Nov. 19, 2025
The vitamin D debate: Are seniors getting enough?
In this episode, hosts Ron Aaron and Dr. Rajay Seudath welcome Dr. Leandro Bosques-Sanchez to explore a vital question: Are older adults getting the vitamin D they need to stay healthy? From bone strength and immune support to mood and energy levels, vitamin D plays a crucial role in aging well.
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Show transcript
Podcast transcript
INTRO
Welcome to Docs in a Pod, presented by WellMed. Over the next half-hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Dr. Rajay Seudath and award winning veteran broadcaster Ron Aaron will share information to improve your health and well-being. And now here are Ron Aaron and Dr. Rajay Seudath.
RON AARON
Hello everybody, and welcome to the award winning Docs in a Pod. We come to you every week with a look at a variety of health and welfare issues as they affect almost everybody. Seniors 65 and over and others. I'm Ron Aaron and our co-host Dr. Seudath is with us, and we're delighted to have him here. Dr. Seudath is board certified in family medicine. He's a Tampa native and a lead physician for Optum. He's at the University location in Tampa. Dr. Seudath earned his medical degree from the University of South Florida Morsani College of Medicine. He is absolutely delighted to practice primary care, guiding his patients to meet their health care goals while maintaining these patients values and a whole lot more. He also is learning Japanese along with his kids. We're going to find out why. Maybe that's where he opens his next clinic. It's good to have you with us.
DR. RAJAY SEUDATH
Good to be back. Thank you for having me.
RON AARON
You were mentioning off the air, and it caught my ear. Every Saturday you drive from Tampa to Orlando to go to Japanese school.
DR. RAJAY SEUDATH
Yes. I actually was a teacher in Japan before I was a doctor, and having that large student population opened me up to the idea of family medicine and having a large age population. My wife is Japanese, and my kids are learning Japanese to preserve that language.
RON AARON
That's cool. You must watch the Dodgers in the World Series.
DR. RAJAY SEUDATH
Oh, very much so. A whole side of the family has been rooting for the Dodgers.
RON AARON
ThatÕs interesting. They have a couple of really talented Japanese players.
DR. RAJAY SEUDATH
Oh yeah. Ohtani is pretty cool.
RON AARON
We're going to be talking about a topic that I know you talk with your patients about quite a bit, and we'll introduce our special guest who's with us. Before I do that, the question we look at is vitamins, supplements, vaccines that are important to seniors. Our guest, Dr. Leandro Bosques, is a board certified family medicine physician at Optum Ð Conway in Orlando, Florida. He's dedicated to providing compassionate, comprehensive care to his patients. He earned his doctorate in medicine from University of the School in Santo Domingo, Dominican Republic, and completed his internship in Puerto Rico. He has a strong foundation in primary care. When he is not doing doctor stuff, Dr. Bosques loves to cook, and he loves to travel. Thank you so much, Leandro, for joining us.
DR. LEANDRO BOSQUES-SANCHEZ
Thank you for having me.
RON AARON
What are the things you like to cook?
DR. LEANDRO BOSQUES-SANCHEZ
Well, I'm a foodie, so I love to cook everything. I like to do some new recipes. I love to grill, bake, you name it. Then my Hispanic food, which is my favorite.
RON AARON
That's cool. Now, one of the things you were telling me off the air, you also love to travel.
DR. LEANDRO BOSQUES-SANCHEZ
Correct. That's one of my passions. I love culture. I love food. I love to eat. I think that's something that we keep in our lives.
RON AARON
One of the topics I know you wanted to talk about today, as a senior, one of the things I discovered very early on, I was very low in vitamin D, but it turns out to be pretty common.
DR. LEANDRO BOSQUES-SANCHEZ
Correct. Vitamin D deficiency is really, really, really common and mainly in our population of patients.
RON AARON
Part of that, of course, is we spend so little time in the sun. When we do, we slather ourselves with sunblock. Right?
DR. LEANDRO BOSQUES-SANCHEZ
Yes.
RON AARON
So, it's counterproductive.
