Natural Standard® Patient Monograph, Copyright © 2014 (www.naturalstandard.com). All Rights Reserved. Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Background

Beta-carotene is a carotenoid. Carotenoids are red, orange, or yellow, fat-soluble compounds. These compounds are naturally present in many fruits, grains, oils, and vegetables. Alpha, beta, and gamma carotene are considered provitamins because they can be converted to active vitamin A.

Commercially available beta-carotene is man-made or taken from palm oil, algae, or fungi. Beta-carotene is converted to retinol, which is essential for vision and growth.

Studies in humans show that beta-carotene has promising use for oral leukoplakia (pre-cancerous mouth lesions) and for sunburn. However there was a lack of benefit for sun damaged skin, mole prevention, heart disease risk, infection with H. Pylori, cataract prevention, diabetes, and stroke.

Research shows that beta-carotene increased the risk of bladder, lung, stomach, and prostate cancer. Also the general incidence of cancer in asbestos workers, smokers, or high risk individuals increased. Additionally, some research suggested increased risk of heart disease and death with beta-carotene supplementation.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

The American Heart Association recommends beta-carotene from a diet high in fruits, vegetables, and whole grains rather than through supplements. Consuming five servings of fruit and vegetables daily provides 6-8 milligrams of beta-carotene.

For age-related macular degeneration, 20-50 milligrams beta-carotene has been taken by mouth daily for 5-14.2 years.

For cancer prevention, 6-75 milligrams of beta-carotene has been taken by mouth daily or every other day for 1-14.2 years. Note: Some research has found an increased risk of death or cancer with beta-carotene supplementation.

For cataracts, 20-50 milligrams of beta-carotene has been taken daily or every other day for 5-8 years.

For chemotherapy side effects, 250 milligrams beta-carotene has been taken by mouth daily for 21 days followed by 75 milligrams daily.

For chronic lung conditions, 20 milligrams of beta-carotene has been taken by mouth daily for 5-8 years.

For cystic fibrosis, 10-300 milligrams of beta-carotene has been taken daily for 14 days to 14 months.

For diabetes, 50 milligrams of beta-carotene has been taken every other day for nine years.

For erythropoietic protoporphyria, 25-300 milligrams of beta-carotene has been taken by mouth daily.

For HIV, 60mg of beta-carotene has been taken three times by mouth daily for 1-3 months.

For mortality reduction, 1.2-50 milligrams of beta-carotene has been taken daily or on alternate days for 28 days to 14.1 years. Note: Some research has found an increased risk of death or cancer with beta-carotene supplementation.

For oral leukoplakia, 60-360 milligrams of beta-carotene has been taken by mouth daily or weekly for six months to one year.

For polymorphous light eruption, 75-180 milligrams of beta-carotene has been taken by mouth daily.

For pregnancy, 4.5 milligrams of beta-carotene has been taken daily beginning before 20 weeks pregnancy; also 2.173-2.307 milligrams of beta-carotene in red palm oil has been taken by mouth daily for eight weeks beginning at 26-28 weeks of pregnancy.

For sunburn, 15-180 milligrams of beta-carotene has been taken by mouth daily for 3-24 weeks.

Children (younger than 18 years)

For erythropoietic protoporphyria, for ages 1-4 years, the daily dose was 60-90 milligrams beta-carotene by mouth, for age 5-8 the daily dose was 90-120 milligrams, for age 9-12 the daily dose was 120-150 milligrams, for age 13-16 the daily dose was 150-180 milligrams, and for age 16 and older the daily dose was 180 milligrams beta-carotene by mouth, with a potential to increase by 30-60 milligrams daily in children under 16 years, and up to a total of 300 milligrams daily in those over 16 if there is resistance. Also, 30-150 milligrams of beta-carotene has been taken daily by mouth.

For polymorphous light eruption 30-150 milligrams of beta-carotene has been taken daily by mouth.

Evidence

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

Key to grades

A
Strong scientific evidence for this use
B
Good scientific evidence for this use
C
Unclear scientific evidence for this use
D
Fair scientific evidence against this use (it may not work)
F
Strong scientific evidence against this use (it likely does not work)

Grading rationale

Evidence gradeCondition to which grade level applies
B

Oral leukoplakia (pre-cancerous mouth lesions)

In early research, taking beta-carotene by mouth induced remission in people with oral leukoplakia. Further research is needed to confirm these results.
B

Sunburn

Beta-carotene alone or with other antioxidants helped prevent sunburn. Further research is needed in this area.
C

Abdominal aortic aneurysm (AAA) prevention

Limited research has shown that beta-carotene lacked an effect in preventing abdominal aortic aneurysm, in which the large blood vessel supplying blood to the stomach becomes abnormally large. Further research is needed in this area.
C

