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AREDS and AREDS2 Supplements for Macular Degeneration

Nutrition is essential for overall health, including eye health. Sometimes we need a little boost to our diets, and supplement them with vitamins or minerals – especially if we are facing a medical condition. Macular degeneration is no different. Two trials have been done to evaluate the effect of nutritional supplements on the development and progression of age-related macular degeneration (AMD); these are known as the Age-Related Eye Disease Studies (AREDS and AREDS2).1 These two trials found that supplementation with certain vitamins and minerals can slow the progression of intermediate to advanced AMD, and for those who have advanced AMD in one eye only, it can slow the progression of AMD in the other eye.1

AREDS vs. AREDS2

The AREDS2 study built upon the original AREDS trial and improved the supplement recommendations because it was found that lutein/zeaxanthin and omega-3 fatty acids were linked with a lower risk of developing AMD; beta-carotene was removed because smokers taking beta-carotene had an increased risk of developing lung cancer, and the combination of lutein/zeaxanthin provided slightly better protection against AMD.2

Supplement formulation

The original AREDS formulation consisted of2:

  • 500 mg of vitamin C
  • 400 IU of vitamin E
  • 15 mg of beta-carotene
  • 80 mg zinc as zinc oxide
  • 2mg copper as cupric oxide

Based on the AREDS2 trial, the recommended supplement formulation was changed to2:

  • 500 mg of vitamin C
  • 400 IU of vitamin E
  • 80 mg zinc as zinc oxide
  • 2 mg copper as cupric oxide
  • 10 mg lutein
  • 2 mg zeaxanthin

It is also recommended to add omega-3 fatty acids, especially DHA and EPA. DHA is necessary for the health of retinal cells and helps promote retinal development and repair.2

What does each nutrient in the formulation do?

Each nutrient in the AREDS2 supplement formulation is there for a reason and plays a role in general health, as well as eye health in particular.

Vitamin C

Vitamin C, or ascorbic acid, is essential in helping your body build blood vessels, cartilage, muscle, and bone collagen. It’s also an antioxidant, which helps protect cells from oxidation and free radicals. Your body doesn’t make vitamin C, so it’s important to get it from outside food sources and supplementation. Food sources can include broccoli, potatoes, peppers, oranges, and grapefruit. Vitamin C has not only been shown to help prevent AMD but also reduce the risk of developing cataracts.3

Vitamin E

Vitamin E is another antioxidant and it also helps with immune system functioning, cell signaling, and metabolic processes.4 It also has anti-inflammatory properties and can possibly reduce the risk of AMD and cataracts.4 Food sources include nuts, spinach, broccoli, mangoes, seeds, and vegetable oils.

Zinc

Zinc helps the immune system, metabolism, and also aids in wound healing.5 Foods are often fortified with zinc, so a deficiency is rare. Other food sources include chicken, red meat, and fortified cereals.

Copper

It might sound odd, but you need copper to maintain a healthy body. Copper helps promote typical growth, aids in nerve function and bone growth, and it also helps your body use iron.6 Food sources can include seafood, organ meats, beans, and nuts. You can also get it from using copper cookware.

Carotenoids

Lutein and zeaxanthin (L/Z) are both carotenoids that accumulate in the macula and retinal pigment epithelial cells and make up part of the macular pigment.7 Supplementation with these carotenoids has been shown to help slow the progression of AMD.7 Food sources of L/Z include asparagus, kale, spinach, pistachios, eggs, corn, and green beans.

Omega-3 fatty acids

As mentioned previously, omega-3 fatty acids are necessary for retinal cell health. Foods high in omega-3 fatty acids include mackerel, salmon, oysters, flaxseeds, chia seeds, and walnuts.

Who should take the AREDS/AREDS2 supplements?

These formulations are often prescribed by a doctor, but since these products are nutritional supplements, one may buy them over the counter or take them individually in the required doses without a prescription. These formulations are especially recommended for those who are at risk of developing advanced AMD, including those with intermediate AMD in one or both eyes, and those with advanced AMD in one eye.2 Talk with your eye doctor about whether you should be adding these supplements to your daily routine.

AREDS/AREDS2 safety precautions

Before taking the AREDS/AREDS2 supplements (or any nutritional supplements), it is important to check with your general practitioner to ensure safety, especially if you are taking other supplements or medications that could interact with those in the AREDS2 formulation. AREDS2 is not designed to take the place of your regular vitamins or medications, so it’s important to speak with your doctor about whether you should continue taking your regular vitamins, as well.

Jaime R. Herndon | January 2019
  1. National Institutes of Health: National Eye Institute. Facts About Age-Related Macular Degeneration. 2015. https://nei.nih.gov/health/maculardegen/armd_facts. Accessed November 5, 2018.
  2. National Institutes of Health: National Eye Institute. For the Public: What the AREDS Means for You. 2018. https://nei.nih.gov/areds2/PatientFAQ. Accessed November 5, 2018.
  3. Mayo Clinic. Vitamin C. 2017. https://www.mayoclinic.org/drugs-supplements-vitamin-c/art-20363932. Accessed November 5, 2018.
  4. National Institutes of Health: Office of Dietary Supplements. Vitamin E –Fact Sheet for Health Professionals. 2018. https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/#h6. Accessed November 5, 2018.
  5. Mayo Clinic. Zinc. 2017. https://www.mayoclinic.org/drugs-supplements-zinc/art-20366112. Accessed November 5, 2018.
  6. Mayo Clinic. Copper Supplement. 2018. https://www.mayoclinic.org/drugs-supplements/copper-supplement-oral-route-parenteral-route/description/drg-20070120. Accessed November 5, 2018.
  7. EisenhauerB, Natoli S, Liew G, Flood V. Lutein and zeaxanthin –food sources, bioavailability, and dietary variety in age-related macular degeneration protection. Nutrients. 2017; 9(2): 120. Doi: 10.3390/nu9020120. Accessed November 5, 2018.