Uses

Carotenoids are a highly colored (red, orange, and yellow) group of fat-soluble plant pigments. All organisms, whether bacteria or plants, that rely on the sun for energy contain carotenoids. Their antioxidant effects enable these compounds to play a crucial role in protecting organisms against damage during photosynthesis—the process of converting sunlight into chemical energy.

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

This supplement has been used in connection with the following health conditions:

Used for Why
2 Stars
Macular Degeneration
6 to 10 mg daily
Lutein and zeaxanthin are antioxidants that protect the retina from damage caused by sunlight. Lutein has been shown to help people with both early and advanced stages of the disease.

Lutein and zeaxanthin are antioxidants in the carotenoid family. These carotenoids, found in high concentrations in spinach, collard greens, and kale, have an affinity for the part of the retina where macular degeneration occurs. Once there, they protect the retina from damage caused by sunlight.1

Harvard researchers reported that people eating the most lutein and zeaxanthin—an average of 5.8 mg per day—had a 57% decreased risk of macular degeneration, compared with people eating the least.2 While spinach and kale eaters have a lower risk of macular degeneration, blood levels of lutein did not correlate with risk of macular degeneration in one trial.3 , 4 In a double-blind study of people with macular degeneration, supplementation with lutein (10 mg per day) for one year significantly improved vision, compared with a placebo.5 Lutein was beneficial for people with both early and advanced stages of the disease. Lutein and zeaxanthin can be taken as supplements; 6 mg per day of lutein may be a useful amount.

1 Star
Macular Degeneration
Refer to label instructions
Lutein and zeaxanthin, antioxidants in the carotenoid family, protect the retina from damage caused by sunlight.

Lutein and zeaxanthin are antioxidants in the carotenoid family. These carotenoids, found in high concentrations in spinach, collard greens, and kale, have an affinity for the part of the retina where macular degeneration occurs. Once there, they protect the retina from damage caused by sunlight.6

Harvard researchers reported that people eating the most lutein and zeaxanthin—an average of 5.8 mg per day—had a 57% decreased risk of macular degeneration, compared with people eating the least.7 While spinach and kale eaters have a lower risk of macular degeneration, blood levels of lutein did not correlate with risk of macular degeneration in one trial.8 , 9 In a double-blind study of people with macular degeneration, supplementation with lutein (10 mg per day) for one year significantly improved vision, compared with a placebo.10 Lutein was beneficial for people with both early and advanced stages of the disease. Lutein and zeaxanthin can be taken as supplements; 6 mg per day of lutein may be a useful amount.

How It Works

How to Use It

Whether people who already consume a diet high in fruits and vegetables would benefit further from supplementation with a mixture of carotenoids remains unknown. While smokers clearly should not supplement with isolated synthetic beta-carotene, the effect in smokers of taking either natural beta-carotene or mixed carotenoids is not clear.

Nonetheless, based on health-promoting effects associated with these levels in preliminary research, some doctors recommend that most people supplement with up to 25,000 IU (15 mg) per day of natural beta-carotene and approximately 6 mg each of alpha-carotene, lutein, and lycopene.

Where to Find It

Carotenoids are found in all plant foods. In general, the greater the intensity of color, the higher the level of carotenoids. In green leafy vegetables, beta-carotene is the predominant carotenoid. In the orange colored fruits and vegetables—such as carrots, apricots, mangoes, yams, winter squash—beta-carotene concentrations are high, but other pro-vitamin A carotenoids typically predominate. Yellow vegetables have higher concentrations of yellow carotenoids (xanthophylls), hence a lowered pro-vitamin A activity; but some of these compounds, such as lutein, may have significant health benefits, potentially due to their antioxidant effects. The red and purple vegetables and fruits—such as tomatoes, red cabbage, berries, and plums—contain a large portion of non-vitamin A–active carotenoids. Legumes, grains, and seeds are also significant sources of carotenoids. Carotenoids are also found in various animal foods, such as salmon, egg yolks, shellfish, milk, and poultry. A variety of carotenoids is also found in carrot juice and “green drinks” made from vegetables, dehydrated barley greens, or wheat grass.

Synthetic beta-carotene is available as a supplement. Mixed carotenoids (including the natural form of beta-carotene) are also available in supplements derived from palm oil, algae, and carrot oil.

