In this, the second part of the "Queen of Denial" lecture for Deaconess Women's Hospital, Dr. Cady takes up where Dr. Gabhart left off, reviewing - briefly and succinctly - the following topics: the needless "psychiatric victimization" of women, discrimination against women in terms of optimal levels of hormones (including testosterone), and the dangers of low DHEA, low cortisol, and low thyroid. The emphasis is that there are BIOLOGICAL things that are frequently wrong, and simply looking at the supposedly "psychiatric" or "depressed" symptoms is frequently barking up the wrong tree.

1. THE QUEEN OF DENIAL –
PART II
With Dr. Louis B. Cady, MD – Founder, CEO – Cady Wellness
Institute & Dr. W. Whitney Gabhart, Naturopathic Doctor

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
because taxes are rising.
crisis, it has to do with the essential welfare
of individuals or with the good health of the
society, not merely with comfort, convenience,
amenity, and business advantage, important as these
are.”
from The Unheavenly City, Edward C. Banfield, 1968, 1970

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

4. Cady Wellness Institute – July 2005
The Reasons:
• A lot of “psychiatric cases” WEREN’T “psychiatric.”
• Nobody was integrated.
• Nobody was looking at ALL of the peer-reviewed
literature.

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

6. PMS – typical views

8. Left
Front of brain DORSOLA
TERAL
PFC
LEFT
Prefrontal
Right side
Left side cortex
Front of brain
Slide courtesy of Dr. Daniel Amen, MD and Amen Clincis.

10. Things that your [normal] doctor could tell
you if he/she looked:
• Anemia – menstrual or GI blood loss
• Hypothyroidism*
• Obstructive sleep apnea, or other sleep
disorders
• The REAL REASON you are gaining weight
*TSH>2.5, or perhaps even >2.
Free T3 and Free T4 in optimum (high normal?) ranges
Reverse T3 well within normal limits

12. 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

14. % Mineral depletion from the soil
during the past 100 years, by continent
North America 85%
South America 76%
Asia 76%
Africa 74%
Europe 72%
Australia 55%
Source: UN Earth Summit Report 1992

15. 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 McCann, J, Ames BM. FASEB J.
Societies for Experimental 2011 Jun;25(6):1793-814.
Biology

16. (permission granted to use photos & data)

17. (permission granted to use photos & data)

18. • 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)

19. Solutions for hypothyroidism:
• Get informed!
• DEMAND at least a Free T3
and Free T4 with your TSH.
• If you are still symptomatic with
“normal” labs, you may require
a “hotter” setting.
• Pursue supplementation
to the optimal level.

20. Things that your [normal] doctor is not
looking for:
• Adrenal exhaustion
• Less than optimal values of
hormones

21. The worst case scenario – Addison’s
Disease

22. Hypoadrenia: The Adrenal Problem Your [conventionally trained] M.D./D.O.
won’t know about
• Non-Addison’s hypoadrenia
• Subclinical hypoadrenia
• Neurasthenia
• Adrenal neurasthenia
• Adrenal apathy
• Adrenal fatigue

23. Adrenal Burnout

24. DHEA – the critical hormone your
doctor never checks
• Produced in the adrenal cortex
– Humans and primates are unique in secreting large
amounts
• Immune system booster
• Insulin regulator
• Energy increase – remarkable
• Boosts growth hormone
– 20% in men; 30% in women in one study
• [Yen, Morales Khorram – one year double-blind placebo
controlled crossover experiment – with 100mg DHEA]

25. Signs & Symptoms of Adrenal Fatigue
• Difficulty getting up in a.m.
• Ongoing lethargy during the day.
• Continued fatigue not relieved by sleep.
• Craving for salt or salty foods.
• Increased effort to do daily tasks
• LESS PRODUCTIVE
• Decreased sex drive
• Decreased ability to handle stress.
• Light-headed when standing up quickly
• Increased recovery time for illness
• Generally less happy about life.

