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From the Townsend Letter
April 2019

Cataracts – An Integrative Medical Approach
by Marc Grossman, OD, LAc
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The Perfect Pair: Glutathione and Vitamin C
The importance of vitamin C to eye health cannot be overstated; concentrations of vitamin C in the lens are 20–30 times higher than those in the plasma.18 Vitamin C doesn't work alone: it needs glutathione to improve the use of ascorbic acid (the purist form of vitamin C) in the body.

Glutathione and vitamin C are thought to work together to promote proper water balance within the lens and prevent the protein clumping that can lead to cataracts.

Very Important Nutrients
Lutein, 6 mg–20 mg per day. This powerful antioxidant is found both in the lens of the eye and retina, and it helps protect the eyes from damage due to sunlight exposure by filtering out light.19-23

Zeaxanthin, 2 mg–12 mg per day. This powerful antioxidant is found in the lens of the eye and the retina, which helps protect the eyes from damage due to sunlight exposure by filtering out light.21-24

Alpha-lipoic acid, 120 mg–300 mg per day. Alpha-lipoic acid has been found to halt complications resulting from blood sugar imbalances and hardening of the lens. Oxidative damage results in cataract formation, and increasing antioxidants, particularly alpha-lipoic acid, can help prevent or stop cataract formation.25-27

Important Nutrients
An optimal potency multivitamin is an important foundation of any cataract prevention program. It should include flavonoids and carotenoids. Scientists found that the risk of cataract formation decreased in the regular users of multivitamin supplements (one-third risk decrease).

Flavonoids, 1,000 mg per day. Quercetin and rutin are important antioxidants that are synergistic with vitamin C, meaning they need each other to work efficiently. Of the two, quercetin seems to be one of the most effective flavonoids in the prevention of cataracts.28,29

BDNF EssentialsHelpful Nutrients
Green tea extract, 500 mg–725 mg per day. High in antioxidants, this supplement helps protect the eyes against oxidative damage.30

Selenium, 200 mcg per day. Patients with senile cataracts were found to have significantly lower blood- and intraocular levels of the mineral selenium than controls.31

N-acetyl-carnosine (NAC), 500 mg per day. Statistical analysis revealed the significant differences over 6 and 24 months in cumulative positive changes of overall characteristics of cataracts in a group taking NAC.32

Bilberry, 180 mg–240 mg per day, taken along with vitamin E, 400 IU per day. Some studies suggest that bilberry may slow cataract formation. Bilberry combined with vitamin E stopped cataract formation in 48 of 50 patients with senile cortical cataracts.33 In an animal model, supplementation with bilberry extract helped to protect DNA and improve enzyme activity in lens tissue.34

Resveratrol, 250 mg per day. Resveratrol activates an enzyme called sirtuin type 1 (SIRT1), which protects against oxidative stress in human lens epithelial cells.35 This enzyme inhibits oxidation in the eye's lens and protects against cataract development.

Melatonin, 1 mg – 3 mg before bed-time. Melatonin can help increase levels of reduced glutathione in the body.36

Milk thistle, suggested dosage 480 mg–960 mg per day. Milk thistle contains silymarin (its main ingredient), which possesses both anti-inflammatory and antioxidant properties. Because of this, milk thistle may help boost glutathione by preventing glutathione depletion in the liver and helping to cleanse the liver, which is essential for lens health.

Vitamin E, suggested dosage 400 IU per day. In percentages that were statistically significant, studies have found that high levels of dietary vitamin E, supplemental vitamin E, and high levels of vitamin E in the bloodstream are all tied to a lower risk of cataract. As the levels of vitamin E dropped, the incidence of cataract increased.32,37-39

Saffron, suggested dosage 20 mg per day. An interesting and related study found that crocin, a saffron apocarotenoid, was helpful in reducing diabetic cataracts.

There is a strong correlation between the risk of cataract onset and the patient's diet. Subjects who ate the most meat had the highest rate of cataracts, and those who ate fish but not meat had a lower rate. Vegetarians had a lower rate and vegans had the lowest rate of cataract incidence.41

Whenever possible, a nutritional program should be maintained for at least three to four months to help with quicker recovery and retinal support, before considering cataract surgery.

Juicing is a great way to deliver nutrients to the body. Our juicing recipe for cataracts is some combination of the following. You can add your favorite fruits and vegetables.

  • Fresh apple, endive, carrots, celery, parsley, blueberry, and fresh leafy-green vegetables.
  • Not too many carrots because of their high natural sugar content.

This combination helps warm and detoxify the body and provide great nutrients for nourishing the eyes.

It is very important to reduce or eliminate all types of refined sugars (particularly white sugar, but also fructose, sucrose, fruit juice concentrates, maltose, dextrose, glucose, and refined carbohydrates). This includes "natural" drinks that contain a lot of sugar, including all fruit juices. Those people who are lactose intolerant are at higher risk for cataracts.42

Drink eight glasses of water per day (preferably filtered or purified). This is optimally taken as a four-ounce glass of water every half-hour, to equal 16 four-ounce glasses.

