AREDS2 Alternatives: What to Take Instead, and When
"Most people asking this question are really asking a different one - whether they needed the AREDS formula in the first place." - Dr. Elena Markovic
1. First, Work Out Which Question You Are Asking
"What else can I take instead of AREDS2?" turns out to be three questions wearing the same coat.
"My doctor prescribed it and I can't tolerate it." A tolerability problem. Usually the zinc. There are real options and they start with a phone call, not a purchase.
"I bought it myself as a precaution and I'm wondering if it's right." A fit problem - and the most common one. The answer here surprises most people.
"I want something that does more than AREDS2 does." A formulation question, and the one where you have to be careful about what "more" means. A side-by-side of the two clinical formulas is in our AREDS2 versus AREDS3 comparison.
2. If Your Doctor Prescribed It
This needs saying plainly. The AREDS2 formula is the only eye supplement combination with large randomised trial data behind it for slowing macular degeneration in people who already have it at a certain stage.
Nothing else on the shelf has that, including ours.
If an eye doctor put you on AREDS2 for intermediate AMD in one or both eyes, or for late AMD in one eye, do not replace it on the strength of an article - any article, this one included.
What you can do is take the tolerability problem back to them. Two things are worth raising:
The zinc dose. AREDS2 compared 80 mg against 25 mg and found no difference in results between them.
The National Eye Institute still publishes 80 mg, because that comparison had no placebo group - but the lower dose is a legitimate conversation, and PreserVision AREDS3 now sells the AREDS2 nutrients at 25 mg. We go through that trade-off in detail in our guide to AREDS2 without the high zinc dose.
The zinc form. Most AREDS products use zinc oxide, which is poorly absorbed and more likely to cause stomach upset than zinc citrate. Same element, different behaviour.
A supplement you stop taking protects nothing. That is the argument to make at your appointment.
3. If You Bought It Yourself
Most people taking an AREDS formula were never prescribed it. They saw it in a pharmacy, recognised the name, and reasonably concluded that the most-recommended eye vitamin was a sensible precaution.
The National Eye Institute addresses this directly, and its wording is worth reading twice.
That is the National Eye Institute, on its own website, about its own formula.
AREDS was built as a clinical intervention for a defined group of patients. If you are not in that group, the 80 mg of zinc and the 500 mg of vitamin C are not doing the preventive job the pack implies.
This does not mean carotenoids stop mattering when you do not have a diagnosis. It means the AREDS dose structure was designed around a different question.
4. If You Want a Formula Built Around Macular Pigment
Here the useful comparison is not brand against brand. It is: what is this formula actually built to do?
AREDS2 and AREDS3 are built around a specific clinical trial protocol. A macular pigment formula is built around the three carotenoids your macula concentrates - lutein, zeaxanthin and meso-zeaxanthin - and how much of each actually reaches the centre of your vision.
Meso-zeaxanthin is the one that separates the categories. It is not in AREDS2 or AREDS3.
It is the carotenoid your body concentrates at the very centre of the macula, the part you use to read a label or recognise a face at a distance. Your retina makes it from lutein - except that for roughly one in five people, that conversion does not raise macular pigment at all.
Those people are called retinal non-responders, and the bottleneck is in the retina rather than in absorption: their blood levels of lutein are usually perfectly good. Taking meso-zeaxanthin directly skips the step.
In the CREST trial, supplementing all three carotenoids together improved contrast sensitivity over twelve months in people free of retinal disease - how well you distinguish edges in poor light, which is what most people mean when they say driving at night has got harder.
5. What to Check on Any Label Before You Switch
| Check | Why it matters |
|---|---|
| Does it contain meso-zeaxanthin, and how much? | The third macular carotenoid, absent from every AREDS formula. Some products list it and some list only lutein and zeaxanthin. |
| Zinc: how much, and which form? | 80 mg oxide is the AREDS dose and the usual source of stomach complaints. 25 mg citrate is gentler. Either is defensible; the label should tell you which you are getting. |
| Is copper in there alongside the zinc? | Every AREDS formula includes 2 mg of copper next to the zinc. A high-zinc product without copper is a gap. |
| Are the carotenoid amounts the actives or the extract weights? | "Lutein 5% extract, 10 mg" and "lutein 10 mg" are very different things. If a label is ambiguous, ask the company. |
| Does it claim to treat or prevent macular degeneration? | No supplement can legally make that claim, and a brand that does is telling you something about itself. |
- Why it matters
- The third macular carotenoid, absent from every AREDS formula. Some products list it and some list only lutein and zeaxanthin.
- Why it matters
- 80 mg oxide is the AREDS dose and the usual source of stomach complaints. 25 mg citrate is gentler. Either is defensible; the label should tell you which you are getting.
- Why it matters
- Every AREDS formula includes 2 mg of copper next to the zinc. A high-zinc product without copper is a gap.
- Why it matters
- "Lutein 5% extract, 10 mg" and "lutein 10 mg" are very different things. If a label is ambiguous, ask the company.
- Why it matters
- No supplement can legally make that claim, and a brand that does is telling you something about itself.
7. References
- Age-Related Eye Disease Study 2 Research Group. JAMA. 2013;309(19):2005-2015.
- National Eye Institute. AREDS/AREDS2 Frequently Asked Questions.
- National Eye Institute. Nutritional Supplements for Age-Related Macular Degeneration.
- Nolan JM, et al. CREST Report 1. Invest Ophthalmol Vis Sci. 2016;57(7):3429-3439.
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About the author
Neuro-ophthalmology, 20+ years in clinical practice
Dr. Markovic reviews every Klaris article for medical accuracy. Her clinical focus is age-related vision change, macular pigment and the nutrition behind both. Read Dr. Markovic’s full profile.