Frequently Asked Questions

The following are Frequesntly Asked Questions answered.

Hello, I have wet macular degeneration and want to start taking Macushield. Is it safe to take along with Bilberry extract, grapeseed extract and Omega 3 vitamins? I have been taking I-Caps for one month but have read information that suggests Macushield may be better as it contains MZ.

Macushield is a dietary supplement which contains the three macular carotenoids; lutein, zeaxanthin and meso-zeaxanthin, which are naturally occurring carotenoids found in nature. A recent study conducted by the research group in Waterford has shown that there are no adverse side effects from taking a supplement containing the three macular carotenoids. This study was conducted on patients who were also taking additional food supplements such as the ones you are currently taking. There have also been many other animal and human studies conducted to investigate the safety of consuming carotenoids such as those contained in Macushield. These can be found on the Publications page of this website.

I am a 73 year old female with dry AMD.  Can MZ help me at this stage or age?

We would strongly recommend that you take a supplement containing meso-zeaxanthin, especially because of your age and the fact that you have AMD. A supplement containing all three macular carotenoids such as Macushield (available in pharmacies and opticians), is aimed at promoting a healthy macula, the part of the back of the eye affected by AMD. Research has shown that the eye pigments such as MZ may play a role in reducing risk of developing advanced stage AMD. As you have AMD we recommend that you visit your ophthalmologist regularly.

What is astaxanthin and if you are taking Macushield for macular degeneration would you need it, or does the meso-zeaxanthin do the same thing?

Lutein, zeaxanthin and meso-zeaxanthin are carotenoids (naturally occurring plant pigments). These carotenoids are found at the back of the eye; the macula. Research has shown that macular pigment (the yellow pigment at the macula believed to protect against age-related macular degeneration, or AMD) increases upon supplementation with lutein, zeaxanthin and meso-zeaxanthin, and that macular pigment increases are higher when all three are taken together. 

Astaxanthin is also a carotenoid like lutein, zeaxanthin and meso-zeaxanthin, but to our knowledge it is not found in the eye. It is typically used as a food colourant given its bright colour.

Please let me know what the benefits are of meso-zeaxanthin versus omega 3.

Omega-3 fatty acid and meso-zeaxanthin are very different compounds with very different functions. Omega-3 is a fatty acid, a naturally occurring fat found in fish and plant oils. Omega-3 is believed to be important as it may help replace the damaged cells at the back of the eye (photoreceptors). Typically these cells at the back of the eye which are required for vision are destroyed when AMD develops. The idea, therefore, is that Omega-3 may help replace the destroyed cells at the back of the eye. However, research has not yet confirmed that this is the case and further study is needed.

Meso-zeaxanthin (MZ), on the other hand, is believed to be important as it has the required properties to protect the cells at the back of the eye before they are damaged. In other words, MZ may prevent the disease and Omega-3 may be important to replenish damaged cells.

My wife was diagnosed with AMD two months ago. We immediately went to the hospital, where the diagnosis was confirmed. My wife immediately started taking Macushield upon recommendation from the ophthalmologist. The photos showed most obviously that the cyst had reduced significantly. My wife will of course continue to take the Macushield and, in fact, her vision is still distorted and with some strange colour effects (particularly yellow). But I wonder if it is possible that the Macushield is significantly responsible for the improvement. Or is it a happy chance - even though the Macushield may have helped.

We are glad to hear your wife's positive results. Over the last number of years we have learned of similar cases to your wife’s situation, and this is consistent with a recent survey performed in the UK and Ireland.  Scientists and doctors understandably interpret individual cases with caution. However, case studies do contribute to the scientific evidence base which the medical and scientific organisations learn from. With respect to the reduced cyst identified, this is good news and may or may not be related to the supplement. The important thing to observe is if visual performance is improving or at least staying the same. Clinical trials have shown that supplementation with Macushield does, indeed, improve visual performance in patients with AMD. However, the benefits for the disease itself have not yet been confirmed and require continued study which is currently underway. We would recommend that your wife continues taking Macushield and remains under the observation of her ophthalmologist and other eyecare specialists.

I am about to start taking a vitamin with lutein, zeaxanthin and meso-zeaxanthin (MZ).  The formulation has 10mg of lutein, 2mg of zeaxanthin and 10mg of MZ.  Since I have AMD, what is the maximum amount of these ingredients I can take to benefit me?

