12min chapter

Relatable with Allie Beth Stuckey cover image

Ep 971 | Question Your Doctor, Save Your Life | Guest: Dr. Casey Means

Relatable with Allie Beth Stuckey

CHAPTER

Uncovering the Root Causes

Exploring the interconnectedness of various health issues stemming from metabolic dysfunction caused by lifestyle and dietary factors, emphasizing the need for a more holistic understanding of physiology and addressing root causes rather than symptoms in healthcare.

00:00
Speaker 2
And I first heard of you. I saw a tweet thread sometime last year about you losing your mom and an article that she wrote that basically said, look, I'm a doctor. I've been in the medical field for a long time and you can't always trust us. And that statement accompanied with your mom's story was really powerful for me. I think for a lot of people who realize that we can't always trust the experts during COVID. So just take us back. Take us back to that tweet thread. Why you wrote that article? And of course, your mom's story. Yeah.
Speaker 1
Well, I think my mom's story is very almost like archetypal of what so many Americans are going through today. Kind of realizing that something is not quite right when it comes to our own health, the health of our kids, the health of our parents. People are so sick in our country and they're getting sicker. And we're put on this chronic disease, sort of pill taking, surgery, treadmill, and yet we're not really getting better. So my mom's story really just is so emblematic of this and played off so much of my own experience in medicine as a surgeon. So my mom, she was very vibrant and from the outside looked pretty healthy, but in her 40s, she had me. I was an almost 12 pound baby. Oh my goodness. It was big. Everyone kind of congratulated for that. No one really thought much of it. She had trouble losing the baby weight. She was in her 50s. Had a tough menopause. Then in her 60s, she started getting the diagnoses that so many Americans have. High blood pressure. Here's an ACE inhibitor. High cholesterol. Here's a stat and prescribed 200 million times per year in the US. High blood sugar. Here's metformin, very common. This is prediabetes. It's a pre-disease. Nothing to worry about. And then all of a sudden she's 72 and she's hiking with my dad near their house in Northern California and she gets a pain in her belly. That's unusual for her at last or a couple days. She goes to her primary care doctor. They order a CT scan and it turns out it's stage four, widely metastatic, pancreatic cancer. And 13 days later, she was dead. At the time of her death, she was seeing what a lot of people call the best doctors in the world. She was being seen at Stanford. She was being seen at Mayo Clinic. Really access to high quality healthcare. And oncologists looked at my family in the eyes and said, you know, I'm so sorry. This was so unlucky. The pancreatic cancer. And knowing what I know about really more a connected root cause perspective on health, to me it's very clear that this cancer was not actually unlucky. It was totally predictable. But in our Western medical system that is so reactive, it's so siloed. It's like whack-a-mole medicine. They saw all those things that my mom had throughout the past 30 years as separated isolated things. The big baby, the trouble losing the baby weight, the tough menopause, all the metabolic issues, blood pressure, blood sugar, cholesterol, and then cancer. In our system, in our reductionist Western medical system, they all look separate and it seems unlucky. But what I'm really, I think, on this planet to share and what my book is about and what all my work is about is that through a different lens, through a root cause lens, through a true physiology lens, what we'd understand is that all those symptoms and diseases she had are actually trunks of the exact same tree. And that tree is metabolic dysfunction. It's a core physiologic problem that's affecting 93% of American adults have some aspect of metabolic dysfunction. Some of the most obvious ones you'd think about it would be like diabetes and obesity, but actually cancer, heart disease, stroke, depression, anxiety, having a big baby, which is called fetal macrosomia, trouble losing the belly fat. It's caused by just because
Speaker 2
I don't know and a lot of people don't know the through line of the different diagnoses that you're talking about. Like going back to you being a 12-pound baby, the only understanding I have of why that typically happens is if a woman has gestational diabetes. So is that part of what you're talking about and all of these things are somehow connected to each other? Absolutely. Yeah. So the trunk of this tree, this
Speaker 1
metabolic dysfunction, it can show up like gestational diabetes. And at its very core and not to get too science and technical, but in our society today with the rapid changes in our diet and our lifestyle over the past just like 50, 75 years, really since World War II, our industrialized diet, our chronic stress from our devices, we're getting 25% less sleep on average than we were 100 years ago. The incredible amount of synthetic toxins in our food, water, air, and homes, it's fundamentally caused a problem with our cells that is super fundamental. It's a breaking of this metabolic machine in our cells. Metabolism is how we convert food to cellular energy. And the reason that this can look like so many different diseases is because if you have a problem converting food energy to cellular energy to power our cells in different cell types, this can look like all different things. If it's in a liver cell, it can look like fatty liver disease, in a blood vessel cell, it can look like heart disease, it can look like in the brain, it can look like depression and anxiety. Essentially, there's this core issue that's caused by our lifestyle and our food system that is really breaking our bodies on a fundamental level, showing