At MD 2.0, we provide patients with superior primary care. We want to be the first to know about any health concerns that may arise. Primary care is performed and managed by your personal physician, Dr. Poncy or Dr. Lubarsky who are available to you 24/7.
Drs. Lubarsky and Poncy believe in more than just treating you when you are sick. Our preventative medicine doctors want to ensure you are healthy year round by promoting a healthy lifestyle, yearly executive level physical exams, and helping to prevent disease.
At MD 2.0, our concierge physician practice focuses on providing high quality care and individualized attention to each patient. Our model allows us to spend more time with each patient, allowing us to work closely with you on prevention, diagnosis, and treatment of diseases and complex illnesses.
Board Certified Internist in Jupiter, FLDr. Amir Lubarsky's love of medicine allows him to listen compassionately and intently to his patients in order to provide the best outcomes.
Board Certified Internal Medicine Doctor in Jupiter, FLDr. Morgan Poncy is a board certified internist who was raised in the Jupiter area.
Studies surrounding vitamin D can be conflicting, often leading to confusion on the part of our patients. So our concierge primary care doctors in Jupiter thought we’d take a look at some of the newest findings about this essential vitamin.
As an example of how different researchers can draw opposite conclusions even from the same study, one doctor recently wrote in The Washington Post that a study she led “found no statistically significant reduction in cardiovascular disease or cancer” in a nationwide randomized trial of 26,000 adults over five years.
Furthermore, she wrote, “My colleagues and I have conducted further studies from VITAL [the study’s title] showing that vitamin D supplements do not decrease the risk of cognitive decline, depression, macular degeneration, atrial fibrillation or several other health conditions. The most recent report showed no reduction in the rate of bone fractures—once the vitamin’s most commonly touted benefit.”
She concluded that the vast majority of Americans are already getting all the vitamin D they need from brief sun exposure and a normal diet.
“Is it necessary for you to spend money on the supplement? For most healthy adults, the answer is no,” JoAnn Manson wrote in The Post.
However, this same researcher told the Harvard Gazette in January of this year that the VITAL study showed subjects who took vitamin D, or vitamin D and omega-3 fatty acids, had a significantly lower rate of autoimmune diseases such as rheumatoid arthritis and psoriasis than those who took a placebo.
“Given the benefits of vitamin D and omega-3s for reducing inflammation, we were particularly in whether they could protect against autoimmune diseases,” she said.
So maybe the vitamin has some value after all, at least for some.
Yet in 2018, another study published in the National Institutes of Health’s (NIH) National Library of Medicine looked at the prevalence of vitamin D deficiency in the U.S. population. In the introduction, the study’s authors wrote that, “Since foods containing natural vitamin D are rare, the primary source of the compound remains . . . exposure to ultraviolet rays in sunlight.”
It went on to assert that “subclinical vitamin D deficiency . . . plays a role in downstream clinical consequences, including cardiovascular disease, cancer, diabetes, osteoporosis, and fractures.”
Why the frequent discrepancy among various studies? One 2020 clinical study published in the journal BMJ sought to answer that question.
“Our analysis of pooled raw data from each of the 10,933 trial participants allowed us to address the question of why vitamin D ‘worked’ in some trials, but not in others,” Adrian Martineau, a professor at Queen Mary University of London (QMUL) and a lead researcher on the study, wrote in a release.
Those who have the lowest levels of vitamin D in their blood seem to show the largest benefit, he said, along with those who took it daily or weekly, as opposed to intermittently.
The Last Word?
A fact sheet on vitamin D produced by the NIH’s Office of Dietary Supplements (ODS) updated last month summarized numerous studies, including the VITAL study.
For each of the most common health claims connected to vitamin D it reached the following conclusions:
Bone health – All adults should consume recommended amounts of vitamin D and calcium from foods and supplements.
Cancer – Taken together, studies to date do not indicate that vitamin D with or without calcium supplementation reduces the incidence of cancer, but adequate or higher levels might reduce cancer mortality rates.
Cardiovascular disease (CVD) – Overall, clinical trials show that vitamin D supplementation does not reduce CVD risk, even for people with low levels as measured in their blood.
