Precision personalized medicine is all about developing a plan of care to maintain optimal health and performance while minimizing the risk of illness, and it’s catered to the unique goals and needs of each individual person. How do we accomplish that?
It’s a big leap from protocols and population-based recommendations on exercise and diet to a comprehensive plan for what to eat and when, what type of exercise is best for you, which supplements or even medications are needed, and what other interventions should be considered. It all starts with your goals – do you want to perform better cognitively, or do you want to lose belly fat (or both)? Is your primary concern related to your moods, or is it the fear of early heart disease?
For some people, we need to focus on sleep. For others, stress management and the use of complementary modalities may be called for.
The Shift from Personalized Health Care to Precision Medicine
This precision personalized plan starts with your goals but is informed by what is going on with each person and what your unique risks are – risks for disease and for general hurdles that can get in the way of accomplishing those goals.
Let’s say your goal is to improve your libido and general energy levels. The first step would be to assess your current hormone status (your testosterone levels, estrogen, insulin, and thyroid) to know where to start. I also need to know what’s going on with your diet and exercise program.
But in order to create a plan that is specific to YOU that will be the most effective, I would need to go deeper. That’s where genetic testing comes in.
Baseline labs tell me where you are at. Genetic testing can explain WHY you are there. It can also guide me on where to start in terms of medications, hormone replacement, supplements, and even recommendations for what type of exercise and diet you should follow.
You may have genes that make it harder for your to detox effectively. That means I’d recommend a very different mix of hormones, supplements, and dietary components than someone who has great detoxification ability but has an inherent inability to activate certain neurotransmitters.
This can get very complicated, but it’s where we are heading in integrative and lifestyle medicine. And it’s beyond exciting. We are going from a one-size fits all approach to a personalized precise plan to help you accomplish the goals that matter to you. And that makes all the difference in living the life you’re here to live.
This approach requires a deep dive into your unique constitution – your health history, family history, lifestyle, GOALS, and the health risks you carry that can interfere with your ability to accomplish your goals. These risks are in part carried in your genetic make-up.
We know that you are NOT a victim of your genes. Epigenetics tells us that you can turn on good genes and turn off bad genes with your lifestyle, diet, medications, and other interventions. But it is essential to know where you start – to understand what specific genetic proclivities you have so that you know which specific interventions you need to follow – which genes need turning off and on. That’s where genetic testing comes in.
There are many types of tests out there. The most common are ones that test for unique genes, call SNPs (Single Nucleotide Polymorphisms). These tests can tell you which form of a particular gene you inherited from your Mom and which from your Dad. 23&Me will give you reports on these.
Why I Recommend 3×4 Genetics
The problem with these tests is not only do they not provide recommendations based on the results, more importantly, they don’t take into account how genes affect one another. If you have one gene that helps build up more serotonin (a neurotransmitter important for healthy moods) and another gene that makes it harder to create serotonin, you don’t know what the net result will be. The majority of functions in the body are controlled by more than one gene, so the interactions among all of the genes are key.
There is another test that actually looks at all of the genes together that impact a particular system. It can account for which genes are stronger and which are weaker. It uses sophisticated algorithms to account for multiple genes that impact particular metabolic pathways in the body, providing an overall individualized assessment of each person’s mix of genes. This is a true personalized and precise test.
This approach that looks at all genes together is far and away the best method to understand your individual risks. This genetic test helps me build a plan for you to accomplish your goals in light of your genetic profile. 3x4genetics even provides tips on supplements, exercise, and dietary recommendations for the issues that arise in your metabolic pathways.
You can’t order this test on your own because it is complicated and needs to be interpreted and explained to you by a healthcare professional. I know that can seem frustrating, but that’s why it’s so good. 3x4genetics only allows trained practitioners to order it so that they can adequately go through the results with you to explain it and make the proper recommendations.
Precision personalized medicine is a giant leap forward from protocolized approaches built for populations. But it requires more sophisticated assessments of each person’s unique risks and an understanding of each person’s goals. That’s what we are all about in integrative, functional, and lifestyle medicine.
Myles Spar, MD is a leading authority in Integrative Men’s Health as an author, teacher, researcher, TED talk speaker, contributor to Men’s Journal and the L.A. Times, expert on Dr. Oz and The Doctors TV shows and a faculty member of University of Arizona.