Relatable with Allie Beth Stuckey - REPLAY | Question Your Doctor, Save Your Life | Guest: Dr. Casey Means

Episode Date: August 29, 2024

Today, we interview Stanford-trained physician Dr. Casey Means about her upcoming book "Good Energy: The Surprising Connection Between Metabolism and Limitless Health." Dr. Means' mission is to maximize human potential and reverse the epidemic of preventable chronic disease by empowering individuals with tech-enabled tools. She believes the underlying cause of chronic disease is metabolic dysfunction, and the cure to this dysfunction is available to every individual through smart and sustainable lifestyle choices. She shares her mother's tragic story as well as what the health care system gets wrong about our health. We also cover the dark truth about the money behind health care and where doctors' incentives could actually lie. Pre-order Dr. Means' book here: https://www.amazon.com/Good-Energy-Surprising-Connection-Metabolism/dp/0593712641 --- Relevant Episodes: Ep 741 | How Functional Medicine Saved My Life | Guest: Taylor Dukes https://podcasts.apple.com/us/podcast/relatable-with-allie-beth-stuckey/id1359249098?i=1000595318788 Ep 693 | The Disturbing Truth About Breast Cancer Awareness Month | Guest: Chris Work (Chris Beat Cancer) https://podcasts.apple.com/us/podcast/relatable-with-allie-beth-stuckey/id1359249098?i=1000583065318 Ep 926 | The Secret Reason Doctors Push Cancer Drugs | Guest: Suzy Griswold https://podcasts.apple.com/us/podcast/relatable-with-allie-beth-stuckey/id1359249098?i=1000640353494 --- Links: Follow Dr. Casey Means on her website here: https://www.caseymeans.com/contact Levels Health: https://www.levelshealth.com/ Read Dr. Means's article in The Free Press: https://www.thefp.com/p/im-a-doctor-you-shouldnt-always-trust-us --- Buy Allie's book, You're Not Enough (& That's Okay): Escaping the Toxic Culture of Self-Love: https://alliebethstuckey.com/book Relatable merchandise – use promo code 'ALLIE10' for a discount: https://shop.blazemedia.com/collections/allie-stuckey

After her mom received a diagnosis of stage four pancreatic cancer and was pressured to endure invasive procedures that would ultimately do more harm than good, Dr. Casey means had a revelation about the medical system. It is not working. Instead of helping Americans get healthy, it is in a lot of cases making us sicker. It treats symptoms without ever getting to the root cause. And it often prioritizes profit over patients. And one of my favorite and most fascinating interviews I've ever done in all of my 1,000 almost episodes of Relatable, a doctor means unravels what she has learned about the corruption in American health care, while also giving us really practical tools to take charge of our health.

Also a very optimistic outlook on our future if we start moving in the right direction. You guys are absolutely going to love this conversation. She is the author of Good Energy, the surprising connection between metabolism and limitless health. We're going to be talking about all of this and so much more on today's episode of Relatable. It's brought to you by our friends at Good Ranchers. Go to Good Ranchers.com. Use Code Alley at checkout for a discount. That's good ranchers.com, code Alley.

Dr. Means, thanks so much for taking the time to join us. First, could you tell us who you are and what you do? My name is Casey Means. I'm a medical doctor. I'm an author of the upcoming book Good Energy. and I'm a co-founder of Levels Health, a metabolic awareness company. Okay, and I first heard of you. I saw a tweet thread sometime last year about you losing your mom and an article that you wrote

that basically said, look, I'm a doctor, I've been in the medical field for a long time, and you can't always trust us. And that statement accompanied with your mom's story was really powerful for me. I think for a lot of people who realize that we can't always trust the experts during COVID. So just take us back, take us back to that tweet thread, why you wrote that article, and of course, your mom's story. Yeah. Well, I think my mom's story is very almost like archetypal of what so many Americans are going through today, kind of realizing that something is not quite right when it comes to our own health, the health of our kids, the health of our parents. people are so sick in our country and they're getting sicker.

And we're put on this chronic disease, sort of pill-taking surgery treadmill, and yet we're not really getting better. So my mom's story really just is so emblematic of this and played off so much of my own experience in medicine as a surgeon. So my mom, you know, she was very vibrant and, you know, from the outside looked pretty healthy. But in her 40s, she had me. I was an almost 12-pound baby. Oh, my goodness.

I was big. Everyone kind of congratulated for that. No one really thought much of it. She had trouble losing the baby weight. She was in her 50s, had a tough menopause. Then in her 60s, she started getting, you know, the diagnoses that so many Americans have. High blood pressure. Here's an ACE inhibitor.

High cholesterol. Here's a statin, you know, prescribed 200 million times per year in the U.S. High blood sugar. Here's metformin. Very common. This is, you know, pre-diabetes. It's a pre-disease. Nothing to worry.

