Lutein and Zeaxanthin for Your Eyes: What AREDS2 Found, and Why It Replaced Beta-Carotene
Lutein and zeaxanthin are the headline ingredients in most eye-health supplements. In the large AREDS2 trial, adding them to the AREDS formula did not cut progression of macular degeneration in the main analysis, but they became the safer replacement for beta-carotene. Here is what the trials show, who the formula is for, and who should be careful.
By Kymata Health Editorial Published Last checked
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NOW Foods Lutein and Zeaxanthin, 120 Softgels
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Label: 1 softgel: 25 mg lutein and 5 mg zeaxanthin (Lutemax 2020, marigold extract).
Best for trying one bottle: $27.91 one-time (checked Oct 14, 2026).
Key takeaways
From 6 sources- In AREDS2, 4,203 people at risk of advanced macular degeneration took 10 mg lutein plus 2 mg zeaxanthin or placebo on top of an AREDS formula; 5-year progression was 29% versus 31%, not a significant difference1.
- Beta-carotene in the original formula was linked to more lung cancers, mostly in former smokers, so lutein and zeaxanthin replaced it in the AREDS2 formula12.
- Ten-year follow-up found lutein and zeaxanthin were linked to slightly lower progression to late macular degeneration than no lutein and zeaxanthin (HR 0.91)2.
- Lutein and zeaxanthin did not lower the overall need for cataract surgery or reduce vision loss in AREDS23.
- The AREDS2 formula is for intermediate or one-eyed late macular degeneration, and its 80 mg of zinc can interact with some antibiotics45.
What this article covers
1 evidence profileThe evidence, graded
Pulled from the trial tables in our evidence profiles. Grades follow our evidence-grading policy.
Graded findings
1 row- ∅No effectProgression to advanced age-related macular degenerationNo effect Adding lutein and zeaxanthin did not further reduce progression to advanced AMD in the primary analysis.Lutein and zeaxanthin · RCT · n=4,203 · 2013 · PMID 23644932
Where these trials agree: Lutein and zeaxanthin and eyes, counted row by row in the Consensus finder.
What AREDS2 tested
Lutein and zeaxanthin are carotenoids that collect in the macula, the centre of the retina. AREDS2, a trial funded by the US National Eye Institute and conducted from 2006 to 2012, enrolled 4,203 people aged 50 to 85 at risk of advanced age-related macular degeneration (AMD)1.
Participants were randomized to 10 mg lutein plus 2 mg zeaxanthin, fish-oil omega-3s, both, or placebo, on top of the original AREDS formula of vitamins C and E, beta-carotene and zinc1. Over a median of 5 years, the chance of progressing to advanced AMD was 31% on placebo and 29% on lutein and zeaxanthin1. The hazard ratio of 0.90 (98.7% CI 0.76 to 1.07; P = .12) was not statistically significant in the primary analysis1.
Funding: AREDS2 was funded by the National Eye Institute through NIH contracts listed on its PubMed record1.
Why lutein replaced beta-carotene
AREDS2 also tested removing beta-carotene from the formula. More lung cancers occurred in people assigned beta-carotene than in those who were not (23, or 2.0%, versus 11, or 0.9%), mostly in former smokers1. Removing beta-carotene did not change progression to advanced AMD, so the authors proposed lutein and zeaxanthin as the carotenoid substitute1.
Ten-year follow-up of 3,882 participants confirmed the trade: the odds of lung cancer were 1.82 times higher (95% CI 1.06 to 3.12) for those assigned beta-carotene, but not significantly raised for lutein and zeaxanthin (odds ratio 1.15, 95% CI 0.79 to 1.66)2.
The same follow-up found progression to late AMD was slightly lower with lutein and zeaxanthin than without (HR 0.91, 95% CI 0.84 to 0.99), and lower than with beta-carotene in a direct comparison (HR 0.85)2. This was an epidemiologic follow-up after the trial ended, and all participants took the AREDS2 formula during it2.
Disclosure: NIH held a royalty-bearing licence with Bausch and Lomb for the AREDS supplement until 2021, and Bausch and Lomb supplied AREDS2 supplements during the last 5 years of follow-up2. Our explainer on beta-carotene in smokers covers the older trials.
Cataracts, macular pigment and healthy eyes
In AREDS2, lutein and zeaxanthin did not change the overall need for cataract surgery (HR 0.96, 95% CI 0.84 to 1.10) or the rate of losing 3 or more lines of vision over a median 4.7 years3. In people with the lowest dietary intake, cataract surgery was less common on lutein and zeaxanthin (HR 0.68), a subgroup finding3.
In people with healthy eyes, a 2021 meta-analysis of 46 studies (3,189 adults) found that 5 to under 20 mg a day raised macular pigment density by 0.04 units, and 20 mg or more by 0.11 units, over 3 to 12 months; intakes under 5 mg a day showed no clear change6. A higher pigment reading is not the same as better vision, and the authors called for research on clinically important changes6.
