What are the common side effects of PreserVision AREDS 2. How severe can the side effects be. Are there any long-term risks associated with taking PreserVision AREDS 2. Who should consider taking PreserVision AREDS 2 supplements.

What is PreserVision AREDS 2 and Who Should Take It?

PreserVision AREDS 2 is a nutritional supplement formulated based on the Age-Related Eye Disease Study 2 (AREDS2) conducted by the National Eye Institute. This supplement is designed to support eye health in individuals with intermediate or advanced age-related macular degeneration (AMD).

Who should consider taking PreserVision AREDS 2? The supplement is specifically beneficial for:

• People with intermediate AMD
• Individuals with late-stage AMD in one eye

It’s important to note that PreserVision AREDS 2 is not recommended for those with early-stage AMD or individuals without AMD. The decision to take this supplement should be made in consultation with an eye care professional or primary care physician.

Common Side Effects of PreserVision AREDS 2

While many people tolerate PreserVision AREDS 2 well, some may experience side effects. The most common side effects include:

• Upset stomach
• Nausea
• Vomiting
• Diarrhea
• Constipation

These side effects are generally mild and may resolve on their own as your body adjusts to the supplement. If these symptoms persist or worsen, it’s advisable to consult your healthcare provider.

Severe Side Effects and Allergic Reactions

While rare, some individuals may experience severe side effects or allergic reactions to PreserVision AREDS 2. These can include:

• Rash or hives
• Itching
• Swelling of the face, lips, tongue, or throat
• Difficulty breathing or swallowing
• Chest tightness
• Unusual hoarseness

If you experience any of these symptoms, seek immediate medical attention. These could be signs of a serious allergic reaction that requires prompt treatment.

Long-Term Considerations and Potential Risks

While PreserVision AREDS 2 has shown benefits in slowing the progression of AMD in clinical trials, there are some long-term considerations to keep in mind:

1. Zinc content: The high zinc content in the supplement may cause problems for some individuals over time.
2. Copper absorption: High zinc intake can interfere with copper absorption, potentially leading to copper deficiency.
3. Interactions with medications: The supplement may interact with certain medications, particularly blood thinners.
4. Smokers: The original AREDS formula containing beta-carotene is not recommended for smokers due to an increased risk of lung cancer.

It’s crucial to discuss these potential long-term risks with your healthcare provider, especially if you have any pre-existing conditions or are taking other medications.

Comparing PreserVision AREDS 2 to Other Supplements

How does PreserVision AREDS 2 compare to other eye health supplements? Unlike many over-the-counter multivitamins, PreserVision AREDS 2 contains higher doses of specific nutrients shown to benefit individuals with intermediate or advanced AMD. These include:

• Vitamin C (500 mg)
• Vitamin E (400 IU)
• Zinc (80 mg)
• Copper (2 mg)
• Lutein (10 mg)
• Zeaxanthin (2 mg)

The combination and dosage of these ingredients are based on extensive research and clinical trials, setting PreserVision AREDS 2 apart from standard multivitamins or general eye health supplements.

Proper Usage and Potential Interactions

To maximize the benefits and minimize potential side effects of PreserVision AREDS 2, proper usage is essential:

• Follow the recommended dosage: Typically, two soft gels daily with meals.
• Avoid taking on an empty stomach to reduce the risk of gastrointestinal side effects.
• Do not exceed the recommended dose unless directed by a healthcare professional.
• Inform your doctor about all medications and supplements you’re taking to avoid potential interactions.

Can PreserVision AREDS 2 be taken alongside other supplements? While it’s generally safe to take PreserVision AREDS 2 with a daily multivitamin, it’s important to be aware of the total nutrient intake from all sources to avoid excessive levels of certain vitamins and minerals.

Monitoring and Managing Side Effects

If you experience side effects while taking PreserVision AREDS 2, there are several steps you can take:

1. Keep a symptom diary to track the frequency and severity of side effects.
2. Try taking the supplement with food if you’re experiencing stomach upset.
3. Consider splitting the daily dose, taking one soft gel in the morning and one in the evening.
4. Discuss any persistent or concerning side effects with your healthcare provider.
5. Do not discontinue use without consulting your eye care professional, as the benefits for AMD progression may outweigh mild side effects.

Remember, your healthcare provider can offer personalized advice on managing side effects while maintaining the potential benefits of the supplement.

Alternative Options for Eye Health

While PreserVision AREDS 2 is specifically formulated for individuals with intermediate or advanced AMD, there are other ways to support eye health:

• Maintain a balanced diet rich in leafy greens, fish, and colorful fruits and vegetables.
• Protect your eyes from UV radiation by wearing sunglasses and a wide-brimmed hat outdoors.
• Quit smoking or avoid secondhand smoke.
• Control other health conditions like high blood pressure and diabetes, which can affect eye health.
• Get regular eye exams to monitor for any changes in your vision or eye health.

For individuals without AMD or those with early-stage AMD, these lifestyle measures may be more appropriate than taking PreserVision AREDS 2.