about. And then all of a sudden she's 72 and she's hiking with my dad near their house in Northern California and she gets a pain in her belly. And that's unusual for her. It lasts her couple days. So she goes to her primary care doctor. They order a CT scan. And it turns out it's stage four, widely metastatic pancreatic cancer. And 13 days later, she was dead. And, you know, at the time of her death, she was seeing what a lot of people would call like the best doctor's in the world. She was being seen at Stanford. She was being seen at Mayo Clinic, you know, really access to high quality health care. And the oncologist looked at my family in the eyes and said, you know, I'm so sorry. This was so unlucky, the pancreatic cancer. And knowing what I know about

really more a connected root cause perspective on health, to me, it's very clear that this cancer was not actually unlucky. It was totally predictable. But in our Western medical system that is so, reactive, it's so siloed, it's like whack-a-mole medicine. They saw all those things that my mom had throughout the past 30 years as separated, isolated things, the big baby, the trouble losing the baby weight, the tough menopause, all the metabolic issues, blood pressure, blood sugar, cholesterol, and then cancer. In our system, in our reductionist Western medical system, they all look separate and it seems unlucky. But what I'm really, I think, on this planet to share and what my book is about and what all my work is about is that through a different lens,

through a root cause lens, through a true physiology lens, what we'd understand is that all those symptoms and diseases she had are actually trunks of the exact same tree. And that tree is metabolic dysfunction. It's a core physiologic problem that's affecting 93% of American adults have some aspect of metabolic dysfunction. some of the most obvious ones you'd think about it would be like diabetes and obesity, but actually cancer, heart disease, stroke, depression, anxiety, having a big baby,

which is called fetal macrosomia, trouble losing the belly fat. Is that caused by just because I don't know, and a lot of people don't know the through line of the different diagnoses that you're talking about, like going back to you being a 12-pound baby. The only understanding I have of why that typically happens is if a woman, has gestational diabetes. So is that part of what you're talking about and all of these things are somehow connected to each other?

Absolutely. Yeah. So the trunk of this tree, this metabolic dysfunction, it can show up like gestational diabetes. And at its very core, not to get too science and technical, but in our society today with the rapid changes and our diet and our lifestyle over the past just like 50, 75 years, really since World War II, our industrialized diet,

our chronic stress from our devices, we're getting 25% less sleep on average than we were 100 years ago. The incredible amount of synthetic toxins in our food, water, air, and homes, it's fundamentally caused a problem with our cells that is super fundamental. It's a breaking of this metabolic machine in our cells. And metabolism is how we convert food to cellular energy. And the reason that this can look like so many different diseases is because, if you have a problem converting food energy to cellular energy to power ourselves, in different cell types, this can look like all different things. If it's, you know, in a liver cell, it can look

like fatty liver disease. In a blood vessel cell, it can look like heart disease. It can look like in the brain, it can look like depression and anxiety. So essentially there's this core issue that's caused by our lifestyle and our food system that is really breaking our bodies on a fundamental level showing up as all these different diseases across the spectrum. And our health care system is totally, totally blind to it, which is why they wait until the symptoms emerge and they treat those isolated symptoms, but they never get to their actual root cause because that's not the way our system works. It's about separation, not connection.

And it's such a blind spot, but it's such a lethal blind spot that it's really why it inspired me to write a book about it because, you know, you look at the trends that are happening today, which is that the more we spend on health care, we're spending $4.5 trillion a year on health care in America, and outcomes are getting worse. The more studies we do, the worse the outcomes are getting. The more specialized we get in health care, the worse the outcomes are getting. You know, it's sort of the definition of unsustainability. And the reason is because we're actually focusing on the wrong problem. We're focusing on reactive symptom-based medicine. as opposed to the connected root cause that's actually underlying most of the American diseases that we're facing today.

And in the case of the big baby, you know, in a mother who has this metabolic dysfunction, her blood sugar starts rising, that then transfers in the blood, the placenta to the baby. So the baby is exposed to that high blood sugar. That then causes the body to make more insulin in the little fetus body. and that insulin is a pro-growth hormone that causes the baby to put on more weight and more fat. So it's how those metabolic blood sugar issues are actually showing up in the fetus. And then being born above about 8.5 pounds, which is considered fetal macrosomia, that sets up the baby for metabolic issues for the rest of their life and also is a sign of the mother having issues. So really at every step along the spectrum, it was all pointed to the same thing.

the health care system is totally blind because it's so focused on reaction. Yeah. Each individual diagnosis. No one's taking a holistic look, even the top doctors. And I want to talk about how this all relates specifically to your mom's story because I know that there are a lot of people out there who either they've been recently diagnosed with cancer or a loved one has or they wish that they would have known this. Or I could see this conversation, someone having this conversation or are listening to it

And then next week, they're going through a similar thing and they're going to be so glad that they heard your story and heard everything that you're saying. So you're saying that your mom, when she was diagnosed with pancreatic cancer, that looking back over her life and some of the things that she suffered from, that it was pretty predictable, maybe not entirely preventable, but pretty predictable. It seems like it came out of nowhere because she was just hiking and she got that pain and she got it checked out. and then it was stage four. And when you talk to the doctors, you said these top doctors, they didn't have anything to say about her previous diagnoses. They weren't interested in that conversation at all? No, I mean, really, if you look at the way the system is designed,

it's so hyper-specialized. We have over 42 medical specialties. And really, like, to climb the ranks as an American doctor, it actually is getting more and more specialized. So I trained in ear, nose and throat surgery. And to really be at the top of my field, I would actually specialize further into either ear, nose, or throat, you know, become a rhinologist, a laryngologist, or an otologist.

And then even within those specialties, you might focus on one specific disease and become the world expert in that. So specialization is literally built into the very foundation of prestige in our system. And what that does is it gets doctors to, you know, really ignore the rest of the body and how things might be connected. There's also a financial incentive for that, right? The business model of our health care system is to do more to more people over long periods of time.

