A Means to an End for Public Health
The Surgeon General might kill you with snake oil, but at least your mitochondria will be optimized
A few months ago, Vanity Fair dropped a detailed and not particularly flattering biography of Calley Means, a former wedding dress entrepreneur, self-proclaimed anti-Big Soda whistleblower, and haughty yet incompetent personal assistant who has somehow climbed the ladder to become US Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr’s chief social media troll. In his current government role, Calley is a professional Twitter replyguy who makes the rounds at MAHA events, podcasts, and media outlets as an aggressively scornful fascist tool who preemptively deflects challenges to the unscientific nonsense about food colorings, preservatives, and vaccines disgorged by Kennedy. He also runs a company called Truemed that allows people to buy Pelotons and Apple Watches with pre-tax health savings accounts (HSAs) and flexible spending accounts (FSAs). You can pay Calley to provide a doctor’s note enabling you to buy tax-free turmeric supplements from Truemed’s partner merchants. Because he is designated as a Special Government Employee, he continues to run and profit from a company regulated by the government department he works for.
I first encountered Calley when he popped up in my replies back in March to sneer at my objection to replacing the NIH policy on scientific integrity with…actually, I’m not sure. There’s now a cheerful “Oops! That page can’t be found” notice and shutdown disclaimer where the policy on scientific integrity used to be. Calley scoffed at my concerns and implied that I was hilariously stupid to believe that a Biden-era policy would “reinstore” scientific integrity at NIH. I went to his profile to see what his deal was (he’s a grifter), which is how I became acquainted with his sister Casey. She’s even worse.
Dr. Casey Means is a health influencer with nearly a million Instagram followers, a diet book called Good Energy: The Surprising Connection Between Metabolism and Limitless Health co-authored with Calley, a Truemed partner company called Levels that sells blood glucose monitors to non-diabetics, and what I’m guessing is at least six figures of brand promotion income from her influencer content alone. She dropped out of her surgical residency, is not board certified in any specialty, holds an expired medical license, and has no public health background whatsoever outside of promoting scientifically unsupported disease remedies in her newsletter. She is also the nominee for US Surgeon General. Her Senate confirmation hearing is on Thursday.
That is most unfortunate, because the last thing we need is yet another shameless profiteer at HHS, especially serving as America’s top physician. Casey is completely unqualified to be the US Surgeon General.
Standard errors of the Means
Both Means siblings have promoted themselves as products of elite education (Stanford for Casey, Stanford and Harvard for Calley) who were inspired to shrug off the yoke of conventional medicine and fight back against the establishment when they did shrooms together after their mother’s death from cancer. They operate as a team, making the rounds on right-wing and medical contrarian podcasts, spreading the word that conventional medicine is bad and corrupt and does not address the “root causes” of all illness. According to them, Big Pharma, Big Ag, and Big Food conspire to keep people chronically ill with metabolic dysfunction brought on by seed oils, vaccines, synthetic food dyes, and fluoridated water.
Metabolism-modulating toxins are everywhere and on top of that, the world is morally and spiritually corrupt with all the medicines and the regulation and the Ozempic and the trans kids and the birth control pills and the vaccine mandates. There are microplastics and endocrine disruptors everywhere, women have jobs and never cook anymore, and as a result, our mitochondria just aren’t cranking out ATP like they used to. Casey told Megyn Kelly that “we’re facing, I would say non-hyperbolically, extinction-level trends in our health right now.” Oh no, it’s the metabolic apocalypse! The only way to stave it off is lettuce wraps made with Means affiliate marketer chia seeds!
Good Energy, Casey’s newsletter, and the Meanses’ social media and businesses all push the thesis that human health is dependent on root cause treatments, which according to them are usually some bullshit about cellular energy production. Root cause treatments include eating whole foods, exercising, “respecting” your Circadian rhythm, and collecting information on metabolic biomarkers from which Casey’s AI-powered Levels app can divine a prescription for better health via supplements, tech, and more biomarker tests. Casey’s goal is to stick a wearable data collection device on as many Americans as possible, with Calley trying to sell more of them by expanding HSA/FSA coverage to pay for them.