DR. RAJAY SEUDATH
It's counterproductive in the sense that we're trying to block out the bad radiation from the sun, but also as we get over the age of 65, our ability to transform that sunlight into active vitamin D becomes a little bit less. Some of that is dependent on the kidneys, and we can have kidney decline as part of our aging process. So, people with chronic kidney disease we can see have lower vitamin D levels. We can see they have lower blood levels because of other hormones that are involved. So, it's one of the things that we can check in and we can try to correct. It's interesting. We live in Florida, and we have so much sunlight here, but so many people spend time inside and outside because it's so hot.
DR. LEANDRO BOSQUES-SANCHEZ
Right.
RON AARON
What role does the kidney play in producing vitamin D?
DR. RAJAY SEUDATH
I would say it helps to change that vitamin D that we either get from our diet or that we get from the sunlight in terms of switching it to the active form, which is the D3. So, that's one of the things that the kidney can do for us. When we supplement, we can supplement with D3 or D2. Typically, as the prescription, it's D2 as a very large amount. Your body slowly converts that into D3. We can also do a supplement of the D3 as well.
RON AARON
Dr. Bosques, you see a patient first visit, you look at him, and you do a blood test. What are the odds they're low in vitamin D?
DR. LEANDRO BOSQUES-SANCHEZ
I will say with my population like, 80% of my patients have low vitamin D. Like Dr. Seudath said, when they become older, the ability of the skin to absorb the vitamin D is less. Also, with aging, some of my patients have some kidney issues and they have inability to produce the active form, as Dr. Seudath said, to help the patient to produce vitamin D and produce phosphorus and calcium, which is vital for the bones. So, 80% of my patients, they have low vitamin D.
RON AARON
What is it that vitamin D does for us? Why is it important?
DR. LEANDRO BOSQUES-SANCHEZ
It helps with our immune system. It helps with our muscles, with bone health. Even there are some studies that say that a good amount of vitamin D, it reduces the chance to get Alzheimer's.
RON AARON
I need more of them. Give me more.
DR. LEANDRO BOSQUES-SANCHEZ
Well, come to Florida.
RON AARON
Let me take a moment and let folks know who may have just joined us, you're listening to the award winning Docs in a Pod. I'm Ron Aaron and our co-host, Dr. Rajay Seudath is with us, and we're talking to Dr. Leandro Bosques. You can find him in at Optum - Conway in Orlando. In addition to vitamin D, are there other vitamins and supplements that seniors might consider taking?
DR. LEANDRO BOSQUES-SANCHEZ
Yeah. We always check for vitamin B12, which is really important. I will say, we check for phosphorus as well. Those are the main vitamins that we check in our blood test.
RON AARON
What does B12 do?
DR. LEANDRO BOSQUES-SANCHEZ
A B12 helps with energy. ItÕs our energy vitamin that has a lot of metabolic benefits in our body.
RON AARON
My wife's a big believer in getting B12 shots.
DR. RAJAY SEUDATH
That's one of the things B12 shots can be helpful for people who don't absorb B12 very well. Oral B12 supplements can be helpful. One of the things we want to be careful with B12, though, is for people who have neuropathy. So, if you have low B12, it can worsen neuropathy. But if you have high B12 in the toxic range above 1,300, that can actually worsen neuropathy. So, it's important that we're replacing a person based on their lifestyle, based on their actual levels as well. I feel tired. Get some B12. If you're tired and you're taking B12, but your B12 is in the toxic range, you don't need more B12. It could be something else.
RON AARON
Remind us of what neuropathy does.
DR. RAJAY SEUDATH
Neuropathy is a misfiring of the nerves that could be indicative of damage to the nerves, usually peripheral neuropathy, meaning hands and feet. It can start off as just numbness and tingling, pins and needles. Then it can become burning electricity, then it can go completely numb afterwards.
DR. LEANDRO BOSQUES-SANCHEZ
Correct.
RON AARON
So, it's not good.
DR. RAJAY SEUDATH
Not good. Typically, we want to do something about it, or at least reverse the cause, because if we get to the numbness where there's no sensation, that can sometimes be irreversible.
RON AARON
I want to pick up more on what you were saying about B12 shots. There are a lot of free-standing clinics that are opening in San Antonio and all over the country where they offer folks, come on in. I will give you a little intravenous this. A little universe that. WeÕll shoot you up with B12. And, man, you'll be a bundle of energy.