Lutein, zeaxanthin and meso-zeaxanthin are all naturally occurring plant pigments, known as carotenoids. The levels of carotenoids you are currently taking have been developed according to a scientific method to provide optimal absorption and minimal waste. Recent studies at Waterford Institute of Technology, Ireland, have shown that the optimal response to these nutrients can be achieved when consumed in the formulation of 10mg, 2mg and 10mg (lutein, zeaxanthin and meso-zeaxanthin respectively) such as that which you are taking. It is possible that taking more of this supplement may not have any benefit but this would require additional study. The reason for this is that carotenoids can compete for uptake into the bloodstream and it is therefore possible to take too much.

Where can I source and purchase the MZ material?

MZ is only commercially available within a supplement called Macushield (http://www.macushield.co.uk).

It is written on your website that "research has also shown that individuals at risk of developing AMD are lacking in MZ, suggesting that these individuals are unable to form MZ from L at this important retinal location, but do respond positively when MZ is provided in a dietary supplement. The researchers suggested that the deficiency of MZ generation in such individuals may be genetic." This is very interesting: could you send me the reference?

Augmentation of macular pigment following supplementation with all three macular carotenoids: an exploratory study.
Curr Eye Res. 2010 Apr;35(4):335-51.
Connolly EE, Beatty S, Thurnham DI, Loughman J, Howard AN, Stack J, Nolan JM.
www.ncbi.nlm.nih.gov/pubmed/20373901

A central dip in the macular pigment spatial profile is associated with age and smoking.
Invest Ophthalmol Vis Sci. 2010 Dec;51(12):6722-8. Epub 2010 Jun 30.
Kirby ML, Beatty S, Loane E, Akkali MC, Connolly EE, Stack J, Nolan JM.
http://www.ncbi.nlm.nih.gov/pubmed/20592234

Macular carotenoid supplementation in subjects with atypical spatial profiles of macular pigment.
John M Nolan, Mukunda C Akkali, James Loughman, Alan N Howard, Stephen Beatty
http://www.sciencedirect.com/science/article/pii/S0014483512001492?v=s5

In addition to supplements, what else do you recommend to help prevent AMD?

There are other steps you can take to keep your eyes healthy. Try to consume at least five portions of fruit and vegetables a day, especially brightly coloured ones like spinach, curly kale, peppers, sweetcorn, red grapes and oranges; also egg yolks. Do not smoke, as smoking is an established risk factor for AMD. Try to wear protective sunglasses or lenses when you are in bright light (either sunlight or artificial light). Keep your body mass index (BMI) under control, as well as blood pressure and cholesterol.

AMD is a genetic eye disease, which means that if you have AMD, any siblings or children you have may be at a higher risk of AMD themselves, and should also take the preventative measures listed above.

Visit http://www.sightrisk.com for more information on AMD risk factors.

Do you know any natural source of meso-zeaxanthin?

There has not been much research conducted to date on the source of meso-zeaxanthin (MZ), however, one publication (Maoka et al) has stated that some seafood (e.g. sea bass, trout) contains amounts of MZ, and it is thought that MZ is most concentrated in the skin of the fish. However, although these foods did contain MZ they did so in very small amounts. Research is currently ongoing (at the Waterford Institute of Technology, Waterford, Ireland, and Tufts University, Boston, USA) to test if other foods (e.g. eggs) contain MZ. Therefore, based on the information that is currently available, the only major known source of MZ is the dietary eye-related supplement called MacuShield.

Maoka et al 1985 "The first isolation of enantiomeric and meso-zeaxanthin in nature": http://www.ncbi.nlm.nih.gov/pubmed/3943294

Where can I purchase mesozeaxanthin? Is it sold separately so I can take it with the pills I now take with Lutein and Zeaxanthin?  I found a product on line that contains all three ingredients; however the amount of mesozeaxthin is not nearly enough. My doctor told me I need 15mg of lutein, 5 mg zeaxanthin and 10 mg meso-zeaxanthin?

There is a commercially available product called Macushield that contains all three macular carotenoids; lutein, zeaxanthin and meso-zeaxanthin. This product is available in most Uk pharmacies and optician practices. Visit http://www.macushield.co.uk for information. This product contains Lutein, zeaxanthin and meso-zeaxanthin in appropriate amounts.

Does meso-zeaxanthin go by any other name?  Is it included in the Bausch and Lomb preservision Areds 2 formula?

Meso-zeaxanthin does not go by any other name. Also, it is not part of the AREDS 2 formula. Therefore, the AREDS 2 results will not be investigating the potential of meso-zeaxanthin for patients with AMD. Many other trials are, however, investigating the potential of this central macular carotenoid.

