Much of the information in this blog post references Macular Degeneration: A Complete Guide for Patients and Their Families, by Michael A. Samuel, M.D.

It’s no secret that a healthy diet along with the appropriate vitamins and supplements is important for a healthy body. It’s likely that you’re already aware that Omega-3 is good for cardiovascular health and that calcium and vitamin D are essential for healthy bones — but did you know our eyes are also in need of specific vitamins and supplements? That need only increases if you are at risk for or have already developed macular degeneration.

Best Vitamins for Macular Degeneration

Macular degeneration is the leading cause of vision loss in people over the age of 55, making it crucial to take the proper measures to manage the condition after the onset of symptoms.¹

The progression of macular degeneration is unique to everyone. With their being two types, dry and wet macular degeneration, and three different stages of early-stage, intermediate and late-stage, individuals find themselves at varying places on the spectrum.

Taking the appropriate vitamins can help to slow the progression of macular degeneration and may help prevent it from developing in a second eye if it is already in one.

The AREDS Study

The nutritional supplements recommended for age-related macular degeneration came from the results of the Age-Related Eye Disease Study (AREDS), published in 2001. This study was done to evaluate the best vitamins for macular degeneration and its progression and involved about 3,600 participants all who had AMD or drusen (substances which cause AMD).²

Throughout the AREDS study, participants were given either a multinutrient formulation or a placebo pill for a span of six years. During this time, the progression of their macular degeneration was monitored, and it was found that the multinutrient formulation had a significant effect on the participant’s vision.²

The risk of developing wet AMD in one or both eyes was reduced by 25% for those who

• Had moderate dry AMD in one or both eyes
• Had wet AMD in one eye (risk reduced for developing it in their other eye)²

Best Vitamins for Macular Degeneration from AREDS Study

The original AREDS formula consisted of supplements that were chosen because of other studies which showed they helped to reduce risk of developing or slow the progression of AMD.

This original AREDS formula included:

Vitamin C

Vitamin C is a potent antioxidant that helps protect against free-radical damage. It also helps to build collagen, which is the connective tissue that builds the body. Vitamin C helps to

• Maintain strong, open blood vessels which help with circulation in the eyes and throughout the body
• Promotes immune function

The AREDS dose of Vitamin C is 500 mg.²

Vitamin E

The most popular form of Vitamin E, and the form used in the AREDS study, is alpha-tocopherol.

Vitamin E helps support circulatory health which is also good for the retinas. This nutrient helps to thin the blood and reduce the risk for blood clots.

The AREDS dose of Vitamin E is 400 IU.²

Zinc

Zinc is very important in the biochemical reactions that occur within the retina and the retinal blood supply. Early eye health studies found that zinc alone helped to maintain vision for those with AMD.²

The AREDS dose of Zinc is 80 mg; however, research shows that there is no benefit to supplementing with 80 mg versus a reduced amount. In fact, the participants in the AREDS 2 study were given an amount of 25 mg zinc and results showed there was no negative impact to the reduced amount of zinc, yet the official AREDS 2 formula left the zinc dosage at 80 mg.³

The EyeScience Macular Formula contains 40 mg as the increased amount of this mineral in the AREDS formula shows no benefit and is in essence over-mineralizing.³

Copper

Zinc has a copper-depleting effect, and with the AREDS formulation containing Zinc, it also includes copper.

The AREDS dose of copper is 2 mg.²

Vitamin Supplements for AMD based off AREDS2 Study

The results of the AREDS study were published in 2001, and in the over 20 years since then, science has found additional nutrients that can help support retinal health and slow down AMD progression. In fact, a second AREDS study, AREDS2, launched in 2006 to see if adding omega-3 fatty acids or lutein and zeaxanthin into the formula would show improvement.⁴

AREDS2 study included⁴

• 4,203 participants
• Ages 50-85
• 82 clinical sites across the U.S.

Participants included those who had intermediate AMD in both eyes or intermediate AMD in one eye and advanced AMD in the other. This study did not include those with early or no AMD because AREDS showed that the formulation had no benefit to those individuals.

AREDS2 results showed that the beta-carotene, an original nutrient in the AREDS formula, increased the risk for lung cancer in those individuals who were former smokers. Thankfully, removing this nutrient from the AREDS formula resulted in no significant changes.