Possible Deficiencies

Carotenoid deficiency is not considered a classic nutritional deficiency like scurvy or beri-beri (severe vitamin C and vitamin B1 deficiencies, respectively). However, given the possible health benefits of carotenoids, most doctors recommend adequate intake. People who do not frequently consume carotenoid-rich foods or take carotenoid supplements are likely to be taking in less than adequate amounts, though optimal levels remain unknown. Also, deficiency may be found in people with chronic diarrhea or other disorders associated with impaired absorption.

Interactions

Interactions with Supplements, Foods, & Other Compounds

At the time of writing, there were no well-known supplement or food interactions with this supplement.

Interactions with Medicines

Certain medicines interact with this supplement.

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • Cholestyramine

    Use of colestipol for six months has been shown to significantly lower blood levels of carotenoids including beta-carotene.46

  • Colchicine

    Colchicine has been associated with impaired absorption of beta-carotene, fat, lactose (milk sugar), potassium, and sodium.61

  • Colesevelam

    Use of colestipol for six months has been shown to significantly lower blood levels of carotenoids including beta-carotene.62

  • Colestipol

    Use of colestipol for six months has been shown to significantly lower blood levels of carotenoids including beta-carotene.64

  • Lansoprazole

    Omeprazole , a drug closely related to lansoprazole, taken for seven days led to a near-total loss of stomach acid in healthy people and interfered with the absorption of a single administration of 120 mg of beta-carotene.133 It is unknown whether repeated administration of beta-carotene would overcome this problem or if absorption of carotenoids from food would be impaired. Persons taking omeprazole and related acid-blocking drugs for long periods may want to have carotenoid blood levels checked, eat plenty of fruits and vegetables, and consider supplementing with carotenoids.

  • Mineral Oil

    Mineral oil has interfered with the absorption of many nutrients, including beta-carotenephosphorus, potassium, and vitamins A, D, K, and E in some,167 but not all,168 research. Taking mineral oil on an empty stomach may reduce this interference. It makes sense to take a daily multivitamin-mineral supplement two hours before or after mineral oil. It is important to read labels, because many multivitamins do not contain vitamin K or contain inadequate (less than 100 mcg per day) amounts.

  • Neomycin

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K.169 , 170 Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Orlistat

    One well-controlled study showed that taking orlistat greatly reduces the absorption of beta-carotene.171 Therefore, individuals taking orlistat for long periods of time should probably supplement with beta-carotene.

Reduce Side Effects

  • Busulfan

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.11 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.12 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.13 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,14 and not all studies have found vitamin E to be effective.15 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).16 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.17

  • Capecitabine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.18 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.19 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.20 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,21 and not all studies have found vitamin E to be effective.22 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).23 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.24

  • Carboplatin

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.25 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.26 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.27 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,28 and not all studies have found vitamin E to be effective.29 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).30 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.31

  • Carmustine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.32 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.33 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.34 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,35 and not all studies have found vitamin E to be effective.36 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).37 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.38

  • Chlorambucil

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.39 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.40 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.41 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,42 and not all studies have found vitamin E to be effective.43 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).44 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.45

  • Cisplatin

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.47 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.48 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.49 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,50 and not all studies have found vitamin E to be effective.51 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).52 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.53

  • Cladribine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.54 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.55 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.56 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,57 and not all studies have found vitamin E to be effective.58 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).59 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.60

  • Cyclophosphamide

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.65 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

  • Cytarabine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.66 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.67 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.68 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,69 and not all studies have found vitamin E to be effective.70 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).71 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.72

  • Docetaxel

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.73 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.74 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.75 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,76 and not all studies have found vitamin E to be effective.77 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

  • Erlotinib

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.78 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.79 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.80 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,81 and not all studies have found vitamin E to be effective.82 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).83 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.84

  • Etoposide

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.85 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.86 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.87 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,88 and not all studies have found vitamin E to be effective.89 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).90 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.91

  • Floxuridine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.92 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.93 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.94 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,95 and not all studies have found vitamin E to be effective.96 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).97 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.98

    The chemotherapy drug cisplatin may cause kidney damage, resulting in depletion of calcium and phosphate.99

  • Fludarabine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.100 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.101 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.102 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,103 and not all studies have found vitamin E to be effective.104 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).105 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.106

  • Fluorouracil

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.107 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.108 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.109 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,110 and not all studies have found vitamin E to be effective.111 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

  • Hydroxyurea

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.112 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.113 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.114 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,115 and not all studies have found vitamin E to be effective.116 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).117 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.118

