Carotenoids supplement health benefit, what is the right dosage, cancer prevention, vision
July 1 2018 by Ray Sahelian, M.D. natural health and nutritional supplement information

Carotenoids are a large group -- several hundred or thousand -- of fat soluble pigments widely distributed in plants and animals. Dietary carotenoids are thought to provide health benefits by decreasing the risk of disease, particularly certain cancers, stroke, heart disease, and eye disease. Carotenoids are also thought to enhance the immune system. The ones that have been most studied in this regard are beta-carotene, lycopene, lutein, zeaxanthin and astaxanthin. In part, the beneficial effects of carotenoids are thought to be due to their role as antioxidants. Beta-Carotene may have added benefits due its ability to convert into vitamin A. Higher plants, algae as well as many fungi and bacteria possess the ability to make carotenoids. However, humans are not able to make them and hence these compounds must be obtained through diet.
    If you plan to take such supplements, it may be a good idea to take a mix of several rather than a high dose of just one type unless you want to focus on one particular area of health improvement. For instance, if you wish to improve vision then lutein is a good option, or Eyesight Rx natural vision enhancer.

Eyesight Rx for better vision within hours or days
Vitamin C (Ascorbic acid)
Citrus bioflavonoids (eriocitrin, hesperidin, flavonols, flavones, flavonoids, naringenin, and quercetin)
Mixed Carotenoids Complex (alpha carotene, astaxanthin, beta carotene, cryptoxanthin, lutein, lycopene,  zeazanthin)
Bilberry extract (Vaccinium myrtillus)
Eyebright extract (Euphrasia officianales)
Jujube extract (Zizyphus jujube). Jujube is used widely in traditional Chinese medicine.
Ginkgo biloba (Ginkgo biloba)
Suma extract (Pfaffia paniculata)
Mucuna pruriens extract (Cowhage)
Cinnamon (Cinnamomum zeylanicum)
Lycium berry extract is also known as Goji Berry (Lycium Barbarum)
Sarsaparila (Sarsaparilla Smilax)
Alpha Lipoic acid is a potent antioxidant

The different carotenoids in foods
Beta-carotene and alpha-carotene are responsible for the orange color of carrots, and lycopene for the red color of tomatoes. Astaxanthin imparts a red or pink color to lobsters and salmon. The term "carotene" refers to carotenoids which contain only carbon and hydrogen (e.g. beta-carotene, alpha-carotene, lycopene), while the term "xanthophylls" refers to compounds which contain hydroxyl groups (lutein, zeaxanthin, beta-cryptoxanthin) or keto groups (canthaxanthin).

Advances in Nutrition 2018. Xanthophylls. Carotenoids are plant pigments commonly found in fruits and vegetables. They are made up of 2 classes, xanthophylls and carotenes. Whereas carotenes are composed of only carbon and hydrogen, xanthophylls include hydroxyl groups, making them slightly more hydrophilic than carotenes. Carotenoids are found throughout the body. Among the carotenoids, the xanthophylls lutein and zeaxanthin selectively accumulate in the eye and brain. In the eye, lutein and zeaxanthin are responsible for the yellow pigment of the macula lutea.

Food sources
Carotenoids are found in a variety of fruits and vegetables, although the primary sources of lycopene are tomato and tomato products, along with watermelon. Lycopene is thought to be potentially helpful in reducing the risk of prostate cancer. Egg yolk is a source of lutein and zeaxanthin. Lutein and zeaxanthin may be protective in eye disease because they absorb damaging blue light that enters the eye.  Carrots are a great source for beta-carotene. Carotenoids from vegetable juices are able to enhance the immune system in those who normally have a low intake of carotenoids.

From food or supplements?
Carotenoids are available in supplement form either individually or as mixed carotenoids.. Carotenoids ingested as supplements act as antioxidants. However, intervention trials with large doses of a single carotenoid, such as beta-carotene, found an adverse effect on the incidence of lung cancer in smokers and workers exposed to asbestos.
   I believe that anyone supplementing with carotenoids should take a combination called mixed carotenoids  rather than a high dose of just one. Although it is possible to obtain plenty of carotenoids through fruits and vegetables, carotenoid supplements are potentially helpful for those who do not eat adequate amounts of produce, or are trying to limit their intake of fructose from fruits.

Carotenoid complex 120 capsules - Now Foods
Many diverse carotenoids besides beta-carotene play vital roles in maintaining good health, especially in protecting against free radical damage. Yet, most Americans don't eat enough vegetables. Supplement Facts:
Serving Size: 2 Vegicaps
Servings per container: 60
Vitamin A (as Beta-Carotene)
Alpha carotene
Additional carotenoids (from D. salina algae: zeaxanthin, beta-cryptoxanthin, Lutein, Floraglo marigold)
Lycopene (LYC-O-MATO tomato extract)
Broccoli concentrate (250 mcg sulforaphane) - 250 mg
Spinach concentrate (75 mcg lutein)
Tomato concentrate (140 mcg lycopene)
Kale powder 
Cabbage powder
Brussels sprouts powder

Suggested Use: As a dietary supplement, take 1 carotenoid Vcaps daily, preferably with meals.

