The document discusses challenges and opportunities for healthcare in America. It begins by introducing the author, Louis B. Cady, MD, and his background. It then outlines several problems facing American healthcare, including declining health, a shrinking middle class, rising costs, and fewer doctors. Recessions, outsourcing, increased medical technology, and more government interference are cited as contributing factors. The results are discussed as higher insurance costs, fewer doctors, and implicit rationing by insurance companies and the government. The document calls for Americans to take responsibility for their health to reduce costs.

1. The Gathering Storm, The Breaking Dawn:
New Challenges & Opportunity for the Health of America
Louis B. Cady, MD – CEO & Founder – Cady Wellness Institute
Adjunct Clinical Lecturer – University of Southern Indiana
Adjunct Clinical Lecturer – Indiana University School of Medicine
Department of Psychiatry
Child, Adolescent, Adult & Forensic Psychiatry – Evansville, Indiana

2. Disaster awaits.
“If some real disaster impends in the city, it is not because
parking spaces are hard to find, because architecture is
bad, because department store sales are declining, or even
If there is a genuine
crisis, it has to do with the essential welfare
of individuals or with the good health of the
society, not merely with comfort, convenience,
because taxes are rising.
amenity, and business advantage, important as these
are.”
from The Unheavenly City, Edward C. Banfield, 1968, 1970

3. www.slideshare.net/lcadymd

4. Here it is again… :)
www.slideshare.net/lcadymd

5. Learning objectives
• Define a problem: America is unhealthy, and the
middle class is shrinking.
• Explore the tautomerism between medical
economics & availability of care.
• Answer the question of “but I just don’t GET it
about those antioxidants.”
• Answer the objections about the scanner “gizmo.”
• Review the literature. Achieve state of the art, up
to date knowledge.
• Review some personal reflections.

6. The health of society & the doctors to
treat it
And why we should all start paying
attention to those “filthy rich doctors” and
how they are getting paid.
• America’s health is declining.
• Doctors are going to get squeezed: more will quit,
YOUR out of pocket costs are going up.
• Americans will have less money to pay for bigger
health care costs
• Average people need to do something NOW to
maintain health and minimize costs.

7. The Problems & The Solution
The good ole days:
•People had jobs
•People had insurance
•Insurance PAID.
•Society was healthier.
•Doctors were
plentiful.
•Your healthcare was
essentially “free,” no
matter how stupidly
you behaved.
Problems:
•2001/2008
recessions
•Outsourcing
•More medical
technology
•More activism from
groups such that
“everything must be
covered.”
•More government
interference in free
market
The RESULTS:
•Medical insurance costs
more $$$.
•Fewer doctors available.
• Doctors are
quitting.
• Insurance
companies/
government =
defacto
RATIONING.
•Now, you “gonna have
to PAY” for poor health
habits, poor nutrition,
obesity, smoking, etc.

8. Everett Napier, an unemployed miner, said he pawned various items while he has
been looking for work, including rifles, tools, jewelry and two guitars he used to
play at church. 'I just swallowed my pride and quit playing. That's all you can do.'
David Stephenson for The Wall Street Journal. November 26, 2013

10. “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

11. “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/

13. ECONOMY ISSUES

14. February 2, 2004

15. www.billfoster.com - Reviving American Manufacturing, accessed 1 27 2014
www.billfoster.com - Reviving American Manufacturing, accessed 1 27 2014

16. http://www.scdigest.com/assets/newsViews/08-06-12-2.php accessed 01 27 2014
http://www.scdigest.com/assets/newsViews/08-06-12-2.php accessed 01 27 2014

17. Look out Pharma reps!!

19. Unemployment, underemployment are
contemporary problems…

24. Feb 6, 2014
- The “SGR” cut: 24 – 30% of Medicare fees
- Has been “patched” 15 times since 2002 for c. $140 billion
-
Additional source: McDonough J.E. “Health Stew” column 12/22/2013
http://www.boston.com/lifestyle/health/health_stew/2013/12/advice_to_congress_pass_sgr_
accessed 2/7/2014

25. Business 101 – 3 doctor internal
medicine clinic
INCOME
NET Revenue: $1.5 million
Income less
expenses =
ZERO.
This balances.
EXPENSES:
Overhead* : $1 million
[support staff salaries, rent,
depreciation, malpractice insurance,
license fees, “MOC” fees, equipment
costs, consumables, cleaning, office
supplies, facilities insurance,
Workman’s comp, retirement plans for
staff and docs, CME, vacation pay, sick
pay, insurance plans for staff and docs]
Salaries – 3 docs: $500K
Total expenses: $1.5 million