The Role of Diet in Eye Health

Can diet alone provide the same levels of antioxidants and zinc as PreserVision AREDS 2? While a healthy diet is crucial for overall eye health, it’s challenging to achieve the high levels of specific nutrients found in PreserVision AREDS 2 through diet alone. However, a diet rich in the following foods can complement the supplement and support overall eye health:

• Leafy green vegetables (spinach, kale, collard greens) for lutein and zeaxanthin
• Citrus fruits and berries for vitamin C
• Nuts and seeds for vitamin E
• Oysters and other shellfish for zinc
• Fish, particularly salmon and sardines, for omega-3 fatty acids

Incorporating these foods into your diet can provide additional benefits beyond what PreserVision AREDS 2 offers, supporting overall health as well as eye health.

The Importance of Regular Eye Exams

While PreserVision AREDS 2 can play a role in managing AMD progression, it’s not a substitute for regular eye exams. Regular check-ups with an eye care professional are crucial for:

• Monitoring the progression of AMD
• Detecting other eye conditions early
• Adjusting treatment plans as needed
• Assessing the effectiveness of supplements like PreserVision AREDS 2

How often should you have an eye exam if you have AMD? For individuals with intermediate or advanced AMD, eye exams are typically recommended every 6 to 12 months, or more frequently if advised by your eye care professional.

Future Research and Developments

As research in eye health and AMD continues, new developments may emerge that could impact the use of supplements like PreserVision AREDS 2. Some areas of ongoing research include:

• Identifying additional nutrients that may benefit eye health
• Exploring the potential of personalized supplement formulations based on genetic profiles
• Investigating new drug therapies for AMD
• Studying the long-term effects of nutritional supplements on eye health

It’s important to stay informed about new research findings and discuss any new developments with your eye care professional. They can help you understand how new information might affect your eye health management plan.

The Role of Genetics in AMD and Supplement Efficacy

Recent research has suggested that genetic factors may influence the effectiveness of nutritional supplements like PreserVision AREDS 2. Some studies have indicated that individuals with certain genetic profiles may respond differently to the supplement formulation.

Does this mean genetic testing is necessary before taking PreserVision AREDS 2? Currently, genetic testing is not routinely recommended before starting the supplement. However, as research progresses, personalized approaches to AMD management based on genetic profiles may become more common. Always consult with your eye care professional for the most up-to-date recommendations based on your individual circumstances.

Complementary Therapies and Lifestyle Changes

While PreserVision AREDS 2 can play a significant role in managing AMD progression, it’s most effective when combined with other healthy lifestyle choices. Consider incorporating the following practices to support your eye health:

• Maintain a healthy weight through diet and regular exercise
• Manage stress through relaxation techniques or meditation
• Get adequate sleep to support overall health and eye function
• Limit screen time and practice the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds)
• Stay hydrated to support tear production and overall eye comfort

These lifestyle factors, combined with appropriate supplement use and regular medical care, can contribute to a comprehensive approach to eye health management.

Making an Informed Decision

Deciding whether to take PreserVision AREDS 2 is a personal choice that should be made in consultation with your eye care professional. Consider the following factors:

• Your current AMD status (early, intermediate, or advanced)
• Your overall health and any existing medical conditions
• Potential risks and benefits based on your individual circumstances
• Your comfort level with taking supplements
• The cost of long-term supplement use

Remember, while PreserVision AREDS 2 has shown benefits for certain individuals with AMD, it’s not appropriate or necessary for everyone. Your eye care professional can provide personalized advice based on your specific situation.

The Importance of Ongoing Monitoring

If you decide to take PreserVision AREDS 2, it’s crucial to maintain ongoing communication with your healthcare provider. Regular check-ups and open discussion about any side effects or concerns can help ensure that you’re receiving the maximum benefit from the supplement while minimizing any potential risks.

How can you effectively monitor your response to PreserVision AREDS 2? Consider keeping a journal to track any changes in your vision, side effects, or overall health. This information can be valuable during your regular eye exams and consultations with your healthcare provider.

Educating Friends and Family

If you’re taking PreserVision AREDS 2 or considering it, it can be helpful to educate your friends and family about AMD and the role of nutritional supplements. This can foster understanding and support for your eye health management plan. Some key points to share might include:

• The progressive nature of AMD and its potential impact on vision
• The importance of early detection and regular eye exams
• The role of nutrition in eye health
• The specific benefits and potential side effects of PreserVision AREDS 2

By sharing this information, you can help raise awareness about eye health and potentially encourage others to take proactive steps in caring for their vision.

PreserVision AREDS 2 Side Effects: Common, Severe, Long Term

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Generic name: multivitamin with minerals

Medically reviewed by Drugs.com. Last updated on Jul 3, 2023.

Note: This document contains side effect information about multivitamin with minerals. Some dosage forms listed on this page may not apply to the brand name PreserVision AREDS 2.