Benefits and uses

Breast cancer
Dr. Laura I. Mignone of the Harvard School of Public Health in Boston reports that the more servings of carotenoid-rich vegetables premenopausal women eat every day, the lower is their risk of developing breast cancer. Laura Mignone examined the relationship between levels of carotenoid-rich fruits and vegetables in the diet and breast cancer risk by comparing the diets of 5,700 women with invasive breast cancer and 6,390 healthy controls. Higher levels of the carotenoids vitamin A, beta carotene, alpha carotene, and lutein / zeaxanthin reduced breast cancer risk among premenopausal women, but not postmenopausal women. Eating at least two servings of carotenoid-rich vegetables each day reduced the risk by 17 percent. International Journal of Cancer, June 15, 2009.

Girls who eat the most fruits and vegetables rich in carotenoids are less likely to get benign breast disease, which include a variety of noncancerous conditions of the breast; some forms raise the risk of breast cancer. May 2014, Pediatrics journal.

Eyes health
The human macula uniquely concentrates three carotenoids: lutein, zeaxanthin, and meso-zeaxanthin. Lutein and zeaxanthin must be obtained from dietary sources such as green leafy vegetables and orange and yellow fruits and vegetables, while meso-zeaxanthin is rarely found in diet and is believed to be formed at the macula by metabolic transformations of ingested carotenoids. Epidemiological studies and large-scale clinical trials have brought attention to the potential ocular health and functional benefits of these three xanthophyll carotenoids consumed through the diet or supplements.

Carotenoids and Macular Degeneration
In a study of healthy women younger than 75 years, consumption of diets rich in the carotenoids lutein and zeaxzanthin, which are found in green leafy vegetables, corn, and squash, seemed to stave off intermediate age-related macular degeneration (AMD). The researchers' findings appear in the August, 2006 issue of Archives of Ophthalmology.

Metabolic syndrome
Br J Nutr. 2015. High serum carotenoids associated with lower risk for the metabolic syndrome and its components among Japanese subjects: Mikkabi cohort study.

Carotenoids and DNA
Carotenoids are 40-carbon molecules with conjugated double bonds, making them particularly effective for quenching free radicals. They are believed to possess anticancer properties, which could be due to their antioxidant potential. Carotenoid supplementation decreases DNA damage and that a combination of carotenoids (lutein, beta carotene, and lycopene), an intake that can be achieved by diet exerts protection against DNA damage.

Carotenoids Research
A community randomized controlled clinical trial of mixed carotenoids and micronutrient supplementation of patients with acquired immunodeficiency syndrome.
Eur J Clin Nutr. 2006. CTN 091/CRIT Cartenoids Study Group. The Community Research Initiative of Toronto, Toronto, Canada.
Low serum carotene concentration is common in AIDS patients and predicts death. Supplementation with vitamins, micronutrients and natural mixed carotenoids may improve survival by correction of a micronutrient deficiency.

Serum carotenoids and other antioxidative substances associated with urothelial cancer risk in a nested case-control study in Japanese men.
J Urology. 2005.
We assayed whether high serum carotenoids and antioxidative substances decrease the risk of urothelial cancer in a case-control study nested in a community based cohort in Japan, that is the Japan Collaborative Cohort Study. Our results suggest that high serum carotenoids may decrease the risk of urothelial cancer with carotenes more effective than xanthophylls.

Dietary lycopene and other carotenoids may protect against prostate cancer, Australian and Chinese researchers report. The findings confirm those of other studies that have identified lycopene as a protective agent against some types of cancers. Lee, of Curtin University of Technology, Perth, and colleagues conducted a study in southeast China involving 130 patients with prostate cancer, and a comparison group of 274 cancer-free "controls." The participants were interviewed about food consumption and a variety of other matters. After factoring in age, total fat and caloric intake, as well as family history, diet appeared to have an influence on the odds of developing prostate cancer. The risk of prostate cancer declined with increasing consumption of lycopene, alpha-carotene, beta-carotene and other carotenoids the investigators report in the International Journal of Cancer. Consumption of foods including tomatoes, spinach and citrus fruits was also associated with a reduced cancer risk. The researchers conclude that "carotenoids in vegetables and fruits may be inversely related to prostate carcinogenesis among Chinese men.": International Journal of Cancer, 2005.