Can you tell me the difference between Meso-zeaxanthin and Zeaxanthin please?  A recent eye-test revealed that I have drusen.  My sister has AMD (the wrong sort) and I have been recommended to take MacuShield which uniquely contains both these, but the suspicious side of me wonders whether it's Boots way of making more money when I can buy cheaper supplements that lack MZ but contains just the Z.

Lutein, zeaxanthin and meso-zeaxanthin are very similar molecules (scientifically, they are known as structural isomers). However, they are also different molecules in that they are shaped differently and function differently with respect to their antioxidant capacity and ability to filter light. We know that best results are seen when all three are present in the supplement. This is likely why the eye has evolved to have the three present.

Do Macushield  capsules contain Omega 3 ?

No macushield do not contain omega 3. Macushield only contains the macular carotenoids to help protect the central macula.

I have been recommended macushield by my optician but he suggested I check the contents as I also take multibionta probiotic tablets which contain a range of vitamins. Do your tablets contain everyday vitamins as well?

Macushied does not contain any multivitamins. It is a specialised eye supplement containing the macular carotenoids only

Is there any evidence base of a beneficial effect of Meso-Zeaxantin as a prophylaxis against Macular Degeneration?

Only insofar as the following: macular pigment (MP) is lacking decades before onset of age-related macular degeneration (AMD) [Nolan J et al, 2007], and the best means of increasing MP is by means of supplementation with meso-zeaxanthin [Sabour-Pickett S et al, 2014);

I have myopic macular degeneration with CNV in my right eye. Would lutein, zeaxanthin & meso-zeaxanthin supplement have any effect on the condition of my macular degeneration?

It is known that a supplement containing L, Z and MZ represents the best way of preserving vision in age-related macular degeneration (AMD);  myopic macular degeneration represents a risk to vision for the same reasons as AMD (I.e. atrophy and choroidal neovascularisation); therefore, there is a biologically plausible rationale whereby Macushield would benefit patients with myopic macular degeneration

Hi ,my mum has md as well as glaucoma ,is it ok to take macushield ?

Yes, one of the benefits of enhancing macular pigment is its ability to reduce the effects of light scatter and glare. We know that patients with Glaucoma suffer greatly with glare and we also know that patients with Glaucoma have lower macular pigment. 

I am on a "new" cancer drug called ibrutinib and must not have any inhibitors or inducers of CYP3A4/5 I cannot tell if it would be safe for me to take your product.  I have CLL as well as wet and dry macular disease. so would welcome any help with my eyes?

Macushield contains no constituents that are inhibitors or inducers of CYP3A4/5, and it is safe for you to take Macushield, one tablet once daily.

I have prescribed drugs for my heart condition [Rivaroxaban and bisoprolol] ,can I take Macushield with these drugs , for my AMD condition?

Macushield contains no constituents that will interact in any way with drugs prescribed for your heart condition, and accordingly would recommend that you take Macushield, one tablet once daily.

My dad has macular degeneration and i would like to take macushield. I take methotrexate so can i take both?

Macushield contains no constituents that interact with methotrexate, and so feel free to take the Macushield to optimise your vision and reduce your risk of Macular Degeneration

What is difference between zeaxanthin and meso-zeaxanthin?

In brief they are isomers of each other, however there are important distinctions. First, macular pigment to exert its maximum anti-oxidant effect, it does need Lutein, zeaxanthin and meso-zeaxanthin (i.e. in other words you need three parts of the jigsaw puzzle); Second, meso-zeaxanthin has a slightly different absorbance spectrum for blue light, and this is important for optimal filtration of blue light at the retina; Finally, meso-zeaxanthin is the dominant carotenoid at the very centre of the macula (where zeaxanthin is the dominant carotenoid just off-centre), and therefore if you were to maximise your macular pigment across its spacial profile you would need to take a supplement that contains lutein (which is the dominant carotenoid in the periphery of the macula), zeaxanthin and meso-zeaxanthin.

I am now taking a product called saffron 2020 made by persivita in the uk which contains saffron, lutein,zinc and vitamins.  Are you familiar with this product?  It does not contain meta-zeaxanthin.  I have AMD and am age 70.

In brief, most evidence does suggest that taking a product that contains lutein, zeaxanthin and meso-zeaxanthin is best for maximising your macular pigment across its spacial profile (because meso-zeaxanthin is the dominant carotenoid at the very centre of the macula), and for optimising visual performance (whether or not you have macula disease). Accordingly, and in keeping with the evidence, I would recommend that you take a supplement such as Macushield or Macuhealth (which contain all three macular carotenoids).

I have three (3) questions pertaing to wet macular: Is PreserVision Areds 2 banned in Europe and South America?What is so dangerous? Lutein and Zeaxanthin is more better? MacuHealth containing Meso-Zeaxanthin 10mg, Lutein 10mg, Zeaxanthin 2mg.

