by Marc R. Rose
Transplanting Retinal Cells
Some exciting work is being done with transplantation of healthy retinal cells to replace damaged ones. This procedure may be available to people with macular diseases at some time in the next few years, although it’s too early to tell whether retinal cell transplantation will be the long-sought cure for macular degeneration. In the meantime, there’s plenty you can do to maintain your remaining vision.
Lasers, radiation, and anti-angiogenesis drugs are used to treat the wet form of macular degeneration. This severe form, which can rapidly cause blindness, sometimes calls for drastic treatment measures. This is the reason we strongly recommend that you implement the lifestyle and nutritional changes suggested in this book to help you prevent the transformation from dry to wet macular degeneration. Other therapies are recommended only when all else has failed to help.
Nutritional Prescription for Macular Degeneration
Vitamin C and Bioflavonoids
Taking extra vitamin C when you have the dry form of macular degeneration helps prevent broken blood vessels and new blood vessel growth across the macula.
Bioflavonoids, which are packaged with vitamin C in nature and enhance the action of vitamin C, are found in colorful fruits such as berries, lemons, grapes, plums, black currants, grapefruit, apricots, and cherries. Rose hips are a popular source of bioflavonoids used in vitamin C supplements.
Essential for proper absorption and use of vitamin C, bioflavonoids assist in maintaining the intercellular glue (collagen) that strengthens connective tissue throughout the body. They have antioxidant powers and are essential for strong blood vessels. As supplements, you can buy quercetin or extract of ginkgo biloba, bilberry, grapeseed, or cranberry. Bilberry specifically goes to the eyes and improves night vision.
Daily dosage: at least 2,000 mg of vitamin C, and 200–400 mg of bioflavonoids
Beta-carotene and Vitamin A
It pays to load up on beta-carotene, which is harmless in high doses as long as it’s taken with vitamin E. I recommend you also take vitamin A, in case your body isn’t converting the beta-carotene properly.
Daily dosage: beta-carotene, 15,000–25,000 IU
Daily dosage: vitamin A, 10,000–25,000 IU (no more than 10,000 if you are pregnant or could become pregnant)
Lutein and Zeaxanthin
Within the nerve layer of the eye, these protective yellow carotenoid pigments work as a blue-light sun filter for the central retina. Until recently, the importance of lutein was largely overlooked by researchers. A study published in the Journal of the American Medical Association showed that adults who regularly consume spinach and collard greens are much less likely to have macular degeneration. Since the three highest-risk groups for macular degeneration—smokers, postmenopausal women, and adults with light-colored eyes—all have half as much lutein and zeaxanthin at the back of their eyes, it’s assumed that these pigments have something to do with the disease.
A few weeks after consuming more lutein-rich foods or lutein supplements, some normal-sighted people report less glare, improved color vision, and sharper vision.
Whether you’re eating lutein-rich foods or using the supplements, try not to do so at the same meal during which you’re taking a beta-carotene supplement or eating beta-carotene-rich foods. They compete for absorption in the digestive tract and for transport on cholesterol particles from the liver to the eye.
Spinach, collard greens, and kale are good food sources. Supplements are derived from marigold flower petals.
Daily dosage: 6–10 mg of lutein, 0.3–1 mg of zeaxanthin
Magnesium
This important mineral works as a natural chelator by playing a key role in the absorption and metabolism of calcium. It is essential to the proper functioning of the heart, and acts as a co-factor for hundreds of biochemical actions in the body. It aids blood flow to the eyes by maintaining proper fluid balance in the cells and reducing muscle spasms.
Daily dosage: 300–500 mg at bedtime
Cold-water Fish and Fish Oils
A serving of cold-water fish such as salmon, tuna, cod, mackerel, or sardines is rich in vitamins A and D. The vitamin A found in these fish is absorbed and used by the body more easily than beta-carotene. Excess is stored in the liver and can be accessed when the eyes need to make more of the visual pigment needed for sight. The consequences of vitamin A and beta-carotene deficiency are seen commonly in developing countries. The rate of blindness in children is much higher, and adults suffer more from an eye disease known as keratomalacia, which begins with night blindness and progresses to blindness.