DR. RAJAY SEUDATH
Those kinds of places are around. I.V. clinics or I.V. bars they can call them. It's just a play on words saying this is a place to come and feel good, so to speak. The question is, are they testing for your blood? For some places, yes. For some places, no. So, that would be the thing that I would say. We want to guide our treatment by, what does your blood say? Because we want to actually work on not just how you feel, because that's important. We want to make you feel good, but we also want to not create new problems. Also, why does a person have low B12? Did you have an intestinal surgery and you're missing half of your intestines? Okay, that makes sense. This person has low B12. Are you a very strict vegan, and you are not eating good sources of protein, right? Because a vegan diet has enough B12 as long as you're eating sources of protein. But some people don't. So, those are the kind of things that we're looking for.
RON AARON
I was a vegan for an hour.
DR. RAJAY SEUDATH
Yeah, it was a good hour I bet.
RON AARON
Yeah, it's very hard. Dr. Bosques, I want to pick up on that. Are you one who recommends to your patients or discusses a variety of eating plans, like the Mediterranean diet, like being a vegan?
DR. LEANDRO BOSQUES-SANCHEZ
I always suggest a variety of foods and a healthy diet. We need to check for everything that is healthy. Depending on the condition of the patient. As Dr. Seudath said, if the patient has a bariatric surgery. If the patient has diabetes. Depending on their needs, we tried to create a like-healthy diet, including every kind of food.
RON AARON
When you say healthy, most folks don't know what that really means.
DR. LEANDRO BOSQUES-SANCHEZ
Yeah. What is healthy for me maybe it's not for them but always have a good source of protein. Eat vegetables. Eat a low amount of carbs, which is damaging our body. Take multiple vitamins to supplement our body and our needs.
RON AARON
All right, stick with me. We're going to come right back to you. I'm Ron Aaron. You're listening to the award winning Docs in a Pod. Dr. Rajay Seudath is with us as our co-host and Dr. Bosques joins us as well. This is Docs in a Pod.
AD
WellMed and you can rely on WellMed and Optum doctors to care for and understand the health needs of older adults. Our commitment to quality is why the Institute of Health Care Improvement recently designated WellMed and Optum as an Age-Friendly Health System. This means WellMed and Optum care teams provide reliable, evidence based, high quality care to older adults. To get the benefits of an Age-Friendly care team, go to WellMedhealth care.com to find a doctor near you.
RON AARON
We are so pleased you're staying with us right here on the award winning Docs in a Pod. our podcast is available wherever you get your podcasts. We're also on the radio in several cities in Texas and Florida as well. For those of you living around the world, podcasts are the best way to join us. I'm Ron Aaron and Dr. Seudath, our co-host is here, and Dr. Leandro Bosques is with us as well. I want to come back to something we were talking about. Dr. Seudath, I'll start with you. Vitamins, I mentioned, in addition to vitamin B and D, what else do you need?
DR. RAJAY SEUDATH
There's actually a lot of vitamin BÕs Those are all B-complex B vitamins. So, there's B1, which is thiamin. ThereÕs pyridoxine, which is B6. There's folate. Typically, you can get a supplement called a B-complex, which has all those B vitamins. Riboflavin, B1 through 12 and everything in between. So, those can be important for people who may have liver disease, who may have been heavy drinkers earlier in their life, or even heavy drinkers now, they typically don't absorb thiamin and folate. That can cause issues for their blood, for their metabolism, things like that.
RON AARON
What does thiamine do for you?
DR. RAJAY SEUDATH
Thiamine is many different metabolic processes. It's a cofactor. It does a couple of different things and other metabolism processes. One of the things we see if a person doesn't have good folate or thiamin is they can get sores on their mouths. I'm pretty sure you can get sores on the inside or towards the outside of the mouth, which is different from cold sores. This is a different mechanism.
RON AARON
And a cold sore isÉ
DR. RAJAY SEUDATH
Cold sores are caused by a virus that can cause a sore on the lips or inside the gums area.
DR. LEANDRO BOSQUES-SANCHEZ
As a common sore, we see it every day.
