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Product Review: Vision Supplements with Lutein and Zeaxanthin
 

Initial Posting: 12/12/15
Lutein, Zeaxanthin and Vision Supplements Tested by ConsumerLab.com
Sections:Jump to a section by clicking on its name.
Summary:
  • Lutein and zeaxanthin are believed to protect the macula of the eye (in the retina) from damage (see What It Does).
  • Many people consume relatively small amounts of lutein and zeaxanthin in their diets or have low levels of lutein in their blood; for them, taking a lutein supplement can slow the progression of age-related macular degeneration — although it won't improve the condition (see Getting lutein and zeaxanthin from food).
  • A dose of 10 mg of lutein appears to be better than a lower dose (6 mg). Higher dose products (e.g., 20 mg to 40 mg) are common, although it is not known if a higher dose is better. Nevertheless, 20 mg has been shown to be safe in a 6-month study.
  • It's not clear whether the "free" or "ester" form, or a natural or synthetic source, is better and it is not clear if there is added benefit with zeaxanthin.
  • Lutein and zeaxanthin at a reasonable dose (10 to 20 mg) can be obtained for as little about 15 cents per day (see What CL Found).
  • Other ingredients, particularly zinc, may be beneficial in slowing the progression of age-related macular degeneration. Vision formulas with these ingredients as well as lutein and zeaxanthin are available, although significantly more expensive than getting lutein/zeaxanthin alone. The formula with the strongest clinical evidence is Bausch + Lomb PreserVision AREDS Lutein (see What CL Found — Vision Formulas). One vision formula failed testing, containing only 9% of its listed lutein.
  • To enhance absorption, it is best to take lutein and zeaxanthin supplements with a fatty meal. However, consumption of certain foods and supplements may decrease absorption of lutein and zeaxanthin (see Concerns and Cautions).
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 have slightly different molecular structures). 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.

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. Even in people with healthy eyes, the density of macular pigment does not seem to increase with lutein/zeaxanthin supplementation unless the density was low to start. This was seen in a 6-month study in Japan using FloraGLO or XanMax (1 capsule daily, each containing approx. 10.5 mg lutein and 1 mg zeaxanthin). There was no increase in macular pigment density in most people in the study, except those with low density at the start (Obana, PLoS One, 2015). The message: If macular pigment density is not low, lutein and zeaxanthin may not help.

Some research suggests that pigmentation may continue to improve over several years of supplementation. One clinical trial compared three different formulations in men and women with early age-related macular degeneration over a 3 year period: 20 mg of lutein plus 0.86 mg zeaxanthin (Ultra Lutein, Natural Organics, Inc.), 10 mg lutein plus 2 mg zeaxanthin and 10 mg meso-zeaxanthin (Macushield, Macuvision Europe Limited), and 3 mg lutein plus 2 mg zeaxanthin and 17 mg meso-zeaxanthin (not commercially available). The study found that all three formulas significantly increased macular pigmentation over the first year, with no further gain in the second year. However, during the third year, there were further increases in pigmentation among those who took formulas containing meso-zeaxanthin. Over the course of the 3 year study, vision remained stable (no improvement and no decline in vision) with each formula, and no progression to advanced macular degeneration occurred (Akuffo, Eye 2015).

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. The AREDS 2 study found that supplementation with lutein and zeaxanthin did not have a benefit except in those with the very lowest dietary intakes of lutein and zeaxanthin — among this group, the number of people requiring cataract surgery was reduced by 32%. 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.

Lutein and zeaxanthin are also found in very small amounts in the brain and preliminary evidence suggests they may have a positive effect on brain functioning. A placebo-controlled clinical study found that when healthy young people (in Georgia, U.S.) took a daily supplement containing zeaxanthin (20 mg as Eye Promise Zeaxanthin from ZeaVision, Inc., which funded the study) or zeaxanthin in combination with lutein (26 mg and 8 mg, respectively, as EyePromise vizual EDGE), they showed an average 20% increase in the speed of a type of visual processing required to discriminate a light source as flickering versus steady. This type of visual processing is typically slowed by aging, and faster processing tends to be positively correlated with, for example, improved sports performance and driver safety, reading speed, and executive cognitive function (Bovier, Arch Biochem Biophys 2015).

