Zoltan P. Rona
We are in the midst of an epidemic of age-related blindness known as macular degeneration (AMD). Globally, it is the leading cause of permanent vision loss.
According to the Macular Society, 20 million people will have the disease by the year 2040. Already, most estimates are that over 11 million people in North America suffer from AMD. Most of these victims are over the age of 60. And it's not just older adults who will develop AMD but also smokers, those on poor diets with nutrient deficiencies, diabetics, and those on multiple drug prescriptions who do not supplement with the nutrients depleted by their drugs.
Aside from vision loss, some of the early symptoms of AMD include difficulty reading, seeing blank spots and colour changes, and other visual distortions. For those who are experiencing any of these symptoms, an eye specialist can confirm the diagnosis.
AMD is thought to be the direct result of free radical damage to the macula, a small area located at the centre of the retina responsible for fine vision.
The retina and lens of the eye are continuously exposed to oxygen and light radiation. This creates free radicals - volatile molecules with unpaired electrons that can damage the retina leading to AMD. The lens can also be attacked by these free radicals, creating a cataract.
In normal circumstances, the body uses substances called antioxidants to protect itself from free radical damage. Unfortunately, as one ages, fewer and fewer of these antioxidants are produced by the body. And unless one can obtain these antioxidants from the diet or nutritional supplements, eye diseases like cataracts, glaucoma, macular degeneration, and other eye disorders develop.
There are two kinds of AMD. One is called the 'dry' form which is the most common (90%), and the other is the 'wet' form which is more serious and follows the dry form after some time. There is no cure for either form, only prevention. Yes, there are expensive eye injections that could improve macular vision (e.g. Lucentis), but these are not cures. As of 2018, your best bet is to prevent the disease in the first place.
Dietary Strategies for AMD Prevention
AMD prevention involves focusing on a better diet along with vitamins and phytonutrients found in certain fruits and vegetables, herbs, and other natural health products.
Tips For AMD Prevention
1. Provided you are not intolerant of them, eat more legumes which have a cleansing effect due to their high content of sulphur-containing amino acids.
2. Consume more fresh fruits and vegetables, especially yellow vegetables. Berries are wonderful; particularly blueberries because of their high content of anthocyanidins, and cherries because they offer carotenes, flavonoids, and vitamins E and C. Carotenoids are most strongly associated with reduced risk of macular degeneration, especially lutein and zeaxanthin. The best sources are spinach, kale, and collard greens.
3. You are what you absorb. Look to gut health if dietary improvements and nutritional supplementation are not having much of an impact. Do you have malabsorption because of a gluten intolerance? Other food intolerances? Do you have leaky gut syndrome? Do you have fungal overgrowth or dysbiosis? Do you need digestive enzymes? Tests done by a naturopath or alternative medical doctor can reveal these issues so that good progress can be made.
Recommended Nutrients For AMD
* Omega-3 fatty acids (from fish oil) - Omega-3 fatty acids consist of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Studies show that eating fatty fish which are high in these two omega-3 components, at least once a week, cuts the risk of AMD in half. I have found, however, that heavy fish eaters tend to develop high mercury blood levels.
Mercury is a dangerous neurotoxin which itself can cause optic nerve damage. (Fish are not as healthy a food choice as they once used to be.) In my view, Canadian consumers are better off supplementing with either liquid or capsule forms of DHA and EPA because the mercury and other toxins have been removed. An ideal dose is 4,000 mg of combined DHA and EPA daily. Other healthy oils that could be added to the diet include olive oil, coconut oil, ghee, hemp oil, and black seed oil. Avoid trans fats, margarine, corn oil, and canola oil.
* Lutein and Zeaxanthin - These are pigments that give vegetables like spinach their colour. They are fat-soluble carotenoids found in the retina that offer antioxidant protection for the retinal cells.
* Vitamin A - Deficiency of this vitamin causes blindness. The primary source of preformed vitamin A in the diet comes from animal sources. There is no vitamin A to be found in the plant kingdom. In vegans, the body uses zinc to convert carotene into vitamin A. Vegans would be wise to check their blood levels of vitamin A if experiencing eye fatigue, blurred vision, or other visual problems.
* Vitamin D - Low blood levels of vitamin D are associated with a greater incidence of AMD. Most Canadians who do not get enough sunshine exposure, or who do not take a supplement, are at higher risk. Those adults who don't get enough sun, or who use a lot of sunscreen that inhibits skin production of vitamin D, need to supplement between 5,000-10,000 IU daily.
* Green drinks - Most green drinks on the market contain large amounts of various carotenoids coming from algae like spirulina, chlorella, or super blue green algae.
* Astaxanthin - This is one of the most powerful of the carotenoid antioxidants that can cross the blood-brain barrier and protect the macula from free radical damage. Astaxanthin has numerous other anti-inflammatory properties and so it has benefits for a wide range of chronic illnesses.