Applies to multivitamin with minerals: oral tablet. Other dosage forms:

• oral capsule, oral liquid, oral tablet, oral tablet chewable
• oral capsule
• oral miscellaneous
• oral wafer

Serious side effects

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your
doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing;
  tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue,
  or throat.
• Very upset stomach or throwing up.
• Severe diarrhea.
• Very bad constipation.
• Muscle weakness.
• Numbness and tingling.

Other side effects

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical
help if any of these side effects or any other side effects bother you or do not go away:

• Upset stomach or throwing up.
• Diarrhea.
• Constipation.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical
advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

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AREDS/AREDS2 Frequently Asked Questions | National Eye Institute

Taking the AREDS formulas

Are the AREDS vitamins right for me?

In clinical trials, the AREDS and AREDS2 formulas benefited people with intermediate or late AMD. There was no benefit for people with early AMD or for people who do not have AMD.

Your primary care physician or eye care provider is in the best position to advise you on how treat your AMD. You may wish to discuss AREDS/AREDS2 supplements with your health care providers to decide which, if any, supplements are right for you.

Will taking the AREDS or AREDS2 supplements prevent AMD?

Nutritional supplements cannot prevent AMD. However, the AREDS/AREDS2 supplements may delay progression of intermediate to advanced AMD and may help you keep your vision longer. The participants AREDS trial have now been followed for more than 10 years, and the benefits of the AREDS formulation have persisted over this time.

Can I take a daily multivitamin if I am taking one of the AREDS/AREDS2 formulas?

Yes. The AREDS and AREDS2 formulas do not substitute for multivitamins. In AREDS, two-thirds of the study participants took multivitamins along with the AREDS formulation. In AREDS2, almost nine of ten participants took multivitamins.

Can a daily multivitamin alone provide the same vision benefits as the AREDS or AREDS2 formulas?

No. The vitamins and minerals tested in AREDS and AREDS2 trials were provided in much higher doses than what is found in multivitamins. Also, it is important to remember that most of the trial participants took multivitamins. Taking an AREDS formulation clearly provided a benefit over and above multivitamins.

Can diet alone provide the same levels of antioxidants and zinc as the AREDS or AREDS2 formulas?

No. The high levels of vitamins and minerals are difficult to achieve from diet alone. However, previous studies have suggested that people who have diets rich in green, leafy vegetables—a good source of lutein and zeaxanthin—have a lower risk of developing AMD. In the AREDS2 trial, the participants who benefitted most from taking lutein + zeaxanthin were those who did not get much of these nutrients in their diet. Within this group, those who received lutein/zeaxanthin supplements had a 26% reduced risk of developing advanced AMD compared with those who did not receive the supplements.

Which AREDS/AREDS2 formula is right for me?

Consult your doctor or eye care professional about which supplement, if any, is right for you.

*Not recommended for current or former smokers
**Added to avoid zinc-related copper deficiency
mg = milligrams
IU = international units

Why are the AREDS and AREDS2 formulas different?

In the AREDS trial, taking the AREDS formula reduced the risk of advanced AMD by about 25% over a five-year period. In the AREDS2 trial, adding omega-3s or lutein + zeaxanthin to the AREDS formulation (containing beta-carotene) had no additional overall effect on the risk of advanced AMD. However, trial participants who took AREDS containing lutein + zeaxanthin and no beta-carotene had a reduction in risk of advanced AMD, compared with those who took AREDS with beta-carotene. Also, for participants with very low levels of lutein and zeaxanthin in their diet, adding these supplements to the AREDS formulation helped lower their risk of advanced AMD. Finally, former smokers who took AREDS with beta-carotene had a higher incidence of lung cancer. (Please see below for more details on the effects of lutein + zeaxanthin vs. beta-carotene.) The investigators found no significant changes in the effectiveness of the formulation when they  lowered zinc.

Where can I get the AREDS2 formula?

The NEI does not produce the AREDS supplements. Bausch & Lomb produced the formulations for the AREDS and AREDS2 trials. The NEI cannot comment on the safety or effectiveness of any specific brand’s formulations.

AREDS and AREDS2 formulation components

What are lutein, zeaxanthin, and beta-carotene?

Lutein, zeaxanthin, and beta-carotene belong to a family of nutrients known as carotenoids. Carotenoids are made by plants and are enriched in green leafy vegetables. They can be stored in animal tissues and are found at relatively low levels in animal-based foods. In the body, beta-carotene is used to make vitamin A, which is required by the retina to detect light and convert it into electrical signals. Beta-carotene itself is not found in the eye. In contrast, lutein and zeaxanthin are found in the retina and lens, where they may act as natural antioxidants and help absorb damaging, high-energy blue and ultraviolet light.

How do lutein and zeaxanthin compare to beta-carotene?

During the AREDS trial, two large trials funded by the National Cancer Institute found that beta-carotene may increase lung cancer risk among people who smoke. Lutein and zeaxanthin are in the same family of nutrients as beta-carotene and are believed to have important functions in the retina. Lutein and zeaxanthin have not been associated with increased cancer risk.