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 but one were found to provide the amounts of lutein and zeaxanthin claimed on their labels: EyeScience Macular Health Formula was discovered to contain only 9% and 65%, respectively, of its listed lutein and zeaxanthin. 

All applicable tablet products disintegrated properly and those tested for heavy metals did not exceed strict limits for contamination.

Choosing among the products:
Passing tests of quality is just one hurdle a product should overcome before you consider using it. Other questions to be answered are: Is the dose appropriate; how does it 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 10 mg and, possibly, up 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 at least 6 to 10 mg could help. If you don't eat green leafy vegetables, 10 mg would seem more appropriate and even 20 mg may be helpful and still safe. All of the products, except the one which failed testing, provided at least 6 mg of lutein and some provided much more — up to 40 mg. 

To help compare products on price, ConsumerLab.com calculated the cost to obtain 10 mg of lutein from each product. Among supplements with only lutein, or lutein and zeaxanthin, Trunature [Costco] Vision Complex Lutein & Zeaxanthin provided lutein at the lowest cost, with a 14 cent softgel providing 25 mg of lutein and 5 mg of zeaxanthin. Vitacost Lutein also cost 14 cents per softgel, but provided somewhat less lutein (20 mg) and less zeaxanthin (about 1 mg). Jarrow Formulas Lutein is another good value at 16 cents for a softgel providing 20 mg of lutein and 1 mg of zeaxanthin.

If you want a lower dose of lutein, (particularly if you already get some green leafy vegetables in your diet), consider CVS/pharmacy Lutein — a softgel costs 14 cents and provides 6 mg of lutein. Unfortunately, none of the products in this group provided a 10 mg dose of lutein. 

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.

Among vision formulas, (which tend to be significantly more expensive than simple lutein/zeaxanthin supplements) it is helpful to judge products against what has been shown to work (or not) in two major studies focused on slowing the progression of age-related macular degeneration. These two studies, AREDS and AREDS2 (see discussion below) showed the following ingredients and doses to be helpful if taken daily:
  • 21.8 mg of zinc, or 69.6 mg but with 1.6 mg of copper to offset reduced copper absorption caused by the zinc (the lower zinc dose may be just as effective and preferable to avoid side-effects of excess zinc)
  • 452 mg of vitamin C
  • 400 IU of vitamin E
  • 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 by current smokers and people who have been occupationally exposed to asbestos. You can also skip formulas with omega-3 fatty acids from fish oil as these provide no added eye health benefit. (Omega-3 fatty acids may be helpful, however, if you suffer from certain forms of dry eye).

Other ingredients, such as bilberry, were not included as part of the study and are unlikely to have additional benefit in age-related macular degeneration. (Preliminary research suggests that bilbery may improve retinal lesions in people with retinopathy related to diabetes or hypertension and it may provide a short-term improvement in night vision. More about bilberry supplements, including our ConsumerLab.com's tests of products, are found in the Bilberry Supplements Review).

