If age related macular degeneration, also known as AMD, is something that is troubling you right now, there is a good chance you are looking for a way to combat it.
In the Global Data on Visual Impairment 2010, published by WHO, it was stated that alongside glaucoma and cataracts, age related macular degeneration is one of the top three causes of vision loss worldwide.
According to the American Macular Degeneration Foundation, macular degeneration is the deterioration of the macula, the central portion of the retina that is responsible for focusing central vision in the eye.
The macula is thin and fragile and is mostly made up of cone cells ,which is responsible for color vision and visual acuity.
When too much macular drusen (undigested tiny whitish/yellowish fatty deposits) gather inside the eye, they clog up the transportation route that transfer oxygen to the cone cells.
When deprived of oxygen, these cone cells quickly degenerate. This leads to the overall degeneration of the macula, thus affecting your central vision and as well as color vision.
Advanced macular degeneration comes in two types: dry and wet.
Dry Macular Degeneration is the more common form of AMD, affecting 80-90% of people diagnosed.
Its progression is slower than the wet type, and is evident via the presence of drusen forming on the retina, causing degeneration of the tissue over time.
Wet Macular Degeneration, on the other hand, is a more advanced form of AMD. It typically accounts for the majority of disease related vision loss.
People with wet AMD tend to experience rapid and severe loss of central vision. Everyone with wet AMD starts with the dry form first.
In people with wet AMD, abnormal blood vessels under the retina will grow towards the macula, and these blood vessels have the tendency to leak fluids, damaging the macula in the process by lifting it up and pulling it away from its base.
Regardless of the type, with age related macular degeneration (ARMD), your central vision becomes affected, making it difficult for you to read fine print and see color well.
As it progresses, your central vision becomes blocked, like having a solid fist in the center of your vision yet you can still see everything else on the peripheral.
There is no cure at the moment for this disease.
AMD is a complex retinal disease that is difficult to study due to its relatively late onset, genes, as well as involvement of a myriad of environmental factors affecting its progression and onset.
As a result of the difficulties, development of relevant intervening strategies can also be challenging.
It is troubling to try to fight a disorder that seems to have no exact cause, except that it seems to be related to aging.
AMD cannot be fixed with corrective lenses.
As it progresses, it is estimated to take away up to sixty to seventy percent of your vision.
It is not total blindness but close to it.
However, the important thing that you need to remember is, the earlier you have it diagnosed, the more aware you are of it, the more likely it is that you are going to be able to halt the progression of the condition or at least to drastically slow it down.
It has been shown that progress of advanced macular degeneration can actually be arrested with appropriate interventions.
There is growing evidence that the use of vitamins, mineral and herbs can help fight AMD.
It is not a cure-all or a panacea. But if you do nothing, it is a one hundred percent losing battle.
Here’s what I can do for you.
If you are just looking for a recommendation for the best eye supplement to delay progress of AMD, simple click here to read my honest review of Bausch & Lomb’s PreserVision AREDS 2 vitamin-mineral supplements.
But if you are interested in the specifics of the mechanisms and associated studies regarding the vitamins used in combating AMD, do read on.
Let’s take some time to consider the vitamins that have been shown to be effective in halting the progress of this disease.
The Age Related Eye Disease Study, or AREDS, a 10 year US based study to learn about macular degeneration and cataracts, found that a combination of antioxidants and zinc could arrest the progress of AMD.
However, the concentrations suggested would need to be very high, above the daily recommended dosage suggested by the FDA.
Here are some of best vitamins and their recommended dosage you can consider to take to prevent macular degeneration.
Your first line of defense for AMD would be vitamin C.
Vitamin C is a nutrient that is essential for humans, and is required for essential metabolic reactions in all living organisms.
It is an antioxidant, and what it does is to protect your body from oxidative stress. This is an important defense your body have in response to disease and degradation.
Vitamin C will help prevent the breaking of blood vessels in the retina. It can also prevent the growth of abnormal blood vessels on the macula.
Diet wise, you can get your vitamin C through fruits such as berries, lemons, grapes, plums, grapefruit, apricots and cherries. These fruits are high in vitamin C and bioflavonoids, a substance which have the added effect of enhancing the action of vitamin C in your body.
However, it may not be practical to obtain such high dosage of vitamin C in order to combat AMD through diet alone.
To put things in perspective, to consume 500mg of vitamin C through your daily diet, you will have to eat at least 7 medium sized oranges (1 medium sized orange has about 70 mg of vitamin C).
