Can AREDS Vitamins Help Protect Your Vision?

Age-related macular degeneration (AMD) is a major cause of vision loss in older adults. More than two decades ago, researchers found that people with moderate AMD could slow the worsening of the condition by taking a particular nutritional supplement (Archives of Ophthalmology, Oct. 2001). The study was later updated as the Age-Related Eye Disease Study, or AREDS. Researchers were pleased to find that lutein and zeaxanthin could replace beta-carotene with equally good results. Unlike beta-carotene, lutein and zeaxanthin do not raise the risk of lung cancer. The trial also found that adding fish oil made no difference (JAMA, May 15, 2013).

AREDS Benefits Persist Over Time

A rare but important long-term follow-up was recently published (JAMA Ophthalmology, June 2, 2022). People who used the AREDS2 version containing lutein and zeaxanthin were less likely to experience worsening retinal damage. Those who took the version with beta-carotene were twice as likely to develop lung cancer during follow-up. Based on these findings, the researchers concluded that the AREDS2 formula appears safe and effective for extended use.

Readers may still wonder whether AREDS vitamins are worthwhile. The answer depends in part on a person’s risk for AMD.

Should You Take AREDS Plus Vitamins?

Q. After cataract surgery, my ophthalmologist recommended PreserVision AREDS 2 to help slow age-related macular degeneration. I understand there was a clinical study showing a 27 percent reduction in degenerative changes. These supplements contain vitamins and antioxidants.

I already take a daily multivitamin, so I worry about getting too much of certain vitamins. Then I noticed products labeled AREDS 2 + Multivitamins.

I compared the vitamins and minerals in AREDS 2 + Multi with my own multivitamin, and they seemed very similar. Are there any important differences in the formulas?

How the Formulas Differ

A. As noted above, the original AREDS study found that this combination of antioxidants and zinc could significantly reduce the risk that macular degeneration would progress (Archives of Ophthalmology, Oct. 2001). In AREDS 2, the researchers replaced beta-carotene with the carotenoids lutein and zeaxanthin.

There are a few other minor differences among these multivitamin products, but one stands out. AREDS 2 + Multivitamins contain the same high amount of zinc, 80 mg, as the original formula. Too much zinc can interfere with copper metabolism, which may weaken muscles and cause other unpleasant effects (Clinical Neuropharmacology, July 31, 2026).

PreserVision AREDS3 has been reformulated. It provides 25 mg of zinc per day, which is a safer amount. It also includes eight B vitamins. For most of these, the amount is two to three times the RDA and remains below the tolerable upper limit, where one has been established.

Ongoing Clinical Trial

The AREDS3 formula is being studied in a clinical trial, but the research is not yet complete. Until the data are collected, analyzed and published, it will not be known whether it offers added protection beyond the AREDS2 formula.

For now, AREDS3 may be a reasonable supplement option. It should not be combined with other multivitamin products, since that could result in excessive intake of some nutrients. Caution is appropriate.

Can AREDS Vitamins Slow Macular Degeneration?

Q. I want to do everything I can to keep my macular degeneration from worsening. Are there any supplements that might help? I strongly prefer something backed by clinical trials.

A. Two major clinical trials have shown that supplements can help slow the progression of macular degeneration. These were called AREDS and AREDS2 (JAMA, May 15, 2013; Advances in Nutrition, Jan. 2017). AREDS3 is still under way, as explained above. The AREDS formula includes vitamin C (500 mg), vitamin E (400 IU), beta-carotene (15 mg), zinc (80 mg) and copper (2 mg). AREDS2 found that replacing beta-carotene with lutein and zeaxanthin worked just as well and was safer for smokers.

You should be able to find a supplement based on the AREDS2 formula, but it is important to read the label carefully to confirm that it matches.

Can You Get AREDS Nutrients Through Food?

You may also want to adjust your diet so it includes nutrients found in both AREDS formulas. That means getting plenty of antioxidants by eating berries, dark green leafy vegetables, corn and avocado (Antioxidants, April 2019).

“High consumption of vegetables rich in carotenoids and fatty fish containing omega-3 fatty acids was beneficial for those at risk of AMD.”

Another study, based on detailed dietary questionnaires completed at several points, found that people who ate more meat and processed foods were three times more likely to develop late-stage macular degeneration than those who followed a more prudent diet rich in vegetables and fruits (British Journal of Ophthalmology, Dec. 6, 2019). In other words, focusing on brightly colored produce may be a good way to get AREDS nutrients that could help protect your sight.

Learn More

Learn more about macular degeneration and ways to slow its progression by listening to a free one-hour interview with Dr. Peter McDonnell, Director of the Johns Hopkins Wilmer Eye Institute. It is Show 1154: How to Take Good Care of Your Eyesight. Another helpful resource is an interview with Dr. Sharon Fekrat, Show 1402: How You Can Protect Your Precious Eyesight and Keep Your Eyes Healthy.