Review of the AREDS & AREDS2 Research Results: An Attempt of Make Them Clearer for Patients and Family Members

In the “If you have…” section below, you will find the stage of each eye in combinations so that you can find your current status.  Under each heading, you’ll find the research done and results, if they are available.

Added 1/3/2018: There is no evidence from either AREDS or AREDS2 that these supplements prevented AMD, reversed AMD or improved the vision of any participants. The results are all about reducing the risk of progression from whatever stage they started the study to advanced AMD at the end of the study.

Disclaimer

We are NOT telling you what to do or what to take, this is NOT to replace a thorough examination & discussion with your eye doctor AND your own research.  We are just trying to simplify the results of 2 important but complex studies.

Notes
  1. Before taking any supplement, please talk to your personal doctor/GP especially if you have other health issues.  These are high-dose supplements which can cause interactions with medications, interactions with other vitamins & minerals and in some cases can worsen other disease processes.
  2. In order to simplify the results of these studies, we have ‘stretched’ the stage assignments from how they were actually done in the studies.  For example, in AREDS, they looked at the lead/most advanced eye & assigned the participant that stage.  So someone with one eye at the intermediate stage & the other with no AMD, early AMD or intermediate AMD would be assigned the intermediate stage.  AREDS2 used a slightly different method.
  3. There are many ‘eye vitamins’ sold as AREDS or AREDS2 but they do not all have the exact ingredients that were a result of the extensive AREDS & AREDS2 research (see References section below for full study articles).  The ingredients & dosages from AREDS were:  antioxidants 400 IUs of Vitamin E, 500 mg of Vitamin C and 15 mg beta carotene.  Because beta carotene was found to be linked to lung cancer in smokers, AREDS2 removed the beta carotene & used 10 mg Lutein and 2 mg Zeaxanthin.  The formulations from both studies included zinc (because of zinc, copper was also included), 80 mg in AREDS and both 80 mg and 25 mg zinc in AREDS2.   It was these exact ingredients that produced the positive results below (“showed reduction of risk  of developing advanced AMD”) so read the labels of any products carefully to make sure they match the study formulation as closely as possible.  There are 2 webpages in References below that compare selected products.
  4. A warning has been issued about the high dose of zinc in the study formulation: “The AREDS supplement was beneficial for most patients, but almost 15% did worse with treatment than with the placebo. This adverse outcome appears to be due to the high-dose zinc component of the AREDS formulation. More research is indicated but, in the meantime, I perform genetic testing to select the optimal nutritional supplement for each patient.” from the Macular Degeneration Association.   For more information about genetic testing, see References below.

If you have…

No AMD Both Eyes
  • In AREDS only (no participants without AMD were included in AREDS2), participants with this combination were put in a separate arm of the clinical trial to study the effect of antioxidants on cataract formation where half got a placebo & half got the antioxidants only (no zinc).  In 2017, AREDS data from the cataract arm was studied by Awh, Zanke and Kustra (2017) and they concluded that taking these high-dose antioxidants may harm those with a specific genotype.  Because of that, the recommendation from study is to NOT take the AREDS or AREDS2 supplements if you do NOT have AMD.  For more information about genetic testing, see References below.
No AMD one eye/early AMD in the other eye
  • There were not enough participants in AREDS to a generate a recommendation. Perhaps results of Awh, Zanke and Kustra (2017) above may apply but it has not yet been studied. There were no participants with early AMD in AREDS2.  If your doctor has recommended that you take the supplement, see “Early AMD in both eyes” below.
No AMD one eye/intermediate or advanced (wet or geographic atrophy) in the other eye
  • AREDS: showed reduction of risk of developing advanced AMD in 5 years. [see notes 3 & 4 above}
Early AMD in both eyes
  • Only studied in AREDS. Not enough participants to generate a recommendation. Perhaps results of Awh, Zanke and Kustra (2017) above may apply but it has not yet been studied. There were no participants with early AMD in AREDS2.   Some eye doctors recommend that those with early AMD in both eyes take the AREDS or AREDS2 supplements.  Please make sure that you discuss the benefits versus the risks (ie, interactions with other medications and/or supplements) with your eye doctor.
Early AMD in one eye/intermediate or advanced (wet or geographic atrophy) in the other eye
  • AREDS: showed reduction of risk of developing advanced AMD in 5 years. [see notes 3 & 4 above}
Intermediate AMD in both eyes
  • AREDS/AREDS2: showed reduction of risk of developing advanced AMD in 5 years. [see notes 3 & 4 above}
Intermediate AMD in one eye/advanced (wet or geographic atrophy) in the other eye
  • AREDS/AREDS2: showed reduction of risk of developing advanced AMD in 5 years. [see notes 3 & 4 above}
Advanced AMD (wet or geographic atrophy) in both eyes
  • No one with this combination was included in either AREDS or AREDS2.   Some doctors tell their patients with geographic atrophy (advanced dry AMD) in one or both eyes to take the supplement to prevent their eyes from progressing to wet AMD (it’s possible to have geographic atrophy AND wet AMD).

If you have any comments or questions, please email me at light2sight5153@gmail.com

References

last updated 1/3/2018

 

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