Comparison of vitamin/mineral supplements.
We recommended last time that Anna, our patient with AMD, take the vitamin and mineral supplements that were used in the Age-Related Eye Disease Study (AREDS). Patients in the AREDS took a total of: vitamin C 500mg; vitamin E 400 international units; beta-carotene 15mg (which is about 25,000 international units); zinc as zinc oxide 80 milligrams; and copper 2 milligrams every day. We know that the progression of AMD was reduced with these doses.
So we tell our patients to take those supplements and they traipse off to their local store. We checked out what was available on the internet and at our local Wal-Mart. The following products, (with their monthly cost in parenthesis) have close to the doses used in the AREDS: Visivite® ($13.95 on the internet); Viteyes® ($26.63 on the internet); Ocuvite Preservision Gel Tabs® ($13.98 at Wal-Mart); ICAPS® ($14.60 at Wal-Mart).
Now for something that is cheap but is not worth it. Wal-Mart markets Equate Vision Formula® which costs only $4.97 for 120 tabs. The bottle says to take one or two pills daily. Even if you take two pills a day you would only get 2000 IU of beta-carotene or 8% of the dose used in AREDS and 30% of the dose of Vitamin E. You would have to take 25 Equate® pills to get the AREDS dose of beta-carotene and then would give you high and probably toxic doses of vitamin C, zinc, and vitamin E. Conclusion? Don’t use Equate Vision Formula®. I hope I don’t find a horse head in my bed.
There are supplements advertised by Paul Harvey. He has various products that contain close to the AREDS doses along with a lot of other supplements of dubious value like bilberry, selenium, and chromium. They cost $44.95 for a 25 day supply. We will discuss in an upcoming blog the evidence, or lack thereof, for bilberry and selenium.
Some patients have heard about lutein which is one of the pigments in the macula and will be a subject in the next blog. There is ICAPS® with lutein but the beta-carotene dose is a measly 6,600 IU. Apparently the chemists thought the lutein would make up for the beta-carotene but there is no evidence for this. Even worse perhaps the Preservision® with lutein contains no beta-carotene at all. I would avoid these products.
Please also be aware of vitamins that state they contain 100% of the minimum daily requirements which are: vitamin C 60mg, beta-carotene 5000 IU; vitamin E 30 IU; and zinc 15mg. These doses are far below that used in AREDS. Patients with AMD may need far more than the 100% daily requirements.
I am not paid by any of these companies. I would recommend Alcon’s ICAPS® (the one without lutein) or Bausch and Lomb’s Preservision Gel Tabs® also without lutein. Both of these companies are reputable and their cost is equal to the others. Patients especially like the Preservision Gel Tabs®. They are easy to swallow and the patients need to only take two of them a day. If you want to take lutein, I would take 2-4 mg of it daily in a separate pill. Or eat a lot of highly colored fruits and vegetables.
Please come back because we have just scratched the surface.
So we tell our patients to take those supplements and they traipse off to their local store. We checked out what was available on the internet and at our local Wal-Mart. The following products, (with their monthly cost in parenthesis) have close to the doses used in the AREDS: Visivite® ($13.95 on the internet); Viteyes® ($26.63 on the internet); Ocuvite Preservision Gel Tabs® ($13.98 at Wal-Mart); ICAPS® ($14.60 at Wal-Mart).
Now for something that is cheap but is not worth it. Wal-Mart markets Equate Vision Formula® which costs only $4.97 for 120 tabs. The bottle says to take one or two pills daily. Even if you take two pills a day you would only get 2000 IU of beta-carotene or 8% of the dose used in AREDS and 30% of the dose of Vitamin E. You would have to take 25 Equate® pills to get the AREDS dose of beta-carotene and then would give you high and probably toxic doses of vitamin C, zinc, and vitamin E. Conclusion? Don’t use Equate Vision Formula®. I hope I don’t find a horse head in my bed.
There are supplements advertised by Paul Harvey. He has various products that contain close to the AREDS doses along with a lot of other supplements of dubious value like bilberry, selenium, and chromium. They cost $44.95 for a 25 day supply. We will discuss in an upcoming blog the evidence, or lack thereof, for bilberry and selenium.
Some patients have heard about lutein which is one of the pigments in the macula and will be a subject in the next blog. There is ICAPS® with lutein but the beta-carotene dose is a measly 6,600 IU. Apparently the chemists thought the lutein would make up for the beta-carotene but there is no evidence for this. Even worse perhaps the Preservision® with lutein contains no beta-carotene at all. I would avoid these products.
Please also be aware of vitamins that state they contain 100% of the minimum daily requirements which are: vitamin C 60mg, beta-carotene 5000 IU; vitamin E 30 IU; and zinc 15mg. These doses are far below that used in AREDS. Patients with AMD may need far more than the 100% daily requirements.
I am not paid by any of these companies. I would recommend Alcon’s ICAPS® (the one without lutein) or Bausch and Lomb’s Preservision Gel Tabs® also without lutein. Both of these companies are reputable and their cost is equal to the others. Patients especially like the Preservision Gel Tabs®. They are easy to swallow and the patients need to only take two of them a day. If you want to take lutein, I would take 2-4 mg of it daily in a separate pill. Or eat a lot of highly colored fruits and vegetables.
Please come back because we have just scratched the surface.
posted by James C. Folk, M.D. at 5:58 PM
3 Comments:
There is a reason why ICAPS comes in a dosage with low dosages of
Vitamin A. Smokers who ingest large doses of Vitamin A have increased incidence of lung cancer. Therefore, knowing some patients with ARMD also smoke, there is a supplement without the large doses of Vitamin A. We all know, 'tis better not to smoke with ARMD...
Will any of these supplements have any impact on the course of adult vitelliform macular dystrophy and/or vitreous detachment?
They won't have any effect on a vitreous detachment. We don't know about vitelliform macular dystrophy but I would recommend at least a daily multivitamin for it. Some cases of AMD are misdiagnoses as vitelliform macular dystrophy however, so in that case, I would recommend the AREDS vitamins. James C Folk, MD
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