The stark reality, the stark economic reality of the American health care system, which is what needs to change if we're going to actually improve the health outcomes of America, But the stark economic reality is that every institution that touches our health, from hospitals to clinics to pharma, even to insurance companies, will make more money if you are sick and less money if you are healthy. And so chronic diseases, these isolated chronic diseases like what my mom had, diabetes, high cholesterol, high blood pressure, the system profits, obviously. treating those as separate things that you do things to for long periods of time, chronic disease management. So not actually healing it, but managing it. And so because that's built in to the deep finances of the largest and fastest growing industry in the United States, which is the healthcare industry, there is no incentive for people to back up and look at all of the things going on and say, wait a minute, maybe we're looking at this wrong. Maybe there's something more fundamental,

the trunk of the tree leading to all of this. Maybe we could just intervene there and a lot of this stuff would melt away. And that is the reality biologically. But because of the trillions and trillions of dollars that are baked into the way the system operates right now, no one has any real incentive to stop and to do that. And so the pieces actually get actively. held apart. If you think about going to the doctor, how often, if you have several specialists you're working with, how often are they talking to each other? Never. Usually the health records are in different systems, and it's almost impossible to even have one doctor see the notes of another doctor from another specialty. It's literally baked in on every level, the separation,

which is not serving patients. It's serving the financial interests of a reactive sick care system that is fee for service. After your mom was diagnosed, what did the doctors recommend? So this was what was so funny was that the second she got the stage four pancreatic cancer diagnosis, it was like full court press from so many different doctors. They wanted a hematologist to help her because her blood counts were low. The cancer was sort of causing her to destroy her red blood cells. There was radiation oncologists, surgical oncologists, medical oncologists, you know, radiation

surgery medication, there was a liver doctor who wanted to put a stent in and everyone was talking and it was incredible how much of a flurry it was. And we all kind of looked at each other and thought, wow, 40 years of symptoms that we kind of know are all connected. And not once was there like a flurry of activity to like truly get my mom healthy, to truly get herself to heal. But the second there was this big diagnosis, you know, very late stage, everyone flies into motion. And what was interesting is that the diagnosis was so bad, you know, pancreatic cancer outcomes are so bad. And my mom was so in touch with her body and her really spiritual knowing that she knew like she was, this was very bad. And she had this sense that it was going to be fast. So we actually declined all the

crazy amount of interventions they wanted to do and went home. And she was able to be. And she was able to die peacefully at home, you know, 13 days later, everything they recommended, nothing would have even basically had any time to have an effect before she died. And none of it would have been worthwhile. You said that there was a, in your article, you said there was a 33% chance that it would extend her life just a little bit. Just a little bit. And then 33% chance that it would do nothing. 33% chance that it would actually kill her, that the remedy so called would actually kill her and curtail her life even more. And so even if you took that 66% chance that she could live a little bit longer or that it would do nothing, she would still possibly if she took those roots

that the doctors were recommending because this was COVID era, she would have been dying in a hospital by herself. She would have been going to these procedures by herself. And you all knew that that's just not the end that she wanted for her. That's not what she wanted. Yeah. Yeah. And those numbers that they gave us didn't even take into account the additional complications she had. When she showed up at the hospital, the diagnosis, she was in liver failure because of the metastasies in the liver and her blood cells were depleted. So I think even that 66% of maybe having a benefit was so overblown. And so we looked at all this and said, you know, no, like we don't want to give my mom up to the hospital where she would have almost unquestionably generated, what, 500,000

dollars plus of revenue for that hospital and had to die alone in a COVID lockdown unit. So we asked questions and they of course were super shaming to us about, you know, not doing the internet, you know, just that it's irresponsible. Literally the liver doctor, if this was my mother, I would absolutely have her in there for that liver stint. I mean, she's in fulminate liver failure. She can barely, this is a few days after the diagnosis she was getting worse really quickly. She was feeling super weak and they are saying, you know, you got to get her in here.

And, you know, it's just so wild if you think that people who might not have the confidence or the background in medicine to ask some of the deeper questions, I think probably 95% of people would just kind of go with whatever the doctors said. Again, they're like the best doctors in the world. And it would have done nothing but hurt her. And that's not to say that people shouldn't take the intensive route, but we absolutely should be asking questions. And I think the system, one of the ways it's become so damaging, especially more

recently is that the system has really created an environment where people, I think, struggle to ask questions. We've been told, you think about the last five years, plastered on billboards practically, trust the science. You know, trust your doctor. And what's so alarming to me, and again, one of the reasons why we wrote this book is that the system when it comes to chronic health issues has really done very little to earn our trust as we've started medicalizing these chronic diseases, which are primarily based in diet and lifestyle, and many of which didn't even exist 75 years ago.

At the same time, we've been asked that trust the science, these diseases have exploded in their rates and are going up every single year as we spend more money on them. So what I think the health care system has done, I mean, it has produced miracles, of course, life expectancy has gone up in the last 100 years. But what our health care system has done well at is acute issues, things that are immediately going to kill you, like an infection or a trauma surgery or something like that you need to have. So acute issues. And that's primarily treating those, which are like the patient comes in, they get treated, they're gone.

Those, I think the health care system does a miraculous job at. But what the health care system has done has asked to take our trust on its success. in acute issues and apply it to chronic issues, issues that last for a long time that need to be treated for life. If you think about an acute patient, that's not recurring revenue, but a chronically ill patient is recurring revenue for decades. And so essentially the system is asking us to not ask questions and to trust blindly because of the trust they engendered from acute issues, apply it to chronic where they're abjectly failing at keeping us safe. They're not preventing these conditions. They're certainly not reversing these conditions.

they're just managing them. And the message that I really want people to understand is that it's actually much less complex than we think to really improve our foundational metabolic health, to improve really the way our cells function and to really generate true health in our bodies. But we've got to focus on the right issue, which is helping to clean up the environment that our bodies and our cells are living in right now that are breaking them. And when we do that and we really do truly heal the foundational pathways of our body related to metabolism and cellular health, we end up getting just incredible health across all these different systems.