RON AARON
And theyÕre a pain.
DR. RAJAY SEUDATH
Yes, they are.
RON AARON
Dr. Bosques, we were talking as well about seniors and those vaccines that we may need. What are your recommendations and why?
DR. LEANDRO BOSQUES-SANCHEZ
That's a big subject. We recommend the flu vaccine to be a yearly booster. IÕve been seeing a lot of influenza virus lately, and it's really, really bad. We also suggest the shingles vaccine. We suggest pneumococcal, which is the famous pneumonia vaccine, the COVID, the new RSV and the tetanus, which is every ten years. That's mainly all the vaccines that we recommend.
RON AARON
When it comes to RSV, that's a relatively new vaccine.
DR. RAJAY SEUDATH
Yes. It's new for adults. Previously, it was only for children because it primarily attacked children. But as more children were getting unvaccinated, that means that there's more people for that virus to mutate, and it made the mutation to go into adults. So, now it's important for people who are at the childhood age and the elderly, over 65 to get it to protect themselves.
RON AARON
How serious is RSV if you get it?
DR. RAJAY SEUDATH
RSV can be deadly for younger kids. For older patients who are very sick.
RON AARON
Did you say it can be deadly?
DR. RAJAY SEUDATH
It can be deadly. That's why we vaccinate for it. In fact, our case manager, she just gave birth, so we were talking about vaccines. Make sure the people who are coming to visit your baby have been vaccinated. We love babies. We want your baby to be healthy. That's the idea is if someone is actively boasting that they're not getting vaccinated, maybe we should wait a little bit longer for them to see your child because we all love babies. We want to keep them around. We don't want to get them hurt.
RON AARON
The first thing we do when we see a new baby, we pick them up and we kiss them and we hug them. Talk about spreading disease.
DR. RAJAY SEUDATH
Absolutely. That's one of the things. As responsible adults, we can get vaccinated if we're over 65. We can have our kids vaccinated. School-age children are where the whole petri dish of viruses is, right? So, cousins and older brothers come back from school, and they go and visit the new baby and they're bringing it. So, if they're not vaccinated, they could be a vector for bringing that disease to new precious life in our community.
DR. LEANDRO BOSQUES-SANCHEZ
I've seen a lot of grandparents taking care of their grandchildren and get RSV, and they ended up in the hospital with pneumonia. So, it's really important for them to get the RSV vaccine.
RON AARON
The shingles vaccine is a relatively newer one there. There has been a shingles vaccine. I've had them both. Do you recommend that people get the old and the new one, Dr. Bosques?
DR. LEANDRO BOSQUES-SANCHEZ
I recommend getting the new shingles vaccine. I have seen shingles lately multiple times and people are saying it's really painful.
RON AARON
For those who don't know, it comes along on a nerve line, so you can get shingles across your face. You can get it in all different parts of your body. And it really hurts.
DR. RAJAY SEUDATH
Yes. It can be especially uncomfortable if you're getting the shingles reactivation in a very sensitive area. So, in the genital area or the upper lip. If it is in your eye, it can actually have a risk for blindness as well. So, itÕs very important to get that shingles vaccine because we don't want that to reactivate.
RON AARON
Who's at risk for shingles?
DR. RAJAY SEUDATH
Everybody over the age of 55 is eligible to get the shingles vaccine. It can come at any time. You could be in your 60s or 70s. You feel like, well, I've never gotten it. I don't need to get this vaccine. But really and truly, everybody is exposed to that virus. The idea is, if you've been vaccinated for chickenpox, you've probably been exposed to the virus. It is dormant. If you've had chickenpox, the virus is absolutely inside of your body waiting to come back to life and to reactivate. That's what the shingles is. It's a reactivation of the chickenpox virus.
RON AARON
When I was a kid, my mother would get a call from a neighbor who said, oh, Spencer's got measles, or Spencer has chickenpox, and she'd send us over there. SheÕd send me and my brother and say, go get it. You want to get it.