* Vitamin C - This vitamin is present in the vitreous humour of the eye in concentrations that are 25 times the normal serum level, and at 100 times the serum level in the retina. In other words, the body stores vitamin C in the eye where it is used as an antioxidant to prevent the lens crystallization that causes cataracts. Vitamin C in high doses also decreases raised eye pressures and has been proven to both prevent and even reverse glaucoma.
* Resveratrol - Resveratrol from red wine is a potent antioxidant that can protect all your organs from free radical damage, including the eyes. If you don't drink, use organic grape juice or supplemental capsules. These raise your good cholesterol (HDL) levels, prevent hardening of the arteries and increase longevity. Cheers!
* Melatonin - One recent study showed that taking 3 mg of melatonin daily delays the onset of AMD. We know that melatonin, secreted by the pineal gland, declines as we age. At age 60 or higher, blood levels of melatonin fall to almost zero. Besides having a great impact on sleep, melatonin is a potent antioxidant that can prevent eye damage.
* N-Acetyl-L-Cysteine (NAC) - N-A-C is an amino acid that, in high doses, is converted into glutathione, the body's major antioxidant that protects the retinal cells of the eyes. N-A-C is better known as something that dissolves excess mucous. It helps resolve sinusitis, bronchitis, coughs, and colds, and it will also protect the macula.
* Selenium - This trace mineral works together with N-Acetyl-L-Cysteine to manufacture the important eye antioxidant called glutathione peroxidase.
* Grape seed extract - This is a potent eye antioxidant that can improve eye circulation, reduce inflammation from allergies affecting the eye, and prevent most eye diseases.
* Vitamin E - Vitamin E works synergistically with selenium in antioxidant protection of the eye.
* Zinc citrate - Zinc is important for normal visual signal transduction in the retina. It is also a part of many enzymes involved in vitamin A-dependent light reactions in retinal cells. Several published studies support the use of zinc supplements to help reverse numerous eye disorders including macular degeneration.
When supplementing with zinc, one should also use small amounts of copper (roughly in a ratio of 15:1 zinc:copper). Also, zinc is best absorbed when taking similar amounts of vitamin B6. As well, zinc, copper, and manganese are essential in the manufacture of an enzyme called superoxide dismutase, an antioxidant enzyme that removes dangerous superoxide free radicals in retinal cells.
* Ginkgo biloba extract - Ginkgo has been used primarily in the treatment of cerebral vascular insufficiency, poor memory, depression, impotence, and low energy. Ginkgo improves retinal circulation and has a protective affect against free radicals and thus helps prevent visual loss.
* Bilberry (Vaccinium myrtillus) - This herb is used in Europe for cataracts, macular degeneration, retinitis pigmentosa, and diabetic retinopathy. Bilberry also prevents further damage from glaucoma by working as an antioxidant in the eyes. Its anthocyanidins increase intracellular vitamin C levels (a critical nutrient for healthy eyes), and decrease capillary fragility.
* Quercetin - This is a bioflavonoid found in onions that prevents damage to the fatty tissue in the eyes caused by UV light. It also inhibits histamine release and relaxes smooth muscles in blood vessels. Swelling in the eyelids caused by allergies can be reduced by high dose quercetin supplementation.
* Rutin - This is another bioflavonoid with benefits for optimal vision because it strengthens and improves the integrity of collagen, a substance important in preventing glaucoma. Eye pressures have been found to be optimized by rutin supplementation.
* Eyebright - Eyebright is a traditional herbal remedy used for centuries for successful treatment of inflammation (conjunctivitis), bloodshot eyes, and numerous other eye infirmities. Its ingredients are considered anti-inflammatory and its use is without side effects.
* Taurine - This is the most abundant amino acid in the eye. It modulates photoreceptor activity and is crucial for normal vision. Taurine also has blood pressure-lowering effects, as well as improving abnormal ear noises (tinnitus). Epilepsy and gallstone production can also be treated successfully with taurine.
Even the most conservative of eye specialists now recommend assorted eye formulas containing at least a few of the above-named nutrients to both prevent and treat AMD. Ophthalmologists will gladly prescribe Big Pharma brands of these nutrients but I'm recommending natural health food brands instead. This is because most health food brands do not contain harmful additives, and have more nutrients than the Big Pharma varieties.
Remember that all drugs deplete nutrients, and if you are on medication you might need far greater nutrient supplementation than a person who is not on prescription drugs.
There are many combination vision support products containing some or all of these nutrients in one pill, available at most health food stores. None of these natural supplements have any serious side effects, beyond greater longevity, but if you have any other health concerns check with your natural health care provider for drug-nutrient interactions.
The writer is a doctor
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