Comparison of all macular vitamin supplements in Australia

I’ve summarised in the previous blogs in this series how good nutrition and vitamin supplements can help slow the progression of age-related macular degeneration (AMD). But it’s not enough to take any supplement or any dose. You need to take the right combination of nutritional supplements in the correct amounts, as determined by the landmark AREDS2 trials.  The specific AREDS2 vitamin supplements for macular degeneration were listed in the previous blog on this topic.

How does my eye specialist know if macular degeneration vitamins are necessary?

There are various factors to consider.  It depends on how severe your macular degeneration is, after the eye specialist has completed the examination.  Also important is what you normally eat – in other words, your baseline nutrition. Other factors include your life expectancy and your financial resources.

There are many characteristics of AMD, as described in the previous blogs in this series. These include drusen, retinal pigment epithelial changes, geographic atrophy (GA), and neovascular membrane formation. After your eye examination, your ophthalmologist will consider how well you fit into the categories determined by the AREDS trials.

Clearly, not every patient with AMD fits neatly into a category of the AREDS trials.  One point to consider is that the AREDS trials were conducted in the United States of America, where a ‘standard diet’ may well be different to that of Australia.  We tend to eat more home-cooked meals here, and are perhaps, as a country, more health conscious.  We also have fresh fruit and vegetables readily available at reasonable prices.

Certainly, a healthy diet with plenty of green vegetables and oily fish will be good for eye health, but there is limited evidence to indicate that a good diet alone can supply all the ingredients specified by AREDS.

There are no prescription drugs with the AREDS2 formulation

Currently, there are no prescription medications that contain the exact mixture of vitamins and antioxidants that AREDS2 specifies. Instead, patients need to choose between the overwhelming number of over-the-counter supplements available. Even though these vitamin and antioxidant supplements are marketed to consumers as slowing the progression of AMD, their ingredients differ significantly. Unfortunately, patients have the difficult task of sorting between the non-standardised over-the-counter supplements, all of which vary to some degree from the AREDS2 formula.

To help patients make an informed decision, it is important to understand which supplements most closely match the AREDS evidence-based formula.  So, my co-authors and I undertook a systematic review of all known macular degeneration vitamin supplements available in the major pharmacy chains that are nationwide in Australia, as well online retailers in Australia, North America, and the United Kingdom.

This research allowed us to categorise all available vitamin supplements for macular degeneration by ingredients and price per dose. We created a list which will help clinicians and patients understand their choices and draw comparisons between available products.

Common problems with macular degeneration vitamin supplements

Some products marketed for macular conditions contain beta-carotene. This ingredient has been reported to have an association with an increased risk of lung cancer. For this reason, beta-carotene was excluded from the AREDS2 formula. It would be wise to check your macular supplement for beta-carotene, especially if you are a smoker, or have smoked previously.

Many supplements contain only lutein and zeaxanthin. However, these vitamins do not have strong evidence for delaying progression of AMD when taken in isolation.

Some companies sell supplements that contain all the recommended vitamins for macular degeneration, but not in the recommended amounts. In fact, I found that the majority of commercially available supplements marketed for AMD do not contain the same ingredients or doses established by AREDS2.

I recommend that you review your product against the AREDS2 formula that we published in our last blog. Alternatively, you can search online for my scientific publication on macular vitamin supplements. Depending on the copyright requirements of the journal, I hope to be able to publish it here too.

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