Surgeon General Nominee Casey Means Nowhere Near As Good At Faking 'Moderate' As She Thinks She Is

The kook always comes out eventually.

Feb 26, 2026

Casey Means just wants people to eat more healthily and exercise. She wants women who have certain health issues to be warned by their doctors that certain kinds of birth control may be dangerous for them to take. She doesn’t oppose vaccines, she just wants people to have “conversations” with their doctors about them. She says her interest in psilocybin mushrooms was limited to their potential use as a treatment for PTSD, something that many mainstream psychologists and doctors agree with, rather than becoming “one with the moon” as she described in her book.

Or, you know, that’s the image the unlicensed former doctor and Trump Surgeon General nominee wanted to project yesterday. The well-known-to-be-batshit “health influencer” attempted to strike a measured tone during her long-awaited Senate hearing yesterday (she went into labor on the day she was originally meant to testify this past October). But anyone who knows enough about her and her nonsense should be able to see through it just as easily as they saw through RFK Jr. during his own hearing.

Weirdly enough, the person most excited to bring up her bullshit was Republican Senator Roger Marshall of Kansas, who, while introducing her, encouraged everyone to read her book!

Like many of us, she was disillusioned by its focus on treating symptoms versus addressing the real causes. She left it to champion preventive metabolic health. She co-founded Levels Health using innovative glucose monitoring to empower metabolic health insights and authored the best-selling book Good Energy, which I’d recommend everybody on this committee to read to better understand exactly who she is. She offered science-based strategies to prevent chronic illnesses through lifestyle changes. Dr. Means brings a forward-thinking vision focused on prevention, innovation, and patient empowerment. She is a proven communicator. She’s appeared on over 200 podcast. She’s a faculty course director at Stanford. She’s been featured in articles in the Wall Street Journal, Forbes, New York Times. She inspires, educates on complex health issues. She’s poised to shift us from reactive sick care to proactive healthcare emphasizing metabolic health to truly make America healthy again.

Well, if she’s been on 200 podcasts.

What Senator Marshall fails to mention is that Casey Means states in this book that sugar (thus the glucose monitoring) is the cause of practically every disease, chronic and otherwise — including but not limited to “depression, anxiety, infertility, insomnia, heart disease, erectile dysfunction, type 2 diabetes, Alzheimer’s, dementia, cancer” and so on. Now, sure, some of those things are affected by sugar, but many of them are not. But not only did she claim that they are caused by sugar, she also claimed that “the ability to prevent and reverse these conditions — and feel incredible today — is under your control and simpler than you think.”

I’m sorry, but no. You can’t actually reverse cancer by not eating sugar or by optimizing your metabolic health. As important as nutrition is, giving people false hope and claiming that it is “simple” to reverse cancer or Alzheimer’s is sadistic.

Oh, I should also mention that Levels Health charges $288 for one month of glucose monitoring and a year of being able to use the dashboard on their app, whatever it is that involves. That is the lowest tier subscription, by the way, and it is called the “self-guided journey.”

Senator Marshall, however, does hint at what makes Means’s woo woo health nonsense so very appealing to the GOP. One of the biggest issues facing US Americans today is lack of access to health care, which is why so, so many of us (including about half of Republicans) want Medicare For All. But Republicans in office, they don’t want that. They want it to just be okay that Americans don’t have access to health care. They want it to be okay that our medications cost sometimes a hundred times more than people pay in other countries, because we shouldn’t be taking them anyway. Surely, if we all just grew our own food and had chickens and goats instead of regular pets (as Dr. Means has suggested), we’d never, ever get sick.

By encouraging people to distrust the medical establishment, by pushing the idea that if someone gets sick, it’s their own fault for not taking enough personal responsibility to prevent that illness, they can perhaps get people to shut up about Medicare For All or the Obamacare subsidies.

During the hearing, Senator Patty Murray (D-Washington) grilled Means on her arguments against birth control — namely that Means has previously claimed that women take birth control pills “like candy” and that they demonstrate a “disrespect of things that create life.”

Means tried to pivot off of her various insane claims about contraception and turn it into mere concern that there are “horrifying side effects” to birth control pills, pointing out that smokers and those with clotting disorders can get blood clots from hormonal birth control. She then claimed that doctors do not have enough time to inform patients of this.

