Lutein and zeaxanthin supplements: what AREDS2 showed and who benefits
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- AREDS2 formula eye vitamins. Best for: People with intermediate AMD whose eye doctor recommends the AREDS2 formula. See options on Amazon
- Lutein and zeaxanthin softgels. Best for: Adults who want lutein and zeaxanthin on their own. See options on Amazon
- Lutein 10 mg with zeaxanthin 2 mg. Best for: People who want the same lutein and zeaxanthin amounts used in AREDS2. See options on Amazon
What lutein and zeaxanthin are
The National Eye Institute (NEI) describes lutein and zeaxanthin as carotenoids, a class of plant-derived vitamins that includes beta-carotene. Supplements are usually made from marigold flower extract; NOW Foods' Lutein and Zeaxanthin, for example, lists both from Tagetes erecta.
NEI tested lutein and zeaxanthin in AREDS2, a large trial designed to see whether they would make the original AREDS eye formula more effective, and whether they could replace beta-carotene.
What AREDS and AREDS2 found
| Question | NEI finding |
|---|---|
| Slows intermediate AMD to advanced AMD? | Yes, AREDS/AREDS2 formulas lower risk by about 25 percent |
| Prevents AMD from starting? | No |
| Affects cataracts? | No |
| Omega-3s help AMD or cataract? | No |
AREDS. The first study enrolled 4,757 people aged 55 to 80. In people with intermediate AMD, or advanced AMD in one eye, a formula of antioxidants plus zinc and copper lowered the risk of advanced AMD by about 25 percent and central vision loss by 19 percent.
AREDS2. NEI enrolled 4,203 people aged 50 to 85 with intermediate AMD. Adding lutein (10 mg) and zeaxanthin (2 mg) to the AREDS formula had no extra overall effect, but people who took the formula with lutein and zeaxanthin instead of beta-carotene (the AREDS2 formula) had an added benefit compared with the original formula.
Smokers. Former smokers in AREDS2 who took beta-carotene had more lung cancer. NEI advises current and former smokers to use the AREDS2 formula, which replaces beta-carotene with lutein and zeaxanthin.
The AREDS2 formula
NEI lists these daily amounts in the AREDS2 formula:
- Vitamin C: 500 mg
- Vitamin E: 400 IU
- Lutein: 10 mg
- Zeaxanthin: 2 mg
- Zinc: 80 mg
- Copper (cupric oxide): 2 mg, added to avoid zinc-related copper deficiency
AREDS2 found no significant change in effectiveness when the zinc dose was lowered. Many products marketed as eye vitamins do not match these amounts, so compare labels to the NEI list if your eye doctor recommends an AREDS2 formula.
Who these supplements are for
- Intermediate AMD, or advanced AMD in one eye. This is the group that benefited in AREDS and AREDS2.
- No AMD or early AMD. AREDS2 excluded these groups because AREDS showed no benefit for them.
- Cataract. Neither formula affected cataracts or the need for cataract surgery.
- General eye health. Lutein and zeaxanthin alone are widely sold, but the AMD evidence comes from the full AREDS2 formula.
NEI notes AMD and cataract are leading causes of vision loss in the United States, and risk rises sharply after age 65. An eye doctor can tell you whether you have AMD and which stage, which decides whether these formulas apply to you.
Reading a lutein and zeaxanthin label
- Amounts. AREDS2 used 10 mg lutein and 2 mg zeaxanthin. NOW Foods' softgel gives 25 mg lutein and 5 mg zeaxanthin, taken once daily with a fat-containing meal.
- Take with fat. These carotenoids are labeled to be taken with a meal containing fat.
- AREDS2 style formulas. Check for the full NEI list of vitamin C, vitamin E, zinc and copper if that is what your doctor advised.
- Avoid beta-carotene if you smoke or smoked. Choose the AREDS2 formula, not the original AREDS formula.
- Extras. Some eye vitamins add omega-3s, which AREDS2 found did not help AMD or cataract.
What to look for when you buy
AREDS2 formula eye vitamins
Best for: People with intermediate AMD whose eye doctor recommends the AREDS2 formula
NEI found the AREDS2 formula lowers the risk of progression to advanced AMD by about 25 percent in this group.
Watch out: Check the label matches NEI amounts. Does not prevent AMD or affect cataracts. High zinc; follow your doctor's advice.
See options on AmazonLutein and zeaxanthin softgels
Best for: Adults who want lutein and zeaxanthin on their own
NOW Foods lists 25 mg lutein and 5 mg zeaxanthin from marigold per softgel, taken with a fat-containing meal.
Watch out: Not the full AREDS2 formula studied for AMD. Ask your provider if pregnant or taking medicines.
See options on AmazonLutein 10 mg with zeaxanthin 2 mg
Best for: People who want the same lutein and zeaxanthin amounts used in AREDS2
Products with 10 mg lutein and 2 mg zeaxanthin match the amounts NEI tested.
Watch out: On its own, it lacks the vitamins and zinc in the full AREDS2 formula.
See options on AmazonQuestions people ask
- Do lutein and zeaxanthin supplements work?
- In people with intermediate AMD, the AREDS2 formula containing them lowers the risk of advanced AMD by about 25 percent. They do not prevent AMD or cataracts.
- How much lutein and zeaxanthin is in AREDS2?
- 10 mg lutein and 2 mg zeaxanthin daily, along with vitamin C, vitamin E, zinc and copper.
- Should smokers take beta-carotene for their eyes?
- No. NEI advises current and former smokers to use the AREDS2 formula, which replaces beta-carotene with lutein and zeaxanthin.
- Can lutein prevent cataracts?
- AREDS and AREDS2 found no effect on cataracts.
- When should I take lutein?
- With a meal containing fat, as NOW Foods directs.
Sources
- AREDS/AREDS2 Clinical Trials (nei.nih.gov), National Eye Institute
- Lutein and Zeaxanthin Softgels (www.nowfoods.com/products/supplements/lutein-zeaxanthin-softgels), NOW Foods