26. Business 101 – 3 doctor internal
medicine clinic
INCOME
(prev) Revenue: $1.5 million
Less 24% cut:
- $360,000
Total income
EXPENSES:
Overhead* : $1 million
[support staff salaries, rent, depreciation,
malpractice insurance, license fees, “MOC”
fees, equipment costs, consumables, cleaning,
office supplies, facilities insurance, Workman’s
now:$1,140,000 comp, retirement plans for staff and docs,
CME, vacation pay, sick pay, insurance plans
for staff and docs]
Income less expenses
= ZERO.
This balances.
Salaries – for 3 docs
= 46,667 per doc
(What’s left over for
salaries: $140,000)
Total expenses: $1.14
million

27. Instant replay
• 24% cut to gross receipts
• 72% cut to doc salaries (from $166,667
down to $46,667
– Working 50 – 60 hours per week
– Hassled by paperwork, Medicare reviewers,
prior authorizations, constant threat of
malpractice lawsuits, continued baseline 2%
inflation per year and no way to make it up.
• WHAT WOULD YOU DO???

28. Medicare patients – you’re safe for now.
So far.

29. Likely developments in healthcare, from
Tyler Cowen, Average Is Over
• “Just as some poorer people will do without fancy
infrastructure, so will others do without advanced
health care.”
• “Since we won't be willing to pay for full-benefit
Medicare and Medicaid for everyone who will need
it, some people will see cut benefits or rationed
access to doctors. Our political system will try to
construct that rationing so that voters blame the
doctors rather than the politicians, but one way
or another rationing will increase.”

32. One solution to higher costs for medical care if you’re an
insurer: fire your doctors so people can’t get to’em.
Connecticut: United Health Group cuts 2,250
physicians (810 primary care, 1,440
specialists) from its “Medical Advantage”
network

33. Another
solution to
financial
outflows from
private insurers
and
Medicaid/Medic
are: close
hospitals &
“reduce beds”
so you’re not
losing money.

34. Heck, let’s run out of saline while
we’re at it.

35. “The United States is expected to have a
shortfall of nearly 160,000 physicians by 2025
– even as allopathic medical schools have
increased their class sizes by 30 percent.”

38. Just because a patient says “I’m insured” and has a card, doesn’t
mean that the doc will be paid.

39. 1. Repeal of SGR
2. Jan 1 2014 – “full” Affordable Care Act
implementation
3. October 1, 2014 – ICD-10 required.
4. “Meaningful use” demanded of EHR’s – to which
physicians must attest by Sept 30.
5. Physician data to be published by Sept 30 under
“Sunshine Act.”

40. Spokesman for Centers for Medicare and Medicaid Services: the
agency was “committed to implementing I.C.D.-10 on Oct. 1,
2014, and that will not change.”
“If you don’t code properly, you don’t get paid.” – W Jeff Terry, MD – Mobile,
“If you don’t code properly, you don’t get paid.” – W Jeff Terry, MD – Mobile,
ALA.
ALA.

43. “Sunshine” in Colorado

53. What are the results of these
pressures?

54. As payments shrink, and overheads
rise, docs are looking for more income
December 17, 2013

55. Doctors quitting medicine
• Suicide* (2004):
– 1.41 X for male physicians vs. general pop.
• "Half of primary care physicians in survey
would leave medicine ... if they had an
alternative." -- CNN, November 2008
* Schernhammer ES, Coldit GZ. Am J Psychiatry. 2004 Dec; 161 (12):2295-302
.

56. REASON: “EHR” requirements. “Would
cost too much in his small medical practice.”

58. 7,288 physician responses
45.8% of physicians had at least ONE symptom of burnout
CONCLUSIONS: “Burnout is more common among physicians than
other US workers.”

59. Medscape Compensation Report –
Would you choose medicine as a
career?
• 2011
• 2012
• 2013
• 2014
69%
54%
?
?

60. “Why I Left Medicine: A Burnt-Out
Doctor’s Decision to Quit”*
• “It may be dramatic
and self-serving to
frame my career
change as a way to
avoid suicide, but I
can attest that
medicine was not
conducive to my
health.”
http://commonhealth.wbur.org/2013/10/why-i-left-medicine-a-burnt-out
date 10/18/2013 – accessed 01/07/2014

61. Clinical details
• I suffered from early morning wakening, even on my
weekends off.
• I had trouble leaving my work at work. I’d go for a run and
spent the entire 30 minutes wondering if I’d ordered the
right diagnostic test.
• I startled easily.
• I found it impossible to relax.
• I worried constantly that I’d make a mistake.
• I no longer remembered the joy I’d felt when I first
began medical school,
• And I couldn’t imagine surviving life as a doctor.”
http://commonhealth.wbur.org/2013/10/why-i-left-medicine-a-burnt-out
date 10/18/2013 – accessed 01/07/2014

