Casey Means, physician nominated by RFK Jr. for Surgeon General, dodged questions about MMR vaccines amid 980 measles cases in South Carolina and child deaths in West Texas during her hearing, where Republicans like Senator Bill Cassidy—despite a $1M donation from Kennedy’s group to oppose him—asked softball queries. Her book Good Energy, co-authored with brother Callie (Trumed’s CEO), oversimplifies chronic diseases, falsely blaming metabolic dysfunction for pancreatic cancer (90% genetic) and psychiatric conditions while promoting pseudoscience like "leaky gut" and distrust of doctors. Critics argue her wellness grifting undermines public health, exposing the dangers of supplement-driven misinformation in a broken healthcare system. [Automatically generated summary]
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Two children died from measles in West Texas.
We now have an outbreak of like a thousand children almost in South Carolina area.
You're a mom.
We're on the verge of losing our measles elimination status.
Would you encourage other mothers to have their children vaccinated against measles with the MMR vaccine?
Like you, I'm a physician.
I believe vaccines save lives.
I believe that vaccines are a key part of every public, of any infectious disease public health strategy.
And I would work with you, the CDC, the NIH ACE.
Would you encourage mothers to vaccinate their children with the MMR vaccine, seeing how we've had children die and this outbreak in South Carolina?
I'm supportive of vaccination.
I do believe that each patient, mother, parent needs to have a conversation with their pediatrician about any medication they're putting in their body or their children's body.
As a nation's doctor, would you encourage her to have her child vaccinated?
I'm not an individual's doctor, and every individual needs to talk to their doctor before putting a medication in their body.
I absolutely am supportive of the measles vaccine, and I do believe vaccines save lives and are important part of the public health strategy.
But the job isn't for an individual doctor.
It is for being the mouthpiece of doctors around the country.
So if that's not the job you're applying for, you probably shouldn't get it.
I mean, that's just one of the many non-answers Casey Means, who of course is RFK Jr.'s pick for surgeon general, gave on Wednesday during her congressional hearing.
As usual, the questioning went along party lines with Democrats actually trying to hold her accountable for her wellness grifting, something we've covered often on this podcast, and Republicans lobbying softballs and having her introduce her family seated behind her.
Casey Means' Congressional Hearing00:02:56
It was a very kombaya moment.
That was done by Senator Bill Cassidy, the man who could have stopped RFK Jr.'s appointment as HHS secretary, but did not.
As a physician, Cassidy tried to play rough as the final person to question means.
You heard him there in that clip, but it was more performative than real, and he didn't do much to push back on her sidestepping over the long run anyway.
Ironically, even though Cassidy was the deciding vote that installed Kennedy, Maha Pack, which is Kennedy's fundraising arm, is donating $1 million to defeat Cassidy in a Republican primary this year.
While the congresswoman that Cassidy's running against, Julia Lettlow, was very pro-COVID vaccine in 2021 after her husband died from the virus, her Twitter feed is fully magified now.
I'm not sure where she currently stands on vaccination, but it says a ton about Maha that they're willing to throw Cassidy under the bus like this.
It'll be interesting to see how he votes on Casey Means' nomination, but I'm certainly not holding my breath that he's going to do the right thing.
Casey Means has been covered all over the place this week.
I'll include some good coverage in the show notes here.
Today, I want to revisit the book that helped her star rise in Maha.
It's called Good Energy: The Surprising Connection Between Metabolism and Limitless Health.
She co-authored it with her brother Callie, who serves as Kennedy's senior advisor when he's not running his supplement sales shop, Trumed.
You probably aren't surprised to learn that neither means sibling is trained in endocrinology, but that did not stop them from claiming expertise on the subject and being rewarded with a bestseller filled with misinformation and misleading information.
I'm Derek Barris, and you're listening to a conspiratuality brief, rereading Casey Means.
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Okay, let's dive in.
From a meta perspective, good energy greatly oversimplifies the causes of chronic diseases and health conditions by attributing them primarily to metabolic dysfunction or the specter that the means have termed bad energy.
Oversimplifying Chronic Diseases00:14:37
The book is heavy on anecdotes.
It has plenty of bad data because it's all about affect, not science.
