What is the recommended daily dose of lutein and zeaxanthin for supporting eye health?

Recommended Daily Dose of Lutein and Zeaxanthin for Eye Health

For general eye health support, the recommended daily dose is 10 mg of lutein and 2 mg of zeaxanthin, which has been shown to benefit visual function and reduce risk of age-related macular degeneration progression. 1, 2, 3

Evidence-Based Recommendations

• The Age-Related Eye Disease Study 2 (AREDS2) formulation, which includes 10 mg of lutein and 2 mg of zeaxanthin, is recommended specifically for patients with intermediate or advanced age-related macular degeneration (AMD) to reduce risk of progression 4, 2
• The Chinese Nutrition Society has proposed a specific daily intake level of 6 mg for lutein with an upper limit of 60 mg 5
• Clinical trials have demonstrated that supplementation with 10 mg lutein and 2 mg zeaxanthin improves several measures of eye health in high electronic screen users 3
• Supplementation with either 10 mg or 20 mg of lutein daily has been shown to significantly increase macular pigment optical density and enhance retinal sensitivity in patients with early AMD 6

Mechanism of Action and Benefits

• Lutein and zeaxanthin are the only dietary carotenoids that accumulate in the retina, specifically in the macula, where they are known as macular pigments 1
• These carotenoids provide protection through:
  • Antioxidant properties that defend against oxidative stress 1
  • Ability to scavenge free radicals 1
  • Filtering of harmful blue light 1
• Lower plasma concentrations of zeaxanthin have been associated with a two-fold increased risk of AMD, supporting its protective role 7

Dosing Considerations

• The average dietary intake of lutein in adults is only 1-2 mg/day, which is significantly lower than the recommended therapeutic amounts 1
• For patients at high risk of AMD progression (those with intermediate AMD or advanced AMD in one eye), the AREDS2 formulation containing 10 mg lutein and 2 mg zeaxanthin should be considered 5, 4
• Supplementation with these carotenoids has been shown to be well-tolerated with no serious adverse effects or significant changes in vital signs or blood safety measures 3

Food Sources

• Key dietary sources of lutein and zeaxanthin include:
  • Dark leafy greens (kale, spinach)
  • Savoy cabbage
  • Broccoli
  • Peas
  • Parsley
  • Corn
  • Egg yolks 1

Clinical Application

• Regular comprehensive eye examinations are recommended for early detection of AMD, as early symptoms may be subtle 4
• The American Academy of Ophthalmology emphasizes that early detection and treatment of AMD is associated with more favorable prognosis and better preservation of vision 4
• For patients with existing AMD, supplementation with lutein and zeaxanthin as part of the AREDS2 formulation can help delay disease progression and associated vision loss 5, 4
• Lutein and zeaxanthin supplementation may be particularly beneficial for high electronic screen users, improving measures of eye health including tear production and photo-stress recovery time 3

Special Considerations

• In the AREDS2 trial, lutein and zeaxanthin were found to be an appropriate carotenoid substitute for beta-carotene in the original AREDS formulation, especially for former smokers due to the potential increased risk of lung cancer associated with beta-carotene supplementation 5, 2
• No diet or medical therapy has proven effective to prevent or treat hydroxychloroquine or chloroquine retinopathy, although patients with age-related maculopathy are sometimes advised to maintain intake of lutein and zeaxanthin as foveal protectants 5