The microbiome is a rich target for medical innovation because of its intimate relationship to, and impact on, human health. For decades, people have been trying to use beneficial bacteria to treat disease. However, these treatments have been either ineffective or inconsistent. The problem is that bacterial strains used thus far are not adapted to survive in the human body. There is a great deal of microbial diversity in each individual which makes microbiome-mediated therapies unpredictable. The microbiome changes quickly in response to the environment (e.g. illness, diet, medications). This makes it even more difficult for a lab-derived bacteria to colonize and provide a benefit.We introduce a highly personalized approach that allows us to modify a patient's native bacteria to perform an unimaginable number of therapeutic actions, such as improve insulin sensitivity or prevent dementia. A single dose has been shown to have life-long benefits in our pre-clinical studies.