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Product Review: Vision Supplements with Lutein and Zeaxanthin
 

Initial Posting: 10/12/12 Updated 5/7/13
Lutein, Zeaxanthin and Vision Supplements Tested by ConsumerLab.com
Sections:Jump to a section by clicking on its name.
What It Is:
Lutein and zeaxanthin are members of the carotenoid family — a group of natural plant pigments that includes beta-carotene and lycopene. Lutein and zeaxanthin have identical chemical formulas and are isomers. They are unique in that they, along with a stereoisomer of zeaxanthin known as meso-zeaxanthin, are the only carotenoids found in high concentration in the macula of the eye and surrounding retinal tissue, where they may protect the eye from damaging light. Lutein and zeaxanthin are available from a wide variety of foods and it is believed that meso-zeaxanthin is synthesized in the retina from lutein. However, most adults in the U.S. consume less lutein and zeaxanthin than the amount believed to lower the risk of macular degeneration. Consequently, dietary supplements are often used to increase lutein and zeaxanthin levels. While meso-zeaxanthin has also become available as a supplement, is not yet clear if ingesting meso-zeaxanthin alone increases its level in the macula.

What It Does:
The macula is an area within the retina of the eye that is responsible for conveying fine color images to the brain. The macula can degenerate with age, resulting in loss of vision. Age-related macular degeneration is the leading cause of blindness in the U.S. More than nine percent of people in the U.S. over age 40 show some form of macular degeneration and it affects 27% of adults 65 and older.

It is believed that lutein and zeaxanthin, both of which are anti-oxidants, protect the macula by scavenging potentially damaging free radicals and absorbing certain high-energy light. Studies of populations generally show that people who get the most lutein and zeaxanthin from their diets tend to have lower rates of macular degeneration. One double blind, placebo controlled study (Richler 2004) showed that after one year of daily supplementation with 10 mg of lutein (or 10 mg of lutein plus a mixture antioxidants, vitamins and minerals) ocular pigment increased and vision improved in people with atrophic age-related macular degeneration. A subsequent study failed to find benefit with lutein, but it used a lower dose (6 mg daily) and involved fewer people (Bartlett 2007). Additional human studies suggest that among people with age-related macular degeneration, those with low blood levels of lutein may be more likely to benefit from taking lutein supplements, and lutein supplements continue to increase macular pigment optical density even after one year of supplementation.

In addition to lutein and zeaxanthin, other ingredients may improve macular degeneration. See the section Eye Health Supplements.

A preliminary study suggests that lutein may help treat retinitis pigmentosa (Bahrami 2006). Population studies also suggest a reduced risk of developing severe cataracts (clouding of the lens of the eye) in people consuming higher amounts of lutein in their diet, although it is not known if supplements offer the same potential benefit. There is also preliminary research suggesting that lutein and zeaxanthin may help protect skin from sun damage. Increased lutein intake has also been associated with a lower risk of colon and breast cancer.

There is preliminary evidence suggesting astaxanthin, another carotenoid, might help prevent eye fatigue and protect the lens of the eye against cataracts, as well as protect the stomach against ulcers, help with male infertility, and reduce risk of macular degeneration. However, more research is needed. Astaxanthin is naturally produced by a type of algae and, through the food chain, provides the pink coloration of salmon, trout, krill, shrimp and other crustaceans. (For more about astaxanthin see the Fish Oil/Omega-3 Supplements Review).

See ConsumerTips for information about ingredient forms, dosage, and safety issues. See the Encyclopedia on this site for additional information about clinical studies with lutein/zeaxanthin and astaxanthin.

Quality Concerns and What CL Tested for:
No government agency is responsible for routinely testing lutein and zeaxanthin supplements for their contents or quality. ConsumerLab.com purchased and evaluated supplements to determine whether they contained the amounts of these compounds stated on their labels. All products were tested for potential contamination with lead and all non-chewable and non-timed release tablets also were tested to be sure that they would properly disintegrate. (See How Products Were Evaluated for information on testing methods and passing score.)

What CL Found:
Among the products selected by ConsumerLab.com, all were found to provide the amounts of lutein and zeaxanthin claimed on their labels. In addition, none exceeded strict limits for lead contamination and all applicable tablet products were able to disintegrate properly.