62. The Future of Medicare
“Medicare is going
bankrupt. The Medicare
Trustees estimate that
the program will run
short of money starting
in 2017.”
•Rep. Bobby Scott,
Senators Jim Webb and Mark Warner
http://www.congress.org/congressorg/bio/userletter/?
id=3181&letter_id=4747883751. Accessed April 3, 2010.
Slide courtesy of John Adams, MBA – CEO, Cenegenics

63. Healthcare Reform–Physicians Perception of
Medicine Over the Next Few Years
http://www.athenahealth.com/index.php?open=26. Accessed April 3, 2010.
Slide courtesy of John Adams, MBA – CEO, Cenegenics

64. Are the Best and Brightest
Staying in Medicine?
“60% of physicians
would not recommend
medicine as a career
to their children.”
http://www.mayorswellnesscampaign.org/wpcontent/uploads/2009/05/merritt-hawkins-survey.pdf.
Accessed April 3, 2010.
•
– The Physicians’
Foundation
Slide courtesy of John Adams, MBA – CEO, Cenegenics

65. “But I’m not a doctor; I’m not going to
have those problems.”
• Dentists, optometrists – mixed fee for service
model (at present) and insurance.
• EVERYONE will be having higher deductibles
(and be cash strapped).
– Manifestations: deferred maintenance (Mercedes)
• If hospitals, or clinics close, service providers
connected with it will lose their jobs.
• If you are a cosmetologist or server –
declining business, declining tips

66. For doctors and society at large…
What are the solutions?

67. Background for this section:
• There are no “drug claims” made for any
products from NuSkin/Pharmanex
• No NuSkin/Pharmanex product– nor any
other “OTC” vitamin or supplement – is
designed to treat, prevent, mitigate, diagnose
or do anything else to or for any disease.
• Pharmanex nutritional supplements & weight
control products are designed to support
the structure and function of the human
body.
(c) 2013 Louis B. Cady, M.D. - all
rights reserved

68. Scientific portion:Learning objectives
• Importance of antioxidants (with refs)
• “It’s not about the antioxidants.”
• Origins and validity of the Biophotonic
Scanner
• The critical “three points” of the “Cady White
Paper”
• AgeLOC technology and “YGC’s” (??)
• Vitality and TR90

69. 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.

71. Evansville Courier & Press: May 29,
2006

73. As of 2/7/2014 (104 more
than in November 2013)

76. As of 2/7/2014 (72 more
than in November 2013)

77. Could it happen to you?

78. 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

79. Oxidative stress in the BRAIN – why
you should “know your numbers”

80. 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

81. •
•
•
•
What are some consequences of
oxidative stress?
Behavioral deterioration
Impaired cognitive function
Decreased memory
Psychiatric symptoms
• Increased inflammation
• Depressed immune system
• DNA damage
• cancer

82. 13,474 as of 2/7/2014

83. - 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.

84. 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.

85. “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

86. 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

87. 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

88. One more time… no supplement, under the DSHEA act, may
be represented to treat, cure, mitigate or prevent any disease.
No such “health claims” are being advanced for any
Pharmanex/NuSkin supplement or product. The following
slides represents a LITERATURE REVIEW It correlates
antioxidants, carotenoids and various conditions described in
the peer reviewed medical literature.
- Louis B. Cady, MD
On February 8th, 2013
More data: a mad dash through
the literature

89. Note: these citations are searched under “carotenoids
with _____” and “antioxidant(s) with _____.” Other
relevant search terms are “oxidative stress with ____”
and “nutrient deficiency with ____.”

99. Antioxidant assessment
Reference:
www.cadywellness.com/cadyw

100. Center for Biomedical Optics – Dixon
Laser Institute, University of Utah
• Werner Gellermann, Ph.D. – Research
Professor
• Colleague – Igor Ermakov, Ph.D., et al.
• Technologies – “Novel Raman Spectroscopy
and Raman Imaging.”
• Funding:
– National Institutes of Health
– State of Utah
– Spectrotek, LLC

101. “A method and apparatus are provided
for the determination of levels of
carotenoids and similar chemical
compounds in biological tissue such
as living skin.”

102. Dissolved carotenoids in stratum corneum
27 days

103. “Results obtained… have shown that carotenoids
are vital components of the antioxidative
protective system of the human skin and could
serve as marker substances for overall
antioxidative status.”

