What is Lutein Used For?
Lutein is primarily used for eye health, specifically to reduce the risk of age-related macular degeneration (AMD) and cataracts, though the evidence for supplementation is mixed and dietary intake from fruits and vegetables appears more beneficial than high-dose supplements alone. 1
Primary Indications for Lutein
Age-Related Macular Degeneration (AMD)
- Lutein is most strongly indicated for patients with intermediate AMD or advanced AMD in one eye as part of the AREDS2 formulation (10 mg lutein + 2 mg zeaxanthin combined with vitamins C, E, zinc, and copper), which reduces progression risk by up to 36% over 10 years. 2
- The AREDS2 formulation should be prescribed to all patients with intermediate or advanced AMD to slow disease progression and preserve vision. 2
- Lutein serves as an appropriate substitute for beta-carotene in the original AREDS formulation, particularly important for former smokers due to beta-carotene's association with increased lung cancer risk. 2
- Observational data suggests lutein and zeaxanthin have a protective effect against cataract development, though this is not supported by level 1 randomized controlled trial evidence. 1
Cataract Prevention
- Dietary intake of lutein/zeaxanthin is associated with modestly lower risk of cataract extraction in men with higher dietary intake. 1
- However, the 2022 American Academy of Ophthalmology guidelines note there is currently no level 1 evidence to support that high-dose antioxidant supplementation (including lutein) slows cataract progression. 1
Mechanism of Action
- Lutein functions as a blue-light filter and antioxidant that quenches photo-induced reactive oxygen species in the retina and lens. 3, 4
- Lutein and zeaxanthin are uniquely concentrated in the macula lutea (responsible for central and high acuity vision) and the lens, where they provide protective effects. 3, 5, 4
Dosing Recommendations
For AMD Prevention/Treatment
- The AREDS2 formulation contains 10 mg lutein and 2 mg zeaxanthin, which is the evidence-based dose for patients at high risk of AMD progression. 2
- The Chinese Nutrition Society recommends 6 mg daily lutein intake, with an upper limit of 60 mg. 2
Dietary vs. Supplemental Intake
- Epidemiological studies suggest 6-14 mg daily lutein intake reduces risk of AMD and cataracts. 6
- Average dietary intake from food is approximately 2.5 mg daily, which may be insufficient for disease prevention in older adults. 6
- Fresh vegetables (particularly green leafy vegetables) provide 63% of dietary lutein, with frozen vegetables contributing 13%. 6
Important Clinical Caveats
Evidence Quality Considerations
- A 2012 Cochrane Systematic Review found no evidence supporting high-dose vitamin E, vitamin C, or beta-carotene for cataract prevention, and while a more recent systematic review suggested lutein had protective effects, this included only observational data, not randomized trials. 1
- The strongest evidence for lutein supplementation comes from the AREDS2 trial specifically for AMD, not for general eye health or cataract prevention. 2
When NOT to Recommend Lutein Alone
- Lutein supplementation outside the complete AREDS2 formulation lacks strong evidence for AMD prevention. 1
- For wet (neovascular) AMD, lutein supplements should complement—not replace—anti-VEGF therapy, which remains the primary treatment. 2
- Multivitamin use alone (without the specific AREDS2 formulation) shows no association with reduced cataract extraction risk. 1
Additional Potential Benefits
- Lutein may improve cognitive function, decrease cancer risk, and improve cardiovascular health measures, though these effects require further investigation. 7
- Lutein supplementation may improve vision performance in young adults and throughout the lifespan. 5
- Skin protection from UV-induced damage is a possible secondary benefit. 3