Some studies prior to AREDS2 (references 1-7) found that dietary intake of lutein, zeaxanthin and omega-3 fatty acids is associated with a lower risk of developing advanced AMD. Analysis from the AREDS2 trial suggests that lutein + zeaxanthin offers similar or better protective benefits against advanced AMD compared with beta-carotene. In the trial, participants who took an AREDS formulation containing lutein + zeaxanthin lacking beta-carotene had an 18% lower risk of progressing to advanced AMD compared with those who took AREDS containing beta-carotene (no lutein or zeaxanthin). Among participants who had the lowest dietary intake of lutein and zeaxanthin, those who took AREDS with lutein + zeaxanthin had a 26% lower risk of progressing to advanced AMD compared to participants taking the original AREDS formula.

What are omega-3s?

Omega-3 fatty acids are made by marine algae and enriched in fish oils. They are believed to be responsible for the health benefits associated with regularly eating fish, including lower rates of cardiovascular disease. The AREDS2 study focused on the omega-3 fatty acids docosahexanoic acid (DHA) and its precursor eicosapentanoic acid (EPA). DHA is needed for the integrity of retinal cells and has been shown to promote retinal development and repair in prior studies.

What is the function of copper in the AREDS/AREDS2 supplements?

In AREDS/AREDS2 trials, copper (as cupric oxide) was added to supplement formulas containing zinc. The goal was to reduce the risk of copper deficiency anemia, a condition associated with high levels of zinc intake. The studies showed clear benefits for patients who took an AREDS formula with zinc, with no evidence of anemia. There was no evidence that 2 mg copper was harmful, nor reason to suspect that it would be. So, in the AREDS investigators’ hands, the use of copper was safe and may have helped balance the effects of zinc.

What is the basis for the concentration of zinc in the AREDS supplements? What concentration should I take?

In the AREDS trial, the 80 mg zinc dose (alone or in combination with antioxidant vitamins) was found to be effective compared to a placebo. Although zinc was found to be an essential component of the AREDS formulation, some nutritional experts recommended a lower dose. In the AREDS2 trial, there was no placebo control. Instead, participants were given the option to take the original formula or to be randomly assigned to receive a modified version, such as a formula containing 25 mg zinc. The investigators did not find a difference in the effects of 80 mg vs. 25 mg zinc. Because AREDS2 did not include a placebo control, results from AREDS, placebo-controlled trial, are still considered the gold standard.

Zinc is found in vegetables, grains, and meat. Vegetables and grains contain other molecules that can prevent zinc absorption and thus reduce its bioavailability. Supplements contain purified zinc, without these competing molecules. Although the chemical form of zinc affects its rate of absorption in the stomach, it is not clear how this affects bioavailability (i.e., the amount of zinc that reaches the retina). For more on this topic, please see the zinc fact sheet from the NIH Office of Dietary Supplements.

Risks and side-effects

What is the risk of lung cancer from taking beta-carotene?

In the AREDS2 trial, current smokers or those who had quit smoking less than a year before enrollment were excluded from receiving beta-carotene. Despite this precaution, lung cancers were observed in 2% of participants who took an AREDS formulation with beta-carotene, compared with 0.9% of participants who took AREDS without beta-carotene. Across both groups, about 91% of participants who developed lung cancer were former smokers.

The dose of vitamin E in the AREDS formulation is higher than the recommended dietary allowance. Is this safe?

The recommended dietary allowance (RDA) of vitamin E for adults over 14 years old is 22.4 IU; but it is not the maximum dose. Rather, it is the dose that nutrition experts have decided is sufficient for most people to remain healthy. The AREDS formula contains 400 IU to provide vitamin E beyond usual dietary intake.

The AREDS and AREDS2 trials found no adverse effects of 400 IU/day vitamin E. Other studies of adults taking more than 1,500 IU/day from natural vitamin E and 1,100 IU/day for synthetic vitamin E observed increased risk of bleeding, including brain bleeds. Most studies of vitamin E supplementation below these levels have shown beneficial or no effects on heart disease.

However, vitamin E can interact with some medications, including blood thinners, chemotherapeutic agents, and lipid-lowering drugs. NEI recommends consulting with a health care provider before taking vitamin E or other nutritional supplements.

For more information, please see the NIH Office of Dietary Supplements page on vitamin E. 

Do the AREDS/AREDS2 formulations interfere with other medications?

High-dose nutritional supplements can sometimes interfere with medications and compete with other vital nutrients for absorption into the body. People who are considering taking an AREDS formulation should make a list of all the medications they take to share with their health care provider. The list should include supplements and over-the-counter drugs.

Does the high-dose vitamin E in the AREDS formulations affect the risk of prostate cancer?

AREDS/AREDS2 found no effect of high-dose vitamin E on prostate cancer risk.