I don’t know what doctors Casey Means has been going to, but back when I was a smoker, doctors did, in fact, tell me that I could not take regular hormonal birth control. This took approximately ten seconds, so I fail to see what the issue is here. I think this is a problem that only occurs in the mind of Casey Means — who, let us remind you, does not currently have a medical license and has literally never practiced as a fully licensed independent physician.

Unfortunately, as we are one of only two nations that allow commercials for prescription drugs on television (one of the few reasonable positions that Means holds is that she opposes this), I am well aware of the potential side-effects and drug interactions of many, many prescription drugs. Pretty much all medications have “horrifying side effects” (“death” often being one of them) and there are many medications that you cannot take if you have certain conditions or take certain other drugs. There are over-the-counter drugs that can be dangerous in certain situations, and there are a hell of a lot of extremely dangerous forms of “alternative medicine” (black salve and Laetrile, for example). Means’s opposition to birth control is not due to “horrifying side effects,” it is that she believes that it is bad to try to avoid getting pregnant.

Unsurprisingly, multiple senators — Democrats Bernie Sanders, Angela Alsobrooks, Patty Murray, Lisa Blunt Rochester, Tim Kaine, and John Hickenlooper and Republicans Bill Cassidy, Lisa Murkowski — questioned her about her stance on vaccines. Means refused to outright say she would, as Surgeon General, encourage parents to vaccinate or not vaccinate their children, specifying that she believes that should be a “conversation” between families and their physicians (the same ones who don’t have time to ask if their patients are smokers before prescribing prescription birth control to them).

Pretty much no one was able to get a straight answer out of this woman and I don’t think it was so much that she is especially clever as it is that she just truly has no idea what she is talking about. She couldn’t explain why she thought the hepatitis B vaccine was a “crime.” She just kept saying she supported what the administration was doing and had no opinions of her own in this regard. Despite also describing herself as someone who would not be afraid to speak up if she thought something was wrong.

Now, Bill Cassidy fucked us with regards to RFK Jr., and I have little doubt that he will vote to confirm this kook as well, but I have to admit that his questioning of her was, by far, one of the most satisfying for me, personally. Why? Because he asked her the same question that I had for her throughout the whole event — what the hell it is that she wants doctors to discuss with patients and that she believes they are not discussing now. Because this was her answer for everything. Absolutely everything. It wasn’t that she opposed birth control, but that she wanted doctors to have “conversations” with patients about the side effects, which they already have. It wasn’t that she opposes vaccines but she just wants doctors to have “conversations” with parents about them. She just wanted more informed consent, she swore.

But when asked what that would look like to her, what she’d want them to say that they do not already say … she couldn’t say! When he asked her if she’d like them to sign a consent form like they’d do if they were having an appendectomy or whatever else, she said no. When asked again, the fuck it is she wants, she said she just wants a “cultural change.”

“I believe that parents want to have a a good faith conversation without shame with their doctors about vaccines and that that and that we need to move toward a medical culture where that’s possible and I genuinely believe that will help restore trust in public health. One more time. Right now, that’s not the current culture of medicine,” she explained, without any evidence to back that up.

It boggles the mind. It truly does.

At another point during the hearing, which does bear mentioning, Susan Collins expressed “concern” over Means’s love affair with psychedelic mushrooms, which she once claimed allowed her to “become one with the moon.”

Now, Means did manage to get through this by suggesting that her only interest in psilocybin was as a possible treatment for PTSD, a practice that has shown a lot of promise.

However, Collins also asked her about the voices she heard whilst on mushrooms, and I’m just going to need to point out that this is probably the first time this question has been posed to any surgeon general nominee in any confirmation hearing in United States history. I’m also going to suggest that it become a standard when confirming any future Trump nominees, as it might explain a few things.

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In one of her newsletters, Means once said, “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.” While this is perhaps not the best test for listeria anyone has ever come up with, I can honestly say that after trying to understand Casey Means’s integrity, looking her in the eye and (metaphorically) petting her cow, I would not feel safe with her as the Surgeon General of the United States.

So let us all just cross our fingers and hope that, somehow, Cassidy, Murkowski, and maybe even Collins will vote against her, and also that the administration will be unable to find themselves someone even worse to nominate afterwards (though that does seem unlikely).

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