Macular Degeneration and Nutrition
Nutritional Supplements and Macular Degeneration
What you eat and the supplements you take can affect your macular degeneration, for better or worse. What do we know for sure, almost for sure, and only maybe?
The Age Related Eye Disease Study (AREDS) is a large, multi-center, controlled study, whose results came out in 2001. This was a large study, which demonstrated that supplementation with vitamins A,C, E, and zinc reduced the risk that macular degeneration would get worse, in people that already had the disease. In the years that followed it became apparent that there is almost certainly more to the picture. A similar large study, AREDS 2, is due to produce results in late 2012. This will compare the effects of supplementation with the AREDS formula vs. AREDS + lutein/zeaxanthin +/or DHA/EPA (fish oil).
It is looking highly probable that taking fish oil and the carotenoids lutein and zeaxanthin will decrease the progression of macular degeneration and may decrease the risk of getting the disease in the first place. There is some evidence that these supplements can even cause some reversal of the disease and improve vision.
Lutein and zeaxanthin are chemicals found in high concentration in the macula, the retina’s center. These help protect the retina from oxidative damage caused by the effect of light on the retina. When light strikes the retina, some of the by-products are “free radicals” that cause tissue damage. Lutein and zeaxanthin also screen blue light from some of the delicate structures in the retina. Blue and violet light are more likely than other colors to cause oxidative damage. White light is composed of all the colors of the rainbow together.
What we do know for sure about these “xanthins” is that the higher the concentration in the macula, the less likely a person is to get macular degeneration or to get worse if they already have the disease. We also know that taking xanthins as food or supplements increases their blood levels, and we also know that higher blood levels lead to higher macular concentrations. Therefore, it is pretty certain that taking xanthins in the diet will decrease the risk of macular degeneration occurring or progressing. This effect is less in obese people.
What are the ideal doses? We don’t know for sure. AREDS 2 is being done with 10 mg of lutein and 2 mg of zeaxanthin. Taking doses close to that would seem prudent.
Lutein and zeaxanthin are found in the diet in dark green leafy vegetables, such as spinach, kale and collard greens, and also in some other foods, but you cannot get doses close to 10 mg per day through diet alone.
Long Chain Omega 3 Fatty Acids: EPA/DHA
These are major components of fish oil and are the best dietary source. Flax seed oil can work for most people too, but some people lack the enzymes to convert it into an effective form. We can’t tell if you have the enzymes or not, so fish oil is a better bet.
Omega 3’s quell inflammation in the retina. Inflammation is thought to be a factor in how one gets macular degeneration. Omega 3’s are also important components of the retina and are necessary for its function.
There are no rock-solid studies yet proving that intake of omega 3’s decrease the risk of or slow macular degeneration, but some studies are very suggestive. AREDS 2 will tell the tale. In the meantime we are recommending our macular degeneration patients to take fish oil supplements. AREDS 2 uses 350 mg of DHA and 650 mg of EPA.
One problem one sometimes encounters with fish oil capsules is that they can cause stomach upset and “fish burps”. These problems are less likely by taking fish oil that is “distilled” or “purified”. Distilled fish oil also contains no toxins, such as mercury or PCPs.
There are other nutrients and supplements that can possibly help. Anything that has anti-oxidant properties, from bilberry to green tea may be of value.
Vitamin A doesn’t work. You will see it deleted from macular degeneration supplements in the future. Smokers or those who have recently quit should not take vitamin A, because it increases the risk of lung cancer.
Zinc is effective. It is recommended that you take copper too, in order to prevent anemia.
Aspirin may increase the anti-inflammatory effects of omega 3s.
Always tell your doctor that you are taking supplements. They can affect other aspects of your health and can interact with medications. Coumadin is especially notorious for interacting with other chemicals. We will notify your doctor, if we put you on supplements.
You must avoid mega-doses of any vitamin, mineral or other supplement. There are almost always negative effects.
What We Recommend
We are currently recommending a supplement called OS2, available through our office or from the Ameriscience web site, https://www.amerisciences.com/?PageId=2002&SKU=2028. As a patient at Leader Heights Eye Center, you will receive information on how to get OS2 at a discounted price. OS2 contains:
Omega 3s: DHA/EPA
We recommend two OS2 capsules per day and a multi-vitamin as well. The multi-vitamin rounds out your overall nutritional needs and has the copper needed to avoid anemia from the zinc.