DR. RAJAY SEUDATH
That's right. That was before we had these comprehensive vaccine campaigns. You would go and you would get the chickenpox. But again, it was still a little bit of a risk because real wild type chickenpox can cause meningitis. It can cause issues. We laugh and we say, chickenpox is not a big deal. We used to have chickenpox parties where the whole neighborhood would try to get it at the same time. That being said though, in that time there were people who would go to the hospital. Someone who went to get it from their friends intentionally. There have been there were cases where those kids ultimately went to the hospital and passed.
RON AARON
What was the motivation? What was driving my mom to send me and my brother Jimmy to get those diseases?
DR. RAJAY SEUDATH
The idea is we can control when you get it. You're not sick, you're not coughing, you're not sneezing, you don't have the flu. You're at a healthy point. We can choose when to get it. Now, if Spencer had gotten chickenpox and his mom called your mom and said, hey, Spencer's got chickenpox, send Ron over. Oh, no. Ron's just coming off a real bad flu. You wouldn't necessarily want to get it at that point.
DR. LEANDRO BOSQUES-SANCHEZ
Correct.
DR. RAJAY SEUDATH
That's the thing with vaccines. We can choose when do we want to get it versus you're just kind of rolling the dice. That's the idea with public health and these kinds of interventions. We're trying to choose when we get our immunity for it.
DR. LEANDRO BOSQUES-SANCHEZ
Yeah. When your immune system is ready. That's why we donÕt talk about when you can get shingles. If there is a patient that is receiving chemotherapy or patient that just had a bad flu or even people with a lot of stress, they can have shingles.
RON AARON
Dr. Bosques, you mentioned the pneumococcal vaccine to deal with pneumonia. ArenÕt there a number of different types of pneumonia? And how many can be prevented with vaccines?
DR. LEANDRO BOSQUES-SANCHEZ
The one that we suggest is pneumococcal, the 20 and the 23. I'm not sure how many types of pneumonia it can prevent. I don't know if Dr. Seudath is aware on how many.
DR. RAJAY SEUDATH
Again, the same amounts of vaccines that we have, those are the pneumonias. So, you can have influenza pneumonia. Pneumonia just means damage to the lungs from an infection. So, you can have COVID pneumonia, you can have RSV pneumonia, you can have influenza pneumonia. The pneumococcal, that's for streptococcus pneumonia. That's the one that causes fevers, you're coughing up blood and mucus and that kind of stuff. It's literally chewing a hole into your lungs. That's what we're trying to prevent. All these vaccines are preventing pneumonias. There's a couple that we don't prevent. Atypical pneumonia, Mycoplasma, Tuberculosis. We don't really vaccinate for that anymore. Then, like Pseudomonas and Legionella. Those ones we don't have vaccines for. Again, we have treatments for that. So, if we can prevent the other types and treat the ones we can't prevent, that's how we're trying to keep the population healthy.
RON AARON
We screen people for tuberculosis. I remember when I was teaching, I had to get a TB test.
DR. RAJAY SEUDATH
Yes, absolutely. Sometimes that TB test can be positive if a person has had, internationally, they had that tuberculosis vaccine, they can show it as positive. Those people usually have to get blood testing for it to confirm or a chest x ray.
RON AARON
And that'll clear you.
DR. RAJAY SEUDATH
That clears you to go to work. That's usually on that form. Have you ever had a TB test? Have you ever had a positive test? That kind of stuff. There's an algorithm to go down and make sure we're keeping everybody safe from tuberculosis.
DR. LEANDRO BOSQUES-SANCHEZ
As you said, itÕs a screening test.
RON AARON
Dr. Bosques, we have less than a minute left. I want to come to an issue that Dr. Seudath brought up, and that is vaccine and anti-vaxxers that seem to be growing like a mole day and night. Are you finding that some of your seniors are rejecting getting some of these vaccines?
DR. LEANDRO BOSQUES-SANCHEZ
Yes. That's a daily conversation with my patients. They're becoming anti-vaxxers. It's really difficult. I personally promote all the vaccines, all the shots.
RON AARON
Good. I've got to stop you right there. We are flat out of time now. Dr. Rajay Seudath, our co-host, thank you. Thank you, Dr. Leandro Bosques. I'm Ron Aaron and thanks for joining us on the award winning Docs in a Pod.
OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.
DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.
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