~Glaucoma, Part 4 - Summary
Current glaucoma research appears to focus on providing neuroprotection to retinal ganglion cells (Osborne et al. 1999a; 1999b). This approach may benefit those displaying normal tension but still experiencing progressive visual-field loss. Recommendations to reduce IOP are also included. Glaucoma represents a serious eye condition, requiring monitored supervision by a qualified ophthalmologist. Best results might be obtained by working with a complementary physician who employs the best of orthodox and alternative wisdom.
Some of the following suggestions replicate the same mechanism and should be structured to individual needs:
- Vitamin B12, methylcobalamin, is the choice of many wishing to delay the death of neurons observed in the aging process. Sublingual methylcobalamin supplementation is considered therapeutic for central and peripheral neurological damage, at dosages of 5 mg dispensed throughout the day so that the total intake amounts to 40 mg a day. Do not eat the tablet as one would candy. Let the B12 dissolve slowly under the tongue. This form of vitamin B12 is an alternative to weekly B12 shots and may be quite useful in the prevention of neurotoxicity.
- Aminoguanidine (300 mg daily) has shown neuroprotective benefits. Aminoguanidine reduces nitric oxide, protecting against oxygen deprivation and decreasing the death of the retinal ganglion cells. Limited clinical experience involving aminoguanidine suggests it should not be used in doses greater than 300 mg a day.
- Alpha-lipoic acid has attained favorable attention in the treatment of glaucoma. It appears to improve ocular hypertension and visual function. Current glaucoma research considers a daily dose of 150 mg adequate for glaucoma treatment.
Note: Much larger dosages are used in diabetes and AIDS (300-600 mg daily) without significant side effects. (This information is included to illustrate the safety parameters of alpha lipoic acid.) Possible side effects include skin rash and hypoglycemia. Lipoic acid can worsen a B1 deficiency. Chronic usage of lipoic acid can interfere with biotin utilization, so make sure you are taking plenty of biotin and vitamin B1 when taking over 100 mg a day of alpha lipoic acid.
Do not use C. forskohlii if prostate cancer is apparent. During C. forskohlii usage, monitor blood pressure, being alert for hypotension.
- Topically applied eye drops may be a more effective delivery system for antioxidant protection. Brite Eyes II contains nutrients that protect against free radicals. The formula also contains the antiglycating agent N-acetyl-L-carnosine, which helps prevent the formation of nonfunctioning protein crosslinks. A daily dose of 1-2 drops in each eye is suggested for general eye health.
- The Life Extension Mix, 9 tablets or 14 capsules daily, or 1 tbsp. of powder daily provides a storehouse of nutrients, including magnesium, zinc, chromium, selenium, vitamin A, thiamine, vitamin C, bioflavonoids, grape-seed-skin extract, vitamin E, and bilberry, which could benefit ocular health. Some individuals may wish to emphasize additional amounts of the most beneficial of these herbs and nutrients, regarding glaucoma management.
- Use vitamin C crystals or a powdered form of vitamin C, buffered with magnesium. (This type is added to a liquid and is considered highly absorbable.) The buffered form of vitamin C is easier on the stomach when large amounts of ascorbate are ingested. The magnesium will tend to act as a calcium channel-blocker and temper a sympathetic nervous response. The vitamin C may assist in lowering IOP and establishing healthy collagen. Some individuals will realize benefit from as little as 2 grams of vitamin C daily; others will need as much as 35 grams daily. Some practitioners use 500 mg of vitamin C per kilogram (2.2 lbs) of body weight, a dose that must be reached gradually. Vitamin C should be spaced throughout the day, allowing a continuous supply of ascorbate.
- Grape-seed-skin extract, rich in proanthocyanidins, increases the effectiveness of vitamin C. Together they support healthy collagen and defend against free radicals. A therapeutic dose of proanthocyanidins is considered to be 150-300 mg daily. Usually this dose can be reduced after a month's saturation.
- Select bilberry by evaluating its anthocyanosides content. (This is calculated by the percentage of anthocyanidin present, typically 25%.) The dosage for bilberry, the "eye herb," is 100 mg, 2 times daily (or as directed by your health-care professional).
- Acetyl-L-carnitine is an important adjuvant in neuropharmacology. A dosage of 3000 mg daily may be used. With most supplements, including acetyl-L-carnitine, gradual introduction of the supplement is advisable, allowing the body to adjust to the actions of the substance.
- Individuals with healthy liver function may use 25,000-50,000 IU daily of vitamin A. (Some research indicates the emulsified form of vitamin A is less stressful on the liver.) Vitamin A from all supplemental sources should be calculated into the daily total, being watchful of the cumulative amounts. Although toxicity is not usually associated with low doses, people should acquaint themselves with the symptoms of vitamin A toxicity (see Appendix A). Pregnant women should use vitamin A only after careful consultation with their physician. The benefits of vitamin A include decreased dry, itchy, inflamed eyeballs and an increase in visual purple, a substance needed for night vision.
- Select Coleus forskohlii standardized to contain 18% forskolin. Use 50 mg (9 mg of forskolin 2-3 times per day) to assist in lowering IOP.
The preceding pages have delineated many pharmaceutical drugs that have been efficacious in glaucoma control. Nutritional pharmacology offers choices, as well. It appears important to have a relationship with a physician who employs the best from all disciplines. Side effects and quality of life should impact the selection of an ongoing protocol. When contemplating the number of therapeutic agents available to a glaucoma patient, obviously the individual has many options.
- Hydergine's mechanism of efficacy appears similar to C. forskohlii. Hydergine reduces hypoxia and free-radical damage. A dosage of 3-20 mg daily is considered appropriate.
- Attempts to reduce stress are valuable to the glaucoma patient. External stress begets internal stress, both of which equate to physical disruption. Unpleasant interactions with others, temperature extremes, and fatigue are not desirable for anyone, especially individuals with glaucoma.
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