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

106. The Biophotonic Scanner – the first of
the IP – protected breakthrough
NSE/Pharmanex technologies

107. First “Portable” BioPhotonic Scanner
2002

108. The Scanner - revised
• Journal of Biomedical Optics, July/Aug 2008
– Peer-reviewed scientific journal

109. “RS accurately measures total carotenoids in human skin
with less intra-individual variability than measurement of
serum carotenoids by HPLC analysis. RS technology
is a valid and reliable noninvasive method
to rapidly assess carotenoid nutritional
status in humans.” (J Am. Coll Nutr 2009)

110. Scientific Validation: Peer-reviewed by the
medical & research communities
• Society of Investigative Dermatology, May 25, 2000.
– Non-Invasive Raman Spectroscopic
Detection of Carotenoids in Human Skin.
• Arch Biochem Biophys. 2010 Dec 1;504(1):40-9. Epub
2010 Aug 1.
– Validation model for Raman based skin
carotenoid detection
• J Eur Acad Dermatol Ven. 2011 Aug;25(8):945-9.
– Skin carotenoid levels in adult patients with
psoriasis.

111. “RSS spectroscopy is a reliable
method for non-invasive
measurement of B-carotene
levels in skin, and may be used
as an important biomarker of
antioxidant status in nutritional
and health studies in humans.”
Ramirez-Velez, et al. Endocrinol Nutr. 2012 April

112. “But is the scanner really valid and
dependable?”

113. • “The totality of the evidence supports the use of skin carotenoid
status as an objective biomarker of fruits/vegetable intake…”
• “..skin carotenoids may effectively serve as an integrated
biomarker of health…”
• “Thus, this biomarker holds promise as both a health
biomarker and an objective indicator of fruits & vegetables
intake….”

114. Scamo S et al. Br J Nutr. 2013
Sep 14;110(5):911-7.
• Good agreement between single and multiple measures (95% CI)
• + association with intake of total carotenoids
• “A single RRS measure was reasonably accurate at classifying
usual skin carotenoid state.”

115. So where do I find this
“white paper”?
• www.google.com
• www.cadywellness.com/
cadywhitepaper2008.pdf

117. What’s up with these caretenoids?
Or…
“The Cady White Paper in 3 slides”

118. Relationships of carotenoids to other more
conventionally measured antioxidants (p 6 -7)
• Svilaas et al (2004):
– 2, 670 adults studied with serum carotenoids
measured and correlated with vitamin
consumption
– serum carotenoids were stronger predictors of
other antioxidants than were alpha, beta, delta,
and gamma tocopherols, as well as
glutathione.*
* Svilaas A, et al. Intakes of antioxidants in coffee, wine, and
vegetables are correlated with plasma carotenoids in humans. J
Nutr. 2004 Mar;134(3):562-7.

119. Convenience of carotenoids as antioxidant
measurement (pp7-11)
• Hata, et al* (2000) – correlated skin
carotenoids (Raman) with carotenoid
levels from skin from abdominoplasty patients
(HPLC).
• “Our technique can be used…for
assessing antioxidant status and the
risk for diseases related to oxidative
stress.” [Palm of skin = highest carotenoid location]
*Hata et al. Non-invasive Raman spectroscopic detection of carotenoids in human
skin. J Invest Dermatol. 2000 Sep; 115(3):441-8.

120. The Svilaas/Hata Syllogism:
• Hata (2000) – Raman measurements of
carotenoid == HPLC skin measurements
• Svilaas (2004) – skin carotenoids = better
predictor of antioxidant status than mixed
tocopherols and glutathione
• THEREFORE [Cady]: Raman spectroscopy
is a better measure of antioxidant status
than mixed tocopherols and glutathione.

121. BTW – what does that “SCS” actually
mean in REAL LAB MEASUREMENTS?
• Y = 12703 * X + 5891.7
– Where Y is the SCS, and X is the carotenoid
concentration in MICROgrams/ml, viz:
•
•
•
•
•
25,000 = 12703X + 5891.7
25,000 – 5891.7 = 12703 * X
19,108.3 = 12703 * X
19,108.3 /12703 = X
X = 1.50 MICROgrams /ml
• Rule of thumb: 1,000 on SCS = .06 ug
carotenoid/ml blood serum
• (e.g., SCS of 40,000 = 2.4 ug carotenoid/ml)
Source: NuSkin/Pharmanex

122. “You don’t need vitamins: (a) you can get’em in
your food; (b)they just make expensive urine.”
“I don’t believe in antioxidants.” – from an MD!!

123. 16,103 people – 1994 – 1996.
ZERO got 100% of all required vitamins and
nutrients
- Highest – B12 =- 82.8% got enough
- 66.8% - had adequate folate
- Lowest – Zinc – only 26.6% got enough.

124. Epidemiology of Vascular Aging (EVA)

125. Epidemiology of Vascular Aging (EVA)
• Study population:
– N=1,389; age range {59-71 yoa}
– 9 year study
• Relative risks:
– all cause mortality at 2.94X in men
in lowest quintile (95% CI, P=0.03)
– cancer 1.72X in men (95% CI, P=0.01
• “Total plasma carotenoids levels
were independently associated
with mortality risk in men.”

