Born Paula Casey Means on September 24,1987,[7][bettersourceneeded] Means shared her full birth name in a podcast interview,stating that she was named after St. Paul,but legally dropped her given name after graduating from medical school.[8] She is the first daughter of Grady and Gayle Means[who?];Grady served as an assistant to U.S. Vice President Nelson Rockefeller,worked on health and human welfare issues at the Department of Health,Education,and Welfare,and was a managing partner at PriceWaterhouseCoopers.[9][verification needed] Gayle died of pancreatic cancer during the COVID-19 pandemic,encouraging her children to resolve "broken health incentives" in the U.S.[10][11]
After graduating from the Madeira School in 2005,[12] Means attended Stanford University,where she graduated with honors with a bachelor's degree in human biology in 2009.[13] She then earned her Doctor of Medicine (M.D.) from the Stanford University School of Medicine in 2014 and was inducted into the Gold Humanism Honor Society.[13][14][15] According to a statement by the medical school:"during her time at Stanford,Means demonstrated a strong commitment to comprehensive patient care,published peer-reviewed articles and held a leadership role in the Arbor Free Clinic,which provides care to underserved populations".[15]
After graduating from medical school,Means started a residency in the Department of Otolaryngology-Head and Neck Surgery of Oregon Health and Science University (OHSU) with the aim of becoming an ENT surgeon.[16] During her studies,she held various research positions (at the NIH,New York University,and OHSU).[17] Six months before the end of the five-year program,she dropped out of her surgical residency,[13] due to self-reported stress and her claim of having become disillusioned with the state of healthcare in the United States.[13][18][19][20][21]
Career
Medical practice
In January 2019,Means established Means Health,a functional medical practice and wellness consulting business,in Portland,Oregon.[3][22] She was granted a medical license from the Oregon Medical Board in December 2018,but it has been inactive since 2024.[3]
Teaching appointments
This section needs expansionwith:any other academic teaching appointments,at Stanford during or after her training,or at other institutions. You can help by making an edit requestadding missing information. (January 2026)
In 2022,Means served as a lecturer in courses on subjects relating to food and health at Stanford,teaching graduate and undergraduate students there.[15]
Businesses
Eventually,after leaving her surgical residency,[23][24] Means founded a company,Levels,and as of 2024 was reported as serving as its chief medical officer;the biotech company has been described as producing a health app that "offers exercise tracking and diet coaching",[23] and that it "uses continuous glucose monitors to help people track their metabolic health".[24] As of May 2025,Gregory Svirnovskiy of Politico relayed that Means' website reports that she is an investor "and/or" adviser in Truemed,a company Calley Means,her brother,founded,that "employs doctors who sign off on the medical necessity of fitness and nutrition programs and advanced health tech so customers can get a tax break".[23]
Means also has capitalized on sponsorships from dietary supplements,creams,teas,and other products appearing on her social media accounts.[25][26]
Writing
Means and her brother,Calley Means,co-wrote a medically related book directed at popular audiences,Good Energy:The Surprising Connection Between Metabolism and Limitless Health,which was published by Penguin-Random House in 2024.[27][28] As described by Blinkist,the book,which is composed of five points—the leading of which is that "[p]oor metabolic health is a leading cause of chronic disease"—presents "the connection between our lifestyle choices and our energy levels" and that it "offers actionable strategies to enhance wellness,increase vitality,and achieve a balanced,energized life...".[29] As described in review by physician and public health professional Joseph E. Scherger,writing for the journal of the Society of Teachers of Family Medicine:
...Means describes... all food becom[ing] energy in the body,converted by the mitochondria [of our bodies' cells] for different purposes. Good energy [comes from] food that nourishes us in positive ways. Bad energy,which occupies much of the book,[comes from] food that results in metabolic dysfunction and a variety of health problems. Good energy... from the food of the natural world... [is] unprocessed,[and] nurtures our metabolism. Bad energy comes from ultraprocessed foods,sugars,and inflammatory proteins and fats.[27]
Scherger notes that,through the book,the Meanses are "on a mission to eliminate bad energy from [the diets of] as many people as possible."[27] Overall,Scherger reviews the book positively,stating,"Good Energy is an excellent book for a lifestyle medicine book club and may be recommended for patients wanting good nutritional advice. It is well worth reading."[27]
Jessica Winter,The New Yorker family,education,and reproductive rights reporter,[30] criticized the work, describing the Means' book as "a memoir,a quasi-anti-establishment screed,and an orthorexic diet guide" advancing core positions of the MAHA movement:
The first is that Big Food and Big Pharma are incentivized to make and keep us sick. The second is that many conventional medicines and interventions do little to improve our health,and often worsen it;... And,third,that most maladies can be prevented or treated through one's own ascetic diet and life-style choices.[31][verification needed]