Our bloodstream can only effectively handle about four ounces at any one time. When you drink more at a time, this means more work for the kidneys to filter water that hasn't had a chance to travel through the lymph system and to clean body tissues. Adequate water intake helps to maintain the flow of nutrients to the lens and to release wastes and toxins from tissues.

Eat foods high in vitamin A or beta-carotene, vitamin C, and vitamin E. These substances are called antioxidants, and most of the nutritional components of cataract prevention and reversal are related to boosting antioxidant levels. Antioxidants are one of the most important combatants against free radicals, a major cause of cataract formation (and other eye disease). A good diet supplemented with antioxidant vitamins and minerals can help prevent the damage due to oxidation and free radicals.43-48 Foods high in antioxidants include leafy-green vegetables, garlic, onions, beans, celery, sea vegetables, apples, carrots, tomatoes, turnips, and oranges.

It is also important to eliminate dairy products, at least temporarily. Some foods, particularly dairy products, can exacerbate eye problems by creating mucus and causing sinus congestion, which can impair lymph and blood drainage from the area around the eyes. When lymph and blood can't flow in and out of the eyes, nutrients don't reach the eyes effectively, and toxins and metabolic wastes aren't eliminated as efficiently. Try avoiding dairy for a month to see whether you become less congested and your eye issues clear up.

Note. Many people are lactose intolerant to some degree. Generally, reducing or eliminating dairy from one's diet has innumerable positive benefits on the eyes and the entire body.

Lifestyle Recommendations
While supplementation is important, nothing replaces a positive, healthy lifestyle that includes regular exercise, daily meditations or walks in nature, and a healthy diet.

The rapid pace of life often interferes with people taking time to care for themselves properly, and on all levels – mental, emotional, spiritual, and physical. However, proper care maximizes the mind/body connection and its inherent healing potential, which is essential for restoring and maintaining health.

Avoid smoking. Researchers have established that smoking cigarettes substantially increases the risk of developing age-related cataracts. Smoking accounts for about 20% of all cataract incidences.49-51

Eye Drop Recommendations
The following eyedrops have either a long history of safe usage for cataract management and/or have research studies showing related benefits to lens health. Take one eyedrop formula to start or any combination of the three. We recommend taking eyedrops for at least three to six months to start; this will help you determine their efficacy. Look for a reduction in common symptoms to cataracts, such as related reduction in blurriness and/or less sensitivity to glare, particularly at night.

Cineraria homeopathic eyedrops, one drop in each eye, two to three times per day, best taken at least 30 minutes apart from other eyedrops. This eyedrop has been listed in the Ophthalmology Physician's Desk Reference herbal section for over 38 years as a treatment for cataracts. They can be taken by themselves or with other eyedrops.52

N-acetyl-carnosine eyedrops 1%, two drops in each eye, two times per day, best to separate each eyedrop by approximately one minute. See Appendix Section 5 for product recommendations.32

Oclumed eyedrops, one drop in each eye, two times per day. These eyedrops contain a range of antioxidants including l-carnosine, n-acetyl-l-carnosine, l-gluta-thione, cysteine ascorbate (providing a source of vitamin C), l-cysteine, taurine and other nutrients to support the repair of the damaged lens tissues.

Long-term regular exercise, as opposed to a burst of exercise training, reduces the risk of cataracts. High levels of inactivity increase cataract risk.53

Many therapies promote improved flow of energy and circulation throughout the body. The daily stress that we encounter due to a poor diet, emotional imbalances, lack of regular exercise, and more can cause areas within the body to tighten up, which restricts circulation. The eyes are the second most biologically active part of the body; only the brain is more active. So, they require a great deal of nutrition and the free flow of blood and energy to remain healthy. Eye exercises are helpful for maintaining good vision and promoting microcirculation in the eyes.

Inversion poses in yoga have been shown to aid blood flow to the heart and head. It may seem counter-intuitive, but the blood is more freely able to move to the upper extremities, these exercises can be very relaxing to the eyes and face. As such, they are particularly helpful in the prevention of eye conditions. One of the best and safest inversion poses is lying on the floor with your legs up a wall. Beginning, as well as advanced yoga practitioners equally enjoy this posture.

After cataract surgery, avoid inversions. This includes standing forward bends like Uttanasana and Prasarita Padottanasana (wide-leg forward bend), and even downward-facing dog. You can still include modified poses like half dog pose at the wall. If you apply the rule of not bending past 90 degrees from vertical, you will minimize the pressure increase to the head and subsequently to the eye. Other rather obvious poses that could have a similar effect are those that require strong, sustained contraction of the abdominal muscles, which would also increase blood pressure in the eyes.

Poses like boat pose (Navasana), deep held twists (even sitting versions), and arm balances like crow pose also fall into this category.

In a time of healing you want to keep the nervous system quiet, spending more time in the "rest and digest" part of the autonomic nervous system. So, spend the two-week healing period doing gentler practices, including lots of supported restoratives and guided meditations on health and healing.

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