But unfortunately right now, that's not what the system is going to help you with. Their revenue model is based on more patients going through the system as quickly as possible, which lends itself to going in, getting a prescription, and leaving. And you mentioned both in the article and you mentioned it in this conversation too, the profit incentive. You talked about how your mom going through all of these procedures would have generated $500,000 for the hospital. But you've also mentioned how the doctors specifically have a financial incentive right to push some of these routes to go down when it comes to diagnoses like your mom's. Yeah, certainly. I mean, I would say just to start, like every single doctor I know,

is like a very good person who went into health care with noble intentions. That is the reality. But unfortunately, we're taking these very bright, eager minds who want to help, and we're putting them in a system with just one dictum, which is economic growth. And so what happens is that every level of the education and the way we practice and the science gets corrupted, right?

Because of that financial incentive. And so I think in many cases, doctors feel like they are practicing good medicine because they're following the science. They're following the guidelines, not totally realizing all the ways in which the science and those guidelines are heavily influenced by things like the pharmaceutical industry or the ultra-processed food industry. You know, 95% of people on the recent USDA food guidelines for America had conflicts of interests with food companies. And so at every level, it's been influenced and corrupted. And so you've got these good minds practicing in a bad system. And I remember when I was in my fifth year of surgical residency going out to launch out as an independent surgeon in the world, you know, the senior surgeons would sit down and talk to you about the business of medicine and say, you know, as a private practice surgeon, you eat what you kill. And that's unfortunately a very unfortunate euphemism that basically just means your income is based on how many surgeries you do.

You eat what you kill. Your income is how much you do. And so because that is the way that you'll get paid, that's how your mortgage is paid and your kids' tuition, of course you want to do as many surgeries as possible. So I would not say it's like you're pushing surgeries on people knowing that it's not what they should have or something like that. but when you have a hammer, everything looks like a nail. And so it's just really baked in. And certainly on a deeper level, many physicians, you know, are paid by hospital system is based on how many RVUs they generate.

RVUs are essentially billing units. And so the more you bill, sort of the more supported you are as a surgeon. And so it's just built in on every level. And interestingly, with the Affordable Care Act, you know, Obamacare, which kind of paid lip service to this idea of value-based care, which in theory sounds really good, as opposed to paying for doing stuff to people, we would pay for better value. And value is outcomes over cost. So that kind of sounds great. Wow, if we have better outcomes, lower cost, we'll get paid more. And the cheapest way that you're going to have

better outcomes, lower cost, is just having people eat healthy. So, like, wait, wait, wow, maybe this will push doctors to push nutritional interventions or exercise. Unfortunately, the whole thing got very corrupted. The outcomes measures that doctors would report on for value-based care, many of them were not actually, did the patient have better health outcomes? It was things like how many of the patients in a doctor's panel were prescribed long-term medication therapy. So instead of the outcome being, did the patient actually get healthier, the outcome was, was the patient well medicated? And if you're not looking closely, you could be like,

well, yeah, we want all the patients with diabetes to be on metformin. Of course, we want all the patients with asthma to be on long-term control inhalers. But because the outcomes were defined by essentially medication adherence and not actually, is the patient actually healthier, it drives to more of the same system, which is intervention-based. So it's a way that's sort of like a good idea can still get shunted towards that reactive intervention-based system. And as you're talking about the more funding that this institution, that this system has, actually the worst outcomes have gotten. That is true in a lot of institutions. It's true in a lot of different sectors of society.

It's true in education, too. We actually spend more per pupil in real dollars than we ever have. I mean, times more than 100 versus what we did 50 years ago, and outcomes are getting worse. And it's just, it's interesting. It is nice sounding that we need to fund something. Of course, this good thing needs more money. If we just give it more money, then it will be able to, accomplish what we wanted to accomplish, but that's kind of an easy way to put a band-aid on something

and not look at what's happening underneath the surface, what's really going on. You've explained really well what's going on in the system and why corruption happens. Do you think that how doctors are educated in the medical school has anything to do with this, or do you feel like this really kind of starts after they get out of medical? school once they start practicing once they see how the so-called game is played and again i'm not trying to ascribe bad you know bad motives to all doctors but as you said this is just kind of how everything works like do you think it goes all the way back to education or do you think it happens after they're in the field and they're just playing the game as it's played oh unquestionably i mean

i think it starts oh it starts as early as college like if you think about it everything in our system funnels you towards fragmentation and specialization as a marker for increased success. So in high school, you learn about, you know, all biology. You learn about like plants and bacteria and cells and human cells. You're kind of learning about everything. Animals. Then in college, if you're a biology major, you know, you focus on human biology. Like my major in college was human biology. So you go from all life to humans. and then medical school, you start focusing on each organ system within the human. Like literally the way the education is structured at Stanford Medical School where I went is like you have a nephrology block and you have a hepatology block and you have a neurology

block and you have a cardiology block and you have a gastroenterology block. It's like the body is just these individual parts. And then you go into residency and you specialize in one of those and then you go to fellowship and you go deeper. So built into the brain. brains of people is disconnection. It's not seeing things as a system. And what's interesting is that it's basically like we're just practicing outdated medicine because 75 years ago when we didn't have metabolomics and proteomics and we couldn't visualize inside the cell the way we can today,

the only way we could describe diseases was basically like how they looked like the symptoms. So like, oh, depression is this constellation of symptoms. That's how we define. the disease. And only recently have we been able to define diseases based on what's actually happening inside the cell, more like physiologic pathways. Okay, so the mitochondria is dysfunctional, and we have chronic inflammation, and we have oxidative stress, and these like invisible processes that we can't see. But, and when you look at that level, what you find is that those same disturbances, these invisible microscopic cellular disturbances, are actually happening all over the body, obviously, we're one body. And they're just showing up in different places as different