What was most striking about the supplements specifically marketed for "vision" or "eye health" was the large variation in their formulas and in the suggested daily dosage of ingredients. For example, daily amounts of lutein ranged from 4 mg to 45 mg while amounts of zeaxanthin ranged from less than 1 mg to 4 mg. Many formulas included other ingredients, such as zinc, resembling ingredients in the formula that successfully reduced the incidence of age-related macular degeneration in a major study known as AREDS. A second major study, AREDS2, used the same zinc-based formulation but also included lutein/zeaxanthin and omega-3 fatty acids. See the in-depth comparison of these products in the section "Vision Formulas Used in AREDS Studies."

Choosing among the products:
As all of the products met our quality requirements, the next questions are: Is the dose appropriate; how do they compare on price; and, if there are other ingredients, do they make the product more or less desirable?

As noted in the ConsumerTips section, a useful daily dosage of lutein for someone who does not get enough from their diet ranges from 6 mg to 20 mg. If you already eat more than half a cup a day of green leafy vegetables, you can probably skip a supplement. If you get some greens but perhaps not enough, a supplement with 6 mg may be fine.

Just lutein and zeaxanthin:
To help compare products on price, ConsumerLab.com calculated the cost to obtain 10 mg of lutein from each product. Target Up and Up Lutein had the lowest cost (12 cents per 10 mg of lutein) among lutein-only products — although it comes as a 20 mg softgel. Interestingly, lutein is available at even lower cost from some products which include zeaxanthin, such as Jarrow Formulas Lutein (9 cents per 10 mg of lutein) which provides 20 mg of lutein, and Spring Valley Natural Lutein (11 cents per 10 mg of lutein), although it provides an unusually large amount of lutein -- 45 mg. Some products contain lutein as an ester and some as non-esterified "free" lutein -- either form is fine. The same holds true with zeaxanthin, which is available in a synthetic form that is also acceptable. If you think you just need a little extra lutein each day, the CVS/Pharmacy Lutein (6 mg) is a good option at just 12 cents per dose.

Vision formulas:
Some of the supplements contained additional ingredients which may provide added benefit, although at significantly increased cost. ICaps Eye Vision (33 cents per day) mimics the formula used in the successful AREDS study, which included vitamins A (from beta-carotene), C, E, and zinc, but with the addition of lutein and zeaxanthin. Bausch & Lomb Preservision AREDS2 Formula ($1 per day) resembles a formula used in the new AREDS 2 study. The results of this study were published in May 2013. This formula includes vitamins C and E, zinc, copper, lutein and zeaxanthin, and the omega-3 fatty acids EPA and DHA. It appears to be at least as effective as the original AREDS formula and it excludes beta-carotene, which should be avoided in smokers and former smokers. (ConsumerLab.com has also tested two products containing the traditional AREDS formula (the original Bausch & Lomb Preservision and ICaps in the Zinc Supplements Product Review.)
 
Other vision formulas include Centrum Specialist Complete Multivitamin Vision (63 cents per day) and Twinlab OcuGuard Plus (78 cents per day), which contain many of the AREDS ingredients as well as some others like vitamin D. Formulas with other ingredients of potential vision benefit, such as bilberry, are Nutrilite Vision Health with Lutein ($1.19 per day), GNC Preventive Nutrition Eye Health Formula ($1.17 per day), USANA Optimizers Visionex ($1.10 per day) and Vitamin Shoppe Ultimate Advanced Ocular Support ($1 per day). An article about the array of supplement ingredients used to prevent macular degeneration is available from the Encyclopedia on this website.

The bottom line on vision formulas:
Based on the AREDS and AREDS2 studies, vision formulas providing the following ingredients taken daily seem to be most helpful for reducing the progression of macular degeneration:
  • Anti-oxidants including 452 mg of vitamin C and 400 IU of vitamin E
  • Zinc in doses of 21.8 mg or 69.6 mg plus 1.6 mg of copper (the lower dose may be preferable to avoid side-effects of excess zinc)
  • Carotenoids including 10 mg of lutein and 2 mg of zeaxanthin, especially if you don't consume enough green leafy vegetables
Beta-carotene, often listed as "vitamin A (as beta-carotene)" on labels, is not needed and should be avoided for current or previous smokers. You can also skip formulas with omega-3 fatty acids from fish oil as these provide no added eye health benefit. Other ingredients, such as bilberry, were not included as part of the study.