By January 2025,the Meanses appeared unlikely to join the Department of Health and Human Services,but remained connected to Kennedy.[39] On May 7,the Trump administration began planning to withdraw Janette Nesheiwat's nomination as surgeon general after her résuméwas questioned and Laura Loomer,a far-right social media political activist,stated that Nesheiwat was "not ideologically aligned" with Trump.[40] Hours later,Trump announced that he would nominate Means as surgeon general.[14] Trump said he did not know Means but nominated her based on Kennedy's recommendation.[41]
In addition to proponents of evidence-based medicine,Means' nomination has been criticized by anti-vaccination campaigners who favored health influencer Kelly Victory,such as Americans for Health Freedom's Mary Talley Bowden,Steve Kirsch and Suzanne Humphries. Laura Loomer was sharply critical of Means' nomination,calling her a "total crack pot".[42] RFK Jr's 2024 running mateNicole Shanahan was also critical of the nomination,claiming there was an understanding that the Means would not play a role in the Trump administration.[33] On July 31,2025,Politico reported that Means' nomination was stalled in the Senate Committee on Health,Education,Labor and Pensions (HELP),pending Means' submission of financial disclosure and ethics paperwork.[43]
Means's scheduled confirmation hearing before the HELP committee,which was to be the first such hearing held virtually,was postponed on October 30,2025,after she went into labor.[44] On January 3,2026,Means's nomination expired per Senate rules,but Trump renominated her 10 days later.[45][46][47] She appeared before the HELP committee on February 25,2026.[48]
After withdrawing from her surgical residency, Means became a practitioner of functional medicine.[50] Her views have been criticized by science communicator Jonathan Jarry of the McGillOffice for Science and Society, who wrote that "[Means] is not a metabolic health expert" and "theories claiming to have found a single cause for all diseases never pan out".[51][52] Means has been noted to "blam[e] the ultra-processed food system for much of the chronic disease in America",[53] and has had ascribed to her the view that the origin of most diseases lie in our exposures to ultra-processed foods and environmental factors, to a lack of sunlight, and to lack of exercise.[citation needed]
Means has spoken in support of raw milk, stating, "When it comes to a question like raw milk, I want to be free to form a relationship with a local farmer, understand his integrity, look him in the eyes, pet his cow, and then decide if I feel safe to drink the milk from his farm."[59]
123Stanford Medicine Staff (May 14, 2025). "Awards & Honors: Statement from Stanford School of Medicine on Alum Casey Means". Stanford University School of Medicine (Stanford Medicine). Retrieved August 5, 2025. [Subtitle and continuing:] Casey Means, MD, has been nominated to serve as the United States surgeon general. / When Casey Means entered the Stanford School of Medicine, she rapidly established herself as an outstanding student. Attending physicians recognized her clinical performance in disciplines ranging from internal medicine to general surgery to psychiatry, citing her technical skill, clinical judgment, breadth of knowledge and critical thinking abilities...
12Stone, Will & Means, Casey (June 14, 2024). "In 'Good Energy,' A Doctor Lays Out How to Measure and Boost Your Metabolic Health"(interview, with reporter's introduction). NPR.org. Retrieved May 7, 2025. [From the reporter's introduction:] Means, who has a medical practice in Portland, Oregon and is chief medical officer for the biotech company Levels... Ultimately she left surgery to practice functional medicine and eventually founded, Levels, which uses continuous glucose monitors to help people track their metabolic health.{{cite web}}: CS1 maint: multiple names: authors list (link)
↑Blinkist staff and AI (January 9, 2026). "Good Energy summary". Blinkist.com. Retrieved January 9, 2026. Note, while the information provided here, from this source, is not within their firewall, further summary information (e.g., the remaining main four points of the book) requires a subscription for access.
↑New Yorker Staff & Winter, Jessica (January 10, 2026). "Jessica Winter"(contributor bio/autobiography). The New Yorker. Retrieved January 10, 2026.
↑Congressional Staff (January 3, 2026). "Highlights / Senate / Chamber Action / Nominations Returned to the President"(p. D2). Daily Digest (January 3, 2026). Washington, DC: U.S. Congress. Retrieved January 10, 2026– via Congress.gov. [Quote:] The Senate ...adjourned at 12:00:27 p.m. until 3 p.m. on Monday, January 5, 2026. ... The following nominations were returned to the President failing of confirmation under Senate Rule XXXI at the time of the adjournment of the First Session of the 119th Congress... [nomination of] Casey Means, of California, to be Medical Director in the Regular Corps of the Public Health Service, subject to qualifications therefor as provided by law and regulations, and to be Surgeon General of the Public Health Service for a term of four years.
↑Jarry has referred to her book[clarification needed] as an example of "scienceploitation", accusing her of using preliminary research on mitochondrial dysfunction to promote dubious products or policy. See Jarry (2024).
Svirnovskiy, Gregory (May 7, 2025). "Trump Picks Casey Means for Surgeon General". Politico. Retrieved May 7, 2025. [Means] started health app Levels, which offers exercise tracking and diet coaching, after dropping out of her surgical residency. ... Means' website says she's an investor and/or adviser in the company her brother founded, Truemed, which employs doctors who sign off on the medical necessity of fitness and nutrition programs and advanced health tech so customers can get a tax break.
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