  • Ifosfamide

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.119 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.120 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.121 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,122 and not all studies have found vitamin E to be effective.123 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).124 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.125

  • Irinotecan

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.126 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.127 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.128 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,129 and not all studies have found vitamin E to be effective.130 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).131 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.132

  • Lomustine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.134 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.135 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.136 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,137 and not all studies have found vitamin E to be effective.138 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).139 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.140

  • Mechlorethamine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.141 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.142 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.143 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,144 and not all studies have found vitamin E to be effective.145 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).146 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.147

  • Melphalan

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.148 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.149 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.150 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,151 and not all studies have found vitamin E to be effective.152 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).153 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.154

  • Mercaptopurine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.155 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.156 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.157 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,158 and not all studies have found vitamin E to be effective.159 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).160 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.161

  • Methotrexate

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.162 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.163 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.164 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,165 and not all studies have found vitamin E to be effective.166 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

  • Paclitaxel

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.172 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.173 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.174 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,175 and not all studies have found vitamin E to be effective.176 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form. In another study, supplementation with vitamin E orally (600 IU per day) reduced the incidence of paclitaxel-induced nerve damage.177

  • Polifeprosan 20 with Carmustine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.178 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.179 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.180 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,181 and not all studies have found vitamin E to be effective.182 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).183 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.184

  • Quinidine

    Some people taking quinidine develop sensitivity to ultraviolet radiation from the sun. In a preliminary study, three people with quinidine-induced skin inflammation were able to tolerate intense sun exposure without recurrence of the rash after supplementing with 90–180 mg of beta-carotene each day.185 Further research is needed to confirm that people taking quinidine can prevent side effects by supplementing with beta-carotene.

  • Thioguanine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.186 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.187 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.188 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,189 and not all studies have found vitamin E to be effective.190 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).191 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.192

  • Thiotepa

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.193 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.194 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.195 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,196 and not all studies have found vitamin E to be effective.197 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).198 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.199

  • Uracil Mustard

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.200 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.201 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.202 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,203 and not all studies have found vitamin E to be effective.204 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).205 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.206

  • Vinblastine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.207 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.208 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.209 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,210 and not all studies have found vitamin E to be effective.211 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).212 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.213

  • Vincristine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.214 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.215 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.216 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,217 and not all studies have found vitamin E to be effective.218 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).219 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.220

Support Medicine

  • none

Reduces Effectiveness

  • none

Potential Negative Interaction

  • none

Explanation Required

  • none

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.

Side Effects

Side Effects

Carotenoids are generally regarded as safe, based primarily on studies with beta-carotene. Increased consumption of carotenoids may cause to the skin to turn orange or yellow—a condition known as “carotenodermia.” This occurrence is completely benign and is unrelated to jaundice—the yellowing of the skin that can result from liver disease or other causes.

Until more is known, people especially smokers should not supplement with synthetic beta-carotene. Two double-blind studies have shown that supplementation with isolated synthetic beta-carotene may increase the risk of lung cancer in people who smoke.221 , 222 Moreover, three of four studies have found small increases in the risk of heart disease in people assigned to take synthetic beta-carotene compared with those assigned to take placebo.223 , 224 , 225 , 226

References

1. Bone RA. Landrum JT. Distribution of macular pigment components, zeaxanthin and lutein, in human retina. Methods Enzymol 1992:213:360-6.

2. Seddon JM, Ajani UA, Sperduto RD, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. JAMA 1994;272:1413-20.

3. Blumenkranz MS, Russell SR, Robey MG, et al. Risk factors in age-related maculopathy complicated by choroidal neovascularization. Ophthalmology 1986:93:552-8.

4. Mares-Perlman JA, Brady WE, Kleain R, et al. Serum antioxidants and age-related macular degeneration in a population-based case-control study. Arch Ophthalmol 1995;113:1518-23.

5. 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;75:216-30.

6. Bone RA. Landrum JT. Distribution of macular pigment components, zeaxanthin and lutein, in human retina. Methods Enzymol 1992:213:360-6.

7. Seddon JM, Ajani UA, Sperduto RD, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. JAMA 1994;272:1413-20.

8. Blumenkranz MS, Russell SR, Robey MG, et al. Risk factors in age-related maculopathy complicated by choroidal neovascularization. Ophthalmology 1986:93:552-8.

