The Super Supplement for AMD
The AREDS 2 multivitamin is a research-backed supplement that can slow the progression of some forms of age-related macular degeneration. Find out if it’s right for you.by Judy Koutsky Health Writer
There's no cure (yet!) for age-related macular degeneration, but if you have intermediate or advanced AMD, your doctor will very likely recommend the AREDS 2 dietary supplement. Filled with a very specific combination of vitamins and minerals, research shows that taking an AREDS 2 every day may be able to stop AMD from getting worse. Here's what you need to know:
What Is AREDS 2 Anyway?
AREDS stands for the Age-related Eye Disease Study, and it was launched by the National Eye Institute after scientists and doctors realized that a diet high in certain vitamins and minerals appeared to stop AMD from getting worse. "Observational studies had demonstrated a possible causal link between a healthy diet high in antioxidants and reducing the progression of macular degeneration," says Caesar Luo, M.D., a board certified vitreo-retinal surgeon, in private practice in Oakland, CA. "Animal studies and small clinical series also showed similar results."
The first study (yep, there was an AREDS 1) followed about 3,600 people with AMD and found that in people with intermediate or advanced AMD, the supplement reduced the risk they would develop the most advanced stages of the condition (wet AMD) by about 25 percent over five years.
Following the first study, however, scientists updated the formula and removed beta-carotene. "The reason behind that was there was an association of increased lung cancer risk in smokers, and the goal was to make a formulation that was safe for everyone (instead of needing different formulations for different people)," says Nathan D. Rock, O.D., an optometrist at Wang Vision Institute, a private practice in Nashville, TN. Thus, AREDS 2 was born. Instead of A, this formula includes the powerful antioxidants lutein and zeaxanthin.
"Altogether, the change by eliminating vitamin A (beta carotene) and adding lutein and zeaxanthin made the formula more effective and took away the increased risk of cancer," says Dr. Rock
Ok, So What's in AREDS 2?
This supplement contains a very specific combination of vitamins and minerals that help protect your eyes against oxidative stress, which is medspeak for damage caused by unstable molecules called free radicals. Over time, they keep nip, nip, nipping at the delicate cells in your macula (the center part of your retina) until waste deposits build up and ultimately interfere with your vision. They are causing damage to the cells in the macula which is responsible for our central vision. AREDS 2 is packed with high doses of antioxidants that fight those free radicals before they can do more harm.
Vitamin C (500 mg)
Some of the biggest sources of free radicals? Sunlight, smoking, and pollution, and vitamin C helps repair the damage that they cause. "While 500 mg may seem high [it's about five times the recommended daily amount], these levels seem particularly beneficial for those of us who have low vitamin C intake at baseline," says Dr. Luo. "As a water-soluble vitamin, excess C tends to be excreted harmlessly in our urine."
Vitamin E (400 IU)
Vitamin E is a fat-soluble antioxidant, which makes is particularly beneficial for eye health: Fatty acids are particularly prevalent in the retina, says Dr. Luo, and they're just as susceptible to free radicals as any other tissue.
Zinc (80 mg)
Zinc is very important to the choroid, says Dr. Rock. "The choroid is the layer under the retina, and it supplies the macula with nutrients. Zinc is one of the key nutrients that help the choroid function best, promoting optimal macular health." Zinc is sometimes called the "helper vitamin" because it brings vitamin A from the liver to the retina and assists in the production of melanin, a healthy pigment that protects the macula from sunlight.
Lutein (10 mg) and Zeaxanthin (2 mg)
The macula contains the carotenoids lutein and zeoxanthin, which are types of pigment. They help absorb excess UV light, which can cause damage to the deeper layers of the macula. This supplement can help increase their density in the eye, providing even more protection.
Case in point: African Americans tend to have a significantly lower risk of macular degeneration compared to Caucasians, according to research, and their higher levels of melanin may be part of the reason why.
Copper (2 mg )
"Copper is a bit of a trick," says Dr. Luo. "This was included in the formulation to prevent copper-deficiency anemia, which can occur with high levels of zinc intake. So copper itself has no true ocular benefit, but it protects against problems that can occur with high zinc supplementation."
Dr. Rock notes that copper deficiency can result in three major issues: One is anemia, or low red-blood cells, which can leave people tired and weak. Another is a decrease in white blood cells, which opens people up to an increased risk of infection. And finally, low copper can cause damage to the spinal cord and peripheral nerves, leading to difficulty walking.
Who Should Take AREDS 2?
Dr. Rock notes that the research shows that the supplement is best for those with intermediate or advance AMD. Studies have not shown that it helps patients with early macular degeneration or that it can prevent AMD from developing in the first place. "Some people will take it, and it certainly will not do any harm. However, the research hasn’t proven preventative benefits," says Dr. Rock.
"For patients with intermediate macular degeneration, they should highly consider the use of this exact AREDS2 formulation. Additional dietary sources are always good, but I wouldn't recommend the individual components separately," says eye surgeon Ming Wang, M.D., founder of the Wang Vision Institute.
Where Can I Buy AREDS 2?
The nice thing is you don't need a prescription for AREDS 2. It's sold over the counter and is available at any place that sells vitamin supplements, such as a pharmacy, grocery store, or big box stores like Costco and Walmart. "There are many brands, patients should look closely at labels and ensure that the formulation says AREDS 2 on it. The most common brand name is PreserVision but generics and other brand names are available." The AREDS 2 supplement also is available in combination with a multivitamin.
AREDS study background: National Eye Institute. (2019). “Age-related Eye Disease Study.” https://nei.nih.gov/research/clinical-trials/age-related-eye-disease-study-areds
Vitamin C: American Optometric Association. https://www.aoa.org/patients-and-public/caring-for-your-vision/diet-and-nutrition/vitamin-c
Zinc: American Optometic Association. https://www.aoa.org/patients-and-public/caring-for-your-vision/diet-and-nutrition/zinc
AMD and African Americans: National Eye Institute. https://www.nei.nih.gov/learn-about-eye-health/resources-for-health-educators/eye-health-data-and-statistics/age-related-macular-degeneration-amd-data-and-statistics