Carotenoid action on the immune response.
J Nutr. 2004.
Early studies demonstrating the ability of dietary carotenoids to prevent infections have left open the possibility that the action of these carotenoids may be through their prior conversion to vitamin A. Subsequent studies to demonstrate the specific action of dietary carotenoids have used carotenoids without provitamin A activity such as lutein, canthaxanthin, lycopene and astaxanthin. In fact, these nonprovitamin A carotenoids were as active, and at times more active, than beta-carotene in enhancing cell-mediated and humoral immune response in animals and humans. Another approach to study the possible specific role of dietary carotenoids has used animals that are inefficient converters of carotenoids to vitamin A, for example the domestic cat. Results have similarly shown immune enhancement by nonprovitamin A carotenoids, based either on the relative activity or on the type of immune response affected compared to beta-carotene. Certain carotenoids, acting as antioxidants, can potentially reduce the toxic effects of reactive oxygen species, and therefore carotenoids, have been implicated in the etiology of diseases such as cancer, cardiovascular and neurodegenerative diseases and aging. Recent studies on the role of carotenoids in gene regulation, apoptosis and angiogenesis have advanced our knowledge on the possible mechanism by which carotenoids regulate immune function and cancer.

Do dietary lycopene and other carotenoids protect against prostate cancer?
Int J Cancer. 2004.
To determine whether dietary intake of lycopene and other carotenoids has an association with prostate cancer, a case-control study was conducted in Hangzhou, southeast China during 2001-2002. The cases were 130 incident patients with adenocarcinoma of the prostate. The controls were 274 hospital inpatients without prostate cancer or any other malignant diseases. The risks of prostate cancer for the intake of carotenoids and selected vegetables and fruits rich in carotenoids were assessed. The prostate cancer risk declined with increasing consumption of lycopene, alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein and zeaxanthin. Intake of tomatoes, pumpkin, spinach, watermelon and citrus fruits were also inversely associated with the prostate cancer risk. The results suggest that vegetables and fruits rich in lycopene and other carotenoids may be protective against prostate cancer.

Effects of beta-carotene supplementation on free radical mechanism in healthy adult subjects.
Int J Vitam Nutr Res. 2004.
Forty-two healthy subjects were supplemented with 5 mg, 10 mg, 20 mg or 40 mg beta-carotene /day, respectively for five weeks. Beta-carotene supplementation of healthy subjects significantly increased plasma beta-carotene status without inducing adverse biological effects. Beta-carotene did not especially protect against oxidative stress, except for the 40 mg group. These data suggest that additional effects of beta-carotene supplementation on well-nourished, healthy subjects are limited.

Plasma carotenoids in relation to acute respiratory infections in elderly people.
Br J Nutr. 2004.
A high plasma carotenoid concentration could improve the immune response and result in decreased risk of infectious diseases. However, data on the relationship of plasma carotenoid concentration with acute respiratory infections, which occur frequently in elderly people, are scarce. We investigated, therefore, the relationship of plasma concentrations of six major carotenoids (beta-carotene, alpha-carotene, beta-cryptoxanthin, lycopene, lutein and zeaxanthin) with the incidence and severity of acute respiratory infections. Plasma carotenoid concentrations were divided into quartiles, the lowest being the reference. Frequency and severity of episodes during the previous 1 year, i.e. staying in bed, medical consultation and episode-related medication, were self-reported by means of a questionnaire. On average 1.6 episodes per person were recorded. The incidence rate ratio of acute respiratory infections at high beta-carotene status was 0.71 as compared with the low beta-carotene concentration group. No association was observed between beta-carotene and illness severity. alpha-Carotene, beta-cryptoxanthin, lycopene, lutein and zeaxanthin were not related to incidence or severity of the infections. We conclude that elderly people with a high plasma beta-carotene concentration may have a lower occurrence of acute respiratory infections.

Supplementation of a low-carotenoid diet with tomato or carrot juice modulates immune functions in healthy men.
Ann Nutr Metab. 2003.
The objective of this study was to investigate the effects of a low-carotenoid diet supplemented with either tomato (providing high amounts of lycopene) or carrot juice (providing high amounts of alpha- and beta-carotene) on immune functions in healthy men.  In a blinded, randomized, cross-over study, male subjects on a low-carotenoid diet consumed 330 ml/day of either tomato juice (37.0 mg/day lycopene) or carrot juice (27.1 mg/day beta-carotene and 13.1 mg/day alpha-carotene) for 2 weeks with a 2-week depletion period after juice intervention. Immune status was assessed by measuring lytic activity of natural killer (NK) cells, secretion of cytokines (IL-2, IL-4, TNFalpha), and proliferation by activated peripheral blood mononuclear cells. Juice consumption resulted in relatively fast responses in plasma carotenoid concentrations which were not accompanied by concomitant changes in immune functions. Increased plasma carotenoids concentrations after vegetable juice consumption are accompanied by a time-delayed modulation of immune functions in healthy men consuming a low-carotenoid diet.

