Repurposed Drugs & Systems Medicine: Measuring What Actually Changes Outcomes (2026)

By Dr Frank Yap, MD

Repurposed drugs do not work in isolation.

They work by modulating systems—metabolism, inflammation, immune signaling, mitochondrial function, and the tumor microenvironment.

Systems medicine asks a different question than conventional care:

Which measurable biological systems are drifting—and which interventions (lifestyle, metabolic, pharmacologic) shift them back toward resilience?

That requires metrics, not narratives.

The Systems Medicine Framework

Systems medicine integrates three intervention layers, all guided by measurable biomarkers:

  1. Foundational physiology (metabolism, sleep, muscle, fitness)

  2. Targeted metabolic & immune modulation (nutrition, supplements, repurposed drugs)

  3. Conventional therapies when required

Health metrics are the feedback loop that connects these layers.

1. Metabolic Metrics (Primary Targets of Many Repurposed Drugs)

Insulin resistance is a shared vulnerability across cancer, neurodegeneration, cardiovascular disease, and aging.

Key metrics:

  • Fasting glucose: <90 mg/dL

  • HbA1c: <5.4%

  • Fasting insulin: <6 μIU/mL

  • HOMA-IR: <1.0

  • Triglyceride-to-HDL ratio: <2

Why this matters in systems medicine:

  • Drugs like metformin, GLP-1 agonists, acarbose, and ivermectin exert downstream effects by altering metabolic signaling, not just single pathways.

  • Without tracking insulin resistance, drug effects are misinterpreted or missed entirely.

Related: Why Repurposed Drugs, GLP-1s, Prevention, and AI Belong Together

2. Inflammation & Immune Signaling Metrics

Chronic inflammation distorts immune surveillance, drug response, and tissue repair.

Key metrics:

  • hs-CRP: <1.0 mg/L

  • Ferritin: 50–150 ng/mL

  • Vitamin D (25-OH): 40–60 ng/mL

Systems relevance:

  • Repurposed agents such as statins, colchicine, ivermectin, low-dose naltrexone, and curcumin influence immune tone, not acute inflammation alone.

  • Tracking inflammation separates true biological response from placebo or noise.

3. Muscle & Body Composition (Drug Response Modifiers)

Muscle mass determines how patients respond to stress, illness, and therapy.

Track:

  • Lean muscle mass trends

  • Grip strength

  • Waist circumference (visceral fat proxy)

Why this matters:

  • Sarcopenia worsens outcomes in:

    • Cancer therapy

    • Neurodegenerative disease

    • Aging interventions

  • Drug efficacy and toxicity are context-dependent on body composition, not just dose.

4. Cardiovascular & Mitochondrial Metrics

Mitochondria sit at the intersection of metabolism, immunity, and aging.

Key metrics:

  • Resting heart rate: 50–70 bpm

  • Blood pressure: <120/80 mmHg

  • VO₂ max: higher = lower mortality

  • SpO₂: 95–100%

Systems relevance:

  • Drugs like methylene blue, statins, ivermectin, and certain antiparasitics affect mitochondrial signaling and redox balance.

  • Without functional metrics, mitochondrial effects remain theoretical.

5. Nervous System & Stress Metrics (Often Ignored, Highly Predictive)

Autonomic imbalance amplifies metabolic dysfunction and immune suppression.

Track:

  • Sleep duration & consistency

  • Heart rate variability (HRV)

  • Resting heart rate trends

Why it matters:

  • Stress alters drug metabolism, immune response, and inflammatory tone.

  • Systems medicine treats stress physiology as signal amplification, not background noise.

Why Repurposed Drugs Fail Without Systems Metrics

Common Mistakes

  • Using drugs without baseline metabolic data

  • Ignoring inflammation and body composition

  • Expecting linear cause-effect responses

  • Treating drugs as replacements instead of modulators

Systems Medicine Approach

  • Establish baseline system function

  • Apply low-risk, multi-node interventions

  • Track directional change, not single lab values

  • Adjust based on biological response, not protocol rigidity

Key Takeaway

Systems medicine is not anti-conventional or pro-alternative.
It is measurement-first, mechanism-aware, and outcome-driven.

Repurposed drugs only make sense when:

  • The right systems are targeted

  • The right metrics are tracked

  • The right context is understood

Without metrics, repurposing is storytelling.
With metrics, it becomes medicine.

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