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If I’m taking AREDS 2 vitamins for Macular Degeneration should I take a multivitamin too?

Dry Macular Degeneration
High levels of antioxidants and zinc significantly reduce the risk of advanced age-related macular degeneration (AMD) and its associated vision loss. Researchers found that people at high risk of developing advanced stages of AMD, a leading cause of vision loss, lowered their risk up to 26% when taking vitamins which contained:

500 milligrams vitamin C

400 international units of vitamin E

10 milligrams lutein

2 milligrams zeaxanthin

80 milligrams zinc

2 mg copper

This dosage of vitamins and minerals is now frequently referred to as the AREDS 2 (for Age Related Eye Disease Study 2) formula and most people at high risk for vision loss from macular degeneration should be on this formula.1

There is some concern however with this formula if you add additional vitamins to it. Especially additional Vitamin E and Zinc

Vitamin E

The level of vitamin E in the AREDS 2 formula is fairly high and although in the study it was shown to be a safe dosage, additional vitamin E may lead to some unwanted side effects.

One analysis found an increased risk of death at doses over 400 IU/day. 2

Another study showed dosages over 400 IU/day may harm adult men in the general population by increasing their risk of prostate cancer.3

Vitamin E can inhibit platelet aggregation and antagonize vitamin K-dependent clotting factors. As a result, taking large doses with anticoagulant or antiplatelet medications, such as warfarin (Coumadin®), can increase the risk of bleeding, especially in conjunction with low vitamin K intake. The amounts of supplemental vitamin E needed to produce clinically significant effects are unknown but probably exceed 400 IU/day.


The doses of zinc used in the AREDS study (80 mg per day of zinc in the form of zinc oxide for 6.3 years, on average) have been associated with a significant increase in hospitalizations for genitourinary causes, raising the possibility that chronically high intakes of zinc adversely affect some aspects of urinary physiology.4

Therefore, total daily supplement of Zinc should probably not exceed the 80MG per day that is in the AREDS 2 formula.


Centrum Silver, one of leading multivitamin supplements, if taken along with the AREDS 2 formula vitamins would add another 50IU of vitamin E and an additional 11 mg od Zinc. Since the AREDS 2 formula already has close to what many consider the daily highest safe dosage of those two ingredients you need to be cautious about adding more to that.

The AREDS 2 formula alone does not provide many of the other vitamins that many people want such as Vitamin D and the B vitamins.  If you want to take those supplements also we recommend you take them without taking additional vitamin E or Zinc. 

In order to accomplish that you need to either buy the other vitamins individually or consider taking an AREDS 2 formula vitamin that is combined with a multivitamin without adding more vitamin E or Zinc.  To accomplish that we recommend utilizing Macular Protect Complete from Science Based Health.  This all in one product assures that you are getting the full AREDS 2 formula without risking the potential toxicity of additional E and Zinc.

1)    The Age-Related Eye Disease Study 2 (AREDS2) Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA 2013;309:2005-15. [PubMed abstract]

2)    Miller ER 3rd, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med 2005;142:37-46. [PubMed abstract]

3)    Klein EA, Thompson Jr. IM, Tangen CM, Crowley JJ, Lucia MS, Goodman PJ, et al. Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA 2011;306:1549-1556. [PubMed abstract].

4)    Johnson AR, Munoz A, Gottlieb JL, Jarrard DF. High dose zinc increases hospital admissions due to genitourinary complications. J Urol 2007;177:639-43. [PubMed abstract]

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Friday, 21 January 2022

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