up as all these different diseases across the spectrum. And our healthcare system is totally, totally blind to it, which is why they wait until the symptoms emerge and they treat those isolated symptoms, but they never get to their actual root cause because that's not the way our system works. It's about separation, not connection. And it's such a blind spot, but it's such a lethal blind spot that it's really why it inspired me to write a book about it because you look at the trends that are happening today, which is that the more we spend on healthcare, we're spending $4.5 trillion a year on healthcare in America and outcomes are getting worse. The more studies we do, the worse the outcomes are getting. The more specialized we get in healthcare, the worse the outcomes are getting. It's sort of the definition of unsustainability. And the reason is because we're actually focusing on the wrong problem. We're focusing on reactive symptom-based medicine as opposed to the connected root cause that's actually underlying most of the American diseases that we're facing today. And in the case of the big baby, in a mother who has this metabolic dysfunction, her blood sugar starts rising, that then transfers in the blood through the placenta to the baby. So the baby is exposed to that high blood sugar. That then causes the body to make more insulin in the little fetus's body. And that insulin is a pro-growth hormone that causes the baby to put on more weight and more fat. So it's how those metabolic blood sugar issues are actually showing up in the fetus. And then being born above about 8.5 pounds, which is considered fetal macrosomia, that sets up the baby for metabolic issues for us in our life, and also is a sign of the mother having issues. So really at every step along the spectrum, it was all pointed to the same thing. But the healthcare system is totally blind because it's so focused on reaction. Each
Speaker 2
individual diagnosis, no one's taking a holistic look, even the top doctors. And I want to talk about how this all relates specifically to your mom's story because I know that there are a lot of people out there who either they've been recently diagnosed with cancer or a loved one has or they wish that they would have known this or I could see this conversation, someone having this conversation or listening to it. And then next week, they're going through a similar thing and they're going to be so glad that they heard your story and heard everything that you're saying. So you're saying that your mom, when she was diagnosed with pancreatic cancer, that looking back over her life and some of the things that she suffered from, that it was pretty predictable, maybe not entirely preventable, but pretty predictable. It seems like it came out of nowhere because she was just hiking and she got that pain and she got it checked out and then it was stage four. And when you talk to the doctors, you said these top doctors, they didn't have anything to say about her previous diagnoses. They weren't interested in that conversation at all.
Speaker 1
No, I mean, really, if you look at the way the system is designed, it's so hyper specialized. We have over 42 medical specialties and really like to climb the ranks as an American doctor, it actually is getting more and more specialized. So I trained in ear, nose and throat surgery and to really be at the top of my field, I would actually specialize further into either ear, nose or throat, become a rhinologist, a laryngologist or an otologist. And then even within those specialties, you might focus on one specific disease and become the world expert in that. So specialization is literally built into the very foundation of prestige in our system. And what that does is it gets doctors to really ignore the rest of the body and how things might be connected. There's also a financial incentive for that, right? The business model of our healthcare system is to do more to more people over long periods of time. The stark reality, the stark economic reality of the American healthcare system, which is what needs to change if we're going to actually improve the health outcomes of America. But the stark economic reality is that every institution that touches our health from hospitals, to clinics, to pharma, even to insurance companies will make more money if you are sick and less money if you are healthy. And so chronic diseases, these isolated chronic diseases like what my mom had, diabetes, high cholesterol, high blood pressure, the system profits off treating those as separate things that you do things to for long periods of time, chronic disease management. So not actually healing it, but managing it. And so because that's built into the deep finances of the largest and fastest growing industry in the United States, which is the healthcare industry, there is no incentive for people to back up and look at all of the things going on and say, wait a minute, maybe we're looking at this wrong. Maybe there's something more fundamental, the trunk of the tree leading to all of this. Maybe we could just intervene there. And a lot of this stuff would melt away. And that is the reality biologically. But because of the trillions and trillions of dollars that are baked into the way the system operates right now, no one has any real incentive to stop and to do that. And so the pieces actually get actively held apart. If you think about going to the doctor, how often, if you have several specialists you're working with, how often are they talking to each other? Never. Usually the health records are in different systems and it's almost impossible to even have one doctor see the notes of another doctor from another specialty. It's literally baked in on every level, the separation, which is not serving patients. It's serving the financial interests of a reactive sick care system that is fee for service.

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