Age-related macular disease (eye disorder causing vision loss)

Taking beta-carotene and other antioxidants has been proposed to help delay progression of age-related macular degeneration, which results in vision loss. However, human research to support this claim is lacking. Further research is necessary in this area.
C

Alzheimer's disease

Limited research has suggested there is a relationship in beta-carotene intake and Alzheimer's disease. Further research is needed in this area.
C

Angioplasty (surgery for blocked arteries)

Antioxidant vitamins, including beta-carotene, might have harmful effects in patients after angioplasty. Additional research is needed to determine the effect of beta-carotene specifically.
C

Arthritis

According to early research, beta-carotene might slow progression of osteoarthritis. Further research is needed before a conclusion can be drawn.
C

Carotenoid deficiency

Consumption of provitamin A carotenoids (such as beta-carotene) can prevent vitamin A deficiency. However, if people take vitamin A without carotenoids, they will still avoid vitamin A deficiency. The Food and Nutrition Board of the Institute of Medicine (IOM) concluded that sufficient evidence was lacking to establish a recommended dietary allowance (RDA) or adequate intake (AI) for carotenoids.
C

Chemotherapy side effects

Limited research suggests beta-carotene may lower side effects in children being treated for lymphoblastic leukemia, a cancer of the blood. However, in theory high-dose antioxidants may interfere with certain cancer therapies. Further research is needed before a conclusion can be drawn.
C

Chronic lung conditions

In limited research, beta-carotene improved breathing function in people with chronic obstructive pulmonary disorder (COPD). However, beta-carotene lacked an overall effect on COPD. Further research is needed in this area.
C

Enhancing recovery from surgery or illness

Limited research shows that supplementation with micronutrients, including beta-carotene, may have beneficial effects on strength and physical function after surgery. Further research is needed in this area.
C

Erythropoietic protoporphyria

Erythropoietic protoporphyria is a rare genetic disorder that involves painful skin sensitivity to sunlight, gallstones, and liver dysfunction. The over-the-counter synthetic beta-carotene product Lumitene® is U.S. Food and Drug Administration (FDA)-approved for helping with the sensitivity to sunlight in this disease. Limited research showed mixed results of beta-carotene in protecting the skin from sunlight. Further research is needed in this area.
C

Exercise-induced asthma prevention

Early evidence shows that a mix of beta-carotene isomers may prevent exercise-induced asthma. Further research is needed in this area.
C

Exercise performance (oxidative stress prevention)

Research presents mixed results for use of beta-carotene in combination with other antioxidants to prevent exercise-induced oxidative stress. Further research is needed in this area.
C

Heart disease

Early research shows that vitamin and mineral combinations, including beta-carotene, lacked an effect on the progression of artery hardening. Further research is needed to determine the effects of beta-carotene on heart disease.
C

HIV

Limited research shows that beta-carotene supplementation increased CD4 counts and lacked an effect on viral count in HIV. Further study is needed.
C

Liver disease

Combination antioxidant supplements containing beta-carotene may increase mortality in patients with liver disease but also decreased liver enzymes levels. Further research on the effect of beta-carotene alone is needed.
C

Mental performance

Limited research showed benefits of beta-carotene for cognition and long term memory and a lack of benefit for short-term memory. Further research is needed in this area.
C

Night vision enhancement

In limited study, beta-carotene lacked an effect on the development of night vision. Further research is needed in this area.
C

Polymorphous light eruption (itchy rash)

Early evidence shows a lack of effect of beta-carotene on polymorphous light eruption. Additional study is needed in this area.
C

Pregnancy

Some research shows that beta-carotene improves anemia, low birth weight, and premature birth. Other research shows a lack of beneficial effects of beta-carotene supplementation during pregnancy. Further research is necessary before a clear conclusion can be made.
D

Actinic keratosis (scaly skin due to sun damage)

Early research shows that beta-carotene lacks an effect on actinic keratosis development. Further well-designed study is needed
D

Birthmark/mole (dysplastic nevi) prevention

Beta-carotene lacked an effect on total number new moles in people with many atypical moles; however there was a decrease in moles on the lower arms and feet.
D

Cystic fibrosis

Individuals with cystic fibrosis (mucus build-up in organs) may be deficient in beta-carotene and vitamin E, and may be more susceptible to cell damage. Limited research shows a lack of effect of beta-carotene on lung function in cystic fibrosis. Further research is needed in this area.
D

