Frequently Asked Questions
AREDS2 has suggested a minor change for the original AREDS formula, substituting lutein and zeaxanthin for beta-carotene.
- Vitamin C 500mg
- Vitamin E 400IU or 268mg α-TE
- Lutein 10mg
- Zeaxanthin 2mg
- Zinc 25mg
- Copper
In smokers and recent ex-smokers high doses of beta-carotene are linked to an increased risk of lung cancer. This has resulted in a search to find a suitable substitute. Lutein and zeaxanthin, as the key macular pigments, were used in the study and were shown to have equal effect overall and to perform better in the absence of beta-carotene.
Therefore, by substituting lutein and zeaxanthin for beta-carotene there can be a single effective product for all.
Whilst adding the key macular pigments, lutein and zeaxanthin, to the original formula had no additional benefit, better results were produced in the absence of beta-carotene.
Therefore, by substituting lutein and zeaxanthin for beta-carotene there can be a single effective product for everyone.
AREDS2 showed that there appears to be competitive uptake of carotenoids, so taking a product which includes both beta-carotene and lutein/ zeaxanthin could be counterproductive.
This is why it is also best to avoid products which contain any other carotenoids such as meso-zeaxanthin and astaxanthin.
The AREDS2 study focused on the omega-3 fatty acids DHA and its precursor EPA. DHA is needed for the integrity of the retinal cells and has been shown to promote retinal development and repair in prior studies.
However, the results from AREDS2 showed that there was no additional benefit to taking omega 3 for the prevention of advanced macular denegation (AMD).
Some nutritionists have been concerned about the high level of zinc in the original AREDS formula because it can cause stomach upsets in some people. AREDS2 examined the effect of lowering the dose of zinc.
The results showed no statistically significant difference in slowing the progression to advanced AMD between the lower and higher dose zinc. They also reported that there was no difference in the number of side effects reported by either group.
Therefore, most experts believe that the dose of zinc should be lowered to 25mg in order to reduce the chances of any side effects and that this will have no long term effect on the effectiveness of the formula.
People considered to be at high risk of developing advanced macular degeneration should take an AREDS2 formulation. These people are defined as having either:
- Intermediate AMD in one or both eyes
Intermediate AMD can be detected by an eye care professional, but usually involves little or no vision loss. - Advanced AMD in one eye, but not the other eye.
Advanced AMD involves either a breakdown of cells in the retina (called geographic atrophy or dry AMD), or the growth of abnormal blood vessels under the retina (called neovascular or wet AMD). Either of these forms of advanced AMD can cause vision loss.
The high doses used in the AREDS2 trial are not typically found in most multivitamins. Even those specifically targeted at eye health can fall short with regard to the doses used.
Our supplements section will help you choose the most appropriate supplement for you.
Yes. In the original AREDS trial around 65% of participants also took multivitamins and in AREDS2 almost 90% of participants took multivitamins as well.
There is nothing better for us than having a good diet and AREDS2 showed that those with the best diet benefit less from taking supplements than those with a poor diet.
The large doses of vitamins and minerals used in the AREDS2 study would be very difficult to achieve through diet alone. Also, even with a good diet, the AREDS2 study showed that progression to advanced AMD can be slowed by taking a supplement. Therefore the best solution is to have a good diet and take and appropriate supplement.
Both AREDS and AREDS2 studies were long term trials and in many cases people have been taking the original AREDS formula for over 10 years. During this time there have been no statistically significant increases in serious side effects (other than the link between high dose beta-carotene with lung cancer in smokers and ex-smokers). Therefore, they are considered to be safe to take regularly over a long period of time.
Although generally well-received, if you take a lot of other medicines it is always worth discussing with your medical practitioner before starting a supplement.
Nutritional supplements fall into a grey area with regard to prescribing. They are technically allowed on an NHS prescription but this will depend on individual GP’s and prescribing authorities.
Certain areas will only allow specific brands or none at all. So it is worth discussing this with your GP, especially if your ophthalmologist has recommended a particular product.