Hacking Your Metabolism With Casey Means

As a former ENT, head and neck surgeon, Casey Means is a medical doctor, tech entrepreneur, and regenerative gardener. Through her clinical experience, she was faced day-in-day out with the constant health epidemics of the western world. Means states that “right now, the biggest health issue we face by far is metabolic disease… it’s a term we don't hear that much about because the modern medical system focuses on looking at disease in isolation, rather than holistically…”. Hailed as the metabolic expert and celebrating the release of her latest book ‘Good Energy’ we sat down to discuss the importance of metabolic health, what it means for our own health and how we can hack into a metabolism for longevity. 

Q) Through your years working in your field, what drove you into changing the narrative and ‘norm’ around your work?

I was in my fifth year of surgical training and looking to launch into independent Private Practice as a faculty surgeon. I was aware I would be on my own two feet as a surgeon and began reflecting a lot on the healthcare system, the role I want to embody in that system. The realisation came when I realised, the system I was in, just isn’t working how it should. In the US, we are spending over 4.3 trillion dollars on health care every year but yet American patients are getting sicker and patients are not getting better. I was seeing the same patients coming just through the revolving doors over and by focusing on the downstream symptoms and isolating them into different silos rather than focusing on the root cause. 

I was dealing almost exclusively with conditions of inflammation. As an ear, nose and throat surgeon, I was seeing parotitis cellulitis, like tracheitis. All these ‘itises’ which I know refer to as the ‘suffix for inflammation in healthcare’. Inflammatory conditions are fundamentally the immune system being chronically activated. The immune system is the defence arm of the body, it's essentially the body believing there is a chronic threat and mounting a response to deal with it. I asked myself, if all my patients have a chronic upregulated threat response. What are all these bodies afraid of? What is this biochemical fear? Is it our metabolic health being in a total state of dysfunction?

Q) So many people think that metabolism is to do with how quickly (or slowly) we’re able to gain and loose weight. Why is that the assumption and is there any truth to that? 

Language around metabolism is often centred around a ‘fast’ and a ‘slow’ metabolism. The key thing for people to realise is that it's so much more than that. Excess body weight can be a manifestation of metabolic issues. Excess weight is essentially a representation of the fact that because our body's not converting food to Cellular energy effectively, it's going to store food as fat because that process of a food energy is not working optimally. Instead, I encourage you to reframe this idea of having a ‘fast metabolism’ to think about how I can build a fast metabolism through my choices every day? 

Q) So what happens when that system is ‘dysfunctional’, and what can that look like from a symptom perspective? 

If a cell is not powered properly, it will become dysfunctional just like a machine would. An underpowered dysfunctional cell will lead to symptoms and disease because it’s unable to use the energy required to power vital cells. The reason metabolic dysfunction is so widespread in our world today is because we’re all living in an unavoidable environment that right now is damaging to our mitochondria.

How it presents is a massive broad spectrum. For some, it can look like depression, anxiety, gout or erectile dysfunction. And others may suffer with migraines, fibromyalgia, arthritis all the way to things like unexpected strokes, types of diabetes, Alzheimer's/dementia or fatty liver conditions. If a cell is being underpowered in the brain it can display as neurological symptoms, whereas if cellular function isn’t where it should be in the ovaries, it can show as polycystic ovarian syndrome or unexplained infertility.

Q) With those points in mind, if someone wanted to ‘work on their metabolism’, what would you advise them to do straight away? 

You firstly want to ask yourself, how do I get each mitochondria to be more functional? And then “how do I get each mitochondria to turn through more energy subject substrates to make energy?’ So it's really simple as we're thinking through our lifestyle choices and our food choices.

We want to be creating more functional mitochondria by promoting  mitophagy  - this is the process where we literally recycle old damaged mitochondria into new healthier mitochondria. So many things we can do to promote my autophagy - physical exercise, especially endurance training. Exercise that is lower intensity but for a longer period of time promotes mitophagy and activates the cell signalling pathways. 

There's compounds in food that can also help induce mitophagy thanks to elegiac acid found in ingredients such as pomegranates that are then converted in the microbiome to post biotics like urolithin - a chemical that goes into the body to promote my topology. Not to forget spices like curcumin from turmeric, quercetin and resveratrol that also promote mitophagy also. The vital part is to ensure that the body feels safe, it's not about losing weight so much as it is about cultivating healthy biochemical machinery that can process energy effectively and therefore work through our stored banks of energy.

Language around metabolism is often centred around a ‘fast’ and a ‘slow’ metabolism. The key thing for people to realise is that it's so much more than that.

Q) There’s also a big trend at the moment around Continuous Glucose Monitors (CGM’s). The research shows their impact on metabolic health so can you tell us a little bit about glucose monitors, what they do and who should be using them?  