In addition, to combat against AMD, AREDS recommended a daily dosage of 400 international units of Vitamin E.
Vitamin E is thought to be the one of the more important fat soluble antioxidant in eye prevention, as it can protect certain parts of the eye that is susceptible to oxidative damage.
Multiples studies have since supported the notion of the protective effects of vitamin E on the retina, by which it retards the destructive processes within the retina that leads to AMD.
The AREDs found that by using a combination of vitamins, including vitamin E, they were successful in reducing the risk of developing ARMD in people who are already showing early signs of ARMD by 25%.
Foods that are rich in vitamin E include almonds, seeds, avocado and broccoli, just to name a few.
You may be wondering how much food we have to eat to get 400 IU vitamin E?
Well, that’s about 54 ounces of dry roasted sunflower seeds daily.
Typically, this measure of beta carotene is usually written as 25000 IU of vitamin A.
Take note that beta carotene is the precursor of vitamin A in our body.
Our body takes the beta carotene and converts it into vitamin A. It is a tightly regulated process within our body so our body typically does not overproduce vitamin A by over processing beta carotene.
Vitamin A serves a number of roles throughout the human body, including facilitating vision, immune functions, skin health and bone metabolism.
Now, in the revised AREDS, the authors actually took beta-carotene out of the equation because in two large clinical studies, they found that increased dosage of vitamin A may be associated with lung cancers in people who smoked.
Did you spot the caveat?
If yes, good for you!
It’s the phrase “ lung cancers in people who smoked.”
How I am interpreting this information is that if you are a non smoker, vitamin A is actually good for your eyes. I looked up the research on the effects of carotenoids and found multiple studies that support the protective effects of carotenoids on eyes.
However, to be extra safe, the researchers replaced beta carotene in the original AREDS formulation with zeaxanthin and lutein.
These compounds, like beta carotene, belong to the same family of nutrients known as carotenoids. They can be found abundant in eggs and green leafy vegetables.
As an aside, if you are actually diagnosed with AMD, you should actually seriously consider quitting smoking because the smoke is an irritant and an additional danger to your overall health, not just for your eyes.
And since we are on the topic of vitamin A and smoking, let’s talk about vitamin D.
Vitamin A and D have been known to work synergistically together, complementing and accentuating the actions of both vitamins in the body.
A 2014 research published in the International Journal of Cancer found that people who were former smokers (had their last cigarette more than 6 months ago), had significantly reduced lung cancer risk by 54% when they combined high doses of vitamin A with at least 400 IU of vitamin D every day.
However, there are also contradictory studies (e.g Jenab et al, 2010) that found that having too high a dosage of vitamin A can reduce the beneficial impacts of vitamin D on other cancers like colorectal cancers in the european population.
The difference you need to note is the form of vitamin A used in the research, similar to what we mentioned above when we talked about the revised AREDS formulation using carotenoids like lutein and zeaxanthin instead if beta carotene.
The issue here is with the variant form of vitamin A - retinoic acid, that have been proposed to potentially disrupt the activation of vitamin D.
In any case, the USDA recommends the daily value of vitamin D for individuals 4 years and above to be at 400 IU.
Did you know that getting yourself out into the sun can also generate your body’s ability to produce vitamin D?
Fatty fish like tuna, salmon and cod are great dietary sources of vitamin A and D.
In addition, these fatty fish contain omega-3 fatty acids, DHA and EPA. Studies have shown DHA to be helpful in retinal repair, as well as maintaining the structural integrity of the retinal cells.
The revised AREDS formulation recommends 1000 mg of omega-3 fatty acids daily.
In order to combat the progression of AMD, the above vitamins should work in tandem with other minerals like zinc and copper.
Zinc is found in great concentrations in the eye and is integral to great eye health. It is required as a cofactor for many enzymes in eyes, bones, skin and other organs. For instance, zinc is an important factor in converting beta-carotene to vitamin A.
In addition, zinc becomes a powerful antioxidant when bound together with a specific enzyme called superoxide dismutase (SOD) that can destroy free radicals that can damage cellular structure.
The AREDS formulation also recommended copper to be included as high dosage of zinc can inhibit the absorption of copper in the body, which can lead to copper deficiency anemia.
In summary, based on the AREDS and multiples studies on macular degeneration prevention, daily high dosage of vitamin c and vitamin e, carotenoids in the form of lutein and zeaxanthin, vitamin d, omega 3 fatty acids, zinc and copper appear to potentially delay the progress of AMD.