26. 349 citations on “DHEA with energy” – as of
of 10/3/2012

27. Don’t be MISS – diagnosed with
depression!
♦ Depressed mood 100%
♦ Reduced energy: 97%3
♦ Fatigue or loss of energy: 94%2
♦ Impaired concentration: 84%3
♦ Tiredness: 73%1
♦ Hypersomnia: 10%–16%4 (Insomnia)
1. Tylee et al. Int Clin Psychopharmacol 1999;14:139-151. 2. Maurice-Tison et al. Br J Gen
Pract 1998;48:1245-1246. 3. Baker et al. Comp Psychiatry 1971;12:354-65. 4. Horwath et
al. J Affect Disord 1992;26:117-25. 5. Reynolds and Kupfer. Sleep 1987;10:199-215.

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

29. 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” medical practice
or an incredible, exciting, and (optimal!!)
stimulating one?
• Would you like “normal” labs or
OPTIMAL ones?

30. How would you take care of a classic?
“Chronic diseases
affect at least 125
million Americans
& cost more than
$500 billion last
year.”
Centers for DiseaseControl – Dec 2003

31. “Age management” “Conventional practice”
There are fuel additives No fuel additives should
we can use to keep our be used. They are
cars burning cleaner and unnatural. Gas is all that
preserve engines. is required.
We should use optimal The quality of the gas is
quality of gas. Cheap gas irrelevant. Anything that
causes “pinging” which is the motor will burn is
hard on the engine. adequate.
We should take our car in Preventive maintenance? This
for preventive is silly! Wait until something
breaks, then have the car
maintenance before
towed in so the mechanic can
anything breaks. really tell what is wrong.

32. The Case of the Crying Cleaner
• 1/11/12 - Symptoms:
– Crying/depressed = on
Citalopram
– Hot flashes
– Night sweats
• RX:
– Estradiol – 2 mg @HS
– Prometrium – 100 mg
@HS
– (continue citalopram)
• 1/15/12 – RESOLVED
• In 4 days!
Photo & data used with permission

33. One destigmatizing notion:
Estrogen as MAOI
• Estrogen & Testosterone (!) decrease
MAO
– Luin, VN. Effect of gonadal steroids on
activities of MAO and choline acetylase
in rat brain. Brain Res. 1975;86:273-306
• Platelet MAO levels inversely
correlated to estradiol levels
– Klaiber EL et al. Psychoneuroendo-
crinology. 1997 Oct;22(7):549-58.
• Estrogen decreases MAO-A & MAO-B
– Holschneider DP et al. Life Sci. 1998;63(3):155-60

34. Estrogen: Good For Your Brain
• Estradiol influences performances of learning and
memory tasks as well as increase working memory
– Sub-point – women are living three decades longer;
hence they are spending more time hypoestrogenic
– Pompilli A et al. Estrogens and memory in physiological and
neuropathological conditions. Psychoneuroendocrinology. 2012
Sept; 37 (9):1379-96
• Estradiol = protective against schizophrenia.
– Kulkarni J, et al. Hormones and Schizophrenia. Curr Opin
Psychiatry. 2012 Mar;25(2):89-95

35. Testosterone: The “sexist” bias against women
(e.g., “your loss of sex drive is just natural for
your age.”)
• Fall in the circulating testosterone and the adrenal
preandrogens most closely parallel increasing
age.
• Accelerated decrease occurs in the years
preceding menopause (like estrogen).
• Their loss affects: libido, vasomotor symptoms
(hot flashes), mood, well-being, bone structure,
and muscle mass.
– Burd, Bachmann. Androgen replacement in
menopause. Curr Womens Health Rep. 2001 Dec;
1(3):202-5.

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

38. 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}
LOW ESTROGEN CAUSES LOW NEUROTRANSMITTERS

42. North Americans, unfortunately, obtain
about one-third of their total calories
from nutrient-poor junk food. Even well-
educated, presumably well-nourished,
adults taking nutritional supplements
frequently do not consume nutritionally
adequate diets and, despite their
supplements, fall short in their
consumption of important minerals, like
magnesium, iron, zinc, and calcium.
Hallfrishch, J., Muller, D. 1993. Experimental
Gerontology, v28 : 473-83.

43. These experiments reveal that carotenoids are a good indicator
of antioxidant status. They show that people with high oxidative
stress, like smokers, and subjects with high sunlight exposure, in
general, have reduced skin carotenoid levels, independent of their
dietary carotenoid consumption. We find the Raman technique to
be precise, specific, sensitive, and well suitable for clinical as
well as field studies.