Their narrative involves each of them rebelling against the corporate establishment by becoming wellness entrepreneurs. Calley came to the MAHA faith when he was supposedly disillusioned by a brief consulting career in Big Food and Big Pharma. Casey had two eureka moments that drove her to compose AI-augmented MAHA poetry from the woke public health-loving devil’s perspective (“I’d give boys man-boobs through toxic food”): when she dropped out of her residency and when her mom died from sluggish mitochondria caused by too many toxins and processed foods (actually stage IV pancreatic cancer). Casey attributes her mother’s death to “metabolic abnormalities” caused by bad blood glucose levels and smoking and eating takeout in New York City decades before, rather than metastatic cancer that was detected too late to treat. If only mom had gotten her biomarkers checked and AI-analyzed, she could have done more intermittent fasting, cold plunges, and optimized her glutathione levels in the two weeks between her diagnosis and her death!
While I sympathize with the Meanses’ grief, I can’t help but notice that they never miss an opportunity to imply that Big Corporate interests and corrupt government authorities metabolically murdered Mother Means. Their bereavement also inspired them both to sell products and services that will supposedly protect your loved ones from meeting a similar fate. Their businesses are conjoined and feed each other customers: Truemed will sell you a Levels continuous blood glucose monitor that you don’t need. You can test for other biomarkers using Function Health, a subscription testing service that Casey invested in. Based on those biomarkers, Levels will recommend all sorts of remedies. If it doesn’t seem like they are working, that’s because they treat the “root cause” of the disease, not the disease itself. You will just need to buy more root cause remedies, most of which they also sell. Casey recommends respecting your Circadian rhythms using $3700 Eight Sleep smart beds, which are also conveniently sold by Truemed. Casey will give you a recipe for the grossest looking beet pancakes in the universe containing numerous ingredients sold by her sponsors. Casey can helpfully direct you to sign up for other subscription services like Function Health.
The Meanses’ willingness to exploit their family relationships to promote both their businesses and their pseudoscientific ideas about health disturbs me. It’s simultaneously deeply cynical and very weird. It’s Flowers in the Attic as a wellness scam—complete with poisonous donuts, inappropriate inter-sibling discussions about reproduction, and constant invocation of an absent, morally compromised yet messianic mother—but with graft, nepotism, and Tucker Carlson instead of incest.
Girls just wanna have fun(ctional medicine)
Casey Means isn’t board certified and she dropped out of her surgical residency before completing it due to her inability to cope with the pressure of the job. Her Oregon medical license has lapsed. But she need not worry about gatekeeping or credentials in the pseudoscientific specialty she chose: functional medicine. If she becomes Surgeon General, we can all expect to have functional medicine imposed on all of us. I hope you’re ready to hear more root cause and biomarker bullshit constantly, because that’s what we’re in for with Surgeon General Casey Means.
Functional medicine is a branch of pseudoscientific thought and practice that is basically as woo-filled as any other form of alternative, complementary, or holistic medicine, except with unnecessary laboratory diagnostic tests instead of crystals or energy baths. Functional medicine proponents love collecting data—the more, the better—and then analyzing it and translating it into medical guidance. The problem is in the translation part: most of the time, this means that the functional medicine guru just makes shit up to sell unneeded or unproven products. Your A1C levels are too low! Your free radicals are too high! You have too much cortisol! You aren’t just tired, you have a chronic illness because your (fill in random biomarker here) levels are out of range! Buy this red light photoimmersion therapy device and start irradiating that root cause away.