symptoms. But medicine hasn't caught up to describe diseases based on what they really are, which is what's going on that invisible layer. They're still describing diseases based on collections of symptoms because that's what we can see. And so of course, depression looks different than cancer. Of course arthritis looks different than erectile dysfunction. Of course, infertility looks different than a stroke on the outside. But when you, you zoom in and really look at what's happening inside the biology, it's all the same thing. And so there's, so yes, I think from the education standpoint, it's basically a like very fragmented look at things, not to mention that pharma underwrites like so much of the actual medical school

education. Like when I was at Stanford Medical School, Pfizer donated $3 million to Stanford. And that was during the time that the new opioid guidelines were being released. So there are currently on the Stanford website articles that say that that money from Pfizer had no impact on how medicine repracted. There's no conflicts. It's an educational grant. But like, money is money. You know, it's, of course, you're not going to be absolutely issuing opioid use for holistic therapies

like acupuncture and micronutrients and stress management in the face of a $3 million grant. So, I mean, maybe I'm wrong, but that just feels kind of logical that you would not be really putting down the medications of the people who are donating huge amounts of money. So yeah, I think it's not only money. It's also just like the real framework of health care that needs to be updated. And when I talk about the fragmentation and disconnection, I think it's, it gets into almost a more, like, esoteric and spiritual issue with our system, which is that we've asked people to really look at their bodies as these like fragmented separate things and not as like this miraculous

system that all works together. And I think people, I think people in America feel very almost, you know, health care and the body seems so complicated. It seems so complex to be healthy. Everyone's really putting the trust like outside of themselves with the experts, you know, and with the science. And it's almost like the system has designed this whole ecosystem that gets us to distrust our own internal knowing about what's right for us and how to be healthy. And what I really want to share with people is like to really just not accept that. Like I believe that every person has such deep internal knowing about what's right. for them. And we've just been asked to be like divorced from our common sense in a way when it

comes to the health of ourselves and our children and our parents and to really put that agency outside of us to our great detriment. And like just step back for a second. We're the only species in the world with a chronic disease and obesity epidemic. And we're the only species in the world with experts and pub med. You know where all the scientific papers are. It's like we are the only species that is eating ourselves to death. And so maybe we need to actually wake up a little bit and get back to really trusting ourselves, getting in touch with our bodies, seeing our bodies as this miraculous connected ecosystem that it is, and like tapping a little bit into that confidence that the system really wants to disempower in us. Because when we feel

week when we feel that it's too complicated for us, when we feel disempowered, what does that do? It gets us to be, you know, rabid consumers of solutions and of experts outside of us, which unfortunately isn't really working very well for us. So I think getting back to like real trust and agency in our own, you know, common sense is really an important part of this too that the system has divorced us from. Wow, I have so many thoughts and questions about everything that you just articulated so well. I was just thinking about my own medical history. I have hypothyroid, and so I take medication for that and have for a long time.

And there have been various times where I've had other symptoms, and they have sent me to specialists, the nephrologist or whatever, when really, at least in my case, of course, I can't speak from a medical professional standpoint and I can't speak for anyone else. but it ended up that it was all actually connected to my thyroid and getting on the, you know, the right level of medication or lifestyle choices. I actually didn't need in my case to go see the specialist. There was nothing wrong with me. There were just these kind of like off symptoms.

And so I'm thinking about that fragmentation and how my nephrologist at the time had no idea what was going on with my thyroid. Didn't even care what was going on with my thyroid. It was just, you know, this is how I look at your kidneys. your kidneys seem to be doing fine. And so then it's left up to the patient. Okay, so I have to bridge the gap. So when I go to my endocrinologist and I say, well, my nephrologist said that my kidneys are fine.

And the thyroid doctor says, well, we're still seeing this. So me, without any medical degree, and I'm speaking probably for a lot of people, I have to be the one to go to WebMD and be like, well, okay, well, what is going on here, which just causes a lot of anxiety? And then what? You have to go see another specialist that's supposed to bridge the gap between those two things. And so we're simultaneously being expected to have the level of confidence and expertise of a doctor while also being told you are too stupid to even ask basic questions about your health. And so we're put in this very tenuous situation of having to be our own health care experts and advocates because our doctors are like, I don't know, I don't know, I don't know.

Even with thyroid asking my endocrinologist, is there anything I can do outside of medical? to help. Nope. Nope. Nope. Nope. The answer is always no. So, okay, I have to become an expert in nutrition. I have to become an expert in metabolic health. I have to become an expert in thyroid. But if I ask you these questions, it's like, how dare you ask me? So it's just so difficult to be a patient in the United States. It is. Or maybe anywhere. Maybe it's that like that everywhere. I don't know. Well, I think a lot of it's unique to the United States or other countries that have move towards a system like ours, but you speak to such an important point, which is this sort of trap that we're in where we are both dependent on the system, but also, you know, really aren't getting

good quality out of the system. And so it's like, it's such a tug of war. Like, you know you're kind of not getting the full answer, but we're also kind of dependent on it because, you know, things are pretty bad with health right now. So we have to keep going to see these specialists, but not quite getting the answers that we want. But there's not really a good alternative, right, unless you're like finding your own functional medicine doctor, which like I recommend for everyone, like someone who's really trained to see the body as a unified system, whether it's functional medicine, precision medicine, naturopathic medicine, doctors that have a bit more of that like put it together perspective. But what I actually think is so exciting about this time, I'm actually extremely optimistic. And what I think is so exciting about the time that we're living in right now is that while some of the trends are like very, very concerning, I mean, we could run through stats, but like children's health terrible. You know, life experience is going down in the United States. Like six and ten adults have a chronic illness. It's all bad, you know. 70% I think are technically obese or at least overweight. 75% overweight or obese. 50% of American adults with pre-diabetes or type 2 diabetes.

almost totally preventable. 30% of children with prediabetes. That was 0% 50 years ago. 45% of children overweight or obese. Nearly 20% of kids with fatty liver disease, things that doctors would never have seen in their career 50 years ago. 40% of 18-year-olds with a mental health diagnosis. It is bananas, like what is happening with the stats and the trends.

