The Era of Personalized Medicine by Dr. Mark Menolascino

By Dr. Mark Menolascino  MD, MS, ABIHM, ABAARM, IFMCP

Due to advances in diagnostics and a shift in the mindset of certain physicians to a functional approach to health we are able to deliver a new type of medicine.  The greatest force behind this movement is the patient.  No longer are we satisfied to be treated as a number or a statistic.  We no longer want to be unique individuals that are regressed to the mean of a population curve. We want a physician that can look at us as a whole person with a model of care that is optimal and unique to our individual needs.  Cardiovascular medicine is the epitome of this change.  With marked advances in biomarker evaluation and a realization of inflammation as a key driver of disease, we are now able to approach the leading cause of death in our country from a more holistic preventative approach.

When Dean Ornish developed his Reversing Heart Disease program now 25 years ago, he changed the face of cardiovascular therapy from bypass surgery to optimal self care-teaching patients how to eat, how to exercise, how to meditate and how to love and you can have a better outcome after a heart attack than if you had cardiac bypass.  This self-care model can yield better outcomes for your body (and your wallet)!  Foods we eat are a key player for providing a healthy heart.  Unique tomato extracts standardized for specific carotenoids content have proven to show a profound effect in reducing the inflammation that is so dangerous to the heart.  We will likely to continue to find multiple health benefits from this amazing compound and addressing cardiovascular disease is a great first step.  With all the recent concerns raised about the safety and efficacy (or lack thereof) for cholesterol lowering statin medications, this is an ideal time to look for healthy, safe and effective alternatives such as carotenoids.

We are now in such a unique time for medicine.  The health care costs are skyrocketing, the safety of many medications is being questioned (appropriately prescribed medications is the third leading cause of death!), our food supply has more unsafe additives than ever before and for the first time in history the current generation will not live longer than their parents!   And one in three children born today will be diabetic as adults!  How is our current expensive and overburdened health care system going to be able to address this huge influx of new diabetics?  And of course there is now no state in our country in which there is an obesity rate less than 30%.  These numbers are not acceptable and patients want help.  They are looking for physicians that can address these issues in a functional medicine type of program that is unique and personalized for each individual.  This sounds daunting; yet it is a fun, exciting, satisfying way to deliver care.  In our clinic on a daily basis we are reversing cardiovascular disease, diabetes, obesity and markedly reducing the health care costs for our clients.  Fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome-they do not exist in our clinic.  Yes the clients are tired, they hurt, they have digestive troubles but they don’t have some mystery syndrome.  We uniquely personalize their evaluation and care plan and are successful most of the time with these syndromes our primary care colleagues are baffled by and use medicines with marginal benefit and marked side effects.

We were taught in medical school to motivate our patients by fear and guilt-“if you don’t stop smoking you will get lung disease or cancer”.  This rarely works.  What we have learned is that is we become teachers for our clients and provide them information to empower them with knowledge to help them make healthy behavior changes that fit THEIR belief system than we can be successful together.  Now we have functional genetics to unlock the last piece of the puzzle.  This is truly what allows personalized medicine to flourish in this era of advanced testing.   By understanding each individual’s microbiome and flora of the gut we realize how unique each person presents their story.  Helping to modify the external and internal environment to use epigenetics to turn on good genes and turn off bad genes we are able to achieve quicker and longer lasting benefits.  The future personalized nature of medicine is becoming an exciting story so jump on our functional medicine wagon to enjoy this next chapter.