Continuous glucose monitors are divine wearable devices that are biosensors. So they're actually doing a lab test on your body every five to ten minutes, 24 hours a day and sending that information to your smartphone. Differing to wearable tech trackers, CGM’s are looking at things like heart rate and movement patterns continuously. These are devices that you wear for 10 days to two weeks on your arm or abdomen taking the data to your smartphone for essentially a movie of what's happening with your blood sugar at any given moment and understanding how all our different dietary and lifestyle choices affect this key metabolic molecule of blood sugar. The beauty here is you can start to understand how individual foods and food combinations are affecting your blood sugar levels and how different types of exercise, sleep or timing of exercise and sleep is affecting blood sugar levels. 

The goal is to keep our blood sugar in a steady range throughout our day and therefore our lifetime as a high blood sugar contributes to the overwhelm of our mitochondria.Similarly, excess blood sugar also can independently create inflammation in the body. Something really interesting that research has shown over the past few years is that two different people were actually responding very differently to the same food in terms of blood sugar levels. So you and I could both eat the exact same protein bar and actually have very different glucose responses based on our biochemical individuality. And so if I have a really big spike and you have a very small spike in blood sugar, it's probably not something that I should be eating every day, but it might be fine for your biology. 

So that's important to know also is the biochemical individuality around different foods. The food culture we're living in is very damaging to our blood sugar and having more awareness of the excessive load of processed food that's coming to our body can be really really helpful. I advise moving to a real whole food diet. It’s true that even though a single spike isn't going to cause long term damage, a lot of people find that individual big spikes during the day can actually just make them feel crummy right away. So after a big spike, we often have a big crash which is called reactive hypoglycemia.

The research has shown that it's when we crash after a big spike. That's often when we have the most cravings for more sugar and more energy rich carbohydrate food because our body is going into panic mode where the blood sugar has gone low and your body wants to bring it back up to Baseline, so the constant grazing and craving isn’t just about willpower.

Q) What about mood? Is there any research around our metabolic health, blood glucose and our mood? 

There’s a very tight relationship between glucose levels, metabolic health and all aspects of mental wellbeing. From mental clarity to cognitive function to mood, we know that people with blood sugar disorders like prediabetes and type 2 diabetes tend to have significantly higher rates of things like depression and anxiety and future risk for neurodegenerative disorders, like Alzheimer's dementia, which the rates are going up regularly and so certainly for anyone dealing with mental health issues, investigating metabolic health and understanding focusing on really improving it I think is one of the best strategies that we can do.

Alzheimer's dementia is being called type 3 diabetes by some scientists because it's so deeply related to our insulin sensitivity and our metabolic health and similarly migraines, which have long been sort of a mysterious condition to treat and understand.

Q) Can we test our metabolic health? 

There are sort of the small, medium and complex levels of testing your metabolic health. And I think that everyone should at least make sure they know their options and do something about it. So those tests are fasting glucose. triglycerides HDL cholesterol, waist circumference, blood pressure and haemoglobin A1c. Those will give you a snapshot of whether you are in that seven percent or 93% to basically be considered metabolically healthy or unhealthy. I encourage everyone to just go find those this week or ask their doctor for those tests. There are also Functional Test options that I explore with my patients too which you can work with a Functional Medicine practitioner to do also.

Q) It just goes to show that there are so many different angles that we should be focusing on and we don’t when it comes to our metabolic health. What would you advise as actionable tips that our Healf readers can take away straight away and work on?  

I think from the food standpoint. The number one thing is we just have to get rid of the ultra-processed foods that have been invented in the past hundred years. They have been a devastating  experiment  on the human species and they just need to be reduced and ultimately eliminated in the human diet as they are damaging our mitochondrial health.

Within my book, I recommend the ‘Good Energy Eating Plan’ where we are looking at sources of antioxidants, probiotics, fats and healthy protein.

By incorporating foods from each of these categories in essentially every meal we have a really good chance of doing our bodies what they need to be metabolically functional. so part of the challenge and the invitation is to figure out a few of the foods you love from each of those categories:

So for me antioxidants are colourful - fruits, vegetables, nuts, herbs, spices, tea, cocoa. For fibre - I love chia, seeds flax seeds, basil seeds and legumes. My protein sources are grass-fed meats and wild caught fish for Omega-3. I love hemp, chia seeds, walnuts and lots of small fatty fish here too. Then for probiotics, I enjoy a lot of kimchi, sauerkraut and yoghurt. By creating a mental map of sources of each of those types of food molecules that support metabolic, hacking your metabolic health through the food you’re eating can become as simple as a kind of mixing and matching.