But I'm very optimistic because we are, we are living in a time where just in the last two to three years, there's sort of this personal empowerment revolution, I think, happening in our health care system. Part of its technology and part of it is, I think, the response from COVID, people are feeling a lot more like I need to, like, be more of an active participant in my health care because the health care system really let us down during that period.

So with the technology side, just in the last few years, there's now tons of companies doing direct-to-consumer lab testing so you don't have to like beg your daughter so you don't have to beg your doctor for basic lab work on their timeline you can literally just go online and order 100 biomarkers for $499 it's amazing and then with like deep interpretations so that's one there's now wearables you know so you can really understand a lot of your core vital signs there's is that what that is this is an aura ring Yeah. So this tells you my sleep, my steps, my oxygen saturation, my heart rate variability, stress levels, all sorts of things. So that's really amazing because then if I start to see something going in the wrong direction, I can take action myself, you know, before it gets to be a problem. We've got biosensors like continuous glucose monitors that can tell you in real time what's happening with your blood sugar as opposed to waiting a year from now for your doctor to give you a single data point about your blood sugar and maybe say, oh, it's getting worse. or whatever, you can see it now in real time without having to go to your doctor. So there's

these trends of personal empowerment and data that are very, very exciting. And currently, those aren't, they're expensive. They're not necessarily accessible to everyone, but it's a movement towards, okay, I'm going to be in control of my day-to-day health to hopefully avoid some of these chronic lifestyle diseases that are totally plaguing us. So that's very, very exciting. and then to speak to what you were talking out with the thyroid and the kidney, I think a big message that I want to really share with people is that it's not as complicated as we've been led to believe. So if we think about symptoms anywhere in the body, liver, kidney, thyroid,

all symptoms, like all symptoms that we have are necessarily the result. of dysfunction within our cells. They have to be. Our entire bodies is just like 40 trillion cells. And we don't have a symptom arise out of thin air. It has to arise out of dysfunction and how our cells are working. And there's not actually that many things that affect how our cells function. It's literally like food, sleep, movement, stress, temperature, light, and top. Of course there's genetics, but those pillars, which I talk about in extensively in my book, those are the knobs that we can turn to like change, you know, how we're meeting the needs of the cell. So if you have a symptom, it means there's cellular dysfunction. And if you have cellular

dysfunction, then you need to run through the list of what's affecting your cells and take stock of what could be hurting them or helping them and make adjustments. And most of the healthcare crisis we're in today could really be wiped away if we actually just sort of ran through that list and of those different pillars of sort of lifestyle and environment and thought about like how am I meeting the needs or not? And then a question would be like, well, how do I know? And one of the ways is by just looking at your own biomarkers, like I just talked about getting the lab testing, whether it's from a direct consumer company or from your doctor, basic lab markers that your doctor orders, and look at what the biomarkers are saying. So if you have symptoms and your biomarkers,

are off, it means you need to turn some of those knobs probably on those dietary and lifestyle things. And again, like pretty simple how to do that. It's like get more sleep, move more, eat more real food, less processed food, et cetera. Again, all outlined in my book. But starting there with like a real first principles framework about what's going on, I think can be really, really empowering. One of the ways that I look at my body is I'm like, it's sort of like I, Casey, I'm like the mother to my 40 trillion cells. And they're all like little infants. And they can't speak in words. So if they're not getting their needs met, they speak in symptoms. And just like a baby, there's not that many things that you would necessarily adjust if you have a crying baby. It's like,

do they need a diaper change? Are they cold or too hot? Do they need to sleep? Do they need milk? Like with our cells, you kind of just run through the checklist as well. It's like, like food, sleep, exercise, stress, temperature, light, toxins, et cetera. And it's just really doing an inventory of like, how do I help meet the needs of what these cells need? And then how do I not overburden them with things that they don't need that are going to cause them to break? They're just little machines.

They're just little factories. And we know how they work. Like, that's the beauty of our scientific world is that we do really know how cells work. And so I believe that all could sound a little intimidating, but like it's actually not not that challenging. The system wants us to think it's complex. But if we got ourselves into this chronic disease mess in 50 to 75 years, clearly it's not that complicated. We know how the environment's changed. We know how to protect ourselves. But we have to be empowered, understand a little bit about the biology, understand a little bit about how to interpret our own biomarkers, which I'm happy

to talk about if you want to, and then just have the boldness to take action in our own lives. And sometimes does that means being a little counterculture and doing things a little differently than everyone else in your community is doing? And it's worth it because being sick is not fun. Yeah. Speaking of counterculture, there is kind of the movement and I don't know how prevalent it is in the actual medical world. It's kind of something that we see more on social media. The body positivity movement, which I think has some positives to it. Absolutely. I don't think that everyone needs to look to a supermodel who is underweight to be, you know, the standard of beauty or the standard of health. And so moving into a more realistic view of the body and health and strength

and all of that, I think can be good. But just like any trend or movement, it can swing too far. and we have seen kind of an either normalization or even glorification of unhealthy lifestyles and obesity and a push against what is referred to as fat shaming even by doctors. And so I think there is a fear of saying one type of choice or one type of lifestyle or one type of diet is bad. or being a certain weight is bad or being fat is bad. Like there's almost a growing stigma around that now because we don't want to say that anyone is making the wrong choice or doing something bad or unhealthy.