44. Your bettings odds
• 1/8 women will develop breast cancer
• 40,000 deaths per year, nationally
– 150 Delta 777-200 aircraft crashing per year-
or 1 every 2.4 days
• Cervical cancer – 3,900 die of it each year
– 11% of women do not have regular exams
• 10% men will develop prostate cancer
• Colon cancer – #2 cause of cancer deaths
– 75% of patients are greater than 50 years of age
with NO KNOWN RISK FACTORS
– One colonoscopy decreases risk of death 90%

45. Actuarial programs abound:

46. Breast cancer as exemplar of better
decision making through new research
• 1 – 2 drinks per day increases risk of breast
cancer 10%
• 3 drinks per day = 30% increased risk.
– (= equivalent of one pack of cigarettes per day)
– Dr. Arthur Klatsky - Kaiser Permanente Medical Care, Oakland,
Calif., European Cancer Organization in Barcelona, 9/27/2007
• NIGHT WORK increases risk – new finding
– Disruption in melatonin rhythm?
– Increased cortisol (stress hormone)?
• Cf: American Cancer Society, 9/13/2007
• 10% reduction possible by 2024 with (a) exercise,
(b) reduction in long term (“fake”) HRT, (c )
decrease alcohol
• Max Perkin, National Cancer Research Conference, Sept 2007

47. Weight and insulin
• What are the stats?
• How does this eating and insulin thing
work?
• Is the problem “all in your glands”?
• What have the Feds said and why are their
recommendations so stupid?
• What’s a rational way to eat (with
references)

48. Current stats on obesity
National Center for Health Statistics

49. “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/

50. The Doc Cady “Candy Bar a Day”
Weight Loss Program
• 1 lb. of fat = 3,500 kcal (“calories”)
• 3,500 / 7 = 500 calories per day
– You need to not eat’em, or burn’em
• Starving yourself slows your metabolism down, and you
lose muscle mass
– Therefore: reduce 250 calories; burn 250 calories
• 250 calories = no candy bar, or “NO” to 1 & ½
Cokes
• 250 calories = ½ - ¾ hour on treadmill
• NET = 500 calories per day, or 1 lb. lost per
week

51. One problem…
• It doesn’t work!
• TBL: It’s the
INSULIN
RESPONSE
• RX: EAT LESS
CARBS AND
SUGAR!!!

52. Glycemic index
• A measure of how fast a
carbohydrate triggers a rise in
circulating blood sugar.
• The higher the number, the greater
the blood sugar response.

53. The Old FDA Food pyramid – R.I.P 2005

54. Lobbying dolalrs (in BILLIONS) 1998-2012

55. Top five crops receiving US farm subsidies
• Wheat
• Corn
• Soybeans
• Rice
• Cotton
Source: www.about.com - What are U.S Farm Subsidies?
http://usliberals.about.com/od/FoodFarmingIssues/a/What-Are-Farm-S
- accessed 04 15 2013

56. W. Wheat Rice Big Mac, Ice cream;
Toast, OJ, cakes, Fries, Shake Coke & chips
coffee coffee
H - 56

57. Doc Cady “Candy Bar a Day”
program FLAWS:
• Not all calories from food do the same
thing to your body:
– Removing 250 cal of sweet potatoes is not
the same as removing 250 calories from
candy bar.
• Doesn’t account for thyroid or thyroid
resistance.
• This program only focuses on WEIGHT
LOSS, and not OPTIMUM HEALTH
H - 57

58. The horrifying facts about the foods
you eat (and think are safe)
(FOOD) (glycemic index)
•Tofutti 115
•Glucose 100
•French bread 95
•Instant rice 90
•Baked potato 85
•Rice cakes (jelly beans) 77/80
•Cheerios 74
•Table sugar (sucrose) 64
•Spaghetti, white 41
•Spaghetti, protein enriched 27

59. • FINAL CONCEPTS:
– ”Denial " is not acceptable.
– Your “glands” – may, in fact, be at fault!
– IT MAY NOT BE “PSYCHIATRIC”!!!
– There are things that should be checked that
most physicians do not.
– Education is the key!
– The sooner you start taking care of your body
the more lasting the positive effects will be.

61. Personal collection
Louis B. Cady, M.D.