Fish oils are also superior sources of the essential oils known as omega-3 fatty acids. These fatty acids have been studied extensively for their positive effects on cardiovascular diseases and related problems.
Decreased blood clotting is a proven benefit gained by people who eat plenty of fish. Anything that helps keep blood vessels clear helps keep macular degeneration from progressing. Diets deficient in omega-3 oils have been shown to result in visual impairment in animal studies.
Because omega-3 oils are unsaturated, they easily can become rancid, which is the down side of taking them in supplement form. If they are rancid, they will do you more harm than good. Our preference is that you eat cold-water fish at least twice a week, but if you absolutely can’t stand fish, go ahead and take a supplement. Look for a brand that specifies that the oil has been preserved in some way, then break open a capsule and smell it to be sure it’s not rancid. Take the capsules with meals. If you’re burping up fish oil, a truly unpleasant experience, that may be an indication that the supplements are rancid or you’re taking too much.
Daily dosage: Follow the directions on the container
Vitamin E
Taking vitamin E every day will keep oxidation at bay and keep blood vessels to the eyes healthy. Alpha tocopherol, a form of vitamin E, is found distributed across the retina; where it is sparse is where the early signs of macular degeneration occur.
Daily dosage: 800 IU
Selenium
Selenium is a component of glutathione peroxidase, which protects cell membranes from oxidation. It also has potent antiviral effects.
Daily dosage: at least 200 mcg
N-acetyl cysteine (NAC)
Take this to keep your glutathione levels high.
Daily dosage: 500 mg, 2–3 times
Taurine
This amino acid is important to good eye and blood vessel health.
Daily dosage: 500–2,000 mg between meals
Garlic
This flavorful bulb will keep blood from clotting, raise HDL, and lower LDL. If you don’t include fresh, raw garlic (the best kind) in your food on a near-daily basis because you don’t like the odor, try odorless garlic capsules. If you like the flavor and don’t mind the odor, use it plentifully. It’s also high in sulfur, which will encourage the production of glutathione.
Daily dosage: about 1,000 mg of the odorless capsules
Zinc
This helps release vitamin A from the liver.
Daily dosage: 15–30 mg if your multivitamin is low in zinc
Coenzyme Q10
This powerful antioxidant will energize the heart and improve circulation.
Daily dosage: 30–200 mg
Hydrochloric Acid
If you don’t have enough stomach acid (see Chapter 9 on digestion), a supplement can help.
Daily dosage: 250 mg beta hydrochloride, with meals
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IN SHORT…
1. Age-related macular degeneration is the most common cause of legal blindness in Americans over the age of fifty.
2. While central vision can deteriorate badly, those with macular degeneration do not go completely blind. They maintain some peripheral vision, no matter how advanced the disease.
3. If you are over sixty-five, have light-colored eyes with little protective melanin pigment, often have been exposed to sunlight without protective eyewe
ar, are or have been a smoker, or are a postmenopausal female, you are at greater risk for this disease than the general population.
4. Symptoms include decreased night vision, trouble making the adjustment from light to dark environments, difficulty recognizing faces, and difficulty reading, writing, and driving. Objects that should be straight will appear to have a bend in the middle. Your ophthalmologist can make a diagnosis using an Amsler grid and by checking for drusen (age spots) on the back of the eye.
5. The dry form of macular degeneration is the most common and is best controlled by diet and supplements. In this form, there is some deterioration of retinal cells, but no hemorrhage or growth of new blood vessels. Vision loss may be minimal if the progression from the dry to the wet form is stopped by using the advice in these pages. The wet form involves leakage of blood into the vitreous humor that fills the eyeball and also the growth of new blood vessels across the retina.
6. Lasers, interferon, and thalidomide are the mainstream treatments of choice. These are used only in treatment of the wet form of the disease and don’t often have good results. Retinal cell transplants may be possible in the next few years.