Like, do you see that in the medical world? Oh, this is definitely happening in the medical world. People are petrified to piss anyone off in our world right now. I mean, I think we have unfortunately an epidemic of California, that's happening in our country because people are so afraid to get any backlash. Because of the way our digital world works, it's so easy for people to like weigh in and to, you know, tell you you're, you know, horrible if you say this and that, that people are really, I think, silencing themselves. You are not one of those people. This is why your platform is amazing. And I think,

but I do think there is such, such fear of being perceived as anything but like the good girl and the good boy. And it's, I mean, great. So we can just like please everyone as our, as Rome burns and as the country gets closer to 100% of people literally being sick. But, you know, it's crazy. But when it comes to this sort of the fat positivity movement, I mean, one thing, that's coming out more and more is like how many of these nutritionists that are pushing some of these messages are actually paid for directly by the processed food companies. So you always have to follow the money. And this has come out in news articles in the past six months that a lot of these TikTok and

Instagram nutrition influencers are getting direct payments from multi-processed food companies who, of course, it would absolutely be in their best interest for everyone to think that, you know, it's terrible to talk about weight because their foods are designed by food scientists to get us to be insatiably hungry and eat as much of it as possible. So always follow the money. But I think the real reframe that needs to happen with the conversation about obesity or weight or BMI is to ignore, maybe ignore the weight component and just focus on metabolic health. Like there are people who are overweight who are metabolically healthy. It's a small percentage. But what everyone needs to know is whether they are metabolically healthy.

Because if that's the case, you're going to avoid a lot of the top killers that are killing people in the United States. And you're going to have better longevity. But if you're not metabolically healthy, you are more likely to suffer from many of the non-lethal symptoms that are plaguing us, from depression, anxiety, migraine, fibromyalgia, gout, infertility, erectile dysfunction, all the way to the things that are going to kill us, like stroke, heart disease, cancer, type 2 diabetes, Alzheimer's, dementia, fatty liver disease. All of those are on the metabolic spectrum. So you have to know if you're metabolically healthy.

And the reason the conversation would benefit from switching from talking about obesity to metabolic health is because it takes away a lot of, I think, the stigma about how someone looks. Right. That's true. And it's a little bit more like just feels more stable. It is very simple to know if you're metabolically healthy or not. You literally have to look at five biomarkers that are generally free on your annual physical. And these are the criteria for metabolic syndrome, which is fasting glucose, triglycerides, HDL cholesterol, waist circumference, and blood pressure.

And if people have a fasting glucose under 100 milligrams for deciliter, a triglyceride level, under 150 milligrams for deciliter, an HGL cholesterol above 50 for women or above 40 for men, waist circumference less than 35 inches for women and 40 for men, and blood pressure under 120 over 85. They fit the criteria for metabolically healthy, and they will likely have a much lower rate of all the chronic diseases affecting Americans today. It's that simple. Those are basically free. They just, I mean, if you get a cholesterol panel, fasting, glucose, and get your blood pressure, taken at the doctor's office and a waist circumference, which is pretty standard on every annual physical. You can know that. The wild information is that only 6.8 of Americans now have the healthy

levels of all five of those biomarkers not on medication. So if you look at the recent research from the American Journal of Cardiology that looks at those biomarkers, if you're in the correct, you know, the healthy range for those biomarkers not on medication, it's only 6.8% of American adults. It should be 100%. Those are all lifestyle-based. So we need to move away from the conversation, I think, about just obesity, which is so charged and talk about empowering people to take full ownership of are you metabolically healthy? Because if those biomarkers, one or more of them are not in the proper, you know, the healthy range, it's a single. It's a single. signal that there's a fundamental problem with how your cells are converting food energy

to cellular energy, which means that you're going to have essentially underpowering of this miraculous body. And of course, that will lead to dysfunction, which shows up as symptoms. So I would just implore people to just make sure they understand their levels on those biomarkers. And then, of course, there's lots more advanced testing you can do to know more about your health, fasting insulin levels, inflammatory markers, liver function tests that together can also add richness to the picture of sort of underlying health. But like, every American should know

where they are, whether they're in that 6.8% or not. And if they're not, they should do everything in their power to get there and make that number bigger because it will have wide ranging positive impacts on every aspect of health. And it's pretty simple. to do. Eat real food. Yeah. Sleep. Move your body. Manage your stress. Don't overload your body with synthetic toxins, et cetera, et cetera. So. Oh my goodness. I feel like I've been to medical school. I feel like I've learned so much in this conversation. That's great advice. And obviously people

are going to get more details about all of those things and even more specific, advice in your book, Good Energy. Give us some tips, if you will, as we kind of close this out on how we can advocate for ourselves to our doctors. You have been in all the positions. You've been a patient. You've had a parent who has had a life-threatening and a fatal diagnosis, and you are a doctor. So from all of those different angles, how should a patient best advocate for ourselves or our loved ones? That is such a great question. The primary thing I would say is that never be afraid to ask questions and always probe deeper, you know, you are the customer. Like, you get to ask the questions. And if your doctor's not willing to sit with you and ask and answer your

questions, like find a new doctor. I think one thing that people can do, if they're feeling sort of lost in their health journey and like they're seeing a bunch of different specialists and it just feels like they're going through the revolving doors, consider seeing like a more holistic focused doctor, like a medicine doctor. There's a great website called ifm.org, which is institute for functional medicine.org. And these are going to be doctors who have this more like connected systems view of the body and can often be that bridge that you were talking about of like looking at all your records and helping you kind of put the pieces together of how they all relate. They'll also often order more extensive lab work. But on that website, you can find practitioners