So I'm going to look into big picture claims, but I want to start with one that jumped out me while I was first reading the book because it highlights how they like to manipulate data to fit into their agenda.
The means is right.
Outdoor cats exposed to harsher environments have significantly less obesity than indoor cats.
And 50% of domesticated dogs over age 10 develop cancer, yet this rarely happens to dogs or wolves in the wild.
Depression afflicts 75% of domesticated dogs, but is rare in wild animals.
Okay, I made it through without laughing.
Jesus Christ, I can't believe I have to fact check this, but yes, every sentence is bullshit.
As a longtime cat owner and as a new puppy owner for a year now, the difference between wild animals and the domesticated animals you invite and bring into your homes is just so wild.
So to think that their health would be similar for some reason is absolutely insane.
And it really sort of highlights the differences on a meta perspective from countries with socialized medicine and those without and how they have to contend with illnesses.
But let's get specific.
Outdoor cats live an average of two to maybe on the high end five years.
Indoor cats, 12 to 18 years, depending on breed.
My Russian blue Osiris almost made it to 22 before he passed a couple years ago.
And of course, outdoor cats are likely less obese because indoor cats have their own sources of food that are delivered to them.
Yet somehow the means feel that this is a good analogy to human health.
And the same goes for dogs here.
Domesticated dogs live longer because they're taken care of.
They get regular vaccines, I hope.
They get checkups, I hope.
They get their medications.
They always have food.
They get plenty of love.
All these things matter.
I mean, I really hope if you have a dog or a cat, you're giving them plenty of love.
Sometimes I see some behavior in the streets and in dog parks that really make me question whether or not humans, some humans should even have animals.
But the chances that dogs will develop cancer later in life is pretty obvious as it's generally a disease of aging.
So saying that dogs over 10 develop cancer, but not wolves is just baffling.
The average lifesty span of a wolf is six to eight years in the wild.
So yeah, it's kind of hard to develop cancer after age 10 if you don't live that long.
That last line too, 75% of dogs develop depression.
I hate to search this one down because the means don't have footnotes in their book, which is weird for a medical or science book at all.
You have to go to Casey Means' site to find them.
And then the link that they used for that specific citation was a dead link.
So to the best of my knowledge, I found one small study in the UK that backed up the 75% dogs developing depression, but it only applied to dogs in Britain.
So the literature on global canine mental health does not confirm any of this.
So, okay, sorry for the pet tangent, but the fact that the means are manipulating data like this and relying on low-quality evidence as if it has anything to do with human metabolism is just absurd.
That said, when they do write about humans, which is most of the book, things do not get any better.
Let's start with the thesis of the book from the front flap.
Quote, nearly every health problem we face can be explained by how well the cells in our body create and use energy.
And then inside the book, the means posit that bad mitochondrial or metabolic function is, quote, the root of virtually every symptom and disease plaguing modern Americans.
This is classic single cause of all disease fallacy.
It's well known and documented.
It's a pattern that has repeatedly failed throughout the history of medicine.
The idea that I can say all these diseases must be caused by this.
The scientific and medical literature does not support the idea that poor metabolic health is either a necessary or a sufficient cause of most chronic diseases.
In fact, many of the diseases that the means is cite may cause poor metabolic function, not the other way around.
So I went through here are a few examples.
Autoimmune diseases like multiple sclerosis, type 1 diabetes, and lupus are all driven by genetic susceptibility and environmental triggers.
These include viral infections, particularly, for example, Epstein-Barr virus for MS. While metabolic dysfunction can exacerbate autoimmunity, the primary drivers of these are immunological and genetic.
That's not how the means is position it, nor any of these other diseases.
They talk a lot about cancers that are supposedly metabolically driven.
They are not.
Examples include tobacco smoking for lung cancer, H. pylori infection for gastric cancer, HPV for cervical cancer, the BRCA one and two mutations for breast and ovarian cancers, UV radiation for melanoma.
I know the anti-sunscreeners don't want to admit that, but it's true.
Radon with lung cancer and alcohol causing or leading to several GI cancers.
Then we get to a favorite of Maha, which is infectious diseases.
You have pneumonia, COVID-19, and upper respiratory infections are all caused by pathogens, not metabolic dysfunction.
