News & Updates

Immune escape is noted with more recent COVID19 virus variants. This means exposed subjects aren't maintaining neutralizing (killing function) antibodies to the evolving COVID virus. For more Covid commentary, see the section on COVID update later in this newsletter.

A recent comparative analysis of efficacy and safety between the novel anticoagulant class of products was reported in the Annals of Internal Medicine. This was a multinational population real world analysis. The study looked at the name brand products of Eliquis, Xarelto, Savaysa and Pradaxa (first in class on the market). As these drugs became available, physicians began to appreciate that Eliquis had a safety profile slightly better in the aged (80 and up) and in kidney disease. This analysis demonstrates this remains true for all patient age groups. This analysis was for stroke prevention in patients with atrial fibrillation (a main cause of stroke).

A new vitamin D study which used genetic risk correlations demonstrates a causal relationship between vitamin D deficiency and mortality. This article is very heavy on complex statistics and is limited in analysis to the UK Biobank -a population from England, Scotland and Wales which is restricted to White European people.

The authors demonstrated correlation of deficiency states of vitamin D with higher mortality from cardiovascular disease, cancer, total all cause mortality and respiratory illness mortality. Some interesting facts from this article include:

1. Blood serum levels of 50 nmoles/ml appears to be the measured vitamin D level target for optimizing the amount of supplementation to lower mortality.
2. The human genome contains at least 13,000 known human cell receptor binding sites for vitamin D.
3. Two key receptor targets include the renin/angiotensin system, which regulates blood pressure and secondly, impaired vitamin D metabolism which affects macrophage differentiation. Inadequate macrophage (a white cell type) differentiation potentially could promote vascular cholesterol retention (plaque build up in arteries).
4. Respiratory epithelial cells convert vitamin 25-(OH)D from serum to 1,25-(OH2)D3 to subsequently produce peptides that have anti-infective effects (protecting one from invasive infection).
5. For cancer mortality reduction, active vitamin D may mediate cell proliferation (growth), differentiation (changing stem cells to specific tissue types) and apoptosis (clearing dying cells from the body).

Influenza Season

There has been a mild increase in influenza activity in Florida in October and November. We have had only one case present to the office and it was this past week (end of November).

Here is a link to the global influenza data. This program is also incorporating COVID information.

Some of you readers may recall when the COVID19 pandemic was officially declared, I reported that this situation was unprecedented. For the first time, the public was going to be able to see in "real time" the evolution of a brand new mass population infectious respiratory illness. As we move into the third and fourth years of this disease, it appears the frequency of infection as well as hospitalizations is markedly lower.

Covid 19 case rates are mildly rising this past reported period. This weekend, I reviewed the pattern of infection and last year's Omicron outbreak began to accelerate just about this time of year. It will be interesting to see how high the numbers peak this year. I suspect it will be much lower because at this point in time nearly all of us have had or certainly been exposed to this virus and have hosted a more broad immune response.

As we have known for decades and are seeing now, there is a seasonal rise in respiratory infections including COVID, Respiratory Syncytial Virus (RSV), rhino enterovirus and influenza. Florida actually had a few weeks of ZERO reported Covid cases in October and so now the weekly average incidence of 4,491 represents a significant rise. This rise is still over 30 times less than the January 2022 peak incidence in Florida.

Regarding COVID19 vaccination, many of my patients know that as the Delta variant outbreak occurred, I became very skeptical of the value of the mRNA Covid 19 vaccines. There appeared to be no clear protection between the vaccinated and the unvaccinated with that wave.

Further, the documentation of numerous cases of COVID vaccine related myocarditis, which by the way, often results in hospitalization, loss of work, morbidity and likely death (in the form of sudden deaths, which may be counted as "natural causes"). Noting the aforementioned, I have definitely been outspoken regarding the CDC and FDA promoting this vaccine especially in children and young healthy adults. At this point I don't feel that I can honestly advise it for any patient, especially noting effective medication strategies to manage acute infection.

