Lutein

Category

Herbs & Supplements

Synonyms

Anhydroluteins, C40H56O2, Calendula officinalis, carotenoids, Compositae, crystalline lutein, helenien, Helenium autumnale L., hydroxy-carotenoids, lutein dipalmitate, lutein ester, luteine, macular pigment, marigold extract, oxygenated carotenoids, trans-lutein, xantophyll, zeaxanthin.

Background

Lutein and zeaxanthin are found in high levels in foods such as green vegetables, egg yolk, kiwi fruit, grapes, orange juice, zucchini, squash, and corn. For some commercially available supplements, lutein is extracted from marigold petals.

Lutein and zeaxanthin are carotenoids in the macular region of the retina of the eye (macular pigment), and thus lutein has been studied for its use in treating cataracts, preventing macular degeneration and retinal degeneration. Lutein and zeaxanthin also have antioxidant capabilities as well as the ability to trap short-wavelength light. The potential for carotenoids, including lutein, to play a preventing role in cardiovascular disease and cancer was recognized in the 1990s.

Most of the information surrounding lutein is based on blood and/or dietary intakes of lutein compared with disease states (e.g. cancer, eye disorders, lung function, muscle soreness, obesity, and pre-eclampsia). More evidence is needed before recommendations can be made in these fields.

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Antioxidant: Many laboratory studies have shown the antioxidant effect of lutein. However, these effects have not been confirmed in human studies.
Grade: C

Atherosclerosis: Currently, there is insufficient available evidence to recommend for or against the use of lutein for atherosclerosis (hardening of the arteries). Additional study is needed in this area.
Grade: C

Cancer: Currently, there is insufficient available evidence to recommend for or against the use of lutein for cancer. Available evidence in humans is conflicting.
Grade: C

Cataracts: Human study has not found a benefit of lutein supplementation on visual performance in people with cataracts. More information is required before a firm recommendation can be made.
Grade: C

Diabetes mellitus: Currently, there is insufficient available evidence to recommend for or against the use of lutein for diabetes. Preliminary evidence is conflicting.
Grade: C

Eye disorders (lens opacities): Spinach and collard greens, both rich in lutein, are associated with a reduced risk for age-related macular degeneration. However, preliminary evidence does not support a link between levels of lutein in the body and reduced risk for lens opacities. More information is required before a firm recommendation can be made.
Grade: C

Eye disorders (macular degeneration): Macular degeneration is a chronic disease of the eyes caused by the deterioration of the central portion of the retina, known as the macula, which is responsible for focusing central vision in the eye. Preliminary evidence suggests that consumption of spinach and collard greens, both rich in lutein, may reduce the risk for age-related macular degeneration, and other preliminary studies support this. Nonetheless, additional study is needed before a firm recommendation can be made.
Grade: C

Eye disorders (retinal degeneration): Lutein supplementation may increase macular pigment optical density in patients with retinal degeneration. However, visual effects are still unknown. Further study in humans is needed.
Grade: C

Lung function: There is early evidence of a role of carotenoids in lung function and severity of respiratory infections. However, there is no association between levels of lutein in the blood and illness severity in the elderly or in lung function in adults. More information is required in this field before a strong recommendation can be made.
Grade: C

Muscle soreness: Numerous laboratory studies have shown the antioxidant effect of lutein. Despite this, in one study a lutein-containing supplement had no effect on muscle soreness or measurements of muscle activity. More information is required in this field before a firm recommendation can be made.
Grade: C

Obesity: Currently, there is insufficient available evidence to recommend for or against the use of lutein for obesity.
Grade: C

Preeclampsia: Preeclampsis is high blood pressure related to pregnancy. Preliminary evidence suggests that preeclampsia risk may decrease with increasing concentrations of lutein. Additional human studies are needed before a firm recommendation can be made.
Grade: C

Sunburn: Numerous laboratory studies have shown the antioxidant effect of lutein. More information is required in this field before a firm recommendation can be made.
Grade: C

Tradition

WARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Burns, breast cancer, cardiovascular disease, colon cancer, cystic fibrosis, dementia, dry skin, eye disorders (glare sensitivity), hyperlipidemia (high cholesterol), immunostimulant, rheumatoid arthritis, skin conditions, sun protection, visual field loss.

Dosing

Adults (over 18 years old)

Lutein is likely safe when used at doses of up to 20 milligrams daily for up to nine weeks, or 15 milligrams three times weekly for up to two years. Purified crystalline lutein is generally recognized as safe (GRAS) based on animal toxicity studies.

Although there is no proven effective dose for lutein, lutein is commercially available in various doses. For instance, the manufacturer Twinlab (Ronkonkoma, NY) makes a 6 milligram or 20 milligram lutein preparation. Lutein 12-15 milligrams been taken by mouth for up to two years as an antioxidant and to treat cataracts. Lutein 10-40 milligrams daily has been used for six to 12 months in the treatment of eye disorders.

Children (under 18 years old)

There is no proven safe or effective dose for lutein in children.

Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to lutein.

Side Effects and Warnings

In general, lutein seems fairly safe. Purified crystalline lutein is generally recognized as safe (GRAS) based on animal toxicity studies.