Funding: that meta-analysis was supported by the Institute for the Advancement of Food and Nutrition Sciences, a nonprofit that pools industry and public funding, through an ILSI North America grant; the funder set the review question and reviewed the protocol and report but did not take part in the analysis, and the authors reported no conflicts6. The lutein and zeaxanthin page grades each finding.
Who the AREDS2 formula is for
The National Eye Institute says AREDS2 supplements may stop intermediate AMD in one or both eyes from turning into late AMD, and may slow progression in the second eye when late AMD affects only one eye4. They do not stop early AMD from becoming intermediate AMD, and probably will not help when late AMD affects both eyes4.
The formula contains 500 mg vitamin C, 400 IU vitamin E, 80 mg zinc, 2 mg copper, 10 mg lutein and 2 mg zeaxanthin, an amount the institute says food and regular multivitamins cannot supply4. For zinc and copper balance, see our zinc forms and upper limit explainer.
Who should be careful
Check with an eye doctor or pharmacist before starting an eye-health formula if any of these apply:
- Current or former smokers: choose a formula without beta-carotene, which was linked to more lung cancers in AREDS2, mostly in former smokers14.
- Quinolone or tetracycline antibiotics: zinc can reduce absorption of both, so take the antibiotic at least 2 hours before or 4 to 6 hours after a zinc-containing supplement5.
- Penicillamine: zinc reduces its absorption, so the two should be taken at least 1 hour apart5.
- Thiazide diuretics: these increase zinc loss in urine over time5.
- High-dose zinc without supervision: the AREDS2 formula's 80 mg of zinc is double the 40 mg adult upper limit, which does not apply to people taking zinc for medical reasons under a doctor's care45.
- Other medicines in general: the National Eye Institute notes that the large vitamin and mineral doses can change how other medicines work4.
Keep reading
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Every graded study, studied doses, interactions and safetyRelated articles
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Where to buy Lutein and zeaxanthin
Products from brands we partner with that contain Lutein and zeaxanthin. Check the amount per serving against the doses studied, and the label for other ingredients.
Lutein and zeaxanthin products from partner brands
4 products Paid links · we earn a commission- Quick pickHerbsProNOW Foods Lutein and Zeaxanthin, 120 Softgels
1 softgel: 25 mg lutein and 5 mg zeaxanthin (Lutemax 2020, marigold extract)
$27.91one-timeChecked Oct 14, 2026 - SupersmartLutein5% off with the Supersmart newsletterGet 5% off with the newsletter (paid link, opens in new tab)
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1 capsule: 20 mg free lutein from marigold extract (no zeaxanthin listed; AREDS2 used 10 mg lutein with 2 mg zeaxanthin); 60 servings
$29.00one-time$24.65subscribeChecked Oct 11, 2026 - OnnitOnnit Alpha BRAIN Neuro Gummies (90 gummies)We use this brand at home. What we useSubscribe & Save 15%
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CGrade C, limited (Grade C) 10 mg lutein and 2 mg zeaxanthin per serving, the AREDS2 amounts; the gummy itself has not been trialed.
Caution: 50 mg caffeine and 7 g added sugar per serving.
3 gummies: 10 mg lutein and 2 mg zeaxanthin (the AREDS2 amounts) with 250 mg DHA, 50 mg caffeine and 7 g added sugar; 30 servings
$24.99one-time$21.25subscribeChecked Oct 20, 2026 - Physician’s ChoicePhysician’s Choice Eye Health (60 capsules)
2 capsules: 20 mg lutein and 4 mg zeaxanthin from Lutemax 2020 marigold extract, with 250 mg vitamin C, 20 mg vitamin E, 25 mg zinc, 2 mg copper, 400 mcg DFE folate, 100 mcg vitamin B12, 50 mg bilberry extract, 25 mg grape seed extract and 5 mg black pepper extract; 30 servings
$23.97one-timeChecked Oct 20, 2026
References
6 sources. Numbers in the text link here.
Sources cited in this article
6 sources- 1Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trialJAMA, 2013 · PMID 23644932
- 2Long-term Outcomes of Adding Lutein/Zeaxanthin and ω-3 Fatty Acids to the AREDS Supplements on Age-Related Macular Degeneration Progression: AREDS2 Report 28JAMA Ophthalmol, 2022 · PMID 35653117
- 3Lutein/zeaxanthin for the treatment of age-related cataract: AREDS2 randomized trial report no. 4JAMA Ophthalmol, 2013 · PMID 23645227
- 4AREDS 2 Supplements for Age-Related Macular Degeneration (AMD)National Eye Institute, 2021
- 5Zinc: Fact Sheet for ConsumersNIH Office of Dietary Supplements, 2022
- 6The Effect of Lutein/Zeaxanthin Intake on Human Macular Pigment Optical Density: A Systematic Review and Meta-AnalysisAdv Nutr, 2021 · PMID 34157098
Lutein and zeaxanthin and other dietary supplements are not intended to diagnose, treat, cure or prevent any disease, and these statements have not been evaluated by the FDA. Talk to your clinician or pharmacist before starting a supplement, especially if you take prescription medicines. Product links on this page are paid partner links.