Prospective study of plasma carotenoids and tocopherols in relation to risk of ischemic stroke.
Stroke. 2004.
We conducted a prospective, nested case-control analysis among male physicians without diagnosed cardiovascular disease followed-up for up to 13 years in the Physicians' Health Study. Samples from 297 physicians with ischemic stroke were analyzed with paired controls, matched for age and smoking, for 5 major carotenoids (alpha- and beta-carotene, beta-cryptoxanthin, lutein, and lycopene), retinol, and alpha- and gamma-tocopherol. Baseline plasma levels of alpha-carotene and beta-carotene and lycopene tended to be inversely related to risk of ischemic stroke with an apparent threshold effect. As compared with men whose plasma levels were in the lowest quintile, the multivariate adjusted odds ratios of ischemic stroke among men with levels in the second through fifth quintiles were 0.59 for alpha-carotene, 0.62 for beta-carotene, and 0.61for lycopene. No association was found for lutein, retinol, and tocopherols. Our data suggest that higher plasma levels of carotenoids, as markers of fruit and vegetable intake, are inversely related to risk of ischemic stroke and provide support for recommendations to consume fruits and vegetables regularly.

Carotenoids in cancer chemoprevention.
Cancer Metastasis Rev. 2002.
Various natural carotenoids, besides beta-carotene, were proven to have anticarcinogenic activity, and some of them showed more potent activity than beta-carotene. Thus, these carotenoids (alpha-carotene, lutein, zeaxanthin, lycopene, beta-cryptoxanthin, fucoxanthin, astaxanthin, capsanthin, crocetin and phytoene), as well as beta-carotene, may be useful for cancer prevention. In the case of phytoene, the concept of 'bio-chemoprevention', which means biotechnology-assisted method for cancerchemoprevention, may be applicable. In fact, establishment of mammalian cells producing phytoene was succeeded by the introduction of crtB gene, which encodes phytoene synthase, and these cells were proven to acquire the resistance against carcinogenesis. Antioxidative phytoene-containing animal foods may be classified as a novel type of functional food, which has the preventive activity against carcinogenesis, as well as the ability to reduce the accumulation of oxidative damages, which are hazardous for human health.

Chemistry, distribution, and metabolism of tomato carotenoids and their impact on human health.
Exp Biol Med (Maywood). 2002.
The most abundant carotenoid in tomato is lycopene, followed by phytoene, phytofluene, zeta-carotene, gamma-carotene, beta-carotene, neurosporene, and lutein. Detailed qualitative and quantitative analysis of human serum, milk, and organs, particularly prostate, have revealed the presence of all the aforementioned carotenoids in biologically significant concentrations. Two oxidative metabolites of lycopene, 2,6-cyclolycopene-1,5-diols A and B, which are only present in tomatoes in extremely low concentrations, have been isolated and identified in human serum, milk, organs (liver, lung, breast, liver, prostate, colon) and skin. Carotenoids may also play an important role in the prevention of age-related macular degeneration, cataracts, and other blinding disorders. Among 25 dietary carotenoids and nine metabolites routinely found in human serum, mainly lutein, zeaxanthin, lycopene, and their metabolites were detected in ocular tissues. In this review we identified and quantified the complete spectrum of carotenoids from pooled human retinal pigment epithelium, ciliary body, iris, lens, and in the uveal tract and in other tissues of the human eye to gain a better insight into the metabolic pathways of ocular carotenoids. Although lutein, zeaxanthin, and their metabolites constitute the major carotenoids in human ocular tissues, lycopene and a wide range of dietary carotenoids have been detected in high concentrations in ciliary body and retinal pigment epithelium. The possible role of lycopene and other dietary carotenoids in the prevention of age-related macular degeneration and other eye diseases is discussed.

Norbixin can be found in the plant annato.

Carotenoid supplement questions
I need to take Vitamin A 25,000 IU in the form of mixed carotenoids, for three months and then reduce to 15,000 IU. What would be a good combination? I am concerned about my skin turning an orange hue. Is Beta Carotene the only one that converts to vitamin A. I noticed combinations with algae and other things in them. Do you get the same results as with straight beta carotene?
    A. Carotenoid supplements contain beta carotene along with several other carotenes. The ideal carotenoid supplement depends on which medical condition is being treated. High dose beta carotene ingestion causes the condition known as carotenemia, which is harmless. Beta carotene is not the only carotenoid that converts into vitamin A. Alpha carotene and beta-cryptoxanthin are common carotenoids that can also convert into vitamin A.