Nevertheless, use cautiously in people at risk for cardiovascular disease due to the possibility of increasing cardiovascular disease risk in those with higher plasma lutein levels. Also, use cautiously in patients at risk for cancer due to the possibility of an increased cancer risk in those with higher plasma lutein levels.

Avoid in patients hypersensitive to lutein or zeaxanthin.

Pregnancy & Breastfeeding

Due to the lack of available human studies, supplementation with lutein is not recommended in pregnant or breastfeeding women.

Interactions

Interactions with Drugs

In humans, moderate consumption of various types of alcoholic beverages (red wine, beer, and spirits) may decrease plasma lutein/zeaxanthin.

Although not well studied in humans, lutein may alter blood sugar levels. Caution is advised in patients taking drugs for diabetes by mouth or insulin. Blood sugar levels should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Although not well studied in humans, lutein may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs and their intended effects may be altered. Patients taking any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

Cholesterol-altering medications, antioxidants, anti-cancer agents, cholestyramine, colestipol, mineral oil, nicotine, orlistat, and retinol all may alter lutein levels in the body. However, the effects of supplementation with lutein and these agents are unknown.

Interactions with Herbs & Dietary Supplements

Alpha-tocopherol (vitamin E), antioxidants, anti-cancer agents, beta-carotene, cholesterol-altering herbs, carotenoids, mineral oil, retinol, and zeaxanthin all may alter lutein levels in the body. However, the effects of supplementation with lutein combined with these agents are unknown.

Lutein may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood.

Dietary fiber may decrease the theoretical antioxidative effects of lutein supplements. Furthermore, the proposed antioxidant activity of lutein has the potential to inhibit fatty acid oxidation and increase levels of polyunsaturated fatty acids from supplements. Caution is advised due to possible additive effects.

Although not well studied in humans, lutein may alter blood glucose levels. Caution is advised when using herbs or supplements that may also alter blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Attribution

This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Jessica Clubb, PharmD (Northeastern University); Julie Conquer, PhD (RGB Consulting); J. Kathryn Bryan, BA (Natural Standard Research Collaboration); Julie Goodfriend, PharmD (Northeastern University); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration).

Bibliography

DISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Andersen LF, Jacobs DR Jr., Gross MD, et al. Longitudinal associations between body mass index and serum carotenoids: the CARDIA study. Br J Nutr 2006;95(2):358-365.

Bloomer RJ, Fry A, Schilling B, et al. Astaxanthin supplementation does not attenuate muscle injury following eccentric exercise in resistance-trained men. Int J Sport Nutr Exerc.Metab 2005;15(4):401-412.

Coyne T, Ibiebele TI, Baade PD, et al. Diabetes mellitus and serum carotenoids: findings of a population-based study in Queensland, Australia. Am J Clin Nutr 2005;82(3):685-693.

Herron KL, McGrane MM, Waters D, et al The ABCG5 polymorphism contributes to individual responses to dietary cholesterol and carotenoids in eggs. J Nutr 2006;136(5):1161-1165.

Ito Y, Wakai K, Suzuki K, et al. Lung cancer mortality and serum levels of carotenoids, retinol, tocopherols, and folic acid in men and women: a case-control study nested in the JACC Study. J Epidemiol. 2005;15 Suppl 2:S140-S149.

Koh HH, Murray IJ, Nolan D, et al. Plasma and macular responses to lutein supplement in subjects with and without age-related maculopathy: a pilot study. Exp.Eye Res. 2004;79(1):21-27.

Lietz G, Mulokozi G, Henry JC, et al. Xanthophyll and hydrocarbon carotenoid patterns differ in plasma and breast milk of women supplemented with red palm oil during pregnancy and lactation. J Nutr 2006;136(7):1821-1827.

Olmedilla B, Granado F, Blanco I, et al. Lutein, but not alpha-tocopherol, supplementation improves visual function in patients with age-related cataracts: a 2-y double-blind, placebo-controlled pilot study. Nutrition 2003;19(1):21-24.

Richer S, Stiles W, Statkute L, et al. Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic age-related macular degeneration: the Veterans LAST study (Lutein Antioxidant Supplementation Trial). Optometry. 2004;75(4):216-230.

Sesso HD, Buring JE, Norkus EP, et al. Plasma lycopene, other carotenoids, and retinol and the risk of cardiovascular disease in men. Am J Clin Nutr 2005;81(5):990-997.

Shao A, Hathcock JN. Risk assessment for the carotenoids lutein and lycopene. Regul.Toxicol Pharmacol 2006;45(3):289-298.

Thurmann PA, Schalch W, Aebischer JC, et al. Plasma kinetics of lutein, zeaxanthin, and 3-dehydro-lutein after multiple oral doses of a lutein supplement. Am J Clin Nutr 2005;82(1):88-97.

Tulley RT, Vaidyanathan J, Wilson JB, et al. Daily intake of multivitamins during long-term intake of olestra in men prevents declines in serum vitamins A and E but not carotenoids. J Nutr 2005;135(6):1456-1461.

Whitehead AJ, Mares JA, Danis RP. Macular pigment: a review of current knowledge. Arch Ophthalmol. 2006;124(7):1038-1045.

Zhao X, Aldini G, Johnson EJ, et al. Modification of lymphocyte DNA damage by carotenoid supplementation in postmenopausal women. Am J Clin Nutr 2006;83(1):163-169.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.