FactoWiki

How much lutein and zeaxanthin? What the AREDS2 dose means

The best-studied amount is 10 mg of lutein with 2 mg of zeaxanthin a day — the dose added in the AREDS2 trial for people at risk of advanced age-related macular degeneration. That is a study dose, not an established recommended intake: there is no official daily requirement for either nutrient, and trials have not shown that supplements benefit people with healthy eyes. The primary trial result for adding lutein was not statistically significant, although secondary analyses were more encouraging.

This article answers one question. For what Lutein is, where it comes from and its other uses, see the Lutein ingredient guide.

Key findings

  • AREDS2 tested lutein 10 mg and zeaxanthin 2 mg daily in people aged 50–85 at risk of advanced AMD.
  • Adding lutein to the existing formula did not significantly reduce progression overall; secondary analyses suggested benefit in some groups.
  • Lutein replaced beta-carotene because of lung cancer concerns in smokers and former smokers.
  • There is no RDA or upper limit for lutein; the zinc in eye formulas is the bigger dose-safety issue.

The dose question in context

“How much lutein should I take?” usually has two different answers depending on who is asking. For people with intermediate age-related macular degeneration (AMD), there is a tested formula from a large government-funded trial. For people with healthy eyes, there is no established supplement dose, because trials have not shown that lutein supplements prevent eye disease or improve normal vision.

What human research has studied

The key study is the Age-Related Eye Disease Study 2 (AREDS2), run by the National Eye Institute. It enrolled 4,203 people aged 50 to 85 who were at risk of progressing to advanced AMD and used a factorial design: participants received the original AREDS formula, with or without added lutein and zeaxanthin, omega-3 fats, or both, and some were also randomised to versions without beta-carotene or with lower zinc [1].

The added lutein dose was 10 mg a day with 2 mg of zeaxanthin [3]. In the primary analysis, adding lutein and zeaxanthin (or omega-3s) to the AREDS formula did not produce a statistically significant further reduction in progression to advanced AMD [1]. Secondary analyses were more favourable: participants with the lowest dietary lutein and zeaxanthin intake appeared to benefit from supplementation, and a formula containing lutein and zeaxanthin without beta-carotene was associated with lower progression than one with beta-carotene and without lutein and zeaxanthin [2]. Secondary analyses are hypothesis-generating rather than definitive, which is why this is the point where evidence summaries differ in tone.

Lutein and zeaxanthin replaced beta-carotene in the recommended formula mainly for safety: beta-carotene had been linked to increased lung cancer risk in smokers and former smokers [2]. The same trial found that lutein and zeaxanthin did not reduce the overall need for cataract surgery [3].

Evidence table

Study or sourcePopulationWhat was testedMain resultLimitations
AREDS2, JAMA 2013 [1]4,203 adults aged 50–85 at risk of advanced AMDAREDS formula ± lutein 10 mg/zeaxanthin 2 mg, ± omega-3; beta-carotene and zinc variationsNo significant additional reduction in progression to advanced AMD in the primary analysisBenefit question was “on top of” an already effective formula
AREDS2 report 3, 2014 [2]Same trial cohortSecondary analyses of lutein/zeaxanthinLower progression in people with low dietary lutein intake, and when lutein/zeaxanthin replaced beta-caroteneSecondary analyses; hypothesis-generating
AREDS2 report 4, 2013 [3]Participants with natural lensesLutein 10 mg/zeaxanthin 2 mg vs noneNo overall reduction in progression to cataract surgeryPopulation at risk of AMD, not a general cataract population

Doses: what each number means

AmountWhat kind of figure it isContext
Lutein 10 mg + zeaxanthin 2 mg dailyStudy doseAmount added in AREDS2 for people at risk of advanced AMD
No RDA or upper limitRegulatoryUS dietary reference intakes do not set a recommended intake or tolerable upper limit for lutein or zeaxanthin
Zinc 80 mg (or 25 mg) with copper 2 mgStudy doseAREDS/AREDS2 formulas; lowering zinc did not significantly change effectiveness
Zinc 40 mg/dayUpper limitAdult tolerable upper intake level from all sources
Amounts above 10 mg per servingCommercial doseSome products sell higher amounts; these are not the AREDS2 tested dose and have not been shown to add benefit

A dose used in a study describes what researchers gave participants. It is not a personal recommendation, and it does not mean a lower or higher amount is safe or effective for you.

The National Eye Institute states that lowering zinc did not significantly change the effectiveness of the formulation [4]. That matters because the original 80 mg zinc dose is twice the adult upper limit of 40 mg a day, which was set partly because high zinc intake interferes with copper absorption [5][6]. The trial formulas included 2 mg of copper for this reason.

Form and formulation differences

Safety

Lutein and zeaxanthin were chosen to replace beta-carotene in AREDS2 because of beta-carotene’s lung cancer concern in smokers and former smokers [2]. The more important safety questions in eye formulas usually involve the other ingredients:

Interactions

We did not find well-documented drug interactions for lutein or zeaxanthin themselves. Zinc can reduce absorption of some antibiotics (such as quinolones and tetracyclines) when taken at the same time, according to the NIH Office of Dietary Supplements zinc fact sheet, and high-dose vitamin E warrants a conversation with a clinician if you take anticoagulants.

Populations requiring caution

Limitations of the research

Practical label reading

For comparing whole products, see how to compare eye health supplements and our reviews of Visivra and Visium Pro. Browse the vision and eye health category.

Frequently asked questions

How much lutein was used in the AREDS2 trial?

10 mg of lutein and 2 mg of zeaxanthin a day, as part of a formula that also contained vitamins C and E, zinc and copper, in people at risk of advanced AMD.

Is more lutein better?

There is no good evidence that amounts above those tested in AREDS2 add benefit, and no trial has established a dose for healthy eyes.

Should people with healthy eyes take lutein?

The main trials involved people with AMD. They do not show that lutein supplements prevent AMD or improve normal vision, so a supplement is not established for healthy eyes.

Why was beta-carotene replaced with lutein?

Beta-carotene was linked to increased lung cancer risk in smokers and former smokers; lutein and zeaxanthin were substituted in the recommended AREDS2 formula.

Can I take lutein with a multivitamin?

Lutein itself is unlikely to be the problem, but check total zinc, vitamin A and vitamin E across all products you take.

Does lutein help cataracts?

In AREDS2, lutein and zeaxanthin did not reduce the overall need for cataract surgery.

References

  1. Age-Related Eye Disease Study 2 Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the AREDS2 randomized clinical trial. JAMA. 2013;309(19):2005–2015. PMID 23644932
  2. AREDS2 Research Group. Secondary analyses of the effects of lutein/zeaxanthin on age-related macular degeneration progression: AREDS2 report no. 3. JAMA Ophthalmol. 2014;132(2):142–149. PMID 24310343
  3. AREDS2 Research Group. Lutein/zeaxanthin for the treatment of age-related cataract: AREDS2 randomized trial report no. 4. JAMA Ophthalmol. 2013;131(7):843–850. PMID 23645227
  4. National Eye Institute. AREDS/AREDS2 frequently asked questions.
  5. NIH Office of Dietary Supplements zinc fact sheet.
  6. ODS copper fact sheet.