Are Vitamin Supplements Recommended For All Patients With Age-Related Macular Degeneration?

Even if they aren’t recommended for my stage of macular degeneration, will it hurt me to take them?

Vitamin supplementation is recommended for patients with a specific stage of macular degeneration. The patients who have been shown to benefit from vitamin supplementation are those with intermediate dry macular degeneration and those with wet or advanced macular degeneration in one eye and not their fellow eye. The intermediate stage is defined by many drusen of medium size, or one or more large drusen.

Those without any evidence of macular degeneration, or with only early dry macular degeneration, have not been shown to benefit from supplementation. Some patients with early dry macular degeneration progressed to the intermediate stage during the AREDS study. The AREDS supple-mentation did not appear to slow this progression.

Patients with macular degeneration should consult their eye care provider, who will help them determine whether or not they should take the vitamins. One should definitely be careful about taking high-dose nutritional supplements without consulting a physician.

While many nutritional supplements are harmless, numerous studies have shown that some may cause serious side effects. For instance, zinc in the concentrations recommended for the over-the-counter supplement may lead to copper deficiency anemia. This concern is addressed by the addition of copper to the AREDS for-mulation.

Studies have also shown that beta-carotene use in smokers increases their risk of developing lung cancer. As a result, there are smokers’ formulations that don’t use the beta-carotene. Vitamin E use has been associated with increased death rates when used in high doses. This risk was not seen in the AREDS trial.

It is recommended that patients consult their primary care physician prior to taking high-dose vitamin supplements. It is wrong to assume that because a nutrient may have beneficial effects with regard to one disease, the nutrient is harmless. Its use may have negative effects with regard to other disease states, such as those described here, or it may impede the body’s absorption of other important nutrients.

These types of effects are typically not apparent until large, carefully conducted trials in thousands of patients, such as the AREDS trial, are performed.