9. Mares-Perlman JA, Brady WE, Kleain R, et al. Serum antioxidants and age-related macular degeneration in a population-based case-control study. Arch Ophthalmol 1995;113:1518-23.

10. 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;75:216-30.

11. Mills EE. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416-7.

12. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481-4.

13. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

14. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

15. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411-8.

16. Pace A, Savarese A, Picardo M, et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol2003;21:927-31.

17. Argyriou AA, Chroni E, Koutras A, et al. Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology2005;64:26-31.

18. Mills EE. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416-7.

19. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481-4.

20. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

21. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

22. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411-8.

23. Pace A, Savarese A, Picardo M, et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol2003;21:927-31.

24. Argyriou AA, Chroni E, Koutras A, et al. Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology2005;64:26-31.

25. Mills EE. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416-7.

26. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481-4.

27. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

28. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

29. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411-8.

30. Pace A, Savarese A, Picardo M, et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol2003;21:927-31.

31. Argyriou AA, Chroni E, Koutras A, et al. Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology2005;64:26-31.

32. Mills EE. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416-7.

33. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481-4.

34. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

35. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

36. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411-8.

37. Pace A, Savarese A, Picardo M, et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol2003;21:927-31.

38. Argyriou AA, Chroni E, Koutras A, et al. Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology2005;64:26-31.

39. Mills EE. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416-7.

40. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481-4.

41. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

42. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

43. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411-8.

44. Pace A, Savarese A, Picardo M, et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol2003;21:927-31.

45. Argyriou AA, Chroni E, Koutras A, et al. Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology2005;64:26-31.

46. Probstfield JL, Lin T, Peters J, Hunninghake DB. Carotenoids and vitamin A: The effect of hypocholesterolemic agents on serum levels. Metabolism 1985;34:88-91.

47. Mills EE. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416-7.

48. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481-4.

49. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

50. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

51. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411-8.

52. Pace A, Savarese A, Picardo M, et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol2003;21:927-31.

53. Argyriou AA, Chroni E, Koutras A, et al. Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology2005;64:26-31.

54. Mills EE. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416-7.

55. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481-4.

56. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

57. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

58. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411-8.

59. Pace A, Savarese A, Picardo M, et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol2003;21:927-31.

60. Argyriou AA, Chroni E, Koutras A, et al. Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology2005;64:26-31.

61. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 223-4 [review].

62. Probstfield JL, Lin T, Peters J, Hunninghake DB. Carotenoids and vitamin A: The effect of hypocholesterolemic agents on serum levels. Metabolism 1985;34:88-91.

63. Probstfield JL, Lin T, Peters J, Hunninghake DB. Carotenoids and vitamin A: The effect of hypocholesterolemic agents on serum levels. Metabolism 1985;34:88-91.

64. Probstfield JL, Lin T, Peters J, Hunninghake DB. Carotenoids and vitamin A: The effect of hypocholesterolemic agents on serum levels. Metabolism 1985;34:88-91.

65. Mills EE. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416-7.

66. Mills EE. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416-7.

67. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481-4.

68. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

69. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

70. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411-8.

71. Pace A, Savarese A, Picardo M, et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol2003;21:927-31.

72. Argyriou AA, Chroni E, Koutras A, et al. Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology2005;64:26-31.

73. Mills EE. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416-7.

74. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481-4.

75. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

76. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

77. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411-8.

78. Mills EE. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416-7.

79. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481-4.

80. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

81. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

82. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411-8.

83. Pace A, Savarese A, Picardo M, et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol2003;21:927-31.

84. Argyriou AA, Chroni E, Koutras A, et al. Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology2005;64:26-31.

85. Mills EE. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416-7.

86. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481-4.

87. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

88. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

89. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411-8.

90. Pace A, Savarese A, Picardo M, et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol2003;21:927-31.

91. Argyriou AA, Chroni E, Koutras A, et al. Vitamin E for prophylaxis against chemotherapy-induced neuropathy: a randomized controlled trial. Neurology2005;64:26-31.

92. Mills EE. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Br J Cancer 1988;57:416-7.

93. Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992;92:481-4.

94. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

95. Lopez I, Goudou C, Ribrag V, et al. Treatment of mucositis with vitamin E during administration of neutropenic antineoplastic agents. Ann Med Intern[Paris] 1994;145:405-8.

96. Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci 1982;393:411-8.

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