Levels, for example, uses continuous blood glucose monitoring on non-diabetics to feed an “AI-powered” app that makes recommendations for metabolic optimization. No studies have shown that monitoring blood glucose provides any kind of health benefit to non-diabetic patients. Yet, according to Casey, Levels glucose monitoring can help people supercharge their metabolic health by personalizing recommendations for things you can buy from her sponsors and partners.
Because this is completely unsupported, Casey justifies this by injecting all of her innovative thinking with a hefty dose of MAHA/MAGA ideology. For example, she hates feminism because it makes women less womanly. Feminism makes women not want to cook. She blames infertility on women’s diets. She has claimed without evidence that hormonal birth control is toxic, increases the risk of breast cancer, and stomps on “the life-giving rhythm of nature.”
An observation I’ve made about functional medicine proponents is that they love collecting data, but none of it ever supports their claims. That’s because functional medicine isn’t a scientific method. It doesn’t generate and collect data to test hypotheses with evidence. Functional medicine manufactures evidence to support predetermined claims.
When it comes to Casey Means, more often than not those predetermined claims help her business. She really doesn’t like Ozempic and other GLP-1 agonist drugs and claimed they have a “stranglehold” on Americans. Nobody would need Ozempic if they were treating the root cause of their obesity by zapping their mitochondria back into action with Levels blood glucose monitoring and AI-powered tips on which supplements, meal kits, and exercise equipment to buy. Functional medicine uses data to make healthy people think they are sick with imaginary diseases like “mitochondrial abnormalities.” Then it uses data to convince them to buy the treatments that they are selling. Casey and Calley made a fortune with this approach. Imagine how much larger their market could become if functional medicine were endorsed by the Surgeon General.
MAHA is mean to the Meanses
You might be wondering how Casey interprets the evidence base supporting vaccines as a worthwhile public health intervention. She doesn’t think much of “The Science.” You probably won’t be surprised to hear that she thinks vaccines are a bad idea too, especially when combined.
No doubt I too would be amazed sitting beside Casey while she tells Tucker Carlson that vaccines are a “treadmill” for the government and pharmaceutical companies to siphon profit from unwitting Americans by forcing dangerous, unneeded, possibly autism-causing vaccines on their babies. I am always amazed when people who know better shamelessly lie about vaccines, even though you’d think I’d be used to it by now. I’d probably be equally amazed sitting next to Calley if I heard him say that pharmaceutical companies have made “hundreds of billions of dollars” from the birth dose of the HBV vaccine, considering it’s laughably untrue. The entire global market for HBV vaccines is valued at under $10 billion, with adult and combination vaccines—neither of which are used for the birth dose—comprising the majority of the market share.
The Meanses’ anti-vax stance has bought them favor with Kennedy and President Trump, but not with the extended MAHA universe. In fact, many hardliners in the movement think that Casey is not anti-vax enough! Per Calley, those are mostly haters who are jealous of her extraordinary success.
Calley has had to do a lot of damage control and sister apologism over at the old hellsite, biting back at charges of disloyalty and other anti-Casey sentiments from all across the vast MAHA ecosystem. Notable haters include Kennedy’s former running mate Nicole Shanahan (who thinks Casey only cares about food and not vaccines and the Meanses are “Manchurian assets”), Trump confidante Laura Loomer (who thinks Casey and Calley’s father encouraged children to be transgender), fanatical ivermectin dealer Mary Talley Bowden (who thinks Casey is not outspoken enough against COVID vaccines), and former feminist and paranoid delusional conspiracy theorist Naomi Wolf (who thinks Levels is shady and agrees with Shanahan that Casey was sent to betray MAHA ideals). It says a lot about the philosophy underlying the concept of “Make America Healthy Again” that a woman who lies about vaccines, traffics in pseudoscience, sells snake oil, hates trans people, and yearns to be a tradwife is insufficiently extreme in her views for the movement’s ideologues.