The substitute for beta-carotene in the AREDS 2 Maculr Degeneration formula is lutein and zeaxanthin, which resulted in an increase in benefit.

Lutein and Zeaxanthin

Lutein and Zeaxanthin are carotenoids, just like beta-carotene, which is why they are the optimal substitute in the AREDS formula. In total, there have been over 600 carotenoids identified, 50 are part of the normal human diet and only two are found in the retina — lutein and zeaxanthin.²

These two carotenoids are also thought to act as blue light filters within the retina.

The AREDS2 dose includes 10 mg lutein and 3mg zeaxanthin.²

Additional Nutrients for AMD

There are additional nutrients beyond those in the AREDS2 formula that are beneficial to vision health and slowing the progression of macular degeneration.² While these nutrients are not included in AREDS formulas, they are available in vitamin supplements such as EyeScience’s Macular Health Formulation to help manage AMD.

Bilberry

As a longtime remedy for eye problems, bilberry has been used for years to sharpen the vision of pilots and to improve night vision. The berries’ anthocyanidin content is thought to provide the vision-enhancing features.²

Studies have shown that bilberry strengthens the walls of the capillaries. A German study included 31 people with AMD who took bilberry and as a result their abnormal capillaries became stronger.²

Bilberry also increases circulation within the retinas by

• Dilating blood vessels
• Reducing cholesterol
• Promoting red blood cell function

The recommended dose of bilberry for vision support is 150 mg per day, which contains 25% anthocyanidins.²

Grape Seed Extract (GSE)

Grape seeds and skins contain bioflavonoids as well as resveratrol, a health-promoting plant chemical. A powerful antioxidant, grape seed extract blocks the chemicals that result in inflammation and breaks up free radicals more effectively than vitamin E.²

Grape seed extract helps blood flow and prevents blood clots. This is particularly beneficial to the retinas in helping to prevent macular degeneration. And since progression from dry AMD to wet AMD is related to blood vessels, grape seed extracts’ blood vessel strengthening properties are extremely important.²

Alpha Lipoic Acid

This antioxidant is recommended to those with diabetes as the high blood sugar levels may induce accelerated oxidation. As Michael A. Samuel, M.D. explains in Macular Degeneration, alpha lipoic acid helps to slow the progression of complications caused by high oxidative stress — this includes diabetic neuropathy, as well as protecting the kidneys and retinas. So, if this antioxidant helps slow the progression of retinal changes in diabetics, it can do the same thing for those with macular degeneration.²

The recommended dose of alpha lipoic acid is 20 mg per day.²

Selenium

When working with vitamin E, selenium enhances antioxidant function and creates glutathione peroxidase which helps protect against damage caused by free radicals. Since most people do not get enough selenium in their diet from food sources, a supplement is advised.²

The recommended dose of selenium for macular degeneration is 50 mcg per day.²

Folic Acid (Vitamin B6 and Folate)

Homocysteine is an amino acid that is harmful to the inner walls of blood vessels. Vitamin B6 and folate are both needed to break down homocysteine, so it doesn’t harm blood vessels. Unfortunately, when enough of these nutrients are not taken in through food such as leafy greens and whole grains, homocysteine levels increase, along with the risk of damage to blood vessels.²

The recommended dose is 50 mg of vitamin B6 and 400 mcg of folate. Check your multivitamin to see if the amounts align with the recommended dose.²

Vitamins and supplements can have a significant impact on the progression of age-related macular degeneration. There are several options on the market which include those nutrients highlighted in the AREDS and AREDS2 studies; however, as the information above outlines, there are additional nutrients that are beneficial to those with macular degeneration.

To learn more about the suggested nutrients for managing macular degeneration, along with a complete guide to living with the disease, we suggest reading Macular Degeneration: A Complete Guide for Patients and Their Families. Written by Michael A. Samuel, M.D., this book helps those with AMD and their loved ones understand the disease and how to effectively manage and help slow its progression.

¹ Brigham Health

² Samuel, M. A. (2015). Macular degeneration: A complete guide for patients and their families. Basic Health Publications.

³ Optometry Today

⁴ National Eye Institute

These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.