Most products currently on the market do not represent what appears to be the ideal formula, as most include beta-carotene or omega-3 fatty acids, neither of which are needed. The product which most closely resembles the most effective formula is Bausch & Lomb PreserVision Eye Vitamin & Mineral Supplement AREDS Lutein (72 cents per day). ConsumerLab.com has not tested this specific product. It is similar to Bausch & Lomb PreserVision (64 cents per day) tested in the Zinc Supplements Review, but that product did not include lutein. A related product tested in this review (below) is Bausch & Lomb PreserVision AREDS2 Formula ($1 per day) which, although it does not contain beta-carotene, unnecessarily includes omega-3 fatty acids and is much more expensive than the other products.


Test Results by Product:
Listed alphabetically below are the test results for 22 supplements containing lutein or lutein and zeaxanthin. Ten were selected by ConsumerLab.com and 12 others (each indicated with an asterisk) are included for having passed the same evaluation through ConsumerLab.com's Voluntary Certification Program. Also listed is a product which is similar to another that passed testing but is sold under a different brand name.

The full list of ingredients is available for each product by clicking on the word "Ingredients" in the first column. Products listed as "Approved" contained their listed amounts of lutein and zeaxanthin and met ConsumerLab.com's quality standards (See Passing Score).

CONSUMERLAB.COM RESULTS FOR LUTEIN, ZEAXANTHIN & VISION SUPPLEMENTS
Click on beneath a product name to find a vendor that sells it.
To find retailers that sell some of the listed products click here.
Product Name, Unit Type, and Suggested Daily Serving

Click on "Ingredients" for Full List and Special Designations)

Claimed Amount of Lutein and Zeaxanthin per Daily Serving

Chemical Form

(If listed)

— TEST RESULTS —
 
OVERALL RESULTS:

APPROVED
(Passed)
or
NOT
APPROVED
(Failed)

Contained Claimed Amount of Lutein and Zeaxanthin

Did Not Exceed Contamination Limit for Lead
Disintegrated Properly
(NA =
Not
Applicable)

Cost for Daily Serving

[Cost of 10 mg Lutein]

Additional Notable Ingredients & Features1

Price Paid
Lutein
CVS/Pharmacy® Lutein 6 mg
(1 softgel)*

Dist. by CVS Pharmacy, Inc.
Ingredients
Lutein - 6 mg

APPROVED


NA

$0.12

[$0.20]

Gluten free, yeast free

$5.99/50 softgels

Finest Nutrition (Walgreen) Lutein 20 mg
(1 softgel)*

Dist. by Walgreen, Co.
Ingredients
Lutein - 20 mg

APPROVED


NA

$0.32

[$0.16]

Contains no wheat, gluten free, yeast free

$9.49/30 softgels

Nature Made® Extra Strength Lutein 20 mg
(1 softgel)*

Dist. by Nature Made Nutritional Products
Ingredients
Lutein - 20 mg
Free form

APPROVED


NA

$0.43

[$0.22]

Gluten free, yeast free

$12.99/30 softgels

Nutrilite® Vision Health with Lutein
(2 tablets)

Dist. by Access Business Group International, LLC
Ingredients
Lutein - 10 mg
Ester form

APPROVED



$1.19

[$1.19]

Vitamin A, bilberry, black currant, spinach

$36.80/62 tablets

Target Up & Up™ Lutein 20 mg
(1 softgel)*

Dist.by Target Corporation
Ingredients
Lutein - 20 mg

APPROVED


NA

$0.23

[$0.12]

Contains no wheat, gluten free, yeast free

$6.94/30 softgels

Lutein/Zeaxanthin Combinations
Bausch & Lomb PreserVision® Eye Vitamin and Mineral Supplement AREDS 2 Formula
(4 softgels)

Dist. by Bausch & Lomb
Ingredients
Lutein - 10 mg

Zeaxanthin - 2 mg

APPROVED


NA

$1.00

[$1.00]

Vitamins C & E, zinc, copper, omega-3 fatty acids

$29.99/120 softgels

Carlson Lutein 6 mg
(1 softgel)

