Benefits
Macular pigment and visual performance
In a 1-year double-blind trial of 115 healthy young adults, 10 mg lutein plus 2 mg zeaxanthin a day raised macular pigment density and blood levels, and improved chromatic contrast and recovery from bright-light glare (photostress) compared with placebo. Glare disability itself did not improve significantly.
Macular health in the AREDS2 eye study
In AREDS2, 4,203 people aged 50 to 85 at risk of advanced age-related macular degeneration took 10 mg lutein plus 2 mg zeaxanthin or placebo alongside the AREDS formula for a median of 5 years. The main analysis found no significant reduction in progression. In 10-year follow-up, lutein and zeaxanthin compared directly with beta-carotene were linked to 15% lower progression (HR 0.85).
Visual comfort with heavy screen use
In a 6-month placebo-controlled trial of 48 healthy young adults with at least 6 hours of daily screen time, 24 mg a day of lutein, zeaxanthin and meso-zeaxanthin improved macular pigment, eye strain, eye fatigue, headache frequency, sleep quality and visual performance tests. One author consults for the study sponsor.
Visual field over 4 years in adults taking vitamin A
In a 4-year trial of 225 nonsmoking adults with retinitis pigmentosa, all taking vitamin A, 12 mg lutein a day did not change the main visual field measure. A secondary measure of mid-peripheral field declined more slowly (P = .05), and no toxic effects were seen. The result applies only to that inherited condition and that combination.
Skin tone and sun sensitivity
In a 12-week trial of 50 adults with dry skin (46 finished), 10 mg lutein plus 2 mg zeaxanthin isomers a day improved overall skin tone and lightness versus placebo, and the dose of UV light needed to redden skin rose. It is a small trial whose authors include employees of the ingredient's maker.
Skin oxidative stress markers after UV exposure
In a crossover trial in 65 healthy volunteers testing lutein or a tomato extract, 12 weeks of oral lutein fully blocked the UV-triggered rise of skin stress genes such as heme oxygenase 1 when taken in the first period, with smaller effects when taken second. Another double-blind trial reported lower UV-related lipid peroxidation in skin with oral lutein and zeaxanthin. Both are small trials of lab markers.
Verbal fluency in older women
In an exploratory 4-month trial of 49 women aged 60 to 80, 12 mg lutein a day improved verbal fluency, as did DHA and the combination. Memory and learning improved only with lutein plus DHA, and processing speed, accuracy and mood did not change. Each group had only 10 to 14 women.
Taking lutein with fat
Lutein is fat-soluble. Healthy fats in a meal and cooking methods affect how much is absorbed from food, and eggs and pistachios are well-absorbed sources. Diet models show that about 5 to 10 mg a day can come from food alone.
Mechanism of action
Macular pigment and blue light
Lutein and zeaxanthin are the main carotenoids that build up in the retina. There they form macular pigment, which absorbs short-wavelength blue light. Supplementation raises macular pigment optical density, which trials link to better glare recovery and contrast.
Antioxidant in skin
Lutein and zeaxanthin occur naturally in skin, where they act as antioxidants. In trials, oral lutein lowered UV-related lipid peroxidation and blunted UV-induced stress genes in skin samples.
Clinical trials
Multicenter randomized double-masked placebo-controlled phase 3 trial, 2 x 2 factorial, lutein 10 mg + zeaxanthin 2 mg and/or DHA + EPA on top of the AREDS formula (AREDS2 Research Group 2013, JAMA)
4,203 adults aged 50 to 85 at risk of advanced age-related macular degeneration; median follow-up 5 years
The primary analysis showed no significant reduction in progression to advanced disease with lutein + zeaxanthin (HR 0.90, 98.7% CI 0.76 to 1.07, P = .12). More lung cancers occurred with beta-carotene than without (2.0% vs 0.9%, nominal P = .04), mostly in former smokers, so the authors called lutein + zeaxanthin an appropriate substitute for beta-carotene.
Multicenter epidemiologic follow-up of the AREDS2 trial for 5 more years, all participants on lutein/zeaxanthin formulas (Chew et al. 2022, JAMA Ophthalmol)
3,882 AREDS2 participants with intermediate disease
At 10 years, lutein/zeaxanthin vs none had an HR of 0.91 for late disease (P = .02), and compared directly with beta-carotene an HR of 0.85 (P = .02). Lung cancer odds were 1.82 with beta-carotene (P = .02) and 1.15 with lutein/zeaxanthin (not significant). The authors describe a potential beneficial association, not a proven effect.
Randomized double-blind placebo-controlled trial, lutein 10 mg + zeaxanthin 2 mg a day for 1 year (Hammond et al. 2014, Invest Ophthalmol Vis Sci)
115 healthy young adults (57 active, 58 placebo)
Macular pigment optical density and serum lutein and zeaxanthin rose significantly. Chromatic contrast and photostress recovery time improved versus placebo. Glare disability did not change significantly.
Placebo-controlled trial, 24 mg a day of lutein, zeaxanthin and meso-zeaxanthin for 6 months (Stringham et al. 2017, Foods)
48 healthy young adults with at least 6 hours of daily near-field screen time
Supplementation improved macular pigment, overall sleep quality, headache frequency, eye strain, eye fatigue and all visual performance measures versus placebo (p < 0.05). One author consults for the funding sponsor.
Randomized double-masked controlled trial, lutein 12 mg a day or control for 4 years, all with vitamin A 15,000 IU a day (Berson et al. 2010, Arch Ophthalmol)
225 nonsmoking adults aged 18 to 60 with retinitis pigmentosa
The primary outcome (HFA 30-2 visual field) showed no significant difference in decline. The secondary HFA 60-4 measure declined more slowly with lutein (P = .05). No significant toxic effects were seen.
Randomized double-blind placebo-controlled trial, lutein 10 mg + zeaxanthin isomers 2 mg a day for 12 weeks (Juturu et al. 2016, Clin Cosmet Investig Dermatol)
50 healthy adults aged 18 to 45 with mild to moderate dry skin (46 completed)
Overall skin tone (P < 0.0237) and skin lightness improved versus placebo, and mean minimal erythemal dose increased. Two authors are employees of the ingredient supplier.
Double-blind placebo-controlled multicenter study of lutein and zeaxanthin given orally, topically or both (Palombo et al. 2007, Skin Pharmacol Physiol)
Human volunteers
The study measured surface lipids, hydration, photoprotective activity, elasticity and skin lipid peroxidation. Combined oral and topical use gave the most antioxidant protection, oral and topical use alone were also active, and oral lutein protected better than topical lutein on lipid peroxidation after UV light.
Randomized double-blind placebo-controlled crossover study, two 12-week treatment phases (Grether-Beck et al. 2017, Br J Dermatol)
65 healthy volunteers, split between lutein and tomato extract groups
Lutein fully blocked UV-induced rises in the stress genes HO1, ICAM1 and MMP1 in skin biopsies when taken in the first period, but had significantly smaller effects when taken second.
Exploratory 4-month double-blind trial: DHA 800 mg, lutein 12 mg, both, or placebo (Johnson et al. 2008, Nutr Neurosci)
49 women aged 60 to 80 without cognitive impairment
Verbal fluency improved in the DHA, lutein and combined groups (P < 0.03). Memory and rate of learning improved only in the combined group. Processing speed, accuracy and mood did not change.