The Truth About AREDS 2

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Concerns About AREDS 2

AREDS 2 has been widely recognized as the gold standard for supporting eye health, particularly for those at risk of age-related macular degeneration (AMD). However, some experts have raised concerns about the nutrient levels in the PreserVision® AREDS 2 Formula, particularly the high amounts of zinc, vitamin E, and vitamin C.

Zinc

One of the biggest concerns is zinc. The AREDS 2 formula contains 80 mg per day—double the tolerable upper limit of 40 mg recommended by many health organizations. While zinc is essential for eye health, high doses have been linked to urinary issues, with some studies suggesting an increased risk of hospitalization for these problems. Even more concerning, long-term zinc supplementation above 75 mg daily has been associated with nearly doubling the risk of aggressive prostate neoplasms.

Vitamin E

The formula also includes 400 IU of vitamin E per day, but research indicates that such high doses may increase the risk of hemorrhagic stroke. Additionally, findings from the SELECT trial suggest a slight increase in prostate neoplasm risk among men who took vitamin E supplements for seven years—though the effect was relatively minor.

Vitamin C

Vitamin C is another ingredient under scrutiny. The AREDS 2 formula provides 500 mg daily, which sounds beneficial, but some research suggests that long-term high doses might have a pro-oxidant effect on the eye’s lens, potentially increasing the risk of cataracts. In fact, studies on older adults have linked vitamin C supplementation—even at just 500 mg per day—to a higher likelihood of developing cataracts.

The Evolution of AREDS 2

The development of AREDS 2 is a testament to scientific progress in the fight against AMD, a leading cause of vision loss in older adults.

The journey began in the 1990s when the National Eye Institute launched the first Age-Related Eye Disease Study (AREDS). At the time, there were no effective treatments for AMD, putting millions at risk of severe vision loss. Researchers aimed to determine whether specific vitamins and antioxidants could slow the disease’s progression.

By 2001, the study’s results were in, and they were promising. A specific blend of vitamin C (500 mg), vitamin E (400 IU), beta-carotene (15 mg), zinc (80 mg), and copper (2 mg) was found to reduce the risk of advanced AMD by about 25%. These nutrients were chosen for their ability to combat oxidative stress, a key factor in AMD development.

As science advanced, so did the need to refine this formula, leading to the launch of the AREDS 2 study in 2006. Researchers sought to improve upon the original formula by addressing several key concerns.

First, beta-carotene, while effective, was found to increase lung neoplasm risk in smokers. Second, emerging research suggested that omega-3 fatty acids and the carotenoids lutein and zeaxanthin could provide additional eye health benefits. Third, some participants in the original study experienced digestive issues from high zinc levels.

To tackle these issues, AREDS 2 researchers tested several modifications:

• Replacing beta-carotene with lutein (10 mg) and zeaxanthin (2 mg) to determine if they provided similar or superior protection.
• Adding omega-3 fatty acids (350 mg and 650 mg doses) to assess their potential benefits.
• Lowering zinc from 80 mg to 25 mg to see if a reduced dose remained effective while minimizing side effects.

Over five years, the study followed more than 4,000 participants to evaluate these changes.

By 2013, the findings were clear. Replacing beta-carotene with lutein and zeaxanthin was just as effective—if not better—without posing a risk to smokers. Reducing zinc from 80 mg to 25 mg had no impact on effectiveness but could help reduce side effects. However, omega-3 fatty acids, while beneficial for overall health, did not significantly improve AMD outcomes.

Today, the most widely available version of this formula is PreserVision® AREDS 2, which largely adheres to these recommendations. However, one major point of contention remains: the formula still contains 80 mg of zinc rather than the lower 25 mg tested in AREDS 2. While this higher dose reflects the original study’s findings, it continues to be a topic of debate among experts.

How To Improve AREDS 2

Can the AREDS 2 formula be improved? Before diving into that, it’s important to clarify one key point: the health concerns surrounding AREDS 2 nutrients aren’t definitive. Taking these supplements won’t automatically cause issues, but at high doses and over the long term, they may increase certain health risks. If you’re using AREDS 2 for age-related macular degeneration (AMD), chances are you’re taking it consistently for years. That’s why it’s worth considering not just how these nutrients support eye health, but also their impact on overall well-being.

With that in mind, let’s look at a more practical, balanced, and long-term alternative to the standard AREDS 2 formula.

Lutein and Zeaxanthin

Lutein and zeaxanthin are the most important ingredients in the formula. These carotenoids play a crucial role in protecting the eyes, and research suggests that supplementing with them alone may be the most effective long-term strategy. Instead of a full AREDS 2 supplement, a simple, generic lutein and zeaxanthin combo with doses similar to those in the formula is a more affordable and likely sufficient option for most people.

Optional Zinc

Zinc is another key component, but the high dose in AREDS 2—80 mg per day—may not be necessary. While older adults can benefit from some zinc, a more moderate intake of around 20 mg daily is likely enough. This lower dose still supports AMD management while also addressing common age-related zinc deficiencies, which can lead to other health concerns.

No Copper

One common concern is that high doses of zinc can interfere with copper absorption, potentially leading to a rare condition called zinc-induced copper deficiency. However, research shows that this usually only becomes an issue with extremely high zinc intakes—typically between 100 and 300 mg per day. Since a more reasonable daily intake of 20 mg of zinc is unlikely to cause problems, there’s usually no need to supplement with additional copper.

No Vitamins C and E

Vitamins C and E are powerful antioxidants that help protect cells from damage, but supplementing with high doses doesn’t seem to provide additional benefits for most people. In fact, some research suggests that excessive amounts of antioxidants could even be harmful. Unless you have a specific deficiency or medical need, extra vitamin C and E supplementation is probably unnecessary—especially in developed countries where deficiencies are rare.

Summary

For most people, a generic lutein and zeaxanthin supplement, combined with a small amount of zinc for older adults, offers a simpler and more balanced alternative to the full AREDS 2 formula. This approach still provides the core nutrients needed for eye health while avoiding potential long-term risks associated with excessive supplementation.

Overall rating

Rating AREDS 2 by effectiveness for eye health, I’m giving it a B. There is good evidence that the AREDS 2 formula can help with AMD as well as possibly cataracts in some populations.

Rating it by cost, I’m giving it a B. It can be replicated at a cheaper cost, however is decently priced for a combination supplement.

Rating it for safety, I’m giving it a C. Although most ingredients are unlikely to be of much cause for concern, the high dose of zinc may cause some people issues.

Overall rating, I’m giving a B. It’s a good option for those looking to help improve eye health and reduce the risk of AMD. However, there are better alternatives out there.

Top alternatives to AREDS 2

• AREDS 2 – 2 caps / day
• Lutein and zeaxanthin – 1 cap / day
• Zinc citrate – 1 cap / day

Learn more about

• Supplement reviews

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