Dist. by Carlson Division of J.R. Carlson Laboratories, Inc.
Ingredients
Lutein - 6 mg
Free form

Zeaxanthin - 0.54 mg
Free form

APPROVED


NA

$0.17

[$0.28]

Vitamin E

$29.90/180 softgels

Centrum® Specialist™ Complete Multivitamin Vision
(2 tablets)

Dist. by Pfizer
Ingredients
Lutein - 10 mg
Free form

Zeaxanthin - 2 mg

APPROVED



$0.63

[$0.63]

Vitamins A, C, D, E, K, B-vitamins, multi-minerals

$18.99/60 tablets

GNC Preventive Nutrition® Eye Health Formula
(2 softgels)*

Dist. by General Nutrition Corporation
Ingredients

Lutein - 20 mg
Free form

Zeaxanthin - 4 mg

APPROVED


N/A

$1.17

[$0.58]

Vitamins C, E, Zinc, Selenium, Copper, DHA, L-Glutathione, Bilberry Fruit Powder, trans-Resveratrol

Contains no wheat, gluten free $34.99/60 softgels

ICaps® Eye Vitamin
(2 delayed release tablets)

Dist. by Alcon Laboratories, Inc.
Ingredients
4 mg combined free form lutein and free form zeaxanthin (Found to be 93% lutein)

APPROVED


NA

$0.33

[$0.90]

Vitamins A, C, E, riboflavin, zinc, selenium, copper, manganese

$19.99/120 delayed release tablets

Jarrow Formulas® Lutein
(1 softgel)

Dist. by Jarrow Formulas®
Ingredients
Lutein - 20 mg
Ester form

Zeaxanthin - 1 mg
Ester form

APPROVED


NA

$0.18

[$0.09]

Contains no wheat, gluten free

$10.77/60 softgels

Nature's Bounty® Lutein 20 mg
(1 softgel)*

Mfd. by Nature's Bounty, Inc.
Ingredients
Lutein - 20 mg

Zeaxanthin - 0.8 mg

APPROVED


NA

$0.47

[$0.24]

Contains no wheat, gluten free, yeast free

$13.99/30 softgels

Nature's Life® Lutein 20 mg Plus Zeaxanthin Eye Health
(1 softgel)

Mfd. by NutraPure, Inc.
Ingredients
Lutein - 20 mg

Zeaxanthin - 0.86 mg

APPROVED


NA

$0.24

[$0.12]

$23.55/100 softgels

Nature's Sunshine® Lutein
(1-2 capsule)

Dist. by Nature's Sunsine Products, Inc.
Ingredients
Lutein — 10 to 20 mg

Zeaxanthin — Amount not listed. A proprietary blend.

APPROVED


NA

$0.65 to $1.30

[$0.65]

$38.99/60 capsules

Pure Encapsulations® Lutein/Zeaxanthin
(1 vegetarian capsules)

Mfd. by Pure Encapsulations, Inc.
Ingredients
Lutein- 10 mg
Free form 

Zeaxanthin - 2 mg
 Synthetic form

APPROVED


NA

$0.36

[$0.36]

Hypo-allergenic, contains no wheat, gluten free, yeast free

$42.70/120
vegetarian capsules

Solgar® Lutein 40 mg
(1 softgel)*

Dist. by Solgar, Inc.
Ingredients
Lutein - 40 mg
Free form

Zeaxanthin - 2 mg
Free form

APPROVED


NA

$0.64

[$0.16]

Hypo-allergenic, contains no wheat, gluten free, yeast free

$19.18/30 softgels

Source Naturals® Lutein
(1 capsule)

Dist. by Source Naturals, Inc.
Ingredients
Lutein - 6 mg
Free form

Zeaxanthin - 0.3 mg
Free form

APPROVED


NA

$0.13

[$0.22]

Contains no wheat, gluten free, yeast free

$5.80/45 capsules

Spring Valley® (Walmart) Natural Lutein 45 mg with Zeaxanthin
(1 softgel)*

Mfd. by US Nutrition, Inc.
Ingredients
Lutein - 45 mg

Zeaxanthin - 1.8 mg

APPROVED


NA

$0.46

[$0.11]

