The Missing Piece to Better Health | Optimizing Your Metabolic Health with Dr. Casey Means

**Dr. Gabrielle Lyon** (0:02)
Welcome to The Dr. Gabrielle Lyon Show, where I believe a healthy world is based on transparent conversations.
Dr. Casey Means, thank you so much for coming on the show. Former surgeon, physician, and truly a trailblazer.

**Dr. Casey Means** (0:22)
Dr. Lyon, I am so thrilled to be here with you in person.

**Dr. Gabrielle Lyon** (0:25)
This is great. We're going to have an amazing conversation.
You've been doing a lot of work on overall metabolic health. Before I say that, let's take a step back and recognize the fact that you are a trained surgeon, actually an ENT and from Stanford, no doubt or surprise, a fine institution, but you, for some reason, switched gears and now focus on metabolic health.

**Dr. Casey Means** (0:51)
Yeah.
For me, I was in my fifth year of surgical training as a head and neck surgeon and I was in this world and looked around me and had this wake-up call, where I'm like, Americans every single year are getting sicker. We are getting sicker, we're getting heavier, we're getting more depressed, we're getting more infertile as a population every single year, despite more health care dollars being spent every year, four trillion dollars now, and doctors working their butts off. I mean, everyone in the health care system, everyone's running around like a chicken with their head cut off in the hospitals, and yet patients are getting worse.
And so as I was finishing my residency and looking down the barrel of a 40-year career in health care, I had to stop and say, what is going on? The more we spend, the sicker we're getting. The more research we're doing, the sicker we're getting. The more medicine becomes hyper-specialized, the sicker we're getting. So what is going on here?
And what's going on is that we're pointing the arrow at the wrong issue. We're focusing on whack-a-mole symptom management, and we're not focusing on the root cause of why people are sick, which is fundamentally metabolic dysfunction. It's a problem inside the cells that unfortunately no medication or surgery can get to, right? This is how we interact with ourselves, with our diet and our lifestyle. And this was, I mean, this like ripped me out of a slumber. You know, I'm like 32 years old. I have been training, you know, Stanford, Stanford, OHSU, in the operating room, killing myself to become a surgeon. And I looked around and I thought, you know, I'm a doctor, and I went into medicine to help people thrive and to create health, and right now I am just managing disease.
And then what happened, unfortunately, soon after this revelation is that it showed up in my family with my mother. And my mother, unfortunately, is kind of an archetypal situation for what I think so many Americans are going through on the chronic disease, you know, pill farm sort of treadmill, which is that, you know, she, as she was getting into her 50s and 60s, she had the high blood pressure crop up. They gave her an ACE inhibitor. She took her pills. Her blood sugar started going up. They gave her the metformin. She took her pills.
Her cholesterol started going up. They gave her the statin. She took her pills. And then she's 72 years old and she's taking a hike with my dad near their home in Northern California and she had a pain in her stomach and she goes to her primary care doctor and they say, oh, this is unusual for you. Let's get a CT scan. She gets a CT scan. The next day she gets a text message that says stage four, widely metastatic pancreatic cancer and 13 days later she was dead.

**Dr. Gabrielle Lyon** (3:18)
And we're, yeah, first of all, I did not know that about you. That is major.

**Dr. Casey Means** (3:25)
Yeah.

**Dr. Gabrielle Lyon** (3:26)
And a massive wake up call.

**Dr. Casey Means** (3:29)
Huge wake up call because, you know, she was the classic American patient who's living her life trying, but these diseases and these symptoms are cropping up throughout her 40s, 50s and 60s. And like a diligent patient, she's going to every specialist she was being seen at the Mayo Clinic. She was being seen at Stanford and Palo Alto Medical Foundation. Best doctors in the world, right? Best institutions in the world and was doing everything they said. She was trying to eat healthy. She was taking all her pills. She was following up and yet her cells never healed because that is not the priority in our American healthcare system. We're not focused on true physiologic intracellular healing. We're focused on disease management.
Unfortunately, it was wild when her oncologists after the diagnosis and then rapid decline towards death, they looked at us and sincerely the oncologist said to my family, I'm so sorry. This is so unlucky. I knew enough to know, was this really unlucky or was this totally predictable?