It will be interesting to see Casey’s approach to her Senate HELP committee hearing on Thursday. The Democrats and some Republicans are all likely going to hammer Casey on her business dealings, qualifications, and medical contrarianism. They should. The Surgeon General should not be in a position to promote health interventions that she will directly profit from. The Surgeon General should not practice medical quackery or peddle fake treatments, whether in literal, digital, or wearable form.
Louisiana Republican Senator Bill Cassidy, the chair of the committee, is still dealing with the political fallout of being the deciding vote on Kennedy’s confirmation. Cassidy voted for Kennedy based on his promises of a vaccination-positive, collaborative relationship, which were immediately broken as soon as he was sworn in. Cassidy is a hepatologist who has been especially incensed by attempts to deschedule the HBV vaccine. He will likely ask Casey pointed questions about it. So will Senators Susan Collins (R-ME) and Lisa Murkowski (R-AK), both of whom are known for raising their concerns, even if they don’t always act on them. Elsewhere on the Republican side, anti-vaxxers like vaccines-don’t-work virology hater Senator Rand Paul (R-KY) and vaccines-cause-autism parrot Senator Markwayne Mullin (R-OK) may criticize Casey for not sufficiently opposing vaccination. Casey is very rarely questioned outside of the context of a friendly medical freedom extremist podcast, so Thursday’s hearing will be a unique opportunity to hear how she responds to criticism.
However, whether she performs well or not, all the Senators on the HELP committee should vote against Casey Means becoming the Surgeon General on the basis of her lack of qualifications and serious documented financial conflicts of interest.
Vice Admiral Means reporting for duty
The US Public Health Service Commissioned Corps is a branch of the US uniformed services, so Surgeons General are also commissioned military officers and by law hold the rank of Vice Admiral. Although the Surgeon General isn’t a particularly powerful position in terms of setting policy, it is extremely influential. The Surgeon General is the principal public health advisor to the HHS Secretary and can dispatch the PHS Commissioned Corps to respond to public health emergencies. The public generally regards the Surgeon General as a trusted source for health advice. Historically, Surgeon General reports and warnings have impacted everything from tobacco regulation to preventive health programs to pandemic responses to education policy. A savvy Surgeon General could advance their business interests substantially with the credibility and prestige of this platform.
In the case of this Surgeon General, that would be at the expense of American health. Casey Means did not complete her clinical training and does not treat patients or operate a clinical practice. She has become wealthy selling treatments for imaginary medical conditions and peddling scientific disinformation. Her advice is uninformed by reality and is designed for her financial enrichment, rather than the improved health of her subscribers and customers. She encourages people to seek treatments that don’t work for medical conditions that don’t exist. And she has a long history of failing to disclose her competing financial interests.
As Surgeon General, she would be able to expand her metabolic scam on a national scale, joining her brother and all their wretched cronies within the nest of corruption that is Kennedy’s HHS. Casey Means should not be confirmed as Surgeon General.
Thank you again, Dr. Rasmussen.
Your piece captures both the scientific and ethical stakes with extraordinary precision.
“Casey Means should not be confirmed as Surgeon General, because she lacks qualifications, promotes pseudoscience, and profits from conflicts of interest.”
“Pseudoscience dressed up as ‘functional medicine’ now threatens to occupy the top levels of U.S. public health leadership.”
Your clarity and rigor are invaluable contributions to public understanding and to the defense of evidence-based medicine.
Like all of the "successful" tradwives on the internet, she does not actually yearn to be a tradwife. She's massively well-resourced. If she actually wanted to be a tradwife, and not a capitalistic juggernaut, she could STFU and get to work feeding her sourdough and making lots and lots of babies with all of the right mitochondria.
The right wing tradwife nonsense is the biggest grift of them all. The most vocal proponents of it are making major bank trying to convince other, poorer (and generally less physically beautiful) women to oppress themselves on behalf of God and 'Murica. See, e.g., Erika Kirk & whatever the name of that annoying blonde press secretary is. Also Katie Britt.
What a load of crap.