One thing that I ask people to think about is moving away from this obsession with exercise and actually move more towards thinking about movement as something we want to get more of. so exercise is wonderful, but the most metabolically healthy body is a body that's moving all throughout the day. When we move our muscles and contract our muscle cells, we move glucose channels to the cell membrane which allows our bodies to take the blood sugar out of the bloodstream and actually process the mitochondria. So if we get up every half hour for just a couple minutes and move our muscles that is going to totally change our biology. The average American is sitting 80% of the time and it's only getting three to four thousand steps per day. So finding ways to just build little bit exercise snacks, a little micro movement into your day is actually so important.

Q) It just goes to show that there are so many different angles that we should be focusing on and we don’t when it comes to our metabolic health. What would you advise as actionable tips that our Healf readers can take away straight away and work on?  

I think from the food standpoint. The number one thing is we just have to get rid of the ultra-processed foods that have been invented in the past hundred years. They have been a devastating  experiment  on the human species and they just need to be reduced and ultimately eliminated in the human diet as they are damaging our mitochondrial health.

Within my book, I recommend the ‘Good Energy Eating Plan’ where we are looking at sources of antioxidants, probiotics, fats and healthy protein.

By incorporating foods from each of these categories in essentially every meal we have a really good chance of doing our bodies what they need to be metabolically functional. so part of the challenge and the invitation is to figure out a few of the foods you love from each of those categories:

So for me antioxidants are colourful - fruits, vegetables, nuts, herbs, spices, tea, cocoa. For fibre - I love chia, seeds flax seeds, basil seeds and legumes. My protein sources are grass-fed meats and wild caught fish for Omega-3. I love hemp, chia seeds, walnuts and lots of small fatty fish here too. Then for probiotics, I enjoy a lot of kimchi, sauerkraut and yoghurt. By creating a mental map of sources of each of those types of food molecules that support metabolic, hacking your metabolic health through the food you’re eating can become as simple as a kind of mixing and matching.

One thing that I ask people to think about is moving away from this obsession with exercise and actually move more towards thinking about movement as something we want to get more of. so exercise is wonderful, but the most metabolically healthy body is a body that's moving all throughout the day. When we move our muscles and contract our muscle cells, we move glucose channels to the cell membrane which allows our bodies to take the blood sugar out of the bloodstream and actually process the mitochondria. So if we get up every half hour for just a couple minutes and move our muscles that is going to totally change our biology. The average American is sitting 80% of the time and it's only getting three to four thousand steps per day. So finding ways to just build little bit exercise snacks, a little micro movement into your day is actually so important.

Q) And what about our environment? Both our physical and mental home? 

I talk a lot about non-toxic living - how do we actually clean up the toxins for our food, water air and personal care products? Many of the chemicals in our environment are metabolic disruptors. So moving towards a cleaner and non-toxic environment and the products we use is vital. 

I'll also mention something that’s often overlooked but of incredible impotence is around emotional health. A key thing that people need to realise is that our mitochondria and our cells hear e very thought that we're thinking  and so if the body is psychologically believing that things are dangerous, then our cells are going to respond to that. 

So one of our most fundamental jobs is to create a sense of safety inside our body. It's extremely important for our metabolic health to create a sense of safety in the body because if you go back to the beginning of our conversation Chronic inflammation is the body's response to something threat or fear-inducing and for the modern, a lot of that comes from our thoughts.

I advise, setting boundaries with social media and really doing the personal work to understand what our various limiting beliefs and wounds and triggers are and even going so far as to examine our relationship with existential feelings too. There’s not a simple fix but figuring out ways to calm and soothe our body through breath movement and simple mindfulness strategies can be actually very valuable for metabolic health.

Q) What about supplementation and products? Is there anything you really love to use with your practice?  

So I think that at a foundational level I try to cover the basic vitamins and minerals that we know are important for mitochondrial function with a really high quality multivitamin. The second thing I love is vitamin D with K2 because vitamin D is involved in a lot of our metabolic processes. I take curcumin which is the active compound in turmeric I take high quality curcumin, which is a potent anti-inflammatory molecule and I also take fish oil for the EPA and DHA. 

For probiotics I use Pendulum, love their probiotics because they’re one of the only probiotic strains that's been shown to lower haemoglobin alongside with sometimes for sleep - I'll take GABA, magnesium and theanine are kind of my nighttime supplements. They really helped me with my deep sleep which we want to get in really good quantity for our metabolic health. 

"Good Energy" is the new Healf release by Dr Casey Means.

Presenting a groundbreaking approach linking metabolic function to overall health. It offers a four-week plan and insights into biomarkers, nutrition, sleep, exercise, and resilience-building techniques to optimise well-being.

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