AREDS2: Focus on Who and What
As I'm writing this, my article 'What About Those Eye Vitamins?' was posted to our Facebook group 19 weeks ago in September 2019. At the time I'm writing this (mid-January 2020), there have been 1,300 likes, 394 comments, and 779 shares. Why is that? That's easy. There is no treatment for dry AMD. Of course, people with dry AMD want to do all that they can to stop or slow down the progression of the disease. If you have dry AMD in one eye or both, YOU want to do all you can to preserve your vision, right?
Confusion around eye vitamins and supplements
Why, then, are so there so many comments on that article that are so different from each other? Why so much confusion? I really wish I knew.
This is not an attempt to rewrite my original article. I want to take 2 of the biggest areas of confusion - who is a good candidate for them and what products are available - and provide additional information which I hope will help.
- I am not a medical person, so I don't give medical advice. Nor am I associated with any company or companies that sell products.
- Talk to your team - your eye specialist and your medical doctor - before starting an AREDS2-based supplement.
The AREDS2 research study
The participants in the AREDS2 research study had intermediate AMD in one or both eyes or wet AMD in one eye but not the other. You may see the TV commercials and read articles where the words 'moderate AMD' are used. If you read the AREDS2 results article, you'll find out it's more complicated than that. People were chosen for the research by the number and size of drusen, the amount and location of any atrophy, and the presence or absence of bleeding under the retina.2
Purpose of the AREDS2 study
Since most people don't know these details about their AMD, it's easier to use the words associated with these stages: intermediate dry AMD or the more advanced stages of wet AMD or geographic atrophy (GA). The purpose of the study was to see if taking the AREDS2 formulation reduced the risk for the eye or eyes with dry AMD of progressing to a more advanced stage of either wet AMD or geographic atrophy. The results showed a reduced risk for some people of progression to wet AMD but not of progression to geographic atrophy.2
I am frequently asked these questions:
- "If I'm not a good candidate - I don't have AMD or I have early dry AMD or I have wet AMD or GA in both eyes - will an AREDS2-based supplement help me anyway?" My answer: We don't know. There has been no research with those who do not have AMD or have wet AMD or GA in both eyes. The first AREDS did have a group of people with early dry AMD, but in the 6 years of the study, there was no change. That's why they were not included in the AREDS2 research.2
- "I have myopic macular degeneration, Stargardt disease, or another type of macular degeneration. Will an AREDS2-based supplement help?" We don't know. It's never been studied.
- Many people will have a second question: "Will it hurt me if take them and I'm not a good candidate?" The answer again is that we don't know. There are high doses of Vitamin E, C, and zinc in the AREDS2 formulation. There's no research into what the effect is of taking them for a long time. Taking any supplement can be a health risk rather than a benefit to some people.3
Bausch & Lomb (B&L) has done a great marketing job. The packaging for their product PreserVision has AREDS2 prominently displayed, and many people think that AREDS2 IS PreserVision - it is not.
History of PreserVision
In 2006 when the results of the Age-Related Eye Disease Study (AREDS) were released, PreserVision WAS the 'only clinically proven formulation.' That's what the product information said.
In 2013 when the results of the Age-Related Eye Disease Study 2 (AREDS2) were released, PreserVision was produced again with the same 80 mg of zinc as their AREDS product. The bottle now says, 'Based on the ONLY clinically proven formula.' Why the change to include 'based on'? It's partly because of new information from the AREDS2 research and partly because starting in 2013, they now had competitors.
The difference in zinc
In the AREDS2 study, both 25 mg of zinc and 80 mg of zinc were tested, all other ingredients the same. They were found to have the same effect.1 I've provided you with references if you want to read the scientific lingo.2 The 25 mg test group was created in the first place because the researchers felt that 80 mg was beyond what the body could safely absorb.
Many AREDS2-based supplement options now
Because so many researchers accepted that 25 mg of zinc worked as well as 80 mg, other companies than Bausch & Lomb started to produce and market their AREDS2-based products, most with 25 mg or less. If you have one of those products, somewhere on the label it says something like 'Based on the AREDS2 research' which is what PreserVision literature says.
What that means is that if you are a good candidate for an AREDS2-based supplement, you have many options that vary basically in the amount of zinc and the price. As I said, I'm not making any recommendations, but my research has shown that some of the companies with these less-zinc AREDS2-based products are Viteyes, VisiVite, MacuShield, Focus, MacuHealth, Lunovus, and Doctor’s Advantage. There are more. You might search for 'AREDS2 based.' You will get a LONG list! Just make sure you read the labels!
Let's talk about zinc issues
Actually, there are 2 zinc issues:
- How much zinc is enough?
- Is it OK for me to take ANY zinc?
How much zinc is enough?
On number 1, my personal opinion is if 25 mg of zinc performs the same as 80 mg, why take 55 mg more (80 mg of zinc turns out to be something like 600% of the RDA!)?4
Is it okay for me to take ANY zinc?
It's the second one that is sometimes an issue. There are 2 groups of researchers who disagree as to whether some people (as many as 15% of those with AMD) have their AMD progress FASTER from taking 80 mg of zinc because of specific genetic markers. One side says, "Yes, there are people who are harmed by the 80 mg zinc because of their genetics." The other side says, "No, all that research is flawed, there's no genetic effect. Keep taking that 80 mg of zinc."
As usual, this article is already too long, so I refer you to this article on our site 'Genetic Testing Predicts Effectiveness of AREDS Supplements for AMD.' Also, advocate Andrea Junge has written about her path to finding out more in her article 'Always Advocate for Yourself.'
With supplements, we have to do our homework
I know it's a lot to take in. There is more that you should know before starting an AREDS2-based supplement. The details are in my previous article 'What About Those Eye Vitamins?'
Supplements are not regulated by the FDA like medications are.5 That means we have to do our homework. I can only provide you with information so your choice is an informed one. Please talk to your eye specialist and your medical doctor before starting an AREDS2-based supplement.
If you have any questions, please ask them. That helps ME help YOU!
Are you aware of assistive technology for AMD?