Metabolic health can influence the susceptibility and severity of disease, but the claim that these diseases are, quote, rooted in bad energy conflates modifiable risk factors with root cause.
So this entire thing gets very religious and terrain theory-esque quickly in the book.
Couple more.
You have genetic diseases like Huntington's, cystic fibrosis, and sickle cell disease.
These are all caused by specific gene mutations, not by how well the mitochondria are functioning in response to modern diet, which is how the means is frame it.
And then finally, the field of psychiatric genetics has identified hundreds of common and rare genetic variants associated with schizophrenia, bipolar disorder, major depression, and autism.
They have no simple metabolic explanations, but the means like to pretend that they do.
Why would they try to reduce all these diseases down to a single cause?
Well, consider the fact that Casey co-founded Levels, a company that sells continuous glucose monitors or CGMs to non-diabetics, often through marketing that posits slight fluctuations in metabolic signals, are really telling you about undiagnosed issues.
And then Kaylee, who partners with hundreds of Alt-Med and supplements companies that sell supposed solutions to the problems that Casey's company has identified.
In that light, the book makes a lot more sense.
It does not make a lot of science, however.
The means is credit their health awakening with the death of their mother, who sadly died from pancreatic cancer, but even the dedication of the book features misinformation.
For Gale Means, born 1949, died in 2021 of pancreatic cancer, parentheses, a preventable metabolic condition.
I've lost friends to this disease.
It's fucking horrible.
Pancreatic cancer has a five-year survival rate of just 11 to 12%.
That's very low.
It's one of the most lethal cancers precisely because it's so difficult to prevent and to detect early.
While type 2 diabetes and obesity are associated with a modestly increased risk of pancreatic cancer, these are risk factors, not causes.
Most people with obesity and diabetes do not get pancreatic cancer, and many people who do get it have no metabolic dysfunction.
What we do know is that the dominant genetic driver is a gene mutation present in nearly 90% of cases.
This mutation is not metabolic in origin.
So calling the death of a specific person from pancreatic cancer preventable and implying that better metabolic choices could have saved her is not supported by decades of evidence.
It's the thing about Maha, they like to pretend that these researchers and doctors and oncologists haven't spent lifetimes looking into this.
It's all this idea that pharma is against you and they just want to feed you chemotherapy and that's how they make a living.
And it's just, it's so deflating to people who spend their lives researching this to have people who are not trained in any of it come along and make these assumptions to sell their alt med products.
And this happens throughout the book.
The means, this one gets me.
The means claim that 93.2% of people have metabolic dysfunction.
And this figure comes from a single 2022 study that defined optimal metabolic health, and they were using very stringent criteria.
And those were simultaneously having optimal levels of fasting glucose, triglycerides, HGL, blood pressure, and waist circumference.
Now, importantly, these levels must all be maintained without medication.
The study found that only 6.8% of U.S. adults meet all five criteria simultaneously.
This definition is not the same as having metabolic disease, however.
Good Energy repeats this statistic to suggest that nearly the entire population is sick in a clinically meaningful way, which is not what the study's authors intended or what the data show.
I've noticed that Robert Lustig, he's a physician who writes these books about how sugar is the cause of all problems, also very much a single cause problem guy.
He's been on social media this week supporting KC's nomination, which makes sense given how heavily Good Energy relies on his health propaganda.
Per Lustig, the book advises readers to throw total cholesterol in the garbage, downplays LDLC as a risk factor, and implies that statins are largely ineffective or that they target the wrong LDL particles.
All of these are false or misleading.
LDL cholesterol is a causal driver of cardiovascular disease, not merely a correlate.
The evidence base includes decades of randomized studies, clinical trials, and mechanistic data.
People with genetically lower LDL have proportionally lower lifetime cardiovascular risk.
This is something I pay attention to because I have genetically high cholesterol.
My father has been on a statin for decades.
I have always been borderline so far, but so I have not gone on a statin yet, but just tomorrow, actually, which will be the day before you listen to this, I am going to get my blood work done again to see if I need to get on a statin.
So this is something I have to pay close attention to given my genetic disposition.
The means falsely claim that statins only reduce large, buoyant LDL and not small, dense LDL, but statins reduce all LDL particles.