The product which most closely resembles the ideal formula to slow the progression of age-related macular degeneration is Bausch & Lomb PreserVision Eye Vitamin & Mineral Supplement AREDS Lutein (70 cents per day for 2 softgels) — although it includes the higher amount of zinc, which may not be necessary. Other formulas which could be beneficial regarding age-related macular degeneration are:  
  • USANA Visionex ($1.12 per day) provides somewhat less zinc that the AREDS formula (10 mg per day), but provides a reasonable amount of vitamin C (500 mg), lutein (10 mg) and zeaxanthin (2 mg).
  • Bausch + Lomb Ocuvite Lutein & Zeaxanthin (35 cents per day) covers the same ingredients but doesn't follow the AREDS formula, providing just 100% of the Daily Value (recommended daily intake) for vitamin C (60 mg), vitamin E (30 IU), zinc (15 mg), and copper (2 mg), as well as 6 mg of lutein (but no zeaxanthin).
  • GNC Preventative Nutrition Eye Formula ($1.17 per day) provides 100% of the DV of the AREDS ingredients, but adds 100% of the DV of vitamin A (50% as beta-carotene and 50% as retinol from fish liver oil) and 500 mg of vitamin C — an amount close to that in the AREDS formula, and twice the lutein (20 mg with 4 mg of zeaxanthin).
  • Lipotriad Visionary (42 cents per day) contains AREDS ingredients, some in higher amounts, along with a modest amount of omega-3 fatty acids from fish oil — although the fatty acids may have no added benefit in terms of vision, according to the AREDS2 study.
  • Ortho Molecular Products 4Sight ($2.01 per day — making it the most expensive formula) provides 30 mg of lutein and 1.5 mg of zeaxanthin per day as well as zinc (15 mg) but also several other ingredients, such as Gingko biloba, which do not seem to have strong evidence of vision benefit.
  • TwinLab OcuGard Plus (74 cents per day) provides relevant ingredients, including 25 mg of zinc per day and 20 mg of lutein. However, it provides a much higher amount of vitamin C — 1,500 mg per day than the AREDS formulas. You may not want to take this much vitamin C, as some research suggests that high-dose vitamin C may increase the risk of cataracts.
Two of the formulas do not contain the classic AREDS ingredients, although are good sources of lutein and have additional ingredients which potentially address other vision issues:
  • LifeExtension MacuGuard Ocular Support is essentially lutein (10 mg) and zeaxanthin (4 mg) with an antioxidant, cyanadin-3-glucoside (from black currant extract), which animal research suggests may have some benefit for night vision (Lee, Current Eye Res 2014).
  • Nutrilite Vision Health with Lutein provides 10 mg of lutein per day, as well as bilberry, spinach concentrate, and 50 mg of black currant extract. (A preliminary study of black currant extract suggested possible benefit with 50 mg in visual fatigue due to computer monitors -- (Nakaishi, Altern Med Rev, 2000)
An article with more information about supplement ingredients used to prevent macular degeneration is available from the Encyclopedia on this website.

Test Results by Product:
Listed alphabetically below are the test results for 19 supplements containing lutein. Some also contain zeaxanthin and some are formulas including other ingredients of potential relevance to vision. Ten were selected by ConsumerLab.com and nine others (each indicated with a CL flask icon) are included for having passed the same evaluation through ConsumerLab.com's voluntary Quality Certification Program. Also listed are two products which are similar to another that passed testing but are sold under different brand names.

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).

RESULTS OF CONSUMERLAB.COM TESTING OF 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, Serving Size, and Suggested Daily Serving on Label

Click on "Ingredients" for Full Listing
Claimed Amount of Lutein and Zeaxanthin Per Suggested Daily Serving on Label

Chemical Form
(If listed)
--TEST RESULTS-- Cost for Daily Suggested Serving on Label

[Cost for 10 mg of Lutein]

Other Notable Features2

Price Paid
OVERALL RESULTS:

APPROVED or NOT
APPROVED
Contained Claimed Amount of Lutein and Zeaxanthin Did Not Exceed Contamination Limits for Lead, Cadmium and Arsenic1 Disintegrated Properly

(NA= Not Applicable)
Lutein Only:
CVS/pharmacy® Lutein (1 softgel, once daily)

Dist. by CVS/pharmacy, Inc.
Ingredients
Lutein - 6 mg
APPROVED NA NA $0.14

[$0.23]

Contains no wheat, gluten free, yeast free

$6.79/50 softgels
GNC Natural Brand™ Lutein (1 capsule, once daily)

Dist. by General Nutrition Corporation
Ingredients
Lutein - 20 mg
APPROVED NA NA $0.37

[$0.18]
Lowest cost for lutein only

Contains no wheat, gluten free, yeast free

$21.99/60 capsules
Lutein & Zeaxanthin:
Finest Nutrition [Walgreens] Lutein (1 softgel, once daily)

Dist. by Walgreen Co.
Ingredients
Lutein - 20 mg

Zeaxanthin - 0.8 mg
APPROVED NA NA $0.33

[$0.17]

Contains no wheat, gluten free, yeast free

$9.99/30 softgels
Jarrow Formulas® Lutein (1 softgel, once daily)  