126. Vitamin/mineral supplementation & cancer,
cardiovascular, and all-cause mortality
(EPIC-Heidelberg) Li K, Kaaks R., et al. Eur J Nutri July 2011
• Purpose: evaluate vitamin/mineral
supplementation with CA, CV dz, and mortality
•
Methods:
– 23,943 healthy participants, followed 11 years
– Baseline and “new-use” supplementation noted
•
Results: 513 CA deaths, 264 CV deaths
– “No MVI supplement had any significant effect”
• “sick user” phenomenon discussed.
• Baseline users of antioxidant
supplements had significantly
reduced risk of cancer [HR 0.52] and
all cause mortality [0.58]

127. Antioxidants and brain tumors?
• “free radicals are another etiological factor
of brain tumor and are removed by cellular
antioxidants in the human body.”
• Inverse correlation between:
– antioxidant levels and oxidative DNA damage
– Grades of malignancy
• Decrease in antioxidants are associated
with severity of malignancy

128. Conclusions
• “It is concluded that
administration of antioxidants
could reduce the incidence of
brain tumors and probably other
types of cancer.”
• - Shewelta SA , Sheikh, BY Curr Drug Metab. 2011
Jul;12(6):587-93. (Dept.of Biosciences & Technology,
Alexandria University, Egypt.)

129. Can you relax with an
81,000 scan score??

130. Total organic fruits/vegetables intake, 9
– 12 servings per day. No supplements.

131. 74,000

132. The train has left the station…

133. what about other
things besides carotenoids
and “Antioxidants”??
Or… why can’t you just “juice” your way
to complete and optimal health???

134. Seismic shift in the
medical literature - 2002
“Pending strong evidence …from randomized trials, it
appears prudent for all adults to take vitamin
supplements.” Fletcher & Fairfield, JAMA 2002

135. “Inadequate intakes may result in chronic
metabolic disruption, including mitochondrial
decay.”
“[They] cause DNA damage, such as chromosome
breaks, in cultured human cells or in vivo.”
“triage theory

136. The Physicians’ Health Study II
• Take a multivitamin!
CONCLUSIONS: “Daily multivitamin
supplementation modestly* but
significantly reduced the risk of total
cancer.”
* Note – “Centrum Silver” was used.

139. http://cadywellness.com/do-vitamins-work-two-recent-studies-say-no-sh
accessed 2/8/2014

140. http://www.lef.org/featured-articles/Federally-Funded-Analysis-Attemptsaccessed 2/8/2014

141. How to lie in your vitamin studies
• Use sub-optimal doses
• Use sub-optimal doses and use just one or two
ingredients. (not a SYSTEM)
• Use excessively high doses (and give side effects)
• Use SYNTHETIC vitamins at toxic doses
• Give’em too late
• Conflate correlation with causation
• Use skewed (fake) placebo group
• Don’t monitor for compliance

142. Essential Fatty Acids – relevant for:
“Psych”
“Medical”
•
•
•
•
•
•
• Seizures
• Rheumatoid arthritis
(& anything with
inflammation)
• Coronary heart
disease (or health
maintenance)
Depression
Bipolar depression
Schizophrenia
Autism
AD(H)D
Learning disabilities

143. Do YOU Need Fish Oil?
5X reduction

144. Symptoms of B12 Deficiency
Mental
•
•
•
•
•
•
•
•
•
Irritability
Apathy
Personality changes
Depression
Memory loss
Dementia
Hallucinations
Violent behavior
Anxiety
Physical
• Diminished sense
of touch and pain
• Clumsiness
• Weakness
• Pernicious anemia
• Chronic fatigue
• Tremors
• GI problems

145. LifePak Nano - % RDA in 2 packets
• B12
1,000% (as 60 MICROgrams
cyanocobalamin)
• B6
500%
• Folic acid/folate - 150%
• Magnesium
76% (as 300 Mg amino acid chelate)
• Zinc
100% (15 mg as zinc chelate)
• Selenium
200% (L-selenomethionine & NaSeO3)
• Iodine
76%
• Chromium
166%
• Vitamin C
834%
• Vitamin A
300% (83% as Beta carotene and plant
extracts)

146. Your brain and B12
• If you are in the bottom 1/3rd for B-12
levels….
• SIX TIMES increase risk of
brain volume loss (Odds ratio =
6.17, 95% CI)
– Vogiatzoglou A et al. Vitamin B12 status and
rate of brain volume loss in community-dwellers.
Neurology. 2008 Sep 9;71(11):826-32.
– (107 volunteers aged 61-87 years of age)

