Eye Vitamins: Part 6 – What’s all the talk about zinc? Introduction

There is a fascinating story to tell of how the topic of ‘eye vitamins’, specifically the AREDS/AREDS2 supplements, evolved from the release of the results of the first AREDS in 2001 until the release of the most recent study from January 2018. It’s a story that has a lot of back and forth between research teams, accusations of conflict of interest, lots of money for some, criticism of statistical methods and results and more. I’m working on condensing the story but it’s complicated and I am not yet done.

The most recent research

It’s the January 8th, 2018, study we’ll start with: CFH and ARMS2 genetic risk determines progression to neovascular age-related macular degeneration after antioxidant and zinc supplementation.  Briefly, this study confirms what has been suspected for many years: the high dose of zinc (80 mg) in the both the original AREDS formulation & the AREDS2 formulation, can INCREASE the risk of progression to wet AMD not decrease it. The results of the study show that:

– Approximately 40% of patients in the study had a 50% reduction in risk of progression from intermediate to wet/advanced AMD, which was double the benefit shown in the 2001 AREDS publication.

– 15% of patients with a specific combination of genetic risk variants nearly tripled their risk of developing wet AMD when treated with the AREDS formulation instead of a placebo.

What does that mean for you?

If you have intermediate/moderate AMD or advanced AMD (wet or geographic atrophy which is advanced dry AMD) in one eye but not the other, AREDS/AREDS2 supplements have been shown to reduce the risk of progression to wet/advanced  AMD UNLESS you have the specific genetic risk.

How can you find out if you have this specific genetic risk?

Genetic testing is available for those in the US and Canada through your physician. The company that does the testing is ArcticDX. Many insurance companies, including Medicare, pay for the test or there is a minimal cost ($50). See our disclaimer below. Click here to find a physician.

What if your physician won’t order the test?

There are supplements available that have the exact AREDS/AREDS2 formulation but with no zinc but you may be missing the benefit of the zinc if you are NOT ‘zinc sensitive’.  There are also ones that have low zinc (25mg) but there’s no evidence that it is safe if you do have the ‘zinc sensitive’ genotype.

Click here for a chart of the low and no zinc supplements that are available.

Press release from Harvard

On January 18th, 2018, Harvard Medical School issued a press release: New study shows strong interaction between genetics and nutritional supplement treatment on progression to neovascular age-related macular degeneration (AMD).

The team was headed by Demetrios G. Vavvas, MD, PhD, Associate Professor of Ophthalmology at Harvard Medical School and Incumbent of the Monte J. Wallace Ophthalmology Chair in Retina at Mass. Eye and Ear.  There were also investigators from University of Toronto and Stanford University.

Dr. Vavvas said “The results of our study show that an individual’s response to the AREDS formulation is influenced by that person’s genetic makeup, and underscores the importance of using genetic testing, whenever possible, to help guide the management of patients with AMD,” said Dr. Vavvas, adding “by utilizing genetics and personalized medicine to develop more precise diagnostics and treatments, we aim to improve the overall outcomes for our patients.”


Here’s a just-out video of Canadian Viteoretinal Surgeon Dr. Netan Choudhry explaining what the results of this study mean to those who have intermediate dry AMD or advanced AMD in one eye but not the other. These are the people who were helped in the AREDS/AREDS2 research. But now, there’ an issue for some of them about taking the supplements with a high dose of zine. https://eyestuff.wistia.com/medias/t0j6epf9fs


Disclaimer.

From Sue and me: While there are other reputable laboratories offering AMD genetic screening, Arctic provides the only testing that gives advice on whether the AREDS supplements are helpful or harmful. We are only providing the information about this offer. The final decision about any testing has to be made between you and your prescribing physician.

Written February 14th, 2018

 

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Eye Vitamins: Part 6 – What’s all the talk about zinc? Introduction
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