Heart disease prevention

Research suggests that diets high in fruits and vegetables containing beta-carotene appear to reduce the risk of heart disease. However, research assessing supplementation with beta-carotene show a lack of effect on heart disease risk. Also, further research showed increased risk of death from heart disease with beta-carotene supplementation. A Science Advisory from the American Heart Association states that there is a lack of evidence to justify the use of beta-carotene for reducing heart disease risk.
D

Research suggests that diets high in fruits and vegetables containing beta-carotene appear to reduce the risk of heart disease. However, research assessing supplementation with beta-carotene show a lack of effect on heart disease risk. Also, further research showed increased risk of death from heart disease with beta-carotene supplementation. A Science Advisory from the American Heart Association states that there is a lack of evidence to justify the use of beta-carotene for reducing heart disease risk.
F

Cancer prevention

While diets high in fruits and vegetables rich in beta-carotene may reduce the risk of certain cancers, evidence for benefit of beta-carotene supplements is mixed. There is some concern that beta-carotene may have cancer-causing effects. Human research shows that beta-carotene supplements have increased the risk of bladder, stomach, and lung cancer and increased the risk of death in smokers and people exposed to asbestos.
F

Cataracts

Research shows that beta-carotene supplementation lacks an effect on cataract prevention. Further well-designed research is needed before a conclusion can be drawn.
F

Diabetes

Limited research shows that higher blood levels of beta-carotene may reduce the risk of type 2 diabetes. However, high-quality research in humans shows a lack of effect of beta-carotene on diabetes.
F

Mortality reduction

Beta-carotene supplements lack support for reduction in mortality rates. Some research has associated beta-carotene supplementation with increased mortality.
F

Stroke

Beta-carotene lacks an effect on incidence of stroke in male smokers. Additionally, research suggests that beta-carotene increases the risk of bleeding inside the head in people who also drink alcohol.

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Anemia, antioxidant, asbestosis (a type of lung disease), bone marrow transplantation, breast disease, gastritis (inflammation of stomach lining), Graves' disease (overactive thyroid), high cholesterol, human papilloma virus (HPV), immune function, infections, lung conditions (premature infants), nasal problems, nutrition (during alcohol rehab), obesity (excessive weight), osteoporosis, Parkinson's disease, respiratory infections, sepsis (severe response to infection), weight loss (after giving birth or in people with HIV).

Interactions

Interactions with Drugs

Beta-carotene may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Beta-carotene may also interact with agents for the skin, eyes, stomach, intestines, lungs, or liver; agents for Alzheimer's, asthma, cancer, diabetes, gout, inflammation, or ulcers; agents that affect the immune, nervous, or musculoskeletal systems; alcohol; antibiotics; antivirals; cholesterol-lowering agents; heart agents; iron; mineral oil; nicotine; orlistat (Xenical®); or thyroid hormones.

Interactions with Herbs and Dietary Supplements

Beta-carotene may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Beta-carotene may also interact with alcohol; antibiotics; antioxidants; antiviral herbs and supplements; canthaxanthin; cholesterol-lowering herbs and supplements; fish oil; heart herbs and supplements; herbs and supplements for the skin, eyes, stomach, intestines, lungs, or liver; herbs and supplements for Alzheimer's, asthma, cancer, diabetes, gout, inflammation, or ulcers; herbs and supplements that affect the immune, nervous, or musculoskeletal systems; iron; lutein; lycopene; mineral oil; multivitamins; nicotine; plant sterols; red palm oil; sunflower oil; thyroid hormones; vitamins A, C, and E; or zinc.

Methodology

This information is based on a systematic review of scientific literature and consensus statements, peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Monograph methodology

Related terms

A-beta-carotene, A-bêta-carotène (French), A-caro-25, alpha carotene, alpha-carotene, B-caro, beta carotene, beta-carotene, bêta-carotène (French), bêta-carotène tout trans (French), beta-caroteno (Spanish), beta-cryptoxanthin, biotene, Caroguard®, Caro-Plete™, caro-t, carotene, carotenes, carotenes (French), carotenoids, caroténoïdes (French), caroténoïdes mélanges (French), dry beta-carotene, eyebright, gamma carotene, gamma-carotene, green leafy vegetables, Lumitene®, marine carotene, Max-Caro®, Mega Carotene®, mixed carotenoids, Oceanic Beta®, orange fruit, orange vegetables, palm oil, provitamin A, provitamine A (French), red palm oil, retinol, sunflower oil, Superbeta Carotene®, synthetic all-trans beta-carotene, Ultra Beta Carotene®.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in people with known allergy or sensitivity to beta-carotene, vitamin A, or any other ingredients in beta-carotene products, such as food preservatives or dyes.

Side Effects and Warnings

Beta-carotene is likely safe when consumed by adults and children in food, in amounts found naturally in food.