147. BRAIN SHRINKAGE…
CONCLUSIONS: “The
accelerated rate of brain
atrophy in elderly with MCI can
be slowed by treatment with
homocysteine-lowering Bvitamins.”
Smith AD, Smith SM, de Jager CA, Whitbread P, et al. (2010) Homocysteine-Lowering by B Vitamins Slows the
Rate of Accelerated Brain Atrophy in Mild Cognitive Impairment: A Randomized Controlled Trial. PLoS ONE
5(9): e12244. doi:10.1371/journal.pone.0012244
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0012244

148. LifePak Nano - % RDA in 2 packets
• B12
1,000% (as 60 MICROgrams
cyanocobalamin)
HOMOCYSTEINE
• B6
500%
lowering
• Folic acid/folate - 150%
• Magnesium
76% (as 300 Mg amino acid chelate)
• Zinc
100% (15 mg as zinc chelate)
• Selenium
200% (L-selenomethionine & NaSeO3)
• Iodine
76%
• Chromium
166%
• Vitamin C
834%
• Vitamin A
300% (83% as Beta carotene and plant
extracts)

149. OK. It slows shrinkage. But are they sharper?
[deJager CA et al. Int J Geriatr Psychiatry. 2012 June;27(6):592-600]
“B-vitamins appear to slow cognitive and clinical
decline in people with MCI.”

150. The Effects of high dose B vitamins
on stress at work
• 3 month, double blind, placebo control, randomized study
– Measured: Personality, work demands, mood, anxiety, and strain
• The vitamin B complex treated
group reported significantly lower
personal strain and a reduction in
confusion and depressed/dejected
mood after 12 weeks.
Strough C et al. The effect of 90 day administration of a high dose vitamin Bcomplex on work stress. Hum Psychopharmacol. 2011 Sept 8. doi
10.1002/hup.1229 (Swinburne University of Technology – Hawthorn, Victoria,
Australia.)

151. “Micronutrient supplementation has a beneficial
effect on perceived stress, mild psychiatric
symptoms, and aspects of mood in apparently
healthy individuals. Supplements containing high
doses of B vitamins may be more effective in
improving mood states.”

152. What happens with biotin
deficiency?
Two LifePak Nano packets have
100% of recommended daily
requirements of Biotin.
“Our results suggest that biotin deficiency
promotes hyperglycemic mechanisms…and
decreased insulin secretion and sensitivity to
compensate for reduced blood glucose
concentrations.”

153. OK.
So I’ll just drink
carrot juice and
pop some high
potency B’s. What
me worry?

154. Total organic fruits/vegetables intake, 9
– 12 servings per day. No supplements.

155. 20 years ago - a hint of bad things to come…
• North Americans, unfortunately,
obtain about one-third of their total
calories from nutrient-poor junk food.
Even well-educated… adults…. fall
short in their consumption
of important minerals, like
magnesium, iron, zinc, and
calcium.
Hallfrisch, J., Muller, D. 1993. Experimental
Gerontology, v28 : 473-83.

156. Magnesium mementos
• One of the first minerals to disappear with:
– Processed food
– Stress
• Decreased by EtOH, caffeine, sodas,
meds
• Considered “anti-stress” mineral
– Decreases cortisol (rel to sleep disruption)
– Relaxes muscles, prevents cramps
– Decreases anxiety; improves sleep

157. Symptoms of Magnesium Deficiency
PSYCHIATRIC ISSUES:
•Difficulty with memory and
concentration
•Depression, apathy
•Emotional lability
•Irritability, nervousness,
anxiety
•Insomnia
Autism
ADHD
Health Conditions Associated
with Magnesium Deficiency

Migraine headaches
 PMS
 Dysmenorrhea
 Fibromyalgia
 Fatigue
 CONSTIPATION

158. SELENIUM DEFICIENCY in FASEB:
• “Adaptive dysfunction of
selenoproteins from the
perspective of the ‘triage’
theory: why
modest
selenium
deficiency may
increase risk of
diseases of aging.”
Foundation of American
Societies for Experimental
Biology
McCann, J, Ames BM. FASEB J.
2011 Jun;25(6):1793-814.

159. I+
Se+

“the foot soldier”
LifePak Nano has 200% of RDA
of selenium.
And 76%of RDA of iodine.

160. Low Zinc associated with low
testosterone
• Per USDA, 60% of US men between 20
– 49 years of age do not get enough.
– [N.B.: Do not supplement with > 50 mg daily
(can interfere with Cu+ metabolism); rationale
for SYSTEMS approach]
• Tsai, E.C., Boyko, E.J., Leonetti, D.L., & Fujimoto,
W.Y. (2000). Low serum testosterone level as a
predictor of increased visceral fat in JapaneseAmerican men. International
Journal of Obesity and Related Metabolic Disorders,
24, 485-491
LifePak Nano has 100%
of daily RDA for Zinc.