However, data from other studies on the relationship between vitamin E and prostate cancer conflict:

• In 1994, the Alpha-Tocopherol, Beta Carotene (ATBC) trial found a 35% reduced risk of prostate cancer in men taking 50 mg of vitamin E (synthetic, equivalent to 56 IU) daily for a follow-up of six years. (reference 8)
• In 2009, the Physicians Health Study II (PHS II) found that 400 IU of vitamin E every other day for a follow-up of eight years had no effect on the incidence of prostate cancer. (reference 9)
• In 2011, the Selenium and Vitamin E Cancer Prevention Trial (SELECT) found a 17% increase in prostate cancer risk among men taking 400 IU of vitamin E daily for a follow-up of seven years. (reference 10) That risk equates to 1-2 more prostate cancers per 1,000 patients who took high-dose vitamin E for one year. For unclear reasons, men who took both vitamin E and selenium did not have an increased rate of prostate cancer.

Many factors influence prostate cancer risk, including age, family history and race. Visit the National Cancer Institute web site for more information about prostate cancer risk factors. NEI encourages men with concerns about taking vitamin E supplements to talk with their health care provider.

About the AREDS/AREDS2 trials

Who conducted these studies and how were they funded?

NEI funded AREDS and AREDS2. The lead investigator was Emily Chew, M.D., who is director of the NEI Division of Epidemiology and Clinical Applications and deputy clinical director of the NEI eye clinic at National Institutes of Health Clinical Research Center. Eleven clinical sites across the country participated in AREDS; 82 sites participated in AREDS2.

Additional support for AREDS2 was provided by the following NIH institutes and centers:

• NIH Office of Dietary Supplements
• National Center for Complementary and Alternative Medicine (now the National Center for Complementary and Integrative Health)
• National Institute on Aging
• National Heart, Lung and Blood Institute
• National Institute of Neurological Disorders and Stroke

The nutrients used in AREDS2 formulations were provided by Alcon, Bausch and Lomb, DSM Nutritional Products Inc., and Pfizer.

How many people participated in AREDS and AREDS2?

The original AREDS trial involved 4,757 participants, ages 55-80 at the time of enrollment. Of 4,203 surviving participants, 3,549 (about 84%) took part in the follow-on AREDS2 trial.

AREDS2 enrolled 4,203 participants, ages 50-85. Because the original AREDS trial established that the formulation does not benefit people with no AMD or early AMD, the AREDS2 trial was limited to people with intermediate AMD in both eyes, or intermediate AMD in one eye and advanced AMD in the other eye.

Will the AREDS/AREDS2 formulations help prevent cataract?

No. AREDS was designed to determine if daily intake of certain vitamins and minerals could reduce the risk of cataract and AMD. There was no effect on cataract. AREDS2 participants with the lowest level of dietary lutein and zeaxanthin, measured at enrollment, who took a formulation including those nutrients had on average a 32% reduction in progression to cataract surgery.

AREDS, AMD and genetic testing

Should I have genetic testing to learn if AREDS/AREDS2 supplements are right for me?

Data suggest that comprehensive dilated eye exams provide the best way to determine AMD risk. Genetic testing adds very little to fine tuning this estimate of AMD risk.

NEI analyses of AREDS and AREDS2 data indicate that AREDS/AREDS2 supplements are beneficial for patients of all tested genotypes. Based on the overall data, the American Academy of Ophthalmology also does not support the use of genetic testing to guide treatment for AMD.

Is genetic testing helpful for AMD? Are there drawbacks?

Although genetic testing is important for research purposes, the NEI does not recommend genetic testing for AMD because results cannot guide prevention or treatment decisions. AMD is a complex disease, involving many known and yet undiscovered genetic risk factors. Even when testing results are weighed with other known risk factors, such as diet and smoking status, genetic status fails to reliably predict risk. Some people with low AMD genetic risk develop severe disease. Likewise, some people with high genetic risk never get AMD.

Drawbacks of genetic testing for AMD include possible increased anxiety. For example, results that indicate high risk could cause needless worry. By contrast, results indicating low AMD risk might discourage regular eye exams and that might catch early signs of disease.

Is genetic testing helpful for other eye diseases?

Although not useful for AMD, genetic tests do help with the diagnosis and treatment of other eye diseases, such as Stargardt disease and von Hippel Lindau disease (VHL). In contrast to AMD, these diseases have a fixed pattern of inheritance, due usually to one faulty gene. AMD is considered complex, involving many genes and other factors. Stargardt disease is most commonly caused by mutations in a single gene called ABCA4. It can look like AMD but typically strikes at a younger age. Genetic testing can help diagnose the disease and potentially match patients to clinical trials. VHL disease can cause tumors in the eye but also in other areas, including the brain, spine, and kidney. Genetic testing for VHL disease is potentially lifesaving because a positive result strongly suggests the need for vigilant surveillance for cancer elsewhere in the body.