7. A summary of the nutritional “Rx” for macular degeneration can be found in Appendix I at the end of this book.
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5
Preventing and Healing Glaucoma
Nicknamed “the sneak thief of sight,” glaucoma is the most common cause of blindness in the United States. It is especially insidious because it can progress to an advanced stage before sight is lost. Except for one rare type of glaucoma, there is no sensation of pain as it encroaches upon the delicate optic nerve. Because it is side vision that is affected, glaucoma often goes unnoticed until a significant amount of vision is lost. Even eye doctors have trouble making a diagnosis of this disease.
Glaucoma is most often a disease associated with aging. According to the National Society for the Prevention of Blindness, as many as three out of one hundred Americans over age sixty-five have glaucoma. You are at a higher risk for glaucoma if you have diabetes or a family history of glaucoma.
There are several kinds of glaucoma. All of them involve damage to the optic nerve, the passageway for visual information into the brain. How the damage comes about results in the differences between them.
Within your eyeballs is a fluid called the aqueous humor that gives the eyeball its shape and resiliency. Your eyes make this fluid, and there is a fluid drain within the eye so that any excess can be removed. Just as blood pressure fluctuates depending on activity, diet, and emotions, so does the fluid pressure within the eyes. It’s all controlled by a delicate regulatory system. If this system gets out of balance, eye pressure can be elevated chronically, just as blood pressure can. Under this pressure the optic nerve is literally squashed by the pressure of the aqueous humor around it. Increased pressure on the optic nerve results in death of its cells from the outside in towards the center. The gradual deterioration of vision creates tunnel vision—the opposite of what happens in macular degeneration.
Diagnosing Glaucoma
While glaucoma has been intensely studied, it has been very difficult for researchers to come to an agreement on how to diagnose it. High fluid pressure within the eye (intraocular pressure) is a well-established cause of the most common variety of glaucoma and is treated aggressively when diagnosed. Risk of glaucoma increases with increasing intraocular pressure, but a diagnosis of elevated eye pressure is not the same thing as a diagnosis of glaucoma.
In people with raised eye pressure, optic disc changes, and vision loss, the diagnosis of glaucoma is unquestionable. The problem is that some eye physicians will make a diagnosis based solely on eye pressure measurements, assuming that elevated pressure on the optic nerve will inevitably cause damage and vision loss if left untreated. That is not always the case. Some people with high eye pressure don’t lose any significant amount of peripheral vision. Some people with normal or even low eye pressure have glaucoma.
Glaucoma can cause elevated pressure within the eye that causes permanent damage to the optic nerve
Treatment of glaucoma and elevated eye fluid pressure (also known as ocular hypertension) with various drugs, which is the typical route taken by mainstream eye doctors, may end up doing the patient more harm than good. Not only can the drugs be harmful, they also don’t do much to preserve vision in those who are suffering from glaucoma. It’s important to be sure you actually have glaucoma before taking the drugs, since they do have negative side effects.
In open-angle glaucoma the drainage canals for eye fluid may be blocked.
Types of Glaucoma
1. Simple or Chronic Open-Angle Glaucoma
In this type of glaucoma, the fluid drain is not totally stopped up but clogged. Fluid is coming into your eyes but isn’t draining out efficiently, which increases the pressure inside the eye. If you have clogged arteries, high blood pressure, or diabetes; if you smoke or drink to excess; if you are of African ancestry; or if you have a history of severe anemia or shock—you are at a higher risk for open-angle glaucoma. This is by far the most common type of glaucoma, representing 70 to 90 percent of glaucoma cases.
Open-Angle Glaucoma
This is the true “sneak thief of the night” type of glaucoma, because it can progress very slowly over many years, and by the time it’s noticed, much vision already may be permanently destroyed.
2. Closed-Angle Glaucoma
When the fluid drains within the eyes are completely blocked, closed-angle glaucoma results. What could block the eye’s drain canals? Some people are genetically predisposed to this kind of glaucoma because of the shape of their eyes. In other cases, the lens of the eye may bulge too far forward, or the iris pigment layer thickens and closes the fluid drain when the pupil dilates in response to light.
