Age-related macular degeneration, or AMD, is a common eye disease that can blur the central vision needed for reading, driving, and recognizing faces. It affects the macula, the part of the retina responsible for clear, straight-ahead sight. While there is no cure for AMD, scientific research has shown that specific nutritional supplements can help slow its advancement in some people, helping to preserve vision.
The Foundational Research for AMD Supplements
The scientific basis for using supplements to manage AMD rests on two landmark clinical trials sponsored by the National Eye Institute (NEI). The first, the Age-Related Eye Disease Study (AREDS), began in 1992 to investigate the effects of high-dose vitamins and minerals on AMD progression. The original AREDS results showed the formulation could reduce the risk of progression to advanced AMD by about 25% over five years for individuals with intermediate AMD or advanced AMD in one eye.
The subsequent Age-Related Eye Disease Study 2 (AREDS2), with results published in 2013, aimed to refine the original formula. Researchers tested modifications, including substituting beta-carotene with two other carotenoids, lutein and zeaxanthin. The AREDS2 trial concluded that the formula containing lutein and zeaxanthin was safer and more effective at reducing the risk of AMD progression. A long-term analysis confirmed these findings, solidifying the AREDS2 formulation as the current standard.
Key Ingredients in Clinically Studied Formulas
The current AREDS2 formula is a specific combination of vitamins and minerals that support retinal health. The formulation is precise, and the dosages are higher than what is found in a standard multivitamin.
- Lutein (10 mg) and Zeaxanthin (2 mg): These carotenoids are found in high concentrations in the macula. They are thought to function as a natural filter for harmful blue light and act as antioxidants, protecting the retina from damage.
- Vitamin C (500 mg) and Vitamin E (400 IU): Both are powerful antioxidants that help neutralize unstable molecules called free radicals, which can cause cellular damage in the eye.
- Zinc (80 mg): This mineral plays a role in maintaining the health of the retina. High levels of zinc can interfere with copper absorption, potentially leading to a copper deficiency anemia.
- Copper (2 mg): To counteract the effect of high-dose zinc, the AREDS2 formula includes copper to prevent a deficiency.
A key change from the original AREDS research was the removal of beta-carotene. The initial study linked high doses of beta-carotene to an increased risk of lung cancer in people who smoked or had recently quit. The AREDS2 study confirmed that replacing it with lutein and zeaxanthin eliminated this risk without compromising the supplement’s effectiveness.
Who Should Consider Taking AMD Supplements?
The benefits of AREDS2 supplements are specific to individuals at certain stages of age-related macular degeneration. These high-dose formulas are not a preventative measure for the general population and are not recommended for individuals who do not have the disease.
The primary group who stands to benefit are those diagnosed with intermediate AMD in one or both eyes. For these individuals, the AREDS2 formulation has been shown to reduce the risk of the disease progressing to the advanced stage, where significant vision loss can occur.
Another group that should consider the supplements are those who have advanced AMD in only one eye. In this case, taking the AREDS2 formula can help slow the progression of AMD in the other eye, potentially preserving its vision.
It is important to understand that current scientific evidence does not support using AREDS2 supplements for people with no signs of AMD or only early-stage AMD. The clinical trials did not find a benefit in these groups, as the supplements slow advancement rather than prevent the disease’s initial development.
Selecting and Using Supplements Safely
Before beginning any new supplement regimen, the first step is to consult with an ophthalmologist. An eye doctor can perform a comprehensive exam to determine the stage of your AMD and confirm if you are a suitable candidate for AREDS2 supplements.
When choosing a product, look for supplements labeled as matching the “AREDS2 formula.” This ensures you are getting the correct ingredients at the dosages proven effective in the clinical trials. Checking the label for the precise amounts is a reliable way to select an appropriate product.
The high doses of vitamins and minerals in the AREDS2 formula can cause side effects. The high level of zinc, for instance, may cause stomach upset for some people. The inclusion of copper is deliberate to prevent a copper-deficiency anemia that can result from long-term, high-dose zinc intake.
It is also important for your ophthalmologist and primary care physician to be aware that you are taking these supplements. High-dose vitamins can sometimes interact with other medications or affect other health conditions. This communication ensures the supplements fit safely within your overall health plan.