161. Erectile dysfunction & antioxidants
with MVI’s??

162. Ways to improve erectile quality
(LP Nano concentrations in parentheses)
• Holistic: physical exercise, improved nutrition,
weight control (R90 & TR90)
• Supplements: adequate intake
– Omega 3 fatty acids ( ~4 grams/ day in LP Nano)
– Antioxidants {+++}
– Calcium (600 mg = 60%)
– Folic acid (folate – 600 ug = 150%)
• RX: Replacement of any T deficiency
Meldrum DR et al. The link between erectile and cardiovascular health: the
canary in the coal mine. Am J Cardiol. 2011 Aug 15;108(4):599-606

163. 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

164. A SYSTEMS approach to nutritional
optimization
3
ega- s
Om cid
tty a
fa
nts
trie
ns
mi
onu
vita
hyt
P
nts
s
a
ral
xid
ine
ntio
m
lth) A
hea
one
(b

165. What does “Nano” mean?
• Cylcodextrin ring – benign, digestable
• Feeds the gut microflora

166. How do nano-nutrients work?
Fat-soluble nutrients like
Nano-encapsulated nutrients do
carotenoids and coenzyme Q10 not clump; they DISPERSE.
CLUMP in watery milieu.

167. The Nanotechnology Difference
pmol/mg protein
5-fold increase in absorption!
Adapted from Craft et al, FASEB Journal. 2005; 19(4): Abstract #281.6, A449.
γ-cyclodextrin
complex

168. Some personal reflections

169. Accessed 2/6/2014

170. Accessed 2/6/2014

171. October 5th, 2013

172. TUNA procedure
And a little bit
of discharge
planning

173. Accessed 2/6/2014

174. Accessed 2/6/2014

175. “About 80% of your
genetic material is
made up not of genes
but of gene switches.
These switches cause
changes in the way a
gene works; this is
called Gene
Expression”
Dr. Oz comments about “gene expression”
science
Source: Dr. Oz Q&A 2012

176. TARGET & RESET YOUTH GENE
CLUSTERS
Young Gene
Expression
TARGET
Old Gene
Expression
Old Gene
Expression
RESET
Transcriptional Biomarkers of Mitochondrial Aging and Modulation by Cordyceps Sinensis Cs-4. Gordon Research
Conference, Biology of Aging, Determinants of Health-Span: From Cells to Humans, August 22-27, 2010. Les Diablerets
Conference Center, Les Diablerets, Switzerland.
1

177. “Youth Gene Clusters” – bogus
or bonanza?
Yeast species
SPECIFIC genes
Comparative genomics of fungal allergens
and epitopes show widespread distribution of
closely related allergen and epitope
orthologues. Bower P, et al, BMC
Genomics. 2006; 7:251.

178. Prostate Cancer – more
relevant?
Pre-invention gene
expression
Post-intervention gene
expression
TRANSLATION: What you eat talks
to your genes and CHANGES THEIR
EXPRESSION.
Changes in prostate gene expression in
men undergoing an intensive nutrition
and lifestyle intervention. Ornish, Dean
Proc Natl Acad Sci USA
2008 June 17; 105(24):8369-8374
et al.

179. An Entirely New Class of Anti-aging Products

180. BEFORE
AFTER 6 MONTHS
*Twice daily usage of ageLOC
Transformation, and twice weekly
usage of ageLOC Galvanic Spa and
Facial Gels.

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

182. MITOCHONDRIAL ACTIVITY DECLINES WITH AGE
8
6
- 40%
4
2
18~39
61~84
”Mitochondrial Dysfunction in the Elderly: Possible Role in Insulin
Resistance” Science 16 May 2003:Vol. 300. no. 5622, pp. 1140 – 1142

183. Three active botanicals:
•Cordyceps
•Pomegranate extract
•Panax ginseng
Promotes Three Dimensions
of Vitality:*
•Physical Vigor
•Mental Acuity
•Sexual Health
* These statements have not been evaluated by the Food and Drug Administration. This product
is not intended to diagnose, treat, cure, or prevent any disease.

184. Active mitochondrial research on
energy

185. http://www.nature.com/scitable/topicpage/mtdna-andmitochondrial-diseases-903

186. Week 12 = +20%
P=0.021
Vitality vs. Placebo
“Targeting Age-related gene expression improves
mental and physical vitality” Ferguson SB SM et al.
Paper presented at 1st World Congress on Targeting
Mitochondria, Strategies, Innovations & Clinical
Applications. Berlin, German. November 18-19, 2010.

