AMD Vitamins: AREDS2 Evidence and Who Should Take Them

If you’ve been told you have age-related macular degeneration (AMD), you might be wondering if taking vitamins can actually help. The answer isn’t simple - it depends on how far the disease has progressed. Not everyone with vision changes needs these supplements. And for some, taking them could be useless - or even risky. The science is clear: AREDS2 is a specific vitamin formula backed by over two decades of research, but it’s only for a very specific group of people.

What Is AREDS2, Really?

The AREDS2 formula isn’t just any eye vitamin. It’s the result of a massive, 10-year clinical trial led by the National Eye Institute (NEI) that followed nearly 4,000 people with AMD. The study didn’t just test one supplement - it compared multiple versions to find the safest and most effective one.

The original AREDS formula, from 2001, included high doses of vitamin C, vitamin E, beta carotene, zinc, and copper. It cut the risk of AMD worsening by 25% in people with intermediate disease. But then researchers found a problem: beta carotene raised the risk of lung cancer in former and current smokers. That’s when the AREDS2 study was launched - to fix that flaw.

The updated formula replaced beta carotene with two nutrients found in leafy greens: lutein and zeaxanthin. These are carotenoids that naturally collect in the macula - the part of the eye that gives you sharp central vision. They act like internal sunglasses, filtering out harmful blue light and reducing oxidative stress.

The final AREDS2 recipe is precise:

• 500 mg vitamin C
• 400 IU vitamin E
• 10 mg lutein
• 2 mg zeaxanthin
• 80 mg zinc (as zinc oxide)
• 2 mg copper (as cupric oxide)

Copper is included because high zinc levels can lower copper in the body. This isn’t a multivitamin. It’s a targeted, high-dose medical formula. You can’t get this from food or regular supplements.

Who Should Take AREDS2 Vitamins?

This is where most people get it wrong. AREDS2 isn’t for everyone with blurry vision or age-related eye changes. It’s only for two specific groups:

1. People with intermediate AMD in one or both eyes - that means many medium-sized drusen (yellow deposits under the retina) or at least one large drusen.
2. People with advanced AMD (geographic atrophy) in one eye, and intermediate AMD in the other.

If you only have small drusen - what’s called early AMD - taking AREDS2 won’t help. It won’t prevent the disease from starting. It won’t improve your vision. And it won’t slow anything down. The same goes for people with no AMD at all. A 2023 analysis from Vision-and-Eye-Health.com put it plainly: "The AREDS2 formula does not offer benefits for individuals with early AMD, nor does it prevent the onset of the condition."

Even more surprising: omega-3 fatty acids (like fish oil) were tested in AREDS2. They showed no benefit at all. So if your supplement includes fish oil, you’re paying extra for something science says doesn’t work for AMD.

New Evidence: AREDS2 Might Help Late-Stage AMD Too

For years, doctors said AREDS2 only worked to delay progression from intermediate to advanced AMD. But new data from July 2024 changes that.

Researchers reviewed retinal scans from 1,209 people in the original AREDS2 trial who had advanced dry AMD - specifically, geographic atrophy (GA). They found that those who took the AREDS2 formula had their disease progress 55% slower over three years - if the damaged area was outside the very center of the macula (the fovea).

This is huge. For people with late-stage dry AMD, vision loss is often permanent. Slowing progression by over half means they might keep useful vision longer - enough to drive, read, or live independently. As Geraldine Hoad from the Macular Society said, "Until now AREDS2 supplements weren’t thought to be effective for those with late-stage dry AMD. By slowing vision loss, they could help people stay independent longer and improve their quality of life."

But here’s the catch: this finding is still from retrospective data. It hasn’t been confirmed in a new, dedicated trial. So while it’s promising, it’s not yet official guidelines. Still, many eye specialists are now considering AREDS2 for this group - especially if the atrophy isn’t centered in the fovea.

What AREDS2 Can’t Do

It’s just as important to know what these vitamins won’t do.

• They won’t restore lost vision. Dr. Emily Chew, who led the 10-year follow-up, says clearly: "AREDS supplements cannot reverse vision damage that has already occurred."
• They won’t prevent AMD. If you’re in your 50s with perfect vision and no drusen, taking AREDS2 won’t stop you from getting it later.
• They won’t help if you have wet AMD. AREDS2 is only for the dry form. Wet AMD needs injections, not vitamins.
• They won’t work if you don’t take them daily. In the study, 91% of participants reported taking their pills every day. That’s how you get the benefit.

Also, don’t confuse AREDS2 with other "eye health" supplements. Many brands add ingredients like astaxanthin, bilberry, or ginkgo. None of these are in the AREDS2 formula. And none have the same level of evidence. Stick to the exact dosages - no more, no less.

Is It Safe Long-Term?

The 10-year follow-up of AREDS2 participants found no major safety issues. Zinc can cause stomach upset in some people, and high doses may interfere with copper or iron absorption. That’s why copper is included. But overall, the formula held up well over a decade.

People with certain conditions should talk to their doctor first:

• If you have kidney disease - high zinc may not be safe.
• If you’re on blood thinners - vitamin E can interact with them.
• If you’re a smoker - avoid any supplement with beta carotene. Stick to lutein and zeaxanthin only.

Always check with your eye doctor before starting. They’ll confirm your AMD stage and rule out other causes of vision changes.

What About Diet?

While AREDS2 supplements are powerful, they’re not a replacement for food. People who ate more leafy greens, eggs, and orange peppers - foods rich in lutein and zeaxanthin - had the greatest benefit from the supplement. That’s because the body absorbs these nutrients better when they come from both food and pills.

Try adding:

• Kale, spinach, collards
• Broccoli and peas
• Eggs (the yolk has zeaxanthin)
• Orange peppers and corn

Even if you’re taking AREDS2, eating these foods supports overall eye health - and your whole body.

Bottom Line

AREDS2 vitamins are one of the few treatments in eye care with solid, long-term evidence. But they’re not magic. They’re a targeted tool for a specific stage of a specific disease.

If you have intermediate AMD - or advanced AMD in one eye with intermediate in the other - talk to your eye doctor about starting AREDS2. Take it every day. Stick to the exact formula. Don’t switch brands unless they match these exact numbers.

If you have early AMD, or no AMD at all - skip it. You’re not helping yourself. You’re just spending money on something science says won’t work.

And if you’re worried about your vision, get a full eye exam. Don’t guess. Don’t self-diagnose. The right diagnosis is the first step to the right treatment.