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Lutein + zeaxanthin

Macular carotenoids with NEJM/JAMA-tier RCT support (AREDS2) for slowing age-related macular degeneration progression.

Why

Lutein and zeaxanthin are dietary carotenoids that concentrate in the macula of the retina, the macular pigment. The AREDS2 trial (Chew JAMA 2013, n=4,203) tested lutein 10 mg + zeaxanthin 2 mg daily in adults at intermediate or advanced AMD; the lutein/zeaxanthin combination significantly reduced progression to advanced AMD in subjects with low dietary intake. Lutein/zeaxanthin is now part of the AMD nutritional standard of care and replaced beta-carotene in the AREDS2 formulation (lower lung cancer risk in former smokers).

How it works

Filter blue light at the macula and quench reactive oxygen species generated by photoreceptor metabolism. Cross the blood-retinal barrier and concentrate in macular pigment, increasing optical density and contrast sensitivity.

Expected onset · Macular pigment optical density changes over 3–6 months; AMD progression endpoints over 3–5 years

How to take

Dosage

AREDS2 dose: 10 mg lutein + 2 mg zeaxanthin per day. Higher doses (up to 20 mg lutein) have been used in shorter trials without added benefit.

Timing

Once daily with a meal containing fat for absorption

On the label

10 mg lutein + 2 mg zeaxanthin (AREDS2 dose). Free-form (FloraGLO) or from marigold extract (Tagetes erecta).

Ideal for

Adults with intermediate or advanced AMD in one eye; people with low dietary intake of leafy greens (the principal food source); adults with strong family history of AMD as nutritional risk-reduction.

Safety

Generally very well tolerated at AREDS2 doses. Mild yellowing of skin at very high doses (carotenodermia), reversible. Replaced beta-carotene in the AREDS2 formulation because beta-carotene raised lung-cancer risk in current/former smokers, lutein/zeaxanthin does not carry this risk. Pregnancy and breastfeeding: dietary intake safe; supplement-dose data limited.

Evidence

At a glance

AREDS2 (Chew 2013 JAMA, n=4,203 AMD patients): 10 mg lutein + 2 mg zeaxanthin daily reduced progression to advanced AMD by ~10% overall and by ~26% in subjects with low baseline dietary intake. Wu 2015 25-year follow-up confirmed dietary lutein/zeaxanthin intake correlated with reduced AMD incidence. AREDS2 dose now replaces beta-carotene in the standard formulation.

Where to get it

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