As a result, many pharmaceutical/health supplement companies came out with various eye supplements that take into consideration the AREDS formulation to help combat AMD.
I strongly recommend Ocu-plus as a daily supplement to boost your general eye health.
However, in conditions like AMD that requires a specific dosage formulation in order to have a certain level of efficacy in prevention, you may benefit from an AREDS formulation based supplements.
Of course, as always, I don’t play a doctor online and don’t intend to. Do check with your physician for the supplements most suitable for your AMD conditions.
Right of the bat, Bausch + Lomb’s PreserVision AREDS 2 Vitamin & Mineral Supplement is the current Amazon’s number one bestselling multiple vitamin-mineral combination supplements.
There are actually 2 versions of Bausch + Lomb’s AREDS supplements in the market. The original AREDS supplement was based on the results that came out from the first leg of the research, which included beta-carotene in the formula.
The AREDS 2 Vitamin & Minerals supplements is the revised version, which is based on the newer research data from AREDS, that replaced beta-carotene with lutein and zeaxanthin, as well as adjusting for the dosage for zinc.
This product has an average rating of 4.7 out of 5 on Amazon review, of which, about 79% gave it a 5 star rating.
Multiple reviewers have remarked on the improvements in their AMD condition, and seem to swear by it after receiving updates on their before and after eye exams.
The formulation is based on the AREDS that is sponsored by the US Federal Government’s National Eye Institute.
The research was based on results from more than 4700 people from eleven medical centers. It spanned over 10 years, and included clinical trials to test the efficacy of the supplements dosages.
There is solid research backing on the efficaciousness of the formulation with regards to reducing the progression of AMD.
Okay, now here is the perhaps controversial bits, but I noted in the research findings that Bausch and Lomb was involved in the provision of funds for the clinical trial portions of the AREDS.
I am guessing that as a result of that sponsorship, Bausch and Lomb had first dibs to base their product on the AREDS formula, and have patented the formula. This also meant that they have access to the clinical trials data, which can impact the choice of material used in creating the supplements.
Other companies have since offered their own versions of the supplements, based on the AREDS formulation.
The dosages required for each of the vitamin and minerals in the revised AREDS formulation vary and can be at rather high levels.
Which means to get to a certain dosage, you may have to take a few pills of a certain vitamin or mineral to get to the suggested strength.
The Bausch and Lomb AREDS 2 supplements offer a convenient solution to this messy counting business.
So instead of downing at least 7 different pills to get the required dosage, you will only need to take 2 of the Bausch and Lomb AREDS 2 supplement daily, one in the morning, one at night.
Size of capsule
Some users shared that the size of the capsules can go a tad too big for them, making it difficult to swallow.
If you always had difficulty swallowing pills, this product may not be suitable for you.
Alternatively, you can try opening the capsules to swallow the contents instead.
Packaging of capsules
Another issue experienced by some people is that the capsules may stick together at the bottom of the bottle, making it difficult for them to pry apart, or wasting a few capsules in the process.
One concern that a few reviewers on Amazon had highlighted is the cost of the product, as compared to other brands available in the market.
I had a look around and found that for cost per capsule, the Bausch and Lomb ones were actually not more expensive than the other brands available.
Other brands may be cheaper, but they may also have less capsules. One competing brand was selling the AREDS 2 formulation about $8 cheaper, but only offered 60 capsules.
So the moral of the story is, always count cost per capsule, rather than to look at the overall cost per bottle.
If cost is a concern, you can actually consider getting the various vitamins and minerals separately. Usually, these vitamins and minerals are available in bulk and would cost less per dosage as per the recommended formulation.
There were a few people that had complaints of gastric issues after taking the capsules. This may be due to the zinc.
If you know your tummy will react to increased zinc intake, this product is probably not for you. Otherwise, I would suggest trying one bottle first, before buying it it bulk.
Advanced macular degeneration is a functionally impairing disease that have no cure at the moment.
However, research have shown that high concentrations of vitamin and mineral supplementation may be helpful in arresting its progression.
I hope this article have been helpful in providing a balanced view on the best vitamins to prevent macular degeneration, and that my honest review of the Bausch and Lomb AREDS 2 vitamin and mineral supplement provided you with options to consider.
As usual, before your try anything, it is definitely good practice to check in with your ophthalmologist for recommendations for the most suitable supplementation for your condition.