References

1. Age-Related Eye Disease Study Research Group, SanGiovanni JP, Chew EY, et al. The relationship of dietary carotenoid and vitamin A, E, and C intake with age-related macular degeneration in a case-control study: AREDS Report No. 22. Arch Ophthalmol. 2007 Sep;125(9):1225-32. doi: 10.1001/archopht.125.9.1225. https://pubmed.ncbi.nlm.nih.gov/17846363/
2. Eye Disease Case-Control Study Group. Antioxidant status and neovascular age-related macular degeneration. Arch Ophthalmol. 1993 Jan;111(1):104-9. doi: 10.1001/archopht.1993.01090010108035. https://pubmed.ncbi.nlm.nih.gov/7678730/
3. Seddon JM, Ajani UA, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. JAMA. 1994 Nov 9;272(18):1413-20. https://pubmed.ncbi.nlm.nih.gov/7933422/
4. Mares-Perlman JA, Fisher AI, et al. Lutein and zeaxanthin in the diet and serum and their relation to age-related maculopathy in the third national health and nutrition examination survey. Am J Epidemiol. 2001 Mar 1;153(5):424-32. doi: 10.1093/aje/153.5.424. https://pubmed.ncbi.nlm.nih.gov/11226974/
5. Snellen EL, Verbeek AL, et al. Neovascular age-related macular degeneration and its relationship to antioxidant intake. Acta Ophthalmol Scand. 2002 Aug;80(4):368-71. doi: 10.1034/j.1600-0420.2002.800404.x.  https://pubmed.ncbi.nlm.nih.gov/12190777/
6. Moeller SM, Parekh N, et al; CAREDS Research Study Group. Associations between intermediate age-related macular degeneration and lutein and zeaxanthin in the Carotenoids in Age-related Eye Disease Study (CAREDS): ancillary study of the Women’s Health Initiative. Arch Ophthalmol. 2006 Aug;124(8):1151-62. doi: 10.1001/archopht.124.8.1151. https://pubmed. ncbi.nlm.nih.gov/16908818/
7. Tan JS, Wang JJ, et al. Dietary antioxidants and the long-term incidence of age-related macular degeneration: the Blue Mountains Eye Study. Ophthalmology. 2008 Feb;115(2):334-41. doi: 10.1016/j.ophtha.2007.03.083. https://pubmed.ncbi.nlm.nih.gov/17664009/
8. Lippman SM, Klein EA, et al.Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2009 Jan7;301(1):39-51. doi: 10.1001/jama.2008.864. Epub 2008 Dec 9. https://pubmed.ncbi.nlm.nih.gov/19066370/
9. Gaziano JM, Glynn RJ, et al. Vitamins E and C in the prevention of prostate and total cancer in men: the Physicians’ Health Study II randomized controlled trial. JAMA. 2009 Jan 7;301(1):52-62. doi: 10.1001/jama.2008.862. https://pubmed.ncbi.nlm.nih.gov/19066368/
10. The ATBC Cancer Prevention Study Group. The alpha-tocopherol, beta-carotene lung cancer prevention study: design, methods, participant characteristics, and compliance. Ann Epidemiol. 1994 Jan;4(1):1-10. doi: 10.1016/1047-2797(94)90036-1. https://pubmed.ncbi.nlm.nih.gov/8205268/

Definitions

AREDS

Age-Related Eye Disease Study

AREDS2

Age-Related Eye Disease Study 2

AMD

Age-related macular degeneration

mg

milligrams

IU

international units

Formulation

In this document, a collection of vitamins and minerals given to participants as part of AREDS or AREDS2

Formula

In this document, the collection of vitamins and minerals found to be effective for slowing progression to advanced AMD in AREDS and AREDS2

Placebo

A pill given during a clinical trial that does not contain any active ingredients.

Troubleshooting saving Excel workbooks – Office

• Article
• 04/13/2023

• Applies to:

  Excel for Microsoft 365, Excel 2019, Excel 2016, Excel 2013, Excel 2010, Microsoft Office Excel 2007, Microsoft Office Excel 2003

Microsoft Excel automatically saves the file as you work with the workbook. Gives the file a temporary file name and places the file in the same folder as the original version. When you manually save a workbook, the original file is deleted and the temporary file is given its original filename.

If this process is interrupted, the workbook might not have completed saving successfully. You may also find one or more temporary files in the folder where you tried to save the file. In addition, you may receive one of the alerts or error messages.

The following information can help you identify possible causes of this problem and suggest solutions to resolve it.

Possible reasons why documents are not saved

Select the tab you are interested in or go to the Quick Resolution section.

• Third party add-ons
• Permissions
• Document not saved
• Disk space
• Antivirus software
• File Sharing
• File name

If you cannot save a workbook in Microsoft Excel running in Windows Safe Mode, the problem may be due to a third-party add-in or a file located in one of Excel’s startup folders. By default, boot files are loaded when Excel starts.

Some third-party software add-ons are designed to work with existing Excel features, while others provide a seamless transition when using a third-party software. Typically, these third-party add-ins do not affect the functionality of Excel. However, some functionality, such as saving a file, may be affected.

To determine and eliminate the possibility that a third-party Excel add-in or file is causing the Excel save problem, try saving the file in safe mode. To do this, follow these steps:

1. Close Excel.

2. Click Start and select Programs .

3. When starting Excel, press and hold the Ctrl key until the following message appears:

   Excel detected that you were holding down the CTRL key. Do you want to start Excel in safe mode?

