AREDS vs AREDS2: What Changed and Which Formula Should You Take?
Written by Dr. Louis Michaelos, Ophthalmologist & Founder, MacuRest | Last reviewed May 2026
Take AREDS2, not the original AREDS formula. The original used beta-carotene, which increases lung cancer risk in smokers. AREDS2 replaced it with lutein 10mg and zeaxanthin 2mg, performs at least as well clinically, and is the formula the American Academy of Ophthalmology recommends today.
AREDS vs AREDS2: What Are the Differences?
The two formulas come from two separate National Eye Institute clinical trials conducted decades apart. The core difference is one ingredient: beta-carotene was removed from the original AREDS formula and replaced with lutein and zeaxanthin in AREDS2. Every other ingredient — vitamin C, vitamin E, zinc, and copper — remained unchanged.
What Was the Original AREDS Formula?
The Age-Related Eye Disease Study (National Eye Institute), conducted 1992–2001, enrolled over 4,700 participants. It found a specific antioxidant and zinc formula reduced the risk of advanced AMD by approximately 25% in participants with intermediate or advanced disease. The original formula: Beta-carotene 15mg, Vitamin C 500mg, Vitamin E 400 IU, Zinc 80mg, Copper 2mg.
Why Was Beta-Carotene Removed in AREDS2?
Two problems emerged. First, the AREDS trial's own data showed beta-carotene increased lung cancer risk in current or former smokers — published in JAMA (PubMed). Second, subsequent research established that lutein and zeaxanthin are the primary carotenoids in the macular pigment and far more biologically relevant to macular protection than beta-carotene, which does not concentrate in the macula.
What Is the Difference Between AREDS2 and AREDS3?
AREDS3 is an ongoing clinical trial — not a completed study. PreserVision and other manufacturers have released "AREDS3-inspired" formulations adding B vitamins (B6, folic acid, B12) and omega-3 fatty acids. However, the AREDS3 trial has not published final results showing these additions improve AMD outcomes beyond AREDS2. The American Academy of Ophthalmology continues to recommend the AREDS2 formula. AREDS3 products are not inferior — they simply don’t yet have the same evidence base.
The Full Formula Comparison
| Nutrient | Original AREDS | AREDS2 | AREDS3 (in development) |
|---|---|---|---|
| Beta-carotene | 15mg ⚠️ | Removed | Removed |
| Lutein | Not included | 10mg ✅ | 10mg |
| Zeaxanthin | Not included | 2mg ✅ | 2mg |
| Vitamin C | 500mg | 500mg | 500mg |
| Vitamin E | 400 IU | 400 IU | 400 IU |
| Zinc | 80mg | 80mg | 80mg |
| Copper | 2mg | 2mg | 2mg |
| B vitamins + omega-3 | No | No | Added (evidence pending) |
Which Formula Should You Take?
The AAO recommends the AREDS2 formula — not the original AREDS. If you are taking a supplement with beta-carotene, review with your ophthalmologist, especially if you smoke or have ever smoked. MacuRest follows the full AREDS2 formula — no beta-carotene, lutein and zeaxanthin at clinical doses — formulated for evening use with melatonin for overnight retinal repair support.
Related: PreserVision vs MacuRest | AREDS2 vs standalone lutein | Should I take AREDS2? Take the quiz
Frequently Asked Questions
What is the difference between AREDS and AREDS2?
The primary difference is the removal of beta-carotene and its replacement with lutein 10mg and zeaxanthin 2mg. Beta-carotene increased lung cancer risk in smokers and doesn’t concentrate in the macula. Lutein and zeaxanthin are the primary carotenoids in macular pigment and are far more biologically relevant to macular protection. All other ingredients — vitamins C and E, zinc, copper — are identical.
What is the difference between AREDS2 and AREDS3?
AREDS3 is an ongoing clinical trial testing whether adding B vitamins and omega-3 fatty acids improves on the AREDS2 results. Final results are not yet published. The AAO continues to recommend the AREDS2 formula. AREDS3-branded products add these ingredients without yet having the same level of clinical validation as the original six-nutrient AREDS2 formula.
Is AREDS the same as AREDS2?
No. AREDS used beta-carotene as its carotenoid; AREDS2 replaced it with lutein and zeaxanthin. The original AREDS formula is not recommended for current or former smokers due to beta-carotene's lung cancer risk. If your supplement contains beta-carotene and you smoke, speak with your ophthalmologist about switching to an AREDS2 formula.
Which is better — AREDS or AREDS2?
AREDS2 is preferred by the AAO for all patients because it performs at least as well as the original, is safe for smokers, and uses lutein and zeaxanthin which are more biologically appropriate for the macula. There is no reason to take the original AREDS formula over AREDS2 today.
Does AREDS2 work for wet AMD?
The AREDS2 trial enrolled patients with intermediate AMD or advanced AMD in one eye and found a 25% reduction in progression risk. For patients with active neovascular (wet) AMD, anti-VEGF injections remain the primary treatment. AREDS2 supplementation is typically continued alongside anti-VEGF treatment to protect the fellow eye.
These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.