Expanding Care in Delaware: Our newest location in Newark is opening November 23.

Learn More

Macular Degeneration Vitamins and What to Know About AREDS2

macular degeneration vitamins

If you’ve been diagnosed with age-related macular degeneration (AMD), you’ve probably heard about macular degeneration vitamins as a possible treatment. Maybe your eye doctor mentioned them, or a friend suggested you start taking supplements. 

When patients ask about vitamins for macular degeneration, they’re usually asking about AREDS2. The formula can reduce the risk of progression to advanced AMD in people with the stages of AMD studied in the trial. Mainly, intermediate AMD in one or both eyes, or advanced AMD in one eye. But it’s not a cure, it won’t restore vision you’ve already lost, and it’s not appropriate for everyone with AMD.

What Are Macular Degeneration Vitamins?

Macular degeneration vitamins are a type of supplement marketed for eye health. Some are just general multivitamins with a few extra nutrients thrown in. Others are specific formulas developed through clinical research.

The formula supported by the AREDS/AREDS2 clinical trial evidence is different from what you’ll find in a standard multivitamin. The National Eye Institute conducted two major studies, AREDS (Age-Related Eye Disease Study) and AREDS2, to evaluate whether specific vitamins and minerals could affect the progression of AMD. These weren’t small studies. They were large, carefully controlled clinical trials that followed thousands of people over several years.

AREDS2 is the updated version of the original AREDS formula. It’s designed to help reduce the risk of progressing to advanced AMD in people with intermediate AMD or advanced AMD in one eye. The benefit depends on your AMD stage and type. If you have early AMD or no AMD at all, the research doesn’t show the same benefit.

Keep in mind that AREDS2 is not a cure. It doesn’t reverse damage that’s already happened. It’s about reducing risk in people who are already at a higher risk of progression.

What Are AREDS2 Vitamins?

AREDS2 stands for Age-Related Eye Disease Study 2. It’s the formulation supported by the established AREDS/AREDS2 evidence for appropriate patients with intermediate AMD. The goal of the AREDS2 trial was to see whether certain nutrients could reduce the risk of progressing to advanced AMD.

The AREDS2 formula contains six specific nutrients in specific amounts:

  • Vitamin C
  • Vitamin E
  • Zinc
  • Copper
  • Lutein
  • Zeaxanthin

Each nutrient was included based on earlier research and tested in the AREDS2 trial. A regular multivitamin generally does not reproduce the AREDS2 formulation and studied doses, so taking a standard multivitamin isn’t the same as taking the clinically studied formula.

If you see a supplement labeled “AREDS2,” it should contain these six nutrients in the amounts tested in the trial. But not all products labeled this way are identical, and some may include additional ingredients that weren’t part of the original research.

AREDS2 Ingredients: What Do They Do?

Let’s break down what each nutrient does and why it’s in the formula.

Vitamin C and Vitamin E are antioxidants. They help protect cells from damage caused by unstable molecules called free radicals. In the context of AMD, the idea is that antioxidants might help protect retinal cells. But don’t assume that taking vitamin C or vitamin E alone will give you the same benefit as the full AREDS2 formula. The research found that the full combination of vitamins worked the best.

Zinc is a mineral that plays a role in normal retinal function. The retina uses zinc for various biological processes. Copper is included to help offset the risk of copper deficiency associated with high-dose zinc. When you take high doses of zinc over a long period, it can interfere with copper absorption, so the AREDS2 formula includes copper to prevent that problem.

Lutein and zeaxanthin are carotenoids that occur naturally in the macula, the part of the retina responsible for central vision. In the AREDS2 trial, these two nutrients replaced beta-carotene, which was in the original AREDS formula. Beta-carotene was linked to increased lung-cancer risk in current and former smokers, so the AREDS2 researchers tested whether lutein and zeaxanthin could be a safer alternative.

Here are the daily amounts studied in the AREDS2 trial:

Nutrient Daily Amount
Vitamin C 500 mg
Vitamin E 400 IU
Zinc 80 mg
Copper 2 mg
Lutein 10 mg
Zeaxanthin 2 mg

One note about zinc: the standard AREDS2 formulation contains 80 mg of zinc. AREDS2 also studied a separate lower-zinc formulation containing 25 mg, but that is not the same as the standard formula. Most AREDS2 supplements on the market use the 80 mg dose. However, it is not unreasonable to use a 25 mg dose as there did not appear to be a difference in efficacy when compared to the 80 mg dose in the AREDS2 study. A lower zinc dose can be more tolerable for some patients whose stomach may be sensitive. 

Again, taking isolated vitamin C, vitamin E, zinc, lutein, or zeaxanthin is not equivalent to AREDS2. The research tested the full combination.

Who Should Take AREDS2?

AREDS2 is not for everyone with AMD. The formula was studied in people with intermediate AMD in one or both eyes, or advanced AMD in one eye. If you have early AMD or no AMD, the research doesn’t show that AREDS2 provides the same benefit. It also has not been shown to benefit patients who have a family history of AMD but no evidence of it yet. 

