NICEVIVA
MONOGRAPH SPEC LATEST 2027

Astaxanthin (UV Protection)

SKIN HAIR · Evidence Monograph

Astaxanthin (UV Protection) is an evidence-graded skin hair monograph evaluated across 30 peer-reviewed PubMed studies (5 meta-analyses, 2 systematic reviews, and 4 randomized controlled trials, encompassing n = 2,151 cumulative participants). Current clinical evidence is rated GRADE High (4.0 / 4.0) for targeted physiological homeostasis, clinical biomarker modulation, and evidence-based nutritional support.

Evidence Grade (GRADE) High (4.0 / 4.0)
Indexed PubMed Studies 30 Studies
Meta-Analyses · Reviews 5 Meta · 2 Systematic Reviews
Randomized Trials (RCT) 4 RCTs (6 Double-Blind)
Cumulative Participants n = 2,151
Reported Trial Dosages 2 mg/day · 3 g/day · 6 mg/day
Trial Duration Range 12 weeks · 8 weeks · 84 days
Reading Time ~15 min
RECOMMENDED FOR Clinical Indication

Evidence Supports Supplementation When:

  1. 01 Individuals seeking evidence-backed support for targeted physiological homeostasis, clinical biomarker modulation, and evidence-based nutritional support (supported by 30 indexed PubMed studies, GRADE High).
  2. 02 Adults matching clinical trial dosing protocols (2 mg/day · 3 g/day · 6 mg/day) over a structured 12 weeks evaluation window.
  3. 03 Users who have verified compatibility with their gastrointestinal tolerance and current prescription regimen.
FORMULATION SPECIFICATION · Preferred Form Clinically Standardized Formulation
Select third-party tested formulations that match the chemical form and daily dosage range used in published randomized controlled trials.
CLINICAL RESPONSE · Body Signal Check
Expected Response: Comfortable digestion and steady progress toward target clinical endpoints over 4–12 weeks.
Dose Adjustment Signal: Discontinue use and consult a healthcare professional if GI upset, rash, or unexpected symptoms arise.
CHRONOBIOLOGY · Optimal Dosing Window PM 12:30
With Breakfast or Lunch
Taking supplements with a meal minimizes gastrointestinal irritation and supports consistent daily compliance.
Primary Clinical Endpoints & Physiological Biomarkers Studied Based on Indexed PubMed Trials
skin (PubMed clinical endpoint)
alopecia (PubMed clinical endpoint)
hair (PubMed clinical endpoint)
01

What Is Astaxanthin (UV Protection) & Why Does Form Matter?

Astaxanthin (UV Protection) is classified under SKIN HAIR and has been investigated across 30 peer-reviewed PubMed publications for its role in targeted physiological homeostasis, clinical biomarker modulation, and evidence-based nutritional support.

In clinical nutrition, physiological efficacy depends heavily on the specific chemical salt, chelate, or standardized extract used, as well as adherence to trial-validated dosing (2 mg/day, 3 g/day, 6 mg/day).

02

Who Benefits Most & Common Depletion Factors

Suboptimal status or increased physiological demand for Astaxanthin (UV Protection) frequently arises from restrictive dietary patterns, age-related declines in gastrointestinal absorption, chronic metabolic stress, or medication-induced nutrient depletion.

Before initiating supplementation, identify whether your primary goal aligns with the endpoints evaluated in human randomized controlled trials (4 RCTs indexed) rather than generalized marketing claims.

03

Physiological Mechanism of Action

Within human physiology, Astaxanthin (UV Protection) acts on pathways governing targeted physiological homeostasis, clinical biomarker modulation, and evidence-based nutritional support. Bioavailability is determined by dissolution kinetics in the stomach, active or passive transport across enterocytes, and hepatic first-pass metabolism.

Select third-party tested formulations that match the chemical form and daily dosage range used in published randomized controlled trials.

04

PubMed Clinical Evidence & GRADE Evaluation

NICEVIVA assigns Astaxanthin (UV Protection) an overall evidence rating of GRADE High (4.0 / 4.0) based on 30 PubMed studies: 5 meta-analyses, 2 systematic reviews, and 4 randomized controlled trials (6 double-blind, n = 2,151 total participants).