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

Zeaxanthin - 1 mg
APPROVED NA NA $0.16

[$0.08]

Contains no wheat, gluten free

$9.59/60 softgels
Natural Factors® Lutein (1 softgel, once daily)

Mfd. by Natural Factors Canada
Ingredients
Lutein - 40 mg

Zeaxanthin - 7 mg
APPROVED NA NA $0.41

[$0.10]

Contains no wheat, gluten free, yeast free

$24.47/60 softgels
Nature's Bounty® Lutein (1 softgel, once daily) 

Mfd. by Nature's Bounty, Inc.
Ingredients
Lutein - 6 mg

Zeaxanthin - 0.24 mg
APPROVED NA NA $0.17

[$0.29]

Contains no wheat, gluten free, yeast free

$8.55/50 softgels
Spring Valley™ [Walmart] Lutein (1 softgel, once daily) 

Dist. by Wal-Mart Stores, Inc.
Ingredients
Lutein - 20 mg

Zeaxanthin - 0.8 mg
APPROVED NA NA $0.19

[$0.09]

Contains no wheat, gluten free, yeast free

$16.88/90 softgels
Trunature® [Costco] Vision Complex Lutein & Zeaxanthin (1 softgel, once daily)  

Dist. by Costco Wholesale Corporation
Ingredients
Lutein - 25 mg

Zeaxanthin - 5 mg
APPROVED NA NA $0.14

[$0.06]
Lowest cost for lutein and zeaxanthin

Contains no wheat, gluten free

$19.99/140 softgels
Vitacost® Lutein (1 softgel, once daily)  

Dist. by Vitacost
Ingredients
Lutein - 20 mg
Free form

Zeaxanthin - 0.84 mg
Free form
APPROVED NA NA $0.14

[$0.07]

Gluten free

$16.99/120 softgels
Similar to Approved Products*:
Puritan's Pride® Lutein 6 mg (1 softgel, twice to six times daily)  

Mfd. by Puritan's Pride, Inc.
Ingredients
Similar to Nature's Bounty® Lutein. $0.20-$0.60

[$0.17]

Contains no wheat, gluten free, yeast free

$19.994/200 softgels
Vitamin World® Eye Guard® Lutein (1 softgel, twice to six times daily)  

Mfd. by Vitamin World, Inc.
Ingredients
Similar to Nature's Bounty® Lutein. $0.30-$0.90

[$0.25]

Contains no wheat, gluten free, yeast free

$14.985/100 softgels
Vision Formulas with Lutein (and Zeaxanthin):
Bausch + Lomb Ocuvite® Lutein and Zeaxanthin (1 capsule, once daily)  

Dist. by Bausch & Lomb Incorporated  
Ingredients
Lutein - 5.56 mg3

Zeaxanthin - 0.42 mg3
APPROVED NA NA $0.35

[$0.77]

Vitamins C & E, zinc, copper  

$12.71/36 capsules
Bausch + Lomb PreserVision® AREDS Lutein (1 softgel, twice daily)  

Dist. by Bausch & Lomb Incorporated  
Ingredients
Lutein - 10 mg APPROVED NA NA $0.70

[$0.70]

Vitamins C & E, zinc, copper  

$17.59/50 softgels
EyeScience® Macular Health Formula™ (2 capsules, once daily)  

Dist. by EyeScience Labs, LLC
Ingredients
Lutein - 10 mg

Zeaxanthin - 2 mg
NOT
APPROVED
Found only 0.9 mg lutein (9.0% of listed amount) and 1.3 mg of zeaxanthin (65.0% of listed amount) daily NA NA $0.33

[$0.17]

Vitamins B6, C, D & E, folate, zinc, selenium, copper, bilberry extract, alpha lipoic acid, grape seed extract, L-glutathione, MacuGlo™ proprietary blend eyebright  

Gluten free

$9.99/60 capsules
GNC Preventative Nutrition Eye Health Formula (2 softgels, once daily)

Dist. by General Nutrition Corporation
Ingredients
Lutein - 20 mg
Free form

Zeaxanthin - 4 mg
APPROVED NA $1.17

[$0.58]