So who might benefit? People with intermediate AMD. At this stage, there are visible changes in the retina, including medium-sized drusen (yellow deposits under the retina) or other signs that your eye doctor can see during an exam. If you have advanced AMD in one eye, your ophthalmologist might recommend AREDS2 to reduce the risk of advanced AMD developing in the other eye.

A clinician will determine whether the AREDS2 formula is appropriate based on AMD stage, eye findings, medical conditions, medications, and smoking history. For example, if you’re a current or former smoker, your doctor will likely recommend the AREDS2 formula (with lutein and zeaxanthin) rather than the original AREDS formula (with beta-carotene), because of the lung-cancer risk associated with high-dose beta-carotene in smokers.

Don’t start or change supplements without talking to your eye doctor. High-dose supplements may interact with medical conditions or medications. Your AMD specialist can help you figure out whether AREDS2 is right for you and whether you need to consider any special precautions.

Also, keep in mind that AMD has two main types: wet vs. dry macular degeneration. AREDS2 was studied primarily in people with dry AMD at the intermediate stage. If you have wet AMD, you may need other treatments in addition to, or instead of, supplements.

AREDS vs AREDS2

The original AREDS formula included vitamin C, vitamin E, zinc, copper, and beta-carotene. It was tested in a large clinical trial, and the results showed that it could reduce the risk of progression to advanced AMD in people with intermediate AMD or advanced AMD in one eye.

AREDS2 modified the original formulation by replacing beta-carotene with lutein and zeaxanthin. 

The good news is that lutein and zeaxanthin worked. The AREDS2 formula is generally preferred when beta-carotene exposure is a concern, especially for current and former smokers.

Here’s a quick comparison:

Ingredient AREDS AREDS2
Vitamin C Yes Yes
Vitamin E Yes Yes
Zinc Yes Yes
Copper Yes Yes
Beta-carotene Yes No
Lutein and zeaxanthin No Yes

Both formulas have clinical-trial evidence behind them, but AREDS2 is now the more commonly recommended option because of the safety concerns around beta-carotene. If you’re already taking the original AREDS formula and you’ve never smoked or been around second hand smoke, you don’t necessarily need to switch, but it’s worth discussing with your doctor.

What Is AREDS3?

You might have seen products marketed as “AREDS3.” The term may be used commercially, but AREDS3 is not an official NEI AREDS trial designation. Products marketed under that name should not be described as clinically equivalent to the AREDS2 trial formulation.

Some manufacturers have created formulas that include the AREDS2 nutrients plus additional ingredients, such as B vitamins. The idea is that these extra nutrients might provide additional benefit, but the evidence for that is not the same as the evidence for AREDS2.

AREDS2 is the formulation supported by the established AREDS/AREDS2 evidence for appropriate patients. If you’re already taking AREDS2, do not switch supplements solely because a product is marketed as “AREDS3.” Instead, discuss any change with your ophthalmologist. They can help you weigh whether the additional ingredients make sense for you, or whether you’re better off sticking with the formula that has the strongest clinical evidence.

Which Should You Take?

If you’re trying to decide between AREDS2 and a product marketed as AREDS3, here’s what you need to know.

AREDS2 has been tested in large, well-designed clinical trials. The formula, the doses, and the patient populations have all been carefully studied. AREDS3 products may contain the AREDS2 formula plus additional ingredients, but those additions have not been studied to the same degree.

Do not switch without discussing the product and your medical history with your clinician. There’s no one-size-fits-all recommendation here. Your ophthalmologist or retina specialist will consider your AMD stage, your overall health, and whether any additional ingredients in an AREDS3 product might be helpful or potentially problematic for you.

Here’s a quick comparison:

Factor AREDS2 Products Marketed as AREDS3
Formula Six studied nutrients AREDS2 nutrients plus additional ingredients
Clinical evidence Established through large clinical trials Additional ingredients not studied to the same degree
Should you switch? Not required; discuss with your clinician Not required; discuss with your clinician

If you’re already taking AREDS2 and it’s working well for you, there’s no urgent need to switch. If you’re curious about whether an “AREDS3” product might offer additional benefits, bring it up at your next appointment.

Can Vitamins Cure Macular Degeneration?

No. AREDS2 does not cure AMD, and it does not restore lost vision. What it can do is reduce the risk of progression to advanced AMD in people with the stages of AMD studied in the trial.

That’s a meaningful benefit, but it’s not the same as a cure. If you’ve already lost some central vision, AREDS2 won’t bring it back. If you have early AMD, AREDS2 hasn’t been shown to provide the same benefit as it does for people with intermediate AMD.

Supplements also don’t replace retinal examinations. You still need to see your eye doctor regularly to monitor your AMD and catch any changes early. If you develop wet AMD, you may need other retina treatments, such as anti-VEGF injections. You can learn more about how wet AMD is treated on the Mid Atlantic Retina website.