The clinical trial evidence for statins is extremely well studied.
It's among the strongest claims in medicine.
This has been decades and decades of research.
So anytime I see these anti-statin influencers come out, I just shake my head.
The means also claim that more than 50% of people who show up in the emergency room with heart attacks have normal cholesterol.
Where do they get this tidbit from?
Mark Hyman, of course, who also wrote a blurb for the book.
Normal by conventional guidelines is a very low bar.
Most such patients have LDL well above the levels associated with minimal risk, and many have other cardiovascular risk factors, including metabolic syndrome itself.
Speaking of hymen, the means present the fictional diagnosis called leaky gut as a solid science throughout the book.
I've covered this so many times.
Intestinal permeability is a real diagnosis.
It's implicated in celiac disease, IBD, irritable bowel syndrome, and some infections.
Leaky gut is a functional medicine marketing term designed to sell you supplements.
Moving on, I don't want to spend too much time on hymen here.
The means claim that poor metabolic health is the root cause of depression.
Most evidence points to depression contributing to metabolic dysfunction, so it's one of those they flipped around.
The most powerful predictors of depression include stressful life events, early childhood adversity, and genetic predisposition.
These factors all dwarf the effect size of metabolic health on depression risk, but you know, the means have vibes on their side.
Alzheimer's and Type 3 Diabetes Claims00:04:13
Okay, let's go to another fun one.
The wellness world has latched onto the term type 3 diabetes to describe Alzheimer's disease.
I looked into it.
This term was coined by Suzanne de Lamonte in 2005 as a hypothetical, not a consensus diagnostic category.
It has never been adopted by the scientific mainstream.
It's not in the DSM.
No clinical guidelines use this term.
In fact, the evidence for insulin resistance causing Alzheimer's is associational at best, but the means say it must be so.
So it's got to be true.
I already mentioned that Casey co-founded Levels and surprise throughout the book, continuous glucose monitors are presented as, quote, the most powerful technology for generating the data and awareness to rectify our bad energy crisis.
And they strongly recommend them for healthy non-diabetic individuals.
CGMs were developed and validated for use in people with type 1 and type 2 diabetes who need to manage blood glucose for medical reasons.
Their clinical utility in metabolically healthy individuals without diabetes has never been established.
But that doesn't stop the means from recommending unnecessary lab work done by Mark Hyman's company, Function Health, where the results of your unnecessary CGM reading get you into an unnecessary supplements downline.
That is the grift.
I wish I could conjure something deeper than that.
I don't know how much the means and hymen and all these people actually buy into their pseudoscience and their correlational data and their misinformation.
I don't know, but I do know that has been the end result for years now.
I could go on and break down how the means get optimal ranges for biomarkers wrong and how they source imprecise data to say that we consume 3,000% more sugar than our ancestors.
All these wellness people, they love talking about how healthy our ancestors wrong when they died at age 15 from a fucking cut.
And of course, the means is rage against seed oils despite extensive research to the contrary.
They also wrongly implicate metabolic dysfunction as a cause of autism and ADHD, which I guess is better than vaccines, but it's still completely unfounded.
They also rail against SSRIs like they do statins, which again, it's just vibes.
I'm going to close with the title of chapter three, trust yourself, not your doctor.
I've also talked about Kelly, who tweeted out once, don't trust your oncologists.
These are really, really good-natured people here.
Their book advises readers not to accept pushback from their doctors on tests like fasting insulin and frames the medical system as primarily a profit-driven obstacle to health.
And oh, oh, the irony.
The means is accuse doctors of over-prescribing statins, SSRIs, and metformin while they simultaneously recommend a lengthy list of tests and implicitly supplements because that's where those tests lead.
And many of those are sold by companies that they are affiliated with.
I've said this forever.
I'll say it until we get socialized medicine, which I don't see in my life, but who knows.
America's for-profit healthcare system is fucked.
There are so many problems with putting profits over people, especially when it comes to our health.
Ironically, Casey didn't once mention socialized medicine as a solution during her congressional hearing, or, to my knowledge, I don't think she's ever mentioned it.
The fact that she drops the ball on the biggest root cause of America's health problems makes her completely unqualified for the position of surgeon general.