The controversy around the preservision  AREDS2 formulation  centres around its zinc concentration (which may in fact be bad for certain sub types of age related macular degeneration). Most evidence now suggests that if you want to maximise your macular pigment (and therefore maximise your protection against progression of age related macular degeneration) you need a supplement that contains lutein, zeaxanthin and meso-zeaxanthin, and very recent evidence also suggests that only a formulation containing all three macular carotenoids results in optimal vision performance (whether or not you have macular disease).

Is there any evidence base of a beneficial effect of Meso-Zeaxantin as a prophylaxis against Macular Degeneration?

In brief, there is no evidence whatsoever that any of the macular carotenoids are useful for prophylaxis against Macular Degeneration (because such a study would involve thousands of healthy subjects being followed for many decades, and then seeing who developed age macular degeneration and who did not). However, there is evidence that lutein and zeaxanthin do protect against progression of age related macular degeneration and visual loss in subjects with age related macular degeneration, and head-to-head studies have shown that a supplement containing all three of macular pigment constituent carotenoids (and not simply lutein and zeaxanthin as in the AREDS2 study)  is superior in terms of augmentation of macular pigment across its spacial profile and in terms of optimisation of vision (whether or not you have macular disease).

I want to take supplements to help prevent getting AMD.but I am confused whether to take a supplement with Zeaxanthin and Meso-Zeaxanthin and Lutein or is just Zeaxanthin and lutein sufficient?

In brief, there three carotenoids that make up macular pigment, these include lutein, zeaxanthin and meso-zeaxanthin. Head-to-head studies have shown that a supplement containing all three macular carotenoids (such as Macushield in Europe or Macuhealth in the USA) is best at augmenting macular pigment across its spacial profile and in optimising vision (whether or not you have macular disease).

Can meso-zeaxanthin be purchased as a separate supplement?

In brief, meso-zeaxanthin cannot be purchased as a separate supplement, but only as a component of a formulation which also contains lutein and zeaxanthin. In brief, it has been shown that you do need all three macular carotenoids for maximum anti-oxidant effect in the central retina.

Using mascara is worst on my eyes if having blepharitis? What could I do?

In brief, if you suffer from blepharitis it is probably a good idea to discontinue the use of mascara for a period of time, treat the blepharitis with any commercially available preservative free artificial tear (these are over-the-counter) and with a regime of lid hygiene. Your local doctor should be able to advise you accordingly.

I am taking a daily supplement of meso-zeaxanthin 10mg, lutein 10mg, and zeaxanthin 2mg.   I am 75 years old.  Are these the correct dosage for effectiveness?  What is the desired dosage for these?

I can assure you that the dosage (in mg) of meso-zeaxantin:lutein:zeaxanthin of 10:10:2 is correct. This is the formulation that is best for augmenting (increasing) across its spacial profile and for optimising vision in patients with age related macular degeneration (and indeed in patients that do not have age related macular degeneration).

I am experiencing blind spots in both eyes and have been told after testing that it is showing very very early stages of Macular Degeneration. Is Macushield the right treatment for this problem?

If you are experiencing blind spots in each eye, these should be assessed by an ophthalmologist. But I can confirm that Macushield is the correct treatment if you have age related macular degeneration, as it contains the best formulation for increasing macular pigment across its spacial profile and for optimising vision in patients with this condition (and indeed in people who do not have any eye disease).

I am having trouble swallowing the capsules that get stuck in my throat. Can you help as tried cutting in half but not possible due to liquid coming out.. Normal tablets  I crush or cut as hard ti get down. Can I buy a iquid  form of Macushield?

As far as we are aware there is no liquid form of Macushield. The reason for this is that the nutrients within Macushield are not water soluble and need to be protected from light and air. In the absence of taking the supplement directly, other methods that have been shown to increase macular pigment include egg consumption, along with a diet consisting fruit and vegetables.

I am being treated for HBP (Verapamil and Cilazipril) plus the occasional sleeping aid: are there any contra-ndications intaking MacuShield? 

Based on studies conducted to date there are no contra indicators with taking other medications. I suggest you consult with a medical doctor regarding this query. 

Hi - when i used to close my eyes i would see a very bright gold colour in the shape of a donut with a black centre - now after 4 years of working on a computer this gold colour is very dotty and patchy,is this macular degeneration? And is this a normal colour to see?

It is impossible to do a diagnosis without a proper medical eye examination. It is good practice to have  routine visits with an eye doctor who can advise.