Recently, I was presented a video of Dr. Scot Youngblood MD, who petitioned his local government recently to stop any further consideration of vaccine mandates. His presentation further supports my position. I have reviewed specifically the NEJM reference he used and agree with his positions. If you look at these four graphics, you can see how natural infection result in sustained (albeit not perfect) immunity to new recurrent COVID. You will see also how vaccines are associated with initial benefit that wanes rapidly and then trends to higher risk of infection. Contrast that with the evidence that persons naturally infected maintain a positive 50% protection as far out as 17 months (and still counting).

It is imperative for folks to appreciated that the current COVID vaccines are totally novel in their mechanism of delivery. This includes a wholesale cellular uptake of genetic coding to make your cells generate a specific small protein in unnatural quantities. This is nothing like our past vaccines. Given the short follow-up time window, It remains experimental. The present evidence is, in my opinion, very strong that under normal circumstances, big pharma would not have recommended this product for market approval. It astounds and disappoints me that our CDC and FDA continue to promote this as preventive treatment.

Historically, the best vaccines involve stimulating antibodies to multiple proteins or modified infective organisms (called live attenuated viruses/bacteria). This method most closely mimics true natural immunity as we normally develop multiple antibodies when exposed to a new pathogen. The mRNA Covid vaccines are only stimulating spike protein antibody production and appears to no longer provide protection.

Dr. Youngblood goes on to demonstrate a fairly iron-clad case showing that at this point, further vaccine boosters will and are paradoxically causing more infections, hospitalization and death. I can't surpass his presentation and so I highly recommend you click the action button below to see his 13 minute presentation. All that is missing is a mic drop at the end.

Having personally experienced social media censorship (LinkedIn), baiting and suspected bots (Twitter) and verbal hostility (Facebook groups. I am exploring using a format called Substack for future newsletters and blogs.

I have witnessed many of the individuals willing to speak up during this strange Covid time, get censored. Many of the censored are finding their voice and being allowed to speak on Substack.

I want my newsletter contacts to be aware as I will include you on my Substack subscribers list if I do. Given the recently announced 4.5% Medicare pay cut for doctors and our thriving DPC practice model, I feel more blogs on the economics of health care are brewing.

Substack does often share with Twitter. Interestingly, with Elon Musk taking over Twitter, I am reactivating my account. Stay tuned for those who enjoy more spontaneous commentary from Dr. Kordonowy,

In order to assist you in optimizing your time and our resources, I wanted to clarify which points of contact you should use for reaching out to us. 

• If you know you need/want an urgent appointment call the office and ask for the receptionist.239-362-3005. State your request. If there is need to clarify urgency, the receptionist may refer you to the clinical staff to assist. 
• The portal (messaging through your chart) is monitored by the team and can be used to request nonurgent services like prescription refills, nonurgent appointment requests or nonurgent medical clarifications.
• We would appreciate if you would not text the physician during office hours. This is distracting and the doctor can only take care of one patient at at time- appointments being the priority.
• For Non Premier members, if you need your doctor after hours, call the office and respond to the prompt that links you to your doctor's phone/voicemail. Premier members have the physician's cell for direct contact for such situations. Any member can upgrade to premier status at their annual contract date.
• The physicians review your reports/labs etc. throughout the workday and often after hours. We will forward report copies with comments through the portal. We see if you read our messages. Further, we are reminded after several days if you don't open a communication.
• Urgent communications will be performed by phone from the clinical staff. We strive to have all data addressed by the end of the week.
• We have a protocol in place to annually audit your chart to assure you are current in health screening and labs. A portal letter will go out once a year around the time of your annual membership date keeping you updated.
• When your doctor is on vacation, the other physician will be available for care issues.

If you are purchasing Pure Encapsulation supplements you can order products directly and have it shipped to your home. The cost of product is the same this way or if you get it at the office. Shipping is waved after a certain dollar amount when ordering. 

There are other links on our website for ordering other physician vetted products/resources on our main website as well. 

I-Remedy is a source for a wide array of products including many over counter products, wound care supplies, braces and support stockings, etc.

Pharmanex is the supplement division of NuSkin which makes many excellent products for optimizing health and skin/beauty products. The NuSkin LifePak Nano is the "Best in Class" total nutrition supplement that is scanner guaranteed. To get the best price from Nuskin/Pharmanex we have a distributer ID that we can provide you when ordering.