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TO YOUR GOOD HEALTH #12345_20221202
FOR RELEASE WEEK OF NOV. February 28, 2022 (COL. 5)
BY LINE: By Keith Roach, MD
TITLE: AREDS vitamins have no effect on glaucoma
DEAR DR. ROACH: I am a healthy 72 year old male who was told this week that my eyes had the onset of glaucoma. There is no change in my 20/20 vision yet. In 2014, I underwent cataract surgery in both eyes. Is there any evidence that AREDS 2 Vitamins (Special Eye Vitamins) will do anything to lessen the effects of glaucoma? –RC
ANSWER: Although there are many eye diseases, three of the most important in the elderly are glaucoma, cataracts and age-related macular degeneration. There may be some confusion about what they are.
Glaucoma is a disease of the retina that is usually (but not always) associated with high pressure in the eye. A person can have glaucoma with normal eye pressures, and some people with high eye pressures never have glaucoma. But, we often treat people with high pressures to prevent the development of glaucoma, and we will certainly treat people with glaucoma and normal eye pressures with medication – almost always eye drops to reduce eye pressure. Some people with glaucoma, or those at risk due to eye pressure or anatomy, benefit from laser surgery rather than medication. Ophthalmologists screen for glaucoma through a comprehensive eye exam, including a careful examination of the retina and measuring eye pressure. Vision loss in glaucoma is gradual and often goes unnoticed because it is in peripheral vision. Vitamins have no effect on glaucoma.
Age-related macular degeneration (AMD) is a very different condition. It’s not clear exactly how the disease starts, but it can be “wet” (with abnormal blood vessels) or “dry” (more common, with atrophy of the macula, the part of the retina in the center where our vision is sharpest). AMD is diagnosed by an eye exam. Wet AMD has treatment options, such as injections into the eye of drugs to prevent the growth of abnormal blood vessels. Dry AMD is treated with AREDS or AREDS 2 vitamins which slow the progression of the disease.
You know all about cataracts, having undergone surgery. These are opacities in the lens of the eye, causing progressive cloudiness of vision. If you live long enough, you will develop cataracts. Surgery is the treatment for cataracts.
DEAR DR. ROACH: What type of calcium supplement is best absorbed? How many milligrams do you suggest for a woman in her 60s? — RD
ANSWER: Most calcium supplements sold are either calcium carbonate or calcium citrate, and either is reasonable for people who need calcium supplementation. I prefer dietary calcium when possible: calcium supplements increase the risk of kidney stones, while dietary calcium (dairy products and fish with tiny bones, such as sardines, are excellent sources) decreases the risk of kidney stones. Additionally, some suggest that calcium supplementation may increase the risk of heart disease, and although the evidence is conflicting, calcium from food seems safer to me than calcium supplements.
The standard recommendation is 1,200 mg of elemental calcium per day from a combination of foods and supplements for a woman over 50 or a man over 70. (Read labels carefully: a 1250 mg serving, which may be one or more calcium carbonate tablets, contains 500 mg of elemental calcium.) Calcium carbonate is best absorbed with food, while calcium citrate calcium is well absorbed with or without food. Calcium carbonate is not well absorbed by people taking proton pump inhibitor drugs such as omeprazole (Prilosec).
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Dr Roach regrets that he cannot respond to individual letters, but will incorporate them into the column whenever possible. Readers can send questions to [email protected] or mail to 628 Virginia Dr., Orlando, FL 32803.
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