Our Science
This page is the technical version. It documents exactly which assays we run, what each one measures, the optimal targets we work toward, the automated safety rules that govern the intake, and the reason protocols are capped at three to five formulas per stage.
If you want the plain-language version, start with the homepage. If you want to know whether the method is rigorous enough to hand your biology to, keep reading.
Three assays, three different questions.
Genomics tells you the terrain. Substrate friction markers tell you the current load. Epigenetics tells you the trajectory. No single one of them is sufficient; the clinical value is entirely in the convergence.
3x4 Functional Genomics
Buccal swab · one-time · permanent
Thirty-six functional pathways scored from a curated SNP panel and grouped into actionable biological areas rather than raw variant lists.
- Methylation — MTHFR, MTR/MTRR, COMT, homocysteine handling
- Detoxification — Phase I/II capacity, GST, NQO1, sulfation
- Oxidative stress — SOD2, CAT, GPX antioxidant defense
- Vascular integrity — endothelial function, lipid handling, NOS
- Inflammation — cytokine response tendencies
- Fat & carbohydrate response — macronutrient partitioning
Genotype is not destiny. It is a map of where your system has the least reserve — and therefore where intervention returns the most.
ZRT Substrate Friction
Saliva × 4 + dried blood spot · at home
The measurements a single fasting morning venipuncture structurally cannot make.
- 4-point salivary cortisol including the cortisol awakening response (CAR) and full diurnal slope
- DHEAS — adrenal reserve against cortisol output
- Fasting insulin — optimal target under 5.0 µIU/mL
- hs-CRP — optimal target under 1.0 mg/L
- HbA1c — 90-day glycemic exposure
A flattened cortisol slope with normal total cortisol is invisible on a standard panel and is one of the most common findings we correct.
TruDiagnostic Epigenetics
Blood collection · Day 0 and Day 150
DNA methylation array analysis producing three distinct outputs.
- OMICmAge — a biological age estimate trained on proteomic and metabolomic outcomes, not chronology alone
- SYMPHONYAge — organ-system-specific ages (heart, brain, liver, kidney, inflammatory, metabolic, hormonal, immune)
- DunedinPACE — the rate of aging. Target under 0.90
Odometer vs. speedometer. Biological age is an odometer — it reports accumulated mileage and moves slowly. DunedinPACE is a speedometer: it reports how many biological years you are accruing per calendar year right now, which is why it is the metric we retest at six months and the one the DunedinPACE Promise stands behind.
| Marker | Conventional “normal” | Functional target | What it reveals |
|---|---|---|---|
| Fasting insulin | 2–25 µIU/mL | < 5.0 µIU/mL | Years of compensation before glucose ever rises |
| hs-CRP | < 3.0 mg/L | < 1.0 mg/L | Low-grade inflammatory tone driving epigenetic pace |
| HbA1c | < 5.7% | 4.8–5.3% | 90-day average glycemic exposure and glycation load |
| Cortisol awakening response | Not routinely measured | Robust rise, clean decline | HPA axis rhythm — energy, sleep quality, visceral fat retention |
| DunedinPACE | Not routinely measured | < 0.90 | Biological years accrued per calendar year |
Functional targets are optimization ranges used to guide nutritional and lifestyle strategy. They are not diagnostic thresholds and do not define disease. Diagnosis and disease management remain with your physician.
Two gatekeepers run before anyone gets a protocol.
Every intake Medical Symptoms Questionnaire is scored automatically across systems. Two rules can fire from that score, and both of them override the standard program path.
Acute symptoms leave the funnel immediately
Any acute cardiorespiratory or neurological symptom scoring 3 or higher — chest pain, syncope, new focal neurological deficit, severe dyspnea, sudden severe headache — triggers an immediate real-time alert to Dr. Bekkum's device and pulls the intake out of the automated sequence.
There is no scenario in which a patient reporting those symptoms receives an automated supplement protocol. They receive a same-day human contact and, where appropriate, an immediate referral to emergency or primary medical care.
This is the single most important rule in the system. A precision longevity program that cannot recognize when it is the wrong tool is a liability, not an asset.
Multi-system clustering forces an exposome workup
When Energy, Mind, Joints, and Gut all score 10 points or higher concurrently, the pattern stops looking like four separate problems and starts looking like one upstream burden.
That combination automatically adds a MosaicDX MycoTOX (mycotoxin) and Heavy Metals workup — included at no additional program cost in the Flagship, and run upfront by default in the Executive tier.
Why this rule exists: pushing methylation and detoxification support into a system carrying an unrecognized mold or metal load can mobilize more than the patient can clear. Finding the burden first changes both the sequence and the pace of everything downstream.
01
MSQ submitted
Scored automatically across all systems at intake.
02
Gatekeepers evaluated
Red flag and cluster rules run before any kit ships.
03
Panel set finalized
Triad, plus exposome workup if the cluster trigger fired.
04
Convergence & sequencing
Findings mapped to IFM nodes; phase order set.
Findings are mapped to systems, not symptoms.