Depression – Overall, clinical trials did not find that vitamin D supplements helped prevent or treat depressive symptoms or mild depression, especially in middle-aged to older adults who were not taking antidepressants.
Type 2 diabetes – Clinical trials provide little support for the benefits of vitamin D supplementation for glucose homeostasis.
Weight loss – Overall, the available research suggests that consuming higher amounts of vitamin D or taking vitamin D supplements does not promote weight loss.
And although the COVID-19 pandemic sparked hope that vitamin D could help prevent or reduce the severity of the illness, two new clinical studies released this month found that it didn’t help with the coronavirus or any other type of respiratory virus.
Vitamin D Overdose?
According to the NIH, the recommended daily allowances for vitamin D are:
- 0-12 months: 10 mcg (400 IU)
- 1-70 years: 15 mcg (600 IU)
- >70 years: 20 mcg (800 IU)
And while many people who supplement with vitamin D take much higher doses than that, too much can be dangerous. Vitamin D is a fat-soluble vitamin, which means it tends to be stored in the body’s fat and can lead to accidental overdoses.
The upper limit of safety appears to be 100 mcg (4,000 IU) daily.
Those who take more than that could experience side effects from supplementing with vitamin D, including nausea and vomiting, constipation, weakness, and kidney damage, among others.
Overall, most studies seem to show that supplementing with vitamin D doesn’t have much effect on various conditions. On the other hand, moderate doses from a reputable manufacturer are generally considered safe. So if you think you could benefit from vitamin D supplements, the decision is up to you.
The Centers for Disease Control and Prevention (CDC) earlier this month approved two new booster vaccines specifically formulated to target the BA.4 and BA.5 omicron subvariants of the SARS-CoV-2 coronavirus, so our primary care concierge doctors in Jupiter want to bring you up to date on the latest information.
What’s different about this vaccine?
The COVID-19 vaccines that have been in use since they were first rolled out in 2021 were all designed to target the original strain. They also effectively reduced hospitalizations and deaths against the different variants that emerged in the following months, including the widespread delta variant.
As the newest omicron subvariants emerged and are now responsible for 90 percent of COVID-19 infections, vaccine makers Pfizer-BioNTech and Moderna developed new, more tailored versions to specifically target them.
The new formula is defined as “bivalent,” meaning it protects against both the original strain as well as the highly contagious BA.4 and BA.5 subvariants. They are the first updated COVID-19 vaccines to be cleared by the U.S. Food and Drug Administration (FDA).
“The updated COVID-19 boosters are formulated to better protect against the most recently circulating COVID-19 variant,” said CDC director Rochelle Walensky.
“They can help restore protection that has waned since previous vaccination and were designed to provide broader protection against newer variants,” she added. “This recommendation followed a comprehensive scientific evaluation and robust scientific discussion.”
Tests in mice have shown they produce a good immune system response to omicron’s BA.4 and BA.5 subvariants.
Are they safe?
Some have questioned the safety of the new versions of the shots because they haven’t been tested in humans, only in mice. But the new vaccines have merely been “tweaked” to “change the recipe,” as the University of Colorado’s UCHealth website explains.
The original Pfizer and Moderna vaccines have been fully tested in humans, and more than 600 million doses in the U.S. and millions more around the world have been given safely. The advisors and experts at both the FDA and the CDC have determined that the newly formulated booster shots are safe.
UCHealth infectious disease and COVID-19 expert Dr. Michelle Barron compared the new boosters to the flu shot, which is updated every fall as vaccine makers guess which strains of the flu will be circulating, and change the recipe to match. But the vaccine itself is not entirely new, she explained.
“We don’t test the flu shot each year. We just change it slightly,” Barron said.
“This new COVID-19 booster just tweaks the formula. The technology is the same. The safety of the vaccines will be exactly the same because it’s not a new vaccine,” she explained.
Who can get them?
The Pfizer vaccine is authorized for anyone ages 12 and older; the Moderna vaccine is authorized for adults 18 and older.