4. Select Yes .

5. Open a new Excel workbook and try to save it. If that helps, try saving the problematic file again.

If the file now saves correctly, the problem is most likely caused by a custom add-in or a file in the Excel Startup folder. To fix the problem, you need to find and remove this add-in or file. Once you have determined which add-on or file is causing the problem, contact the vendor for more information or an update that will resolve the issue.

For more information about Microsoft Excel Safe Mode, press F1 in Excel to access the Help menu. Type Safe Mode in the Search field, and then click Search to view the information you need.

For more information about how to determine the folders that Excel uses at startup, and additional options to disable this feature, see the following articles:

• Use startup folders in Excel
• Prevent automatic opening of files in Excel

Quick fix

If any of the above reasons doesn’t apply to you, or if you still can’t save workbooks, try the following options to save files in Excel. To learn more about the steps, select the chevron image on the left or the option title.

Additional Resources

To avoid problems saving documents properly, we recommend that you enable AutoSave. For more information, see What is AutoSave?

If you are having problems using Excel, go to the following website to find more information about your program version: a more detailed description of these options.

You may experience problems saving a Microsoft Excel workbook if any of the following conditions are true.

• The user is trying to save an Excel workbook to a network drive without the required permissions.
• You are trying to save an Excel workbook on a disk with insufficient free space.
• The connection to the Excel workbook was lost.
• There is a conflict with the antivirus program.
• An attempt is being made to save a shared Excel workbook.
• The path length limit (218 characters) was exceeded when saving an Excel workbook.

Workarounds for saving Excel workbooks

Use the following methods to work around this issue and save your work before troubleshooting. You may not be able to restore the current file in its current form, depending on the cause of the problem. However, the following methods are often useful. They are arranged according to the degree of format preservation (taking into account the attempt to save the file in a format as close as possible to the original).

The methods described below do not always allow you to save all the latest changes, formatting, and settings specific to the version of Excel you are using. They are designed to save a file in a form that allows its use. You will need to save the file to your local hard drive using a unique filename.

Option 1: Save the workbook with a new name

1. From the File menu, select Save As .
2. Saving a book with a unique name

Option 2: Move source sheets to a new workbook

1. Add a placeholder sheet to the book. To do this, press Shift+F11.

   Note.

   This sheet is required because after moving all the required data sheets, at least one sheet must remain in the workbook.

2. Group all sheets (except the filter). To do this, click the first data sheet, then hold down the Shift key and click the last data sheet.

3. Right-click the grouped sheets and select Move or copy .

4. In the To book list, select (New book) .

5. Press OK .

   Note.

   As a result of these actions, active (grouped) sheets should be moved to a new workbook.

If the workbook contains VBA macros, copy the modules to a new workbook.

Option 3: Save the file in a different Excel format

1. From the File menu, select Save As .
2. In the File type list, select a file format other than the current one. If you are using Microsoft Excel 2007 or later, save the file in XLSX or XLSM format instead of XLS.

Option 4: Try saving the book to a different location

Try saving the workbook to a different location, such as a local hard drive, a network drive, or a removable drive. If you managed to do this, the following causes of the problem are possible:

• Antivirus conflict
• Lack of necessary permissions
• Excessive file name length
• File sharing conflict

Option 5: Try saving the new workbook to its original location.

To save the new Excel file to its original location, do the following:

1. Create an Excel workbook.

2. From menu File select command Save as .

3. In the Save as dialog, do the following:

   1. In the Folder field, click the folder where the source workbook is stored.
   2. In field Filename , enter a name for the new file.
   3. Select Save .

If the new workbook can be saved to its original location, the problem may be caused by the following reasons.

• File name too long
• File sharing conflict

If the new workbook cannot be saved to its original location, the problem may be caused by the following reasons.

• Not enough disk space

If you have enough free disk space, try method 3.

Option 6: Try saving the workbook in safe mode

Restart Windows in safe mode and try saving the workbook to your local hard drive.

Notes .

• If you use a network folder to save the workbook, restart Windows in Safe Mode with Networking and try to save the workbook again.
• You cannot use Windows Safe Mode to troubleshoot problems in Microsoft Excel 2010 and later versions.

For more information about starting Windows in Safe Mode, see Advanced startup options (including Safe Mode).

If the workbook is saved after restarting Windows in Safe Mode, try saving the file again. To do this, select menu File Item Save .

If the workbook is not saved after restarting Windows in Safe Mode, the problem may be caused by the following reasons:

• Use of third-party add-ons
• Antivirus conflict
• Lack of necessary permissions
• Excessive file name length

Need more help? Go to the Microsoft Community site.

