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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!

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  1. 1. How to Live Longer Than Your DoctorLouis B. Cady, MD – CEO & Founder – Cady Wellness Institute Adjunct Clinical Lecturer – Indiana University School of Medicine Department of PsychiatryChild, 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. 2. “There are two objects of medical education: toheal 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. 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. 4. CURRENT PRACTICE OF MEDICINE:What a patient had to say about her “specialists”: •“They just monitor my degeneration.”
  5. 5. Differences in life expectancy (2006- 08) – as a function of age
  6. 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 reduced5%)2030 – 56%
  7. 7. S N O TI CA BODYD IN M
  8. 8. The Functional Medicine component Dead Doctors Don’t Lie - Joel Wallach, DVM, ND
  9. 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. 10. Longevity stats for average Americans• 77.9 years of age - in 2007 – Source: Centers for Disease Control and Prevention. –• 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. 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. 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
  13. 13. Aging in America - 80 – The 3rd Half of Life!
  14. 14. 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.”
  15. 15. Oxidative stress, and freeradicals…. WHERE DO ALL THE FREE RADICALS COME FROM?
  16. 16. 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
  17. 17. Oxidative stress in the BRAIN
  18. 18. 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
  19. 19. What are some consequences of oxidative stress?• Impaired cognitive function• Decreased memory• Depressed immune system• Increased inflammation• DNA damage• cancer• Behavioral deterioration
  20. 20. - 27,000,000,000,000,000 (27 TRILLION) pounds of chemicalsproduced in or imported to US, each year.- Amer. Acad. Of Pediatrics – note “thousands of chemicals” childrenare exposed to daily.
  21. 21. 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.
  22. 22. “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. - allNadenko,O et al. High levels of toxic industrial chemicals contaminate cats and dogs. rights reservedApril 2008. Environmental Working Group. - accessed 2/13/2013
  23. 23. • 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. - accessed 2/13/2013
  24. 24. 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: (c) 2013 Louis B. Cady, M.D. - all rights reserved
  25. 25. 1976 – 2009 METASTATIC breast cancer:- Compounded increase of 2.07% peryear over 34 year period (c) 2013 Louis B. Cady, M.D. - all rights reserved
  26. 26. 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 tobe attributable to observed changes in explanatoryfactors, including lifestyle characteristics such assmoking and obesity.”“Recent years have seen a SUBSTANTIAL, and asyet UNRECOGNIZED age-independent population- November 2009level decrease in T in American men.” “Alpha Male” issueTravison, Araujo, et al. Jrnl of Clin. Endocrinol & Metabol 92:1; 196-202.
  27. 27. Mitochondrial Damage: Loss of EnergyMitochondria Free radicaldamage alterstheir energyproductioncapability. Plus,they “breathetheir ownexhaust.”
  28. 28. WHAT TO DO?
  29. 29. Modern Medicine’s Paradigm:Two Standard Deviations – “if you are not sick, then you must be well.” “NORMAL” OPTIMAL? OPTIMAL
  30. 30. 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?
  31. 31. 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
  32. 32. 63 patients with “subclinical hypothyroidism”HAM-D and MADRS scales with serum TSH Free T4, free T3TPO 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?
  33. 33. (permission granted to use photos & data)
  34. 34. (permission granted to use photos & data)
  35. 35. • 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)
  36. 36. (permission granted to use photos & data)
  37. 37. (c) 2013 Louis B. Cady, M.D. - all rights reserved
  38. 38. “Low thyroid” So what do most doctors check?!TSH T4 T3 In the presence of cortisol… Reverse T3 = NOT USEFUL thyroid hormone
  39. 39. 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.
  40. 40. OK – how do we stack the odds• Wear your seatbelt. – (reduces risk of serious injury or death by 50%) – CDC statistics http ://• 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
  41. 41. “Excess body weight is correlated with excess morbidityand mortality. In particular, Grade 2 or higher obesity(BMI>35) significantly increases the risk of death.” (c) 2013 Louis B. Cady, M.D. - all ( rights reserved
  42. 42. 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”
  43. 43. “Do you feel lucky?” (c) 2013 Louis B. Cady, M.D. - all rights reserved
  44. 44. 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
  45. 45. 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 syndromeRx: Any “MVI” used should have its results MEASURED
  46. 46. The Physicians’ Health Study II • Take a multivitamin!CONCLUSIONS: “Daily multivitaminsupplementation modestly butsignificantly reduced the risk of totalcancer.”
  47. 47. The Critical TestsYou(& your doc!!!)Need to Have…But THAT YOUR DOCTOR ISNOT ORDERING… (c) 2013 Louis B. Cady, M.D. - all rights reserved
  48. 48. 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
  49. 49. 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
  50. 50. What if we could just look at neurotransmitters like they would on Star Trek ? Cell rate 
  51. 51. Low estrogen, DHEA, cortisol, and low NT’s – putting it all together 52 yo woman, s/p TAH with fatigue and depressionHormone Value normsCortisols All barely various above pathologicalDHEA 47.66 {106-300}Estradiol (E2) <1.00 {1.0 – 3.2 = post menopausal}Testosterone 8.44 {6.1 – 49 – female}
  52. 52. HOW TO MEASUREsupplement effects (Benefits) (c) 2013 Louis B. Cady, M.D. - all rights reserved
  53. 53. RAMAN SPECTROSCOPYA blue LED light is shined into your hand for90 seconds. The computer determines yourtotal carotenoid antioxidant level by “RamanShift.” (c) 2013 Louis B. Cady, M.D. - all rights reserved
  54. 54. (c) 2013 Louis B. Cady, M.D. - all rights reserved
  55. 55. (c) 2013 Louis B. Cady, M.D. - all rights reserved
  56. 56. Skin Carotenoid score40,000+:“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
  57. 57. Skin carotenoids distribution – a “lump left” bell curve distirbutionScan 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).
  58. 58. What to do??(c) 2013 Louis B. Cady, M.D. - all rights reserved
  59. 59. 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
  60. 60. A Double Blind Placebo Study Showingthe Effect of [a high quality supplement] on Skin Carotenoid Scores CWI recommended MVI
  61. 61. If needed, supplement! (c) 2013 Louis B. Cady, M.D. - all rights reserved
  62. 62. So why do you need aSYSTEM in your vitaminsupplement/mineralcomplex?? And what’s a‘nano’?
  63. 63. Wrapping Up: The “Survival Curve” – Where Are You?
  64. 64. 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. (
  65. 65. A personal close:How do YOU want to age? Me – Jan 2013
  66. 66. 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.
  67. 67. Contact information: Louis B. Cady, M.D. Office: 812-429-0772 Presentation slides: Download fromiTunes or Android App store now!