. - all rights reserved

53. What if we could just look at neurotransmitters
like they would on Star Trek ?
Cell rate 

54. Low estrogen, DHEA, cortisol, and low NT’s – putting it all together
52 yo woman, s/p TAH with fatigue and depression
Hormone Value norms
Cortisols All barely various
above
pathological
DHEA 47.66 {106-300}
Estradiol (E2) <1.00 {1.0 – 3.2 =
post
menopausal}
Testosterone 8.44 {6.1 – 49 –
female}

55. HOW TO MEASURE
supplement effects (Benefits)
(c) 2013 Louis B. Cady, M.D. - all
rights reserved

56. RAMAN SPECTROSCOPY
A blue LED light is shined into your hand for
90 seconds. The computer determines your
total carotenoid antioxidant level by “Raman
Shift.”
(c) 2013 Louis B. Cady, M.D. - all
rights reserved

57. (c) 2013 Louis B. Cady, M.D. - all
rights reserved

58. (c) 2013 Louis B. Cady, M.D. - all
rights reserved

59. Skin Carotenoid score
40,000+:
“Safe Zone”
50,000 and Higher
40,000 to 50,000
30,000 to 40,000
20,000 to 30,000
10,000 to 20,000
Less than 10,000

60. Skin carotenoids distribution – a “lump left” bell
curve distirbution
Scan of 1375 people – carotenoid levels ranged from:
 A low of 1500 – cancer patient.
 A high of 73,000 – a 2-month old baby!
The mean score was 19,281 – (very scary).

61. What to do??
(c) 2013 Louis B. Cady, M.D. - all
rights reserved

62. WILL an apple a day keep the doctor
away?
• Liu S, et al. Intake of vegetables rich in carotenoids and risk of coronary heart disease in
men: The Physician’s Health Study. Int. J Epidemiol. 2001 Feb;30(1):130-5.
• Findings adjusted for age, randomized treatment,
BMI, smoking, alcohol intake, physical activity, DM
history, HTN history, high cholesterol, use of
(conventional) MVI’s..
• 2.5 servings/day of vegetables had a
“RR (relative risk) of 0.77” for CAD vs.
men in lowest category
– (<1 serving per day)
(c) 2013 Louis B. Cady, M.D. - all
rights reserved

63. A Double Blind Placebo Study Showing
the Effect of [a high quality supplement] on Skin Carotenoid Scores
CWI recommended
MVI

64. If needed, supplement!
(c) 2013 Louis B. Cady, M.D. - all
rights reserved

65. So why do you need a
SYSTEM in your vitamin
supplement/mineral
complex?? And what’s a
‘nano’?

67. Wrapping Up: The “Survival Curve” –
Where Are You?

68. HOW OBVIOUS DOES IT HAVE TO BE?
Ron Hunt lost an eye but suffered
no brain damage after a freak
accident with a large drill bit.
(ABCNEWS.com)

69. A personal close:
How do YOU want to age?
Me – Jan 2013

70. Success and Failure (Jim Rohn)
What about you? You’ve only got one body.
• “Errors in judgement” - High glycemic eating,
no exercise, poor nutrition, obesity no labs and
“flying blind”, lousy/no supplementation, high
stress lifestyle.
- “Good disciplines” – appropriate diet, labs,
supplementation, exercise, hormones. Stress
management. Rational lifestyle.

71. Contact information:
Louis B. Cady, M.D.
www.cadywellness.com
www.tms-relief.com
Office: 812-429-0772
Presentation slides:
www.slideshare.net/lcad
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