Contains no wheat, gluten free, yeast free

$13.94/30 softgels

Twinlab® OcuGuard® Plus
(4 capsules)*

Mfd. by Ideasphere, Inc.
Ingredients
Lutein - 20 mg
Free form

Zeaxanthin - 0.8 mg
Free form

APPROVED


NA

$0.78

[$0.39]

Vitamins A, C, D, E, riboflavin, zinc, selenium, chromium, bilberry, citrus bioflavonoids, amino acids

$23.25/120 capsules

USANA® Optimizers Visonex™
(2 tablets)*

Dist. by USANA Health Sciences, Inc.
Ingredients
Lutein - 10 mg

Zeaxanthin - 2 mg

APPROVED



$1.10

[$1.10]

Vitamin C, potassium, magnesium, zinc, bilberry

$30.88/56 tablets

Vitamin Shoppe® FloraGLo® Lutein 20 mg
(1 softgel)*

Dist. by The Vitamin Shoppe®
Ingredients
Lutein - 20 mg
Free form

Zeaxanthin - 1 mg
Free form

APPROVED


NA

$0.26

[$0.13]

Contains no wheat, gluten free, yeast free

$31.49/120 softgels

Vitamin Shoppe® Ultimates Advanced Ocular Support
(2 vegetarian capsules)*

Dist. by The Vitamin Shoppe®
Ingredients
Lutein - 20 mg
Free

Zeaxanthin - 4 mg Synthetic form

APPROVED


NA

$1.00

[$0.50]

Bilberry, blueberry grape seed, DHA

Contains no wheat, gluten free, yeast free

$29.99/60 vegetarian capsules

Similar to Approved Products**:
Vitamin World® Eye Guard® Lutein 20 mg
(1-2 softgels)

Mfd. by Vitamin World, Inc.
Ingredients
Similar to: Nature's Bounty® Lutein 20 mg. Different usage instructions.
N/A: Not applicable: Only non-chewable, non-capsule, non-enteric coated, and non-time release formulations are tested for disintegration.
*Tested through CL's Voluntary Certification Program prior to, at time of, or after initial posting of this Product Review.
** Product identical in formulation and manufacture to a product that has passed testing but sold under a different brand. For more information see CL's Multi-Label Testing Program.

1 Not tested but claimed on label.
Unless otherwise noted, information about the products listed above is based on the samples purchased by ConsumerLab.com (CL) for this Product Review. Manufacturers may change ingredients and label information at any time, so be sure to check labels carefully when evaluating the products you use or buy. If a product's ingredients differ from what is listed above, it may not necessarily be of the same quality as what was tested.

The information contained in this report is based on the compilation and review of information from product labeling and analytic testing. CL applies what it believes to be the most appropriate testing methods and standards. The information in this report does not reflect the opinion or recommendation of CL, its officers or employees. CL cannot assure the accuracy of information.
Copyright ConsumerLab.com, LLC, 2012. All rights reserved. Not to be reproduced, excerpted, or cited in any fashion without the express written permission of ConsumerLab.com LLC.

ConsumerTips™ for Buying and Using:
Getting lutein and zeaxanthin from food:
There is no government recommended daily intake for lutein or zeaxanthin. Population studies suggest a reduced risk of both age-related macular degeneration and cataract formation in people who get about 6 mg per day of these compounds from foods. It is estimated that the average U.S. adult consumes a total of only 2 to 4 mg per day of lutein and zeaxanthin from foods.

It is possible to get from food the amount of lutein and zeaxanthin associated with a decreased risk of macular degeneration and cataract formation. As little as a half-cup of cooked kale, Swiss chard, spinach, or collard greens will provide 6 mg or more of lutein and zeaxanthin, as they are among the richest food sources. Other foods with fairly high amounts of lutein and/or zeaxanthin are corn, celery, kiwi fruit, endive, grapes, zucchini, and broccoli. Even iceberg lettuce and green peas will contribute these anti-oxidants to your diet. Most foods contain more lutein than zeaxanthin, but orange pepper, oranges and orange juice typically contain more zeaxanthin than lutein. Specially produced eggs, from chickens fed marigold petals, may also provide high levels of lutein.

For an extensive listing of the amounts of lutein, zeaxanthin in foods, see the USDA-NCC Carotenoid Database at http://www.nal.usda.gov/fnic/foodcomp/Data/car98/car98.html.