Secondary Closed-Angle Glaucoma
Secondary glaucoma is brought on by a known factor. For example, steroid medications, often prescribed for asthma or for healing after eye surgery, cause changes in the molecules within the eye drain and cause it to swell shut (steroid-induced glaucoma). Flakes of pigment may come off the iris (pigmentary glaucoma) or particles may flake from the lens (pseudoexfoliative glaucoma) and become lodged in the drain. Allergies may cause the drain to become blocked by release of histamine (allergic glaucoma).
Acute Closed-Angle Glaucoma
Most glaucoma of the closed-angle type is chronic, meaning it takes a long time to come on, and its progression is gradual. But sometimes, in acute glaucoma, the eye pressure rises suddenly, causing severe pain, nausea, and even vomiting. This type of glaucoma causes intense pain and requires immediate laser surgery to open a path for the eye fluid. Until that happens, unwanted pressures are exerted on the optic nerve and may cause permanent damage. Acute glaucoma can be caused by eye drops that dilate the pupil or anticholinergic medications such as Donnatol (commonly prescribed for stomach cramps).
3. Low-Pressure or Low-Tension Glaucoma (also known as Circulatory Glaucoma)
In this type of glaucoma, eye pressure is well within normal ranges and sometimes goes below normal.
The only symptom is loss of side vision. Circulatory glaucoma is the result of poor circulation to the eyes. This often reflects a weak heart muscle that can’t pump enough blood to the extremities. Even if the heart is strong, constriction of blood vessels (vasospasm) caused by stress, high blood cholesterol levels, an imbalance of calcium and magnesium, or a combination of all three, can keep blood away from the optic nerve. Those who have this type of glaucoma usually suffer from heart disease as well. Optic nerve cells die for lack of nutrients and oxygen, resulting in vision loss.
4. Toxic Glaucoma, or Toxic Optic Neuropathy
Toxic glaucoma is a type of secondary glaucoma because it is brought on by known substances that are toxic to eye nerve cells. Cigarette smoke, the flavor enhancer monosodium glutamate (MSG), and (in some sensitive people) aspartame are all optic nerve toxins. Glutamate
is a neurotransmitter and a crucial dietary component, but if levels climb too high, it becomes harmful to your body.
You may think that MSG, a compound very high in glutamate, is found only in Chinese restaurant food, but it is everywhere these days. It is nearly always found in foods served in restaurants and is used in thousands of packaged foods, including most so-called health foods. Packaged foods designed for children tend to be especially high in MSG. At least twenty different names are used on food labels to disguise MSG. (See the box “The Many Disguises of MSG,” below.) Ask the server at your favorite restaurants to have the chef omit the MSG from your meal.
Aspartame, commonly known as NutraSweet, is not a well-understood substance and has been linked to loss of memory and headaches. I’d advise you to avoid it if at all possible.
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THE MANY DISGUISES OF MSG
The packaged food industry has gotten very clever about disguising the presence of MSG in its food. Read labels carefully.
Additives That Always Contain MSG (Monosodium Glutamate):
Hydrolyzed Vegetable Protein
Hydrolyzed Protein
Hydrolyzed Plant Protein
Plant Protein Extract
Sodium Caseinate
Calcium Caseinate
Yeast Extract
Textured Protein
Autolyzed Yeast
Hydrolyzed Oat Flour
Additives That Frequently Contain MSG:
Malt Extract
Malt Flavoring
Bouillon
Broth Stock
Flavoring
Natural Flavoring
Natural Beef or Chicken Flavoring
Seasoning
Spices
Additives That May Contain MSG or Excitotoxins:
Carrageenan
Enzymes
Soy Protein Concentrate
Soy Protein Isolate
Whey Protein Isolate
Reprinted with permission from Excitotoxins: The Taste That Kills, by Russell L. Blaylock, M.D., (1997). Health Press, Santa Fe, N.M.