Like the previous coronavirus vaccines, the new boosters are free to the public. They will be available to anyone who has already had their primary vaccine series from any authorized U.S.-approved company regardless of how many boosters they’ve already received.
Public health officials recommend that those who are pregnant or have been pregnant recently should also get the updated boosters because they are at a slightly increased risk of more severe illness and death from COVID-19.
For those who recently received a booster of the previous vaccines, the FDA has set a minimum waiting period at two months, but advisers to the CDC recommend waiting longer: at least three months for those at high risk, or as long as six months for everyone else.
It’s also recommended that anyone who has recently recovered from a COVID-19 infection should wait at least three months to be vaccinated, not only to boost the effects of the vaccine but also to avoid the possibility of a rare side effect, heart inflammation, that sometimes affects teen boys and young men.
“If you wait a little more time, you get a better immunologic response,” CDC adviser Dr. Sarah Long of Drexel University told CBS News.
According to the CDC, side effects are expected to be similar to those associated with the current vaccine, including headache and muscle soreness, occasional fatigue, and redness and swelling at the injection site.
What about other vaccines?
As we head into the fall flu season, several of our clients have asked whether they can get a coronavirus vaccine along with a flu vaccine. The answer is yes, one in each arm.
In fact, health officials have recommended this protocol, and the government is preparing to launch a campaign that will urge Americans to do just this, due to the possibility of the high spread of flu and COVID-19 this season.
As for the Jynneos monkeypox vaccine, the CDC suggests that adolescent and young adult men consider waiting four weeks after receiving the monkeypox vaccine before receiving a Moderna, Novavax, or Pfizer COVID-19 vaccine, because of the risk of inflammation of the heart muscle (myocarditis) or inflammation of the tissue surrounding the heart (pericarditis).
However, the agency adds that the monkeypox vaccination “should not be delayed” due to recently receiving a coronavirus vaccine.
If you have any questions about whether or not to get the new booster, don’t hesitate to contact us for advice.
My husband and I have been patients of Dr. Poncy for over ten years and have been extremely pleased and happy for him. He is not only a brilliant internist, but also a wonderful person. Now that he and his partner, Dr. Lubarsky, have opened the concierge practice it is better than ever. The nursing staff is superlative as is the front office staff. The office is very well appointed and comfortable. We feel very fortunate to have such a competent and caring physician.
About 11 years ago, I first met with Dr. Poncy. I came away from my appointment with him confident he understood my problem and contributed some thoughtful suggestions. Over the years, he has never changed. The outstanding staff Dr. Poncy has put together, along with his partner, Dr. Lubarsky, are the best! I honestly feel, when I have an appointment, it is like visiting "family".
I recommend Dr Lubarsky emphatically. He is a true professional: thorough, compassionate and an excellent diagnostician!
We have been concierge members for only 6 months but so far we have been very pleased. The office atmosphere is very relaxed and the doctor is able to give us the time we need. Time in the waiting room is minimal and we have been able to obtain spur of the moment appointments with no difficulty. We are happy that we joined
The new practice has a very warm, friendly, feeling to it. We don't have long waiting times. Everyone is very prompt.
I have been a patient for over 30 years. I actually look forwarded to a visit. Pleasant, professional in every way, I consider myself very lucky.
A great Dr. & great staff, minimum wait time. Spends as much time with you as you need. Same day appointments.
Dr. Poncy has been my primary care doctor for over 8 years. I've known Dr. Poncy for over 8 years. My neighbor recommended him for my diabetes and heart problem. The staff at Dr. Poncy's office is always very pleasant and Dr. Poncy is very patient to my concerns.
I have been a patient of Dr. Lubarsky since 2004. He has been such a great physician to me and my wife for several years. Recently, I was hospitalized at Jupiter Medical Center. My wife contacted him and he immediately responded and came to the hospital. Without Dr. Lubarsky's support, I don't think I would be at the health level I am at today.
I'm a big fan of Dr. Lubarsky! After moving from New York, I researched area Internist throughout Jupiter and Palm Beach Gardens. Dr. Lubarsky was a home run!