I am on a "new" cancer drug called ibrutinib and must not have any inhibitors or inducers of CYP3A4/5 I cannot tell if it would be safe for me to take your product.  I have CLL as well as wet and dry macular disease. so would welcome any help With my eyes. 

Based on research conducted to date, there is no evidence of contra indicators for patients consuming Macushield who are on other medications. However, please consult your medical doctor with this query.

I have Chronic Kidney Disease and am on dialysis. I also have high blood pressure and diabetes. I have recently been recommended Macushield for macualar degeneration. Is it safe for me to take?

Based on research conducted to date, there is no evidence of contra indicators for patients consuming Macushield who are on other medications. However, please consult your medical doctor with this query.

Do you have information on Lumega-Z?  Guardion Health Sciences , San Diego, CA I can only find information the site puts out?

No, and we are not in a position to comment on products without declared meso-zeaxanthin, but would like to emphasize that the current body of evidence is in favor of a supplement containing all three macular carotenoids (lutein, zeaxanthin and mes-zeaxanthin), such as MacuHealth or Macushield.

I have dry macular degeneration and am taking 1x I Caps daily, as prescribed by the consultant.  Can I take the Macushield supplement as well? It does say in the I Caps instructions not to exceed the prescribed dose. I read an article in the Daily Telegraph where a patient said her dry condition had all but disappeared after a course of twelve months. Your advice would be much appreciated.

Certainly, the recommended dose of Macushield for the dry form of age-related macular degeneration is one tablet/day; however, many patients choose to take two/day, and to do so is safe because there is no toxicity associated with the contents of Macushield; Macushield Gold, however, should only be taken once/day.

I have very early AMD and am going to start taking Macushield having just found out about it. What I would like to know is what other vitamins should I be taking and in what quantity? I take Multivitamins for over 70's plus joint capsules which include cod liver oil capsules. Is it possible to take too much? Thats my worry so would appreciate any advise you could give me.

In brief, if you have early AMD, Macushield will be sufficient if you are taking multi-vitamins for over 70s. You cannot take too much Macushield (one tablet a day will be sufficient), as there is no toxicity associated with any of its contents.

Is there any advantage in taking Macushield Gold (vitamins + zinc+copper )or would it be preferable to take Macushield and a good multivitamin?

The only difference between Macushield and Macushield Gold rests on the inclusion of vitamin C, E, Zinc and Copper in Macushield Gold (and these are not in Macushield). Macushield in someone with a healthy diet, or in someone taking a standard multi-vitamin supplement, will suffice in someone with age-related macular degeneration and it is not essential that they take the Macushield Gold (unless he/she has a poor diet). However, it is important that a person does take Macushield (or Macushield Gold) if they have age-related macular degeneration, as the concentrations of its constituent compounds are required in doses which are not found in a typical diet (and therefore supplementation with Macushield or Macushield Gold is required).

I read that some people don't have the enzyme that converts lutein to meso-zeaxanthin.  What is the name of the enzyme and is there a test to determine if that enzyme is diminished or not present?

The enzyme that converts lutein to meso-zeaxanthin has not yet been discovered.  Indeed, recent evidence is suggesting that, although some retinal meso-zeaxanthin is derived from retinal lutein, dietary sources of meso-zeaxanthin are important (and meso-zeaxanthin is found in edible fish).

1. Verification of Meso-Zeaxanthin in Fish. Nolan JM, Beatty S, Meagher KA, Howard AN, Kelly D, Thurnham DI. J Food Process Technology 5:335. doi: 10.4172/2157-7110.1000335

2. What is meso-zeaxanthin, and where does it come from? Nolan JM, Meagher K, Kashani S, Beatty S. Eye (Lond). 2013 Aug;27(8):899-905
Furthermore, it is not certain that is an enzymatic reaction, and therefore those supplementing are probably best to supplement with a formulation that contains all three macular carotenoids (lutein, zeaxanthin and meso-zeaxanthin).

I am highly allergic to seafood.  Does MacuHealth have any form of seafood diritive added.  If  so, it could be life-threatening for me to take it

A seafood allergy does not represent risk If you take MacuHealth.

Do you have information on Lumega-Z?  Guardion Health Sciences , San Diego, CA I can only find inormation the site puts out.

In brief, Lumega-Z from its name appears to contain Omega3 fatty acids. The recent AREDS2 report (published in 2013) shows that inclusion of Omega3 fatty acids in a supplement for age-related macular degeneration are not beneficial. Accordingly, for patients with age-related macular degeneration we recommend a formulation that contains MZ:L:Z (mg) in a ratio of 10:10:2.