in your area who practice that type of medicine. Parsley Health is a wonderful digital health organization that's very affordable and takes insurance that practices functional medicine. And then I would also just consider if you have a diagnosis that's stubborn, like a hypothyroidism or something like that, like go into Google and search your symptom and then just write, you know, functional medicine or like dietary and lifestyle strategies after it. And you're going to end up going seeing a lot of other types of like blog posts and articles that might give you like some ideas for books or podcasts that can just sort of expand or thinking about what's possible like and it's not like this is fringe the cleveland clinic

which is one of the premier hospitals in the country has the cleveland clinic center for functional medicine and at thomas jefferson university in philadelphia there's thomas jefferson marcus institute for precision medicine which is practicing this way um and so there's different hospital systems that are like major and mainstream who are like practicing this way and they have weightless for like years because people want someone to put the pieces together but at a very at a minimum you can start to like shape the way you're researching online with a few of those like extra search terms to basically see if there's you know thought leaders that you know that that resonate with you I also highly recommend books by obviously good

energy is filled with its information that comes out May 14th but Dr. Mark Hyman has written 19 books on a root cause approach to health. Many New York Times bestsellers cannot recommend his books enough. Sarah Gottfried, Terry Walls is an autoimmune expert who's written books about autoimmunity and root cause perspectives. Jason Fung, Kara Fitzgerald, David Perlmutter. There's wonderful academic thought leaders out there who are talking about this stuff. And I think books can often be a gateway to a whole new way of thinking about things. So yeah, all of those have impacted me greatly. Wow. Dr. Means, can I just say that you have been one of my favorite ever guests? And I really mean that. We have almost a thousand episodes of Relatable now. I've interviewed a lot of

people. I love all of my guests, but you not only are so knowledgeable, but you are so good at articulating the knowledge that you have and not everyone has that ability. So I really do believe that God has given you special gifts. And you said at the beginning that you feel like you've been put on this planet to talk about this. And I can see it. I really can. I can see that this is something that you have been called to do.

And, you know, it's really interesting how God redeems tragedies because I'm sure you would not have chosen for your mom to get that diagnosis and for it to unfold the way that it did. And yet he is so good at bringing beauty out of ashes and then using something. that no one ever would have chosen using something so dark and so tragic to then not just help you, but to help countless people through the message that you're conveying. So thank you for doing that. Thank you so, so much. Thank you for using your voice to always push for a better world. I appreciate you so much. And that last point you just made resonates so much. Nothing has helped

me feel more spiritually grounded and more in touch with a bigger picture than this experience with my mom. and then seeing how it's unfolded, seeing beauty come out of tragedy, I think that that in and of itself and how it was transformed into beauty in my own life has made me realize on a bigger level that there is, there's not as much to fear in the world as I think we are made to believe. And I think that's a big part of our health journey too, is waking up to realizing that like there's actually, we live in a really beautiful universe and we live in a really, you know,

there's a bigger picture. And kind of popping up into that bigger picture, I think, is actually also incredibly important for our health journey. Like that things can seem really bad, you know, here day to day. But it's like there's actually a really beautiful bigger picture going on. And I think that knowing has actually been a huge part of my health journey too. So I appreciate you saying that. And I think when we can tap into that awe, it helps on every level. Definitely.

Well, Dr. Means, thank you so much. I really do encourage everyone. They can go ahead and pre-order your book? Yes. Okay, so they can pre-order your book. It'll be out May 14th. I'm so excited for you. I hope it's a bestseller. So I'm so excited to read it. I'm excited to go back and listen to this conversation to take notes on everything that you said. So thank you so much, Dr. Means. I appreciate it. Thank you. Okay. I hope you guys loved that conversation. I was thinking the whole time that she was talking about the importance of seeing the body as one unit with many parts about how the church, is described as one body with many parts. Like even though it is speaking metaphorically in scripture, it still emphasizes this same principle that the body has different parts that are working together. So I didn't have a way really to fit this into that conversation,

but I wanted to use it as just a closing encouragement to you and a reminder that God is so wise. So this is 1st Corinthians. 13, starting in 1 Corinthians 12, rather, starting in verse 14. For the body does not consist of one member, but of many. If the foot should say, because I am not a hand, I do not belong to the body. That would not make it any less a part of the body. And if the ear should say, because I am not an eye, I do not belong to the body. That would not make it any less a part of the body.

If the whole body were an eye, where would be the sense of hearing? If the whole body were in ear, where would be the sense of smell? But as it is, God arranged the members in the body, each one of them as he chose. If we were all a single member, where would the body be? As it is, there are many parts, yet one body. And he goes on, of course, he's talking about the spiritual gifts that each member of the body of Christ brings to the church. But again, the underlying principle here is clear that all parts are necessary, that all parts work together, that all parts depend. upon one another. Isn't it interesting that these biblical writers so many thousands of years ago

understood something that apparently many of our top medical doctors don't understand today? And I was also reminded of Ephesians 415. Rather, speaking the truth in love, we are to grow up in every way into him who is the head into Christ, from whom the whole body joined and held together by every joint with which it is equipped when each part is working properly makes the body grow so that it builds itself up and love. God is so wise and just as with everything. Science is always catching up to God. All of the things that become new discoveries today,

we can always go back to scripture and say the principle was always there because the God who created all of this, who was the author of life, the creator of our bodies, he has known it from the beginning because he is the source of all truth. And so we are just on a journey figuring out and catching up to the wisdom that God has always had and has given us through His word. So I just wanted to end with that, with that spiritual truth.