B vitamin supplements may reduce eye damage in glaucoma

Glaucoma is a serious eye disease that is often detected too late. In worst case, it can lead to blindness. A Swedish study from Karolinska Institutet, published in Cell Reports Medicine, shows that supplementation with various B vitamins can improve the metabolism in the eye, which may slow down the deterioration of the optic nerve. It is also important to get enough of the different B vitamins if you want to prevent the condition.

Around 80 million people worldwide suffer from glaucoma. The disease, which includes various complex eye disorders, is caused by damage to the optic nerve, which leads from the retina to the brain’s visual center. Over time, these changes can affect the field of vision, resulting in progressive visual deterioration and, in the worst case, blindness. In its early stages, the disease is asymptomatic, which is why it is often detected too late. However, an eye doctor can observe early changes in the optic nerve, and this often happens in connection with regular checkups.
It is well known that aging increases the risk of developing glaucoma. It has also been suggested that elevated levels of homocysteine in the blood increase the risk. Homocysteine is an amino acid that is produced by the body’s cells after breaking down the amino acid methionine. Homocysteine must then be converted into the amino acid cysteine, which is involved in many metabolic processes. Homocysteine is a metabolic waste product of amino acid metabolism, and levels of this compound must be regulated, as it can be toxic in high doses. Elevated homocysteine levels can cause oxidative stress and inflammation, which, among other things, can damage nerve cells in the eye.
Because of homocysteine’s natural role in cellular metabolism, researchers from Karolinska Institutet in Stockholm wanted to investigate the specific metabolic processes involved in humans and rodents with glaucoma. The researchers found several abnormalities, the most important of which were metabolic changes related to the retina’s ability to utilize certain vitamins. These changes slow down the metabolism in retinal cells and make it inefficient, which contributes to the progression of the disease.
The researchers concluded that homocysteine, rather than being a driving factor in the development of the disease, appears to be a consequence. Therefore, they wanted to investigate whether supplementation with certain vitamins could protect the retina.

Promising results with supplements of vitamins B6, B9, B12, and choline

In studies of mice and rats with glaucoma, the researchers administered supplements of vitamin B6, vitamin B9 (folic acid), vitamin B12, and choline. These B vitamins are needed for the conversion of homocysteine to cysteine. Choline, which belongs to the B vitamin family, is also known to play a role in eye health, including the prevention of glaucoma.
The Swedish study showed that the supplements had a positive effect. In mice with a slow-developing form of glaucoma, optic nerve damage was completely halted. And in rats with a more aggressive form of glaucoma, disease progression was slowed, making it less severe.
These studies in mice and rats with glaucoma did not affect the intraocular pressure in the eyes of the animals. The researchers find this interesting, as it indicates that supplementation with these B vitamins and choline must slow disease progression through a mechanism other than lowering eye pressure.
According to the researchers, their results are so promising that they have now launched a clinical trial involving patients with different forms of glaucoma. The patients have been recruited from St. Erik Eye Hospital in Stockholm. For glaucoma prevention, it is also relevant to be well-supplied with these B vitamins, which many people lack.

• B vitamins are found in coarse and green foods such as whole grains, vegetables, legumes, nuts and seeds, as well as liver, eggs, meat, and fish. Vitamin B12 is found only in animal products, which are also the richest source of choline.
• Deficiency of B vitamins and choline may be due to unbalanced diets, high sugar intake, alcohol abuse, stress, antacid medications, antibiotics, and the aging process.

Vitamin B3 may have additional potential in prevention and treatment

Mice that are genetically predisposed to glaucoma can avoid the disease if vitamin B3 is added to their drinking water. This was shown in a previous American study published in Science, where the researchers explain how vitamin B3 boosts the production of NAD (nicotinamide adenine dinucleotide), which helps strengthen and repair nerve cells. According to the scientists, B3 vitamin may even protect against glaucoma in humans. Read more:

»Vitamin B3 prevents glaucoma in mice and possibly even in humans«

Referencer:

James R Tribble et al. Dysfunctional one-carbon metabolism vitamin B6, B9, B12 and choline as neuroprotective in glaucoma. Cell Reports Medicine. 2025

Karolinska Institutet. Vitamin supplements slow down the progression of glaucoma. ScienceDaily 2025

Jackson Laboratory. Vitamin B3 prevents glaucoma in laboratory mice. ScienceDaily 2017