Conserve and sustainably use the oceans, seas and marine resources for sustainable development – Sustainable Development

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Goal 14: Conserve and sustainably use the oceans, seas and marine resources for sustainable developmentElmira Tairova2020-07-29T13:49:33-04:00

The ocean determines the operation of global systems that make the Earth habitable for mankind. Our rainwater and drinking water, weather, climate, coastlines, much of our food, and even the oxygen in the air we breathe are all ultimately provided and regulated by the sea. The rational use of this most important global resource is the key to a sustainable future. However, coastal waters are now steadily deteriorating due to pollution, and ocean acidification is adversely affecting ecosystem functioning and biodiversity. It also negatively affects small-scale fisheries.

Saving our ocean must remain a priority. Marine biodiversity is critical to the health of people and our planet. Marine protected areas must be effectively managed and adequately resourced, and regulations must be adopted to reduce overfishing, marine pollution and ocean acidification.

COVID-19 response

Ocean conservation and action must not stop while we fight the COVID-19 pandemic. We need to look for long-term solutions for the health of our planet as a whole. Our lives depend on the health of our planet. The health of the ocean is closely related to our health. According to UNESCO, the ocean can become an ally in the fight against COVID-19: bacteria found in the depths of the ocean are being used to conduct rapid tests to determine the presence of COVID-19. And the diversity of species found in the ocean holds great promise for the development of pharmaceuticals. The pandemic offers an opportunity to revive the ocean and start building a sustainable ocean economy.

A report by the United Nations Economic and Social Commission for Asia and the Pacific suggests that the COVID-19 pandemic could provide the marine environment with a much-needed respite and let her start to recover. The UN Ocean Conference, originally scheduled for June 2020, has been rescheduled to a later date (tbc) due to the COVID-19 pandemic.

• Facts and figures

• Tasks

• Useful links and numbers

• percent of the total area of ​​the planet.
• More than three billion people depend on marine and coastal biodiversity.
• Globally, the market value of marine and coastal resources and industries is estimated at $3 trillion a year, or about 5 percent of global GDP.
• The oceans contain nearly 200,000 identified species, but the real numbers could be in the millions.
• The oceans absorb about 30 percent of the carbon dioxide produced by humans, helping to offset the effects of global warming.
• The oceans are the world’s largest source of protein, with more than 3 billion people dependent on the oceans as their main source of protein.
• Marine fish stocks provide employment directly or indirectly to more than 200 million people.
• Fisheries subsidies contribute to the rapid depletion of many fish species and hamper efforts to conserve and restore the world’s fish stocks and create related jobs, causing the ocean fisheries industry to lose $50 billion each year.
• Current levels of ocean acidification have increased by 26 percent since the start of the industrial revolution.
• Observed global trends indicate continued deterioration of coastal waters due to pollution and eutrophication (excessive nutrient levels in the water, often due to sewage from land entering the marine environment, leading to vigorous plant growth and death of animals due to lack of oxygen) . If action is not taken, eutrophication will increase by 20 percent by 2050.

• Targets

• 14.1 By 2025, prevent and substantially reduce pollution of the marine environment, including from land-based activities, including marine debris and nutrient pollution
• 14.2 By 2020, sustainably manage and protect marine and coastal ecosystems to prevent significant adverse impacts, including by enhancing the resilience of these ecosystems, and take action to restore them to ensure healthy and productive oceans
• 14. 3 Minimize and eliminate the effects of ocean acidification, including through the development of scientific cooperation at all levels
• 14.4 By 2020, effectively manage harvests and end overfishing, illegal, unreported and unregulated fishing and destructive fishing practices, and implement science-based management plans to restore fish stocks as soon as possible, bringing them to at least up to levels that are capable of producing the maximum sustainable yield, taking into account the biological characteristics of those stocks
• 14.5 By 2020, protect at least 10 per cent of coastal and marine areas, in accordance with national and international law, and based on the best available scientific information
• 14.6 By 2020, ban certain forms of fisheries subsidies that encourage overcapacity and overfishing, eliminate subsidies that encourage illegal, unreported and unregulated fishing, and refrain from introducing new such subsidies, recognizing that appropriate and effective application of special and differentiated regime for developing and least developed countries should be an integral part of the negotiations on
  Fisheries subsidies operated under the World Trade Organization
• 14. 7 By 2030, increase the economic benefits to small island developing States and least developed countries from the sustainable management of marine resources, including through sustainable management of fisheries, aquaculture and tourism
• 14.a Increase scientific knowledge, research and transfer of marine technology, taking into account the Criteria and Guidelines for the Transfer of Marine Technology developed by the Intergovernmental Oceanographic Commission, in order to improve the ecological state of the ocean environment and enhance the contribution of marine biodiversity to development of developing countries, especially small island developing States and least developed countries
• 14.b Ensure that small-scale artisanal fishers have access to marine resources and markets
• 14.c Improve the conservation and sustainable use of the oceans and their resources by complying with international law as enshrined in the United Nations Convention on the Law of the Sea, which, as noted in paragraph 158 of The Future We Want, provides the legal framework for the conservation and rational use of the oceans and its resources

• useful links

  On the current course of development, nearly 600 million people will be living in extreme poverty by 2030.