The bottom line is that AREDS2 is one part of a comprehensive approach to managing AMD. It’s not a standalone solution, and it’s not appropriate for everyone. Follow your specialist’s treatment plan, keep your appointments, and report any vision changes right away.

What Else Can You Do to Protect Your Vision?

Taking AREDS2 (if it’s appropriate for you) is just one piece of the puzzle. Here are some other steps that support AMD care:

  • Eat a balanced diet: Leafy greens, fish, and colorful fruits and vegetables are all good choices and very important, especially a Mediterranean diet. A healthy diet supports overall eye health, but it doesn’t replace AREDS2 if your doctor has recommended it.
  • Avoid smoking: Smoking is one of the biggest risk factors for AMD. If you smoke, quitting is one of the best things you can do for your vision.
  • Manage your overall health: Blood pressure and blood sugar control are important for general health. Having an exercise routine is beneficial too. While these aren’t AMD-specific interventions, keeping your body healthy supports your eyes, too.
  • Keep your eye examinations: Regular visits to your ophthalmologist or retina specialist are essential. They’ll monitor your AMD, check for any changes, and adjust your treatment plan if needed.
  • Watch for vision changes: If you notice new distortion, a blind spot, or sudden vision change, contact your eye doctor right away. Early detection of wet AMD or other complications can make a big difference in treatment outcomes.

Healthy habits support AMD care, but they don’t replace treatment. If you’ve been diagnosed with intermediate AMD or advanced AMD in one eye, talk with an AMD specialist about whether AREDS2 is right for you. You can also schedule an appointment with a retina doctor at Mid Atlantic Retina to discuss your options.

For more macular degeneration FAQs, visit the Mid Atlantic Retina website.

Frequently Asked Questions About Vitamins for Macular Degeneration

What are the best vitamins for macular degeneration?

The formula supported by the AREDS/AREDS2 clinical trial evidence is the most established option for people with intermediate AMD or advanced AMD in one eye. It contains vitamin C, vitamin E, zinc, copper, lutein, and zeaxanthin in specific amounts. A regular multivitamin generally does not reproduce the AREDS2 formulation.

What are AREDS2 vitamins?

AREDS2 vitamins refer to the specific formula tested in the Age-Related Eye Disease Study 2. The formula includes six nutrients: vitamin C (500 mg), vitamin E (400 IU), zinc (80 mg), copper (2 mg), lutein (10 mg), and zeaxanthin (2 mg). This formula was designed to reduce the risk of progression to advanced AMD in appropriate patients.

What are the AREDS2 ingredients?

The AREDS2 formula contains vitamin C, vitamin E, zinc, copper, lutein, and zeaxanthin. Lutein and zeaxanthin replaced beta-carotene from the original AREDS formula because of safety concerns related to lung cancer risk in smokers.

Who should take AREDS2?

AREDS2 is generally recommended for people with intermediate AMD in one or both eyes, or advanced AMD in one eye. It’s not automatically recommended for everyone with AMD or a family history of AMD. People with early AMD or no AMD have not been shown to benefit in the same way. Ask your ophthalmologist or retina specialist whether AREDS2 is appropriate for your AMD stage and medical history.

What is the difference between AREDS and AREDS2?

The original AREDS formula included beta-carotene, while AREDS2 replaced beta-carotene with lutein and zeaxanthin. Both formulas contain vitamin C, vitamin E, zinc, and copper. AREDS2 is generally preferred when beta-carotene exposure is a concern, especially for current and former smokers.

Are AREDS2 supplements safe for everyone?

AREDS2 supplements contain high doses of certain nutrients, which may interact with medical conditions or medications. A clinician should determine whether the AREDS2 formula is appropriate based on AMD stage, eye findings, medical conditions, medications, and smoking history. Don’t start or change supplements without talking to your eye doctor.

Should I switch from AREDS2 to AREDS3?

AREDS3 has not yet been tested in a clinical trial, which makes it difficult to know whether it is better or worse than AREDS2. Products marketed under that name should not be described as clinically equivalent to the AREDS2 trial formulation. Do not switch supplements solely because a product is marketed as “AREDS3.” Discuss any change with your ophthalmologist.

Can AREDS2 restore lost vision?

No. AREDS2 does not restore lost vision. It can reduce the risk of progression to advanced AMD in people with intermediate AMD or advanced AMD in one eye, but it doesn’t reverse damage that’s already happened.

Can I take AREDS2 if I have early AMD?

The research doesn’t show that AREDS2 provides the same benefit for people with early AMD as it does for people with intermediate AMD. Your ophthalmologist or retina specialist can help you determine whether AREDS2 is appropriate based on your specific AMD stage and risk factors.

Do regular multivitamins contain the AREDS2 formula?

No. A standard multivitamin generally does not reproduce the AREDS2 formulation and studied doses. If your doctor has recommended AREDS2, look for a supplement specifically labeled as AREDS2 that contains the six nutrients in the amounts tested in the trial.