187. 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

188. Identification of Gene Expression Pathways
Linked to
Fat Storage and Fat Metabolism
LifeGen pre-clinical study of Adipose,
Gastrocnemius muscle, Hypothalamus

189. Gene Expression relates to the Appetite Control
Center of the Brain
•
•
•
Appetite Control
Eating Behavior
Regulation of energy intake
Ghrelin
Leptin
Insulin
References:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Smeets et al. Proceeding of the Nutrition Society. 2012;71:511-520.
Guthoff M, et al. J Clin Endocrinol Metab. 2010;95:748-755.
De Silva, et al. Cell Metab. 2011;14:700-706.
Malik S, et al. Cell Metab. 2008;7:400-409.
Farooqi IS, et al. Science. 2007;317:1355
Suzuki K, et al. Experimental Diabetes Research. 2012:1-19.
Viquerie N, et al. Diabetologia. 2005;48(1):123-131.
Mager et al. European Journal of Endocrinology. 2008;158:
Mutch DM, et al. Am J Clin Nutr. 2011;94(6):1399-1409.

190. Withings WS-50 Smart Body Analyzer

191. (Start weight: 168.5 lbs – Oct 28th)
10 lbs of total weight
loss = 6% body weight

192. (43.1 lbs – Oct 28th)
7.7lbs of fat loss
10 lbs of total loss
= 77% of weight
loss was FAT loss

193. TR 90 – a look back
October 28, 2013
January 28, 2014

194. Stats & Significance
• Confounds:
– Time of year – Halloween & Holidays
– Busy schedule. Travel. Meals on road.
– Somewhat imperfect execution
• Results:
– 10 lbs gone (of which 7.7 lbs was fat)
– Lost:
• 2.5 on waist
• 4% body fat (from 26.5% down to 22.5%)

195. Final reflections….

196. “work ‘til you drop or can retire”
plan
The “Cash Flow Quadrant”
concept by Kyosaki
The Facts of Life
of Business
• You have a job. (E)
• You own a job (or it
owns you). (S)
• You have built a
business (& your
minions make
money for you) (B)
• You have so much
money you can live
off your investments
(I).

197. Business 101 – 3 doctor internal medicine clinic
– what does this REALLY MEAN?
As your fees stagnate or are cut, and as yourEXPENSES:
overhead
INCOME
continues to rise, you will:
(prev) Revenue: $1.5 million
Overhead* :
million
•Pinch pennies on overhead, do 5-7 minutes per$1depreciation,
patient
[support staff salaries, rent,
Less 24% cut:
- $360,000
malpractice
and try to be cheap. (Unsuccessful). insurance, license fees, “MOC”
fees, equipment costs, consumables, cleaning,
•Work harder and longer hours to keepfacilities insurance, Workman’s
supplies, pace and feed
Total income now:$1,140,000 officecomp, retirement plans for staff and docs,
your family (and burn yourself out)… pay, sick pay, insurance plans
CME, vacation
Income lessnot get to see your kids grow up. for staff and docs]
• …And expenses
(What’s left over for
= ZERO.
• Marital problems; divorce.
salaries: $140,000)
• This balances. out on life.
You will miss
Salaries – for 3 docs
•Use the “work ‘til you drop” retirement plan.
Total expenses: $1.14
•Or= 46,667 per doc
you will quit if you’ve made enough and eithermillion
retire
or do something else.

198. The Third Way: the health
matrix dialectic
Or…
Doctors, dentists, optometrists, DC’s, ND’s,
NP’s & other health care & fitness
professionals:
You can synergize with your patients’ needs
and contribute to the health of America

200. May 1, 2013

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

205. October 5th, 2013

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

207. 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.”

208. Dr. Catherine Hamlin, MD. 90 years of age. Still practicing ob-gyn in
Ethiopia. Focus: repairing obstetric fistulae.
Source:
http://www.nytimes.com/2014/02/06/opinion/kristof-at-90-this-doctor-is-still-calling.html?_r=0
accessed 02 08 2014. photo by Joni Kabana

209. “There are things
known and there are
things unknown, and
in between are the
doors.”
- Jim Morrison

210. “Truth is a constant
variable.”
– William Mayo, MD. “Dr. Will”
Gonda extension, Mayo Clinic Building
2004. © Louis B. Cady, M.D.

211. “Probably the most interesting period of
medicine has been that of the last few
decades. So rapid has been this advance, as
new knowledge developed, that the truth
of each year was necessarily
modified by new evidence, making
the truth an ever-changing factor.”
- Charles Mayo, MD “Dr. Charlie”
Plummer
Building lobby.
Photo: © Louis
B. Cady, MD
2004