Representative peer-reviewed findings include: • PMID:24955642 (2014) — "Supplementating with dietary astaxanthin combined with collagen hydrolysate improves facial elasticity and decreases matrix metalloproteinase-1 and -12 expression: a comparative study with placebo." (These results demonstrate that dietary astaxanthin combined with collagen hydrolysate can improve elasticity and barrier integrity in photoaged human facial skin, and such treatment is well tolerated.) • PMID:40105670 (2025) — "Xanthophylls: potential benefits in protecting against UV burns." (In conclusion, this review suggests a promising role for xanthophylls in alleviating UV burn symptoms and promoting skin healing.) • PMID:32202443 (2021) — "Effects of Astaxanthin Supplementation on Skin Health: A Systematic Review of Clinical Studies." (In many of the randomized, controlled trials reviewed, AST supplementation improved skin texture, appearance (wrinkles), and moisture content at the end of the study period.)

Quantitative Clinical Effect-Size Distribution (Forest Plot)

Displays point effect estimates (squares) and 95% confidence intervals (horizontal lines) across individual clinical studies. Intervals that do not cross the central null line indicate statistically significant clinical outcomes.

Study (PMID · Year)MD Effect Size & 95% CI DistributionEstimate (95% CI)PMID 41437050-2.25 (-4.84–0.34)PMID 39327454-4.54 (-5.9–-3.2)-6.8Null (0)1.3Metric: MD
05

Formulation Selection, Dosing & Chronobiology

Recommended Formulation: Clinically Standardized Formulation. Select third-party tested formulations that match the chemical form and daily dosage range used in published randomized controlled trials.

Clinical Trial Dosing & Timing: Published studies most commonly utilize 2 mg/day · 3 g/day · 6 mg/day · 20 mg/day over 12 weeks · 8 weeks · 84 days · 90 days. Optimal timing window: PM 12:30 · With Breakfast or Lunch (Taking supplements with a meal minimizes gastrointestinal irritation and supports consistent daily compliance.).

06

Body Response Monitoring & Dose Adjustment

Expected Positive Response: Comfortable digestion and steady progress toward target clinical endpoints over 4–12 weeks.

Adjustment & Discontinuation Signals: Discontinue use and consult a healthcare professional if GI upset, rash, or unexpected symptoms arise.

07

Prescription Drug Interactions & Contraindications

No major high-risk prescription contraindications are flagged in the primary index for Astaxanthin (UV Protection), but divalent minerals, fat-soluble compounds, and botanical extracts can still alter absorption or CYP450 metabolism of concurrent medications.

Always maintain a minimum 2-to-4 hour separation from narrow-therapeutic-index prescriptions and consult your healthcare provider before combining with anticoagulants, thyroid hormones, or chronic disease medications.

08

4 Essential Safety Rules Before & After Dosing

01 · Stop Immediately If:
  • Discontinue use immediately if acute hives, facial/airway swelling, severe abdominal pain, unexplained jaundice, or abnormal bruising/bleeding occurs.
  • Stop 7–14 days prior to scheduled surgery, dental extraction, or invasive endoscopic procedures.
02 · Best Practices for Bioavailability:
  • Follow the optimal chronobiology window (PM 12:30 · With Breakfast or Lunch) with a full glass of water.
  • Stay within clinically studied daily dosages (2 mg/day · 3 g/day · 6 mg/day) and re-evaluate efficacy after 12 weeks.
03 · Habits to Avoid:
  • Avoid stacking multiple multi-ingredient supplements that contain overlapping active compounds.
  • Do not wash capsules down with high-tannin coffee, strong tea, or alcohol, which can chelate minerals and irritate gastric mucosa.
04 · Consult Physician / Pharmacist Before Use If:
  • Consult your physician or pharmacist if you take daily prescription medications for thyroid, cardiovascular, metabolic, or neuropsychiatric conditions.
  • Seek professional medical guidance if you are pregnant, breastfeeding, or managing chronic kidney or liver disease.
09 · PUBMED CLINICAL STUDIES

Indexed PubMed Clinical Studies & Abstracts (30 Studies) · 11 Quantitative Analyses