Getting lutein and zeaxanthin from supplements:
Based on population studies, supplements were often designed in the past to provide 6 mg of lutein. But more recent research specifically using supplements showed that 10 mg of lutein appears to be an effective dose for improving vision in people with atrophic age-related macular degeneration — although it does not seem to prevent disease progression. Consequently, some products now provide 10 mg of lutein, along with lesser amounts of zeaxanthin.

Some promotional literature on the Internet suggests that a higher (20 mg) dosage should be taken by people with advanced macular degeneration. There is no evidence yet to support this recommendation, although it is known that larger doses do increase levels of these anti-oxidants in the blood. Research from the National Eye Institute using supplements containing free form lutein (see "Forms of Lutein: Free vs. Ester" below) show that normal adult blood serum levels of lutein double with a daily dose of just 2.5 mg, almost triple with 5 mg, and quadruple with a daily dose of 10 mg. This would suggest, however, a diminishing return with even higher doses. Nevertheless, a six-week study using 20 mg of lutein in people suffering from retinitis pigmentosa, another sight—robbing condition, experienced improvements in their vision (Bahrami 2006).

Be aware that some manufacturers sell supplements providing very small amounts of lutein — often just a fraction of milligram — sometimes as part of a larger formula. The multivitamin Centrum Silver, for example, provides just 0.25 mg (250 mcg) of lutein. While this allows the product to promote lutein as an ingredient, it is questionable whether such a small dose provides health benefit.

If you already get a high amount of lutein from your diet, evidence suggests that you may not get additional benefit from supplements.

When using supplements, lutein levels in the blood rise over time, peaking at 3 months. Once stopped, blood levels fall over a period of months and return to normal in about six months.

Forms of lutein: Free vs. ester:
Lutein in supplements comes as either lutein "esters" (such as the trademarked XANGOLD lutein) or the nonesterified "free" form of lutein (such as the trademarked FloraGLO lutein). Lutein and zeaxanthin found in green vegetables, fruits and egg yolk exist in the free form. Much of the lutein in supplements is extracted from marigold petals, which naturally contain lutein in the esterified form, although this can be converted to the free form through a process called saponification. Both forms are equally well absorbed by the body, but are best absorbed when taken with fats or oils. Consequently, it is generally recommended to take lutein supplements with meals -- preferably high-fat rather than low-fat meals.

Lutein may have an odor --- described by some as similar to vase water in which flowers have remained too long. This is a result of the extraction and concentration of lutein esters from marigold flowers which, themselves, can have a rough odor. This odor is normal and may be particularly strong in products containing higher amounts of lutein, such as 20 mg. The odor tends to be greater with esterified lutein than with free form lutein. The odor may be reduced by formulating the lutein within materials such as microencapsulated beadlets.

A recent bioavailability study comparing equivalent amounts of free lutein given as FloraGLO (a starch-based beadlet formula) or Lyc-O-Lutein (an alginate-based beadlet formula) found a much greater increase in lutein levels in the body with FloroGLO (Evans, Eur J Nutr 2012). At 14 hours after administration, plasma lutein levels increased by 126% with FloraGLO compared to 7% with Lyc-O-Lutein. (FloraGLO is found in products from the following brands in this Review: Carlson, Centrum, ICaps, Pure Encapsulations, Source Naturals, Solgar, TwinLab, and both products from Vitamin Shoppe.)  

Synthetic zeaxanthin:
Most zeaxanthin is derived from plants, but, a synthetic form has become available in supplements in recent years. An analysis of the safety of this form was recently performed by the European Food Safety Authority. It concluded that synthetic form is safe and that a daily dose up to 53 mg does not raise safety concerns (EFSA Journal 2012).

SPECIAL SECTION: Vision Formulas Used in AREDS Studies:
AREDS: A large study known as AREDS (Age-Related Eye Disease Study) evaluated the effects of a combination of supplements on eye health. This study did not evaluate lutein or zeaxanthin. It evaluated the effect of taking zinc by itself or taking a combination of vitamin C, vitamin E, beta-carotene, and zinc. The study found that zinc alone or the combination of zinc with vitamin C, E and beta-carotene can slow the progression of age-related macular degeneration when taken on a daily basis. The supplements reduced the risk of progressing to advanced age-related macular degeneration by 25% over a period of 5 years compared to a placebo.