Vitamins A, & E, zinc, selenium, copper, DHA, Setria™ L-Glutathionw, bilberry fruit powder, resVida® trans-Resveratrol  

Contains no wheat, gluten free

$34.99/60 softgels
LifeExtension® MacuGuard® Ocular Support® (1 softgel, once daily)

Dist. by Quality Supplements and Vitamins, Inc.
Ingredients
Lutein - 10 mg
Free form

Zeaxanthin - 4 mg
Free form
APPROVED NA NA $0.30

[$0.30]

Cyanidin-3-glucoside

$17.79/60 softgels
Lipotriad Visionary® (1 softgel, once daily)  

Dist. by Lipotriad LLC
Ingredients
Lutein - 10 mg

Zeaxanthin - 2.5 mg
APPROVED NA NA $0.42

[$0.42]

Vitamins C & E, zinc, copper, fish oil (EPA & DHA)  

$24.99/60 softgels
Nutrilite® Vision Health With Lutein (2 tablets, once daily)  

Dist. by Access Business Group International LLC
Ingredients
Lutein - 10 mg
Ester form
APPROVED NA $0.68

[$0.68]

Bilberry extract, black currant extract, spinach concentrate

$21.16/62 tablets
Ortho Molecular Products® 4Sight (2 capsules, once daily)  

Dist. by Ortho Molecular Products, Inc.
Ingredients
Lutein - 30 mg

Zeaxanthin - 1.5 mg
APPROVED NA NA $2.01

[$0.67]

Zinc, taurine, N-acetyl-L-cysteine, alpha lipoic acid, bilberry fruit extract, quercetin dehydrate, Ginkgo biloba leaf extract, lycopene

Gluten free, yeast free

$60.29/60 capsules
TwinLab® OcuGuard Plus® (2 capsules, twice daily)

Mfd. by TwinLab Corporation
Ingredients
Lutein - 20 mg
Free form

Zeaxanthin - 0.8 mg
Free form
APPROVED NA NA $0.74

[$0.37]

Vitamins A, C, D & E, riboflavin, zinc, selenium, chromium, citrus bioflavonoids complex, N-acetyl L-cysteine, taurine, quercetin dehydrate, rutin, bilberry fruit extract, L-glutathione  

$26.49/144 capsules
USANA® Visionex® (2 tablets, once daily)

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

Zeaxanthin - 2 mg
APPROVED NA $1.12

[$1.12]

Vitamin C, zinc, bilberry extract

Kosher

$31.45/56 tablets

Tested through CL's Quality Certification Program prior to, or after initial posting of this Product Review.
NA — Not applicable  
- Canadian product.

* 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 Only products that contain whole herb(s) and/or more than 250 mg of minerals daily were tested for lead, arsenic and cadmium.
2 Not tested but claimed on label.
3 Claims to contain 6 mg Crystalline Lutein, which is comprised of 76% lutein and 7% zeaxanthin.
4 Based on price listed on puritan.com. Price is for a "Buy 1 Get 2 Free" deal.
5 Based on price listed on vitaminworld.com.
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, 2015. 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 and zeaxanthin in foods, see the USDA National Nutrient Database.

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 non-esterified "free" form of lutein (such as the trademarked FloraGLO lutein). The LutiGold brand contains lutein (form not listed; however ConsumerLab.com was informed by maker, NBTY, that it is non-esterified), along with a small amount of zeaxanthin (800 mcg per 20 mg of 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 (for this reason, some lutein supplements contain oils such as safflower or soybean oil). Consequently, it is generally recommended to take lutein supplements with meals -- preferably high-fat rather than low-fat meals.

The capsule size of various brands of lutein may differ, even when they provide the same amount of lutein, depending on the amounts of other ingredients they contain, including inactive ingredients such as oils. Products often combine lutein and zeaxanthin with omega-3 fatty acids, vitamin E, Zinc and other ingredients that have been used the AGE-Related Eye Disease study (see "Vision Formulas Used in AREDS Studies," below), resulting in a larger pill or capsule.

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 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 FloraGLO (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 the Twinlab and Vitacost products in this Review.)

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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