Your results do not get filed by which lab produced them. They get mapped onto the seven interconnected physiological nodes of the Institute for Functional Medicine matrix — which is what makes it possible to see that four complaints share one upstream cause.
Nothing downstream works if intake does not become usable substrate. Barrier integrity, gastric and pancreatic output, bile flow, and microbial ecology determine whether the food and the formulas you take actually arrive where they are needed.
Why it is Phase 1: giving a methylation formula to someone who cannot absorb it is an expensive way to change nothing. Assimilation gets addressed first in every single protocol, without exception.
Read from: MSQ Gut domain, 3x4 inflammation and fat-response pathways, exposome panel when triggered.
Chronic low-grade inflammatory tone is one of the strongest modifiable drivers of epigenetic pace of aging. This node is where hs-CRP, the 3x4 cytokine-response pathways, and symptom clustering converge.
Optimal target: hs-CRP under 1.0 mg/L. Between 1.0 and 3.0 is conventionally acceptable and functionally a standing tax on every other system.
Read from: hs-CRP, 3x4 inflammation and oxidative stress pathways, MSQ Joints and Energy domains.
Fatigue that survives a full night of sleep is rarely a sleep problem. It is usually a production problem — mitochondrial substrate availability, oxidative burden outpacing antioxidant capacity, or insulin dynamics quietly restricting fuel access.
Optimal target: fasting insulin under 5.0 µIU/mL. Normal glucose with elevated insulin means the system is paying to stay normal.
Read from: fasting insulin, HbA1c, 3x4 SOD2/CAT/GPX and carbohydrate-response pathways, MSQ Energy domain.
Your genetic clearance capacity is fixed; your exposure load is not. When the 3x4 panel shows constrained Phase I or Phase II capacity and the exposome panel shows real burden, the intervention order changes completely — support clearance before mobilizing anything.
Phase 2 territory: this node and the HPA axis are addressed together in the second 30-day stage, after assimilation is functional.
Read from: 3x4 detoxification pathways (GST, NQO1, sulfation), MosaicDX MycoTOX and Heavy Metals when triggered.
Delivery infrastructure. Endothelial function and lipid handling determine whether oxygen, nutrients, and hormones reach tissue — and whether metabolic waste leaves it. The 3x4 vascular integrity pathways often explain why two people on identical diets have entirely different lipid responses.
Read from: 3x4 vascular integrity and lipid-handling pathways, hs-CRP, SYMPHONYAge cardiovascular organ age.
The signaling layer — and the node where the four-point cortisol curve does its most important work. A blunted cortisol awakening response with a flat afternoon slope produces a specific, recognizable clinical picture that a total-cortisol blood value renders completely invisible.
Brain-Body Axis: COMT and methylation status shape neurotransmitter clearance, which shapes stress tolerance, which shapes the cortisol curve, which shapes sleep architecture, which shapes insulin sensitivity. This loop runs in both directions.
Read from: 4-point salivary cortisol + CAR, DHEAS, 3x4 methylation/COMT pathways, MSQ Mind domain.
The node most functional medicine practices under-serve, and the one Dr. Bekkum's 33 years of CCEP extremity and structural correction work address directly. Metabolic optimization that ignores how a body actually loads and moves leaves capacity on the table — and mechanical dysfunction that ignores inflammatory tone never fully resolves.
For local patients: StructureIQ 3D motion analysis and CCEP extremity work are available in-office in Moorhead and billed separately from the precision medicine programs.
Read from: MSQ Joints domain, functional movement assessment, 3x4 inflammation pathways.
Why we cap the protocol at three to five formulas.
The most common failure mode in precision medicine is not a wrong protocol. It is a correct protocol the patient stopped taking in week three because it arrived as fourteen bottles and a spreadsheet.
Gut
Assimilation, barrier integrity, hydration and mineral status. Food-first, with three to five targeted formulas.
Rationale: absorption gates every subsequent phase. Correcting it first raises the effective potency of everything that follows.
Detox / HPA
Biotransformation capacity and cortisol rhythm, sequenced against your 3x4 detoxification pathway scores and your four-point curve.
Rationale: clearance capacity must be functional before mobilization, and the HPA axis sets the recovery ceiling for everything in Phase 3.
Epigenetic Reversal
Methylation support, inflammatory tone, and the nutritional and lifestyle levers with the strongest evidence for moving pace of aging.
Rationale: this is the phase the Day 150 retest measures. It only works because Phases 1 and 2 removed the friction that would otherwise absorb the effect.
Food First, always
Every phase leads with nutritional strategy and nutrigenomic targeting — specific foods chosen against your specific pathway scores. Nutraceuticals are used to close gaps that diet cannot reach in the available timeframe, not as the primary intervention. A protocol you can eventually eat instead of purchase is a protocol you keep for decades.
Adherence is a clinical variable
A five-formula protocol followed at 90% outperforms a fourteen-formula protocol followed at 40%, every time. We treat the size of the ask as a design constraint rather than an afterthought — which is why the phases are sequenced rather than stacked.
The method only matters if it is applied to your data.
Fifteen minutes with Dr. Bekkum to review what has already been measured, what has not, and whether this architecture is the right tool for what you are dealing with.