The tablets used in AREDS were manufactured to contain the following minimum contents throughout their shelf-life: 7,160 IU of vitamin A (from beta carotene), 113 mg of vitamin C (ascorbic acid), 100 IU of vitamin E (dl-alpha tocopheryl acetate), 17.4 mg of zinc (zinc oxide), and 0.4 mg of copper (cupric oxide). It's important to note that the reason for copper in this formula is not to promote eye health, but to prevent copper deficiency due to the high amount of zinc in the formula -- zinc can reduce copper absorption (see Concerns and Cautions below).

Four tablets were taken daily, providing a total of 28,640 IU of vitamin A (from beta-carotene), 452 mg of vitamin C, 400 IU of vitamin E, 69.6 mg of zinc, and 1.6 mg of copper. [NOTE: Some articles about the AREDS report suggest that the supplement used contained slightly higher amounts of ingredients, such as 80 mg of zinc per day, but the actual specifications for the product are those described above. The higher numbers include the non-active salt portion of each ingredient, which is not typically included in product labeling. For example, 80 mg of "zinc oxide" actually provides 69.6 mg of active zinc.]

AREDS 2: In May 2013, results from the AREDS2 (Age-Related Eye Disease Study 2) study were published. This study was similar to the first AREDS trial, but sought to test variations of the original supplement formula. Researchers evaluated the original AREDS formula and added either 10 mg lutein and 2 mg zeaxanthin, 350 mg DHA and 650 mg EPA, or the combination of lutein+zeaxanthin and DHA+EPA.

In addition, some people in the study received the original AREDS formulation, but with some slight modifications. One group received a version with a lower dose of zinc - 21.8 mg of zinc (25 mg zinc oxide) instead of the original 69.6 mg (80 mg zinc oxide). Another group received a version without beta-carotene. And a third group received AREDS with the lower zinc dose and no beta-carotene.

The findings of AREDS2 show that:
  • Adding lutein and zeaxanthin to the original AREDS formulation provided no additional benefit overall; however, in people with very low dietary intake of lutein and zeaxanthin the addition of these ingredients reduced the risk of disease progression by about 36% compared to the original AREDS formulation.
  • The addition of omega-3 fatty acids (from fish oil) provided no additional benefit.
  • Adding the combination of lutein and zeaxanthin plus omega-3 fatty acids provided no additional benefit.
  • Substituting lutein plus zeaxanthin for beta-carotene in the original AREDS formulation might offer additional benefits. An exploratory analysis of study data suggests that using lutein plus zeaxanthin instead of beta-carotene reduced the risk of disease progression by about 18%.
  • Using the lower dose of zinc (21.8 mg vs. 69.6) did not have any effect on the risk of disease progression.
  • Removing beta-carotene from the original AREDS formulation also did not impact the risk of disease progression. This is good news for smokers and former smokers since beta-carotene can increase the risk of lung cancer, strokes and death from heart disease in these groups.
Concerns and Cautions:
Lutein supplementation appears to be safe at a dose of 10 mg. A six-month study using 20 mg of lutein also showed no safety problems (Bahrami 2006). However, a study based on subject's memory of the previous 10 years suggests that long term use of supplementation with lutein as well as vitamin A (from beta-carotene or retinol) was associated with an increased risk of lung cancer (Satia 2009). Long-term use should not be recommended for lung cancer prevention, particularly among smokers.

Simultaneous consumption of the fat substitute olestra, found in fat-free chips, may decrease the absorption of lutein and zeaxanthin. Beta-carotene from food and supplements may also decrease the absorption of lutein, zeaxanthin, and astaxanthin.

More information about the uses and clinical studies with lutein and zeaxanthin is found in the Encyclopedia on this website.

To further assist consumers, ConsumerLab.com licenses its flask-shaped CL Seal of Approved Quality (see The CL Seal) to manufacturers for use on labels of products that have passed its testing. ConsumerLab.com will periodically re-evaluate these products to ensure their compliance with ConsumerLab.com's standards.

Information on this site is provided for informational purposes only. It is not an endorsement of any product nor it is it meant to substitute for the advice provided by physicians or other healthcare professionals. The information contained herein should not be used for diagnosing or treating a health problem or disease.


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