Casey Means

Casey Means (born Paula Casey Means; September 24, 1987) is an entrepreneur and author.

Means graduated from Stanford University School of Medicine in 2014. She dropped out of her surgical residency and subsequently chose to practice functional medicine, a form of alternative medicine. Her medical license has been inactive since the beginning of 2024. She co-founded the health company Levels. Means co-authored Good Energy, a wellness book with her brother, Calley, in 2024.

On May 7, 2025, President Donald Trump nominated Means as surgeon general, following the withdrawal of Janette Nesheiwat's nomination. She is considered one of the leaders of the Make America Healthy Again movement.

Paula Casey Means^[1] was born on September 24, 1987.^[2] In a podcast interview in 2023, Means stated that she was named after Paul the Apostle, but legally dropped Paula from her name after graduating from medical school.^[1] She is the first daughter of Grady and Gayle Means. Grady served as an assistant to 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.^[3] Her brother, Calley, is a former food industry lobbyist.^[4] Gayle died of pancreatic cancer during the COVID-19 pandemic, encouraging her children to resolve "broken health incentives" in the U.S.^[5][6]

Means graduated with honors from Stanford University, earning a bachelor's degree in human biology.^[7] In 2014, she graduated from the Stanford University School of Medicine.^[7][8] After medical school, she started a residency in the Department of Otolaryngology-Head and Neck Surgery of Oregon Health and Science University with the aim of becoming an ENT surgeon.^[9] Six months before the end of the five-year program, she dropped out of her surgical residency,^[7] due to stress and having become disillusioned with healthcare in the United States.^{[7][10][11][12][13]} During her studies, she supported research at New York University and OHSU.^[14]

After quitting residency, Means established a functional medicine practice in Portland, Oregon in 2019.^[15][16] The business dissolved in 2021.^[16] Means's state medical license was shifted to "inactive" status on January 1, 2024.^[17]

Means is the co-founder and chief medical officer of Levels, a company that offers continuous glucose monitors. She is involved in her brother's company, Truemed.^[18] Means sells sponsored dietary supplements, creams, teas, and other products on her social media accounts.^[19][20]

Means and her brother, Calley, co-wrote Good Energy: The Surprising Connection Between Metabolism and Limitless Health in 2024.^[21] Its focus is the energy produced by the mitochondria in the body from food. It advises eating foods which promote a healthy metabolism while avoiding foods which cause inflammation and other dysfunctions.^[22]

Jessica Winters, writing in the The New Yorker, described the book as "a memoir, a quasi-anti-establishment screed, and an orthorexic diet guide" which advanced three core positions of the Make America Healthy Again (MAHA) movement:^[23]

"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."

Through her social media impact and close association with Robert F. Kennedy Jr., Means is considered one of the leaders of the Make America Healthy Again movement.^[24][25][26] Means and her brother, Calley, served as close advisers for Kennedy's 2024 presidential campaign, helping to negotiate his eventual endorsement of Donald Trump.^[19] By October 2024, she had been considered as a potential appointee to lead a food and health agency in Trump's second presidency, according to The Washington Post.^[27] The Wall Street Journal wrote the following month that she had been mentioned by Kennedy, Trump's then-nominee for secretary of health and human services, for surgeon general or commissioner,^[4] as well as assistant secretary for health, according to Politico.^[28] Means and her brother, Calley, served as advisers to Kennedy by that month.^[29]

By January 2025, the Meanses appeared unlikely to join the Department of Health and Human Services, but remained connected to Kennedy.^[30] On May 7, the Trump administration began planning to withdraw Janette Nesheiwat's nomination as surgeon general after her résumé was questioned and Laura Loomer, a far-right social media political activist, stated that Nesheiwat was "not ideologically aligned" with Trump.^[31] Hours later, Trump announced that he would nominate Means as surgeon general.^[8] Trump said he did not know Means but nominated her based on Kennedy's recommendation.^[32]

In addition to proponents of evidence-based medicine, Means' appointment 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. Far-right activist Laura Loomer was sharply critical of Means' nomination, calling her a "total crack pot".^[33] RFK Jr's 2024 running mate Nicole Shanahan was also critical of the nomination, claiming there was an understanding that the Means would not play a role in the Trump administration.^[25]

After withdrawing from her surgical residency, Means became a practitioner of functional medicine.^[15][34] She believes that the real origin of most diseases is metabolic dysfunction caused by ultra-processed foods, environmental factors,^[35] lack of sunlight, and lack of exercise.^[36][34] In a 2024 interview, she compared "Type 2 diabetes, obesity, Alzheimer's, dementia, cancer, [and] chronic kidney disease" to different "branches" of a tree, the "trunk" of which she believes to be metabolic dysfunction.^[15]

Her views have been criticized by science communicator Jonathan Jarry of the McGill Office 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".^[37] Jarry points to her book as an example of "scienceploitation", using preliminary research on mitochondrial dysfunction to promote dubious products or policy.^[38]

Means has criticized the National Childhood Vaccine Injury Act,^[39] and has repeated current FDA Commissioner Marty Makary's controversial claim that the third leading cause of death in the United States is "medical error and medication".^[37][40] According to New York magazine, she has "raised long-settled questions about the safety and efficacy of vaccines despite not representing herself as an anti-vaxxer".^[34]

Means has referred to infertility as a crisis,^[41] and has been critical of hormonal contraception on both medical grounds—questioning how it affects women's health—and moral grounds—referring to it as a "disrespect of life".^[34]

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."^[42]

• Official website