Beta-carotene is possibly safe when used short-term as a supplement under the direction of a health care provider.

Beta-carotene may cause burping, constipation, diarrhea, dizziness, headache, increased risk of disease (including bladder cancer, colds, coronary heart disease, lung cancer, mortality, prostate cancer, and stomach cancer), joint pain, lung problems, muscle pain, stomach and intestine problems, vision problems, worsening cholesterol levels, yellow deposits in the eyes, and yellowing of the skin.

Beta-carotene may increase the risk of bleeding or bruising. Caution is advised in people with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Use cautiously in people who have eating disorders, eye disorders, kidney disorders, lung disorders, musculoskeletal disorders, or nervous system disorders.

Use cautiously in combination with antibiotics, cholesterol-lowering agents, fat substitutes, iron, lutein, mineral oil, nicotine, orlistat, plant sterols, proton pump inhibitors, very low-fat diets, and vitamin E.

Avoid using beta-carotene supplements alone or with other antioxidant vitamins, immediately before and after angioplasty (surgery for blocked arteries).

Avoid in children and in pregnant or breastfeeding women.

Avoid in people who smoke, drink high levels of alcohol, and have an increased risk of cancer, a history of exposure to asbestos, a liver disorder, or heart disease.

Avoid in people with known allergy or sensitivity to beta-carotene, vitamin A, or any other ingredients in beta-carotene products, such as food preservatives or dyes.

Pregnancy and Breastfeeding

There is a lack of scientific evidence on the use of beta-carotene supplementation during pregnancy or breastfeeding.

Selected references

  1. Bjelakovic G, Nikolova D, Gluud LL, et al. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane.Database.Syst.Rev. 2012;3:CD007176.
  2. Cortes-Jofre M, Rueda JR, Corsini-Munoz G, et al. Drugs for preventing lung cancer in healthy people. Cochrane.Database.Syst.Rev. 2012;10:CD002141.
  3. Eliassen AH, Hendrickson SJ, Brinton LA, et al. Circulating carotenoids and risk of breast cancer: pooled analysis of eight prospective studies. J.Natl.Cancer Inst. 12-19-2012;104(24):1905-1916.
  4. Evans JR and Lawrenson JG. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. Cochrane.Database.Syst.Rev. 2012;11:CD000254.
  5. Hu F, Wang, Yi B, et al. Carotenoids and breast cancer risk: a meta-analysis and meta-regression. Breast Cancer Res.Treat. 2012;131(1):239-253.
  6. Li FJ, Shen L, and Ji HF. Dietary intakes of vitamin E, vitamin C, and beta-carotene and risk of Alzheimer's disease: a meta-analysis. J.Alzheimers.Dis. 2012;31(2):253-258.
  7. Li L, Ying XJ, Sun TT, et al. Overview of methodological quality of systematic reviews about gastric cancer risk and protective factors. Asian Pac.J.Cancer Prev. 2012;13(5):2069-2079.
  8. Mathew MC, Ervin AM, Tao J, et al. Antioxidant vitamin supplementation for preventing and slowing the progression of age-related cataract. Cochrane.Database.Syst.Rev. 2012;6:CD004567.
  9. Mayne ST, Ferrucci LM, and Cartmel B. Lessons learned from randomized clinical trials of micronutrient supplementation for cancer prevention. Annu.Rev.Nutr. 8-21-2012;32:369-390.
  10. Miller PE and Snyder DC. Phytochemicals and cancer risk: a review of the epidemiological evidence. Nutr.Clin.Pract. 2012;27(5):599-612.
  11. Pabalan N, Jarjanazi H, Sung L, et al. Menopausal status modifies breast cancer risk associated with the myeloperoxidase (MPO) G463A polymorphism in Caucasian women: a meta-analysis. PLoS.One. 2012;7(3):e32389.
  12. Thorne-Lyman AL and Fawzi WW. Vitamin A and carotenoids during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta-analysis. Paediatr.Perinat.Epidemiol. 2012;26 Suppl 1:36-54.
  13. Ulbricht C, Basch E, Chao W, et al. An evidence-based systematic review of vitamin A by the natural standard research collaboration. J.Diet.Suppl 2012;9(4):299-416.
  14. Weber D and Grune T. The contribution of beta-carotene to vitamin A supply of humans. Mol.Nutr.Food Res. 2012;56(2):251-258.
  15. Zhang X, Dai B, Zhang B, et al. Vitamin A and risk of cervical cancer: a meta-analysis. Gynecol.Oncol. 2012;124(2):366-373.

This evidence-based monograph was prepared by The Natural Standard Research Collaboration

www.naturalstandard.com