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

  • Cimetidine

    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.47 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.

  • Cimetidine in Normal Saline

    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.47 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.

  • Colchicine

    Colchicine has been associated with impaired absorption of beta-carotene, fat, lactose (milk sugar), potassium, and sodium.63

  • Colesevelam

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

  • Colestipol

    Use of colestipol for six months has been shown to significantly lower blood levels of carotenoids including beta-carotene.66

  • Famotidine

    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.47 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.

  • Famotidine (PF)

    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.47 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.

  • Famotidine in Normal Saline

    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.47 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,171 but not all,172 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.173 , 174 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.

  • Nizatidine

    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.47 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.

  • Orlistat

    One well-controlled study showed that taking orlistat greatly reduces the absorption of beta-carotene.176 Therefore, individuals taking orlistat for long periods of time should probably supplement with beta-carotene.

  • Ranitidine

    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.47 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.

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.49 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.50 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.51 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,52 and not all studies have found vitamin E to be effective.53 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).54 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.55

  • 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.56 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.57 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.58 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,59 and not all studies have found vitamin E to be effective.60 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).61 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.62

  • 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.67 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.68 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.69 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.70 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,71 and not all studies have found vitamin E to be effective.72 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).73 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.74

  • 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.75 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.76 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.77 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,78 and not all studies have found vitamin E to be effective.79 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.80 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.81 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.82 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,83 and not all studies have found vitamin E to be effective.84 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).85 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.86

  • 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.87 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.88 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.89 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,90 and not all studies have found vitamin E to be effective.91 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).92 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.93

  • 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.97 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.98 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.99 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,100 and not all studies have found vitamin E to be effective.101 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).102 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.103

    The chemotherapy drug cisplatin may cause kidney damage, resulting in depletion of calcium and phosphate.104

  • 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.105 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.106 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.107 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,108 and not all studies have found vitamin E to be effective.109 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).110 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.111

  • 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.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.

  • 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.117 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.118 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.119 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,120 and not all studies have found vitamin E to be effective.121 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).122 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.123

  • 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.124 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.125 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.126 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,127 and not all studies have found vitamin E to be effective.128 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).129 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.130

  • 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.131 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.132 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.133 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,134 and not all studies have found vitamin E to be effective.135 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).136 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.137

  • 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.138 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.139 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.140 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,141 and not all studies have found vitamin E to be effective.142 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).143 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.144

  • 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.145 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.146 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.147 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,148 and not all studies have found vitamin E to be effective.149 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).150 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.151

  • 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.152 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.153 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.154 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,155 and not all studies have found vitamin E to be effective.156 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).157 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.158

  • 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.159 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.160 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.161 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,162 and not all studies have found vitamin E to be effective.163 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).164 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.165

  • 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.166 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.167 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.168 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,169 and not all studies have found vitamin E to be effective.170 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.177 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.178 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.179 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,180 and not all studies have found vitamin E to be effective.181 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.182

  • 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.183 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.184 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.185 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,186 and not all studies have found vitamin E to be effective.187 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).188 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.189

  • 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.190 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.192 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.193 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.194 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,195 and not all studies have found vitamin E to be effective.196 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).197 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.198

  • 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.199 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.200 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.201 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,202 and not all studies have found vitamin E to be effective.203 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).204 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.205

  • 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.206 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.207 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.208 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,209 and not all studies have found vitamin E to be effective.210 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).211 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.212

  • 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.213 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.214 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.215 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,216 and not all studies have found vitamin E to be effective.217 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).218 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.219

  • 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.220 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.221 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.222 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,223 and not all studies have found vitamin E to be effective.224 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).225 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.226

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.227 , 228 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.229 , 230 , 231 , 232

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. Tang G, Serfaty-Lacronsniere C, Camilo ME, Russell RM. Gastric acidity influences the blood response to a beta-carotene dose in humans. Am J Clin Nutr 1996;64:622-6.

48. Tang G, Serfaty-Lacronsniere C, Camilo ME, Russell RM. Gastric acidity influences the blood response to a beta-carotene dose in humans. Am J Clin Nutr 1996;64:622-6.

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

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

51. 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.

52. 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.

53. 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.

54. 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.

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

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

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

58. 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.

59. 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.

60. 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.

61. 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.

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

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

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. 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.

66. 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.

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

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

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

70. 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.

71. 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.

72. 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.

73. 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.

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

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

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

77. 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.

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