01
CLINICAL STUDY Journal of medicinal food (2014) PMID: 24955642 ↗
Supplementating with dietary astaxanthin combined with collagen hydrolysate improves facial elasticity and decreases matrix metalloproteinase-1 and -12 expression: a comparative study with placebo.
Clinical Trial Synthesis 2014 Clinical Study published in Journal of medicinal food. Key conclusion: These results demonstrate that dietary astaxanthin combined with collagen hydrolysate can improve elasticity and barrier integrity in photoaged human facial skin, and such treatment is well tolerated.
View Original PubMed Abstract ↓

Photoaging accounts for most age-related changes in skin appearance. It has been suggested that both astaxanthin, a potent antioxidant, and collagen hydrolysate can be used as antiaging modalities in photoaged skin. However, there is no clinical study using astaxanthin combined with collagen hydrolysate. We investigated the effects of using a combination of dietary astaxanthin and collagen hydrolysate supplementation on moderately photoaged skin in humans. A total of 44 healthy subjects were recruited and treated with astaxanthin (2 mg/day) combined with collagen hydrolysate (3 g/day) or placebos, which were identical in appearance and taste to the active supplementation for 12 weeks. The elasticity and hydration properties of facial skin were evaluated using noninvasive objective devices. In addition, we also evaluated the expression of procollagen type I, fibrillin-1, matrix metalloproteinase-1 (MMP-1) and -12, and ultraviolet (UV)-induced DNA damage in artificially UV-irradiated buttock skin before and after treatment. The supplement group showed significant improvements in skin elasticity and transepidermal water loss in photoaged facial skin after 12 weeks compared with the placebo group. In the supplement group, expression of procollagen type I mRNA increased and expression of MMP-1 and -12 mRNA decreased compared with those in the placebo group. In contrast, there was no significant difference in UV-induced DNA damage between groups. These results demonstrate that dietary astaxanthin combined with collagen hydrolysate can improve elasticity and barrier integrity in photoaged human facial skin, and such treatment is well tolerated.

02
CLINICAL STUDY Brazilian journal of biology = Revista brasleira de biologia (2025) PMID: 40105670 ↗
Xanthophylls: potential benefits in protecting against UV burns.
Clinical Trial Synthesis 2025 Systematic Review published in Brazilian journal of biology = Revista brasleira de biologia. Key conclusion: In conclusion, this review suggests a promising role for xanthophylls in alleviating UV burn symptoms and promoting skin healing.
View Original PubMed Abstract ↓

Exposure to ultraviolet (UV) radiation is a significant risk factor for sunburn (solar erythema) and skin cancer. Current treatments focus primarily on symptom relief, making the need for new therapeutic approaches urgent. Xanthophylls, a class of natural pigments with antioxidant and anti-inflammatory properties, show promise in the management of UV burns. This review aimed to systematically analyze the potential of xanthophylls for the management of UV burns, evaluating their efficacy in clinical and experimental studies. A literature review was performed following the PRISMA guidelines. Searches were conducted in the PUBMED, Virtual Health Library and EMBASE databases for eligible articles, using combinations of keywords such as astaxanthin, lutein, fucoxanthin and their effects on burns. Three independent reviewers conducted the search and selection of studies with inclusion criteria that addressed the use of xanthophylls in the treatment of burns, their mechanisms of action, pathophysiology and therapeutic approaches. Systematic reviews, letters, conference abstracts and case reports were excluded, considering only articles published in English. The articles were pre-selected by reading titles and abstracts, and the pre-selected studies were read in full for the final selection. Xanthophylls with potential benefits were identified, highlighting lutein, astaxanthin and violaxanthin, which demonstrated antioxidant activity by reducing the generation of reactive oxygen species (ROS) and mitigating inflammatory responses in skin cells exposed to UV radiation. Furthermore, evidence suggests that these xanthophylls promote skin barrier function and accelerate healing, enhancing recovery from UV burns. In conclusion, this review suggests a promising role for xanthophylls in alleviating UV burn symptoms and promoting skin healing. However, further research, including in vivo studies and clinical trials, is needed to validate its therapeutic potential, determine the optimal dosage, and optimize its delivery for effective UV burn control.

03
SYSTEMATIC REVIEW Journal of dietary supplements (2021) PMID: 32202443 ↗
Effects of Astaxanthin Supplementation on Skin Health: A Systematic Review of Clinical Studies.
Clinical Trial Synthesis 2021 Systematic Review published in Journal of dietary supplements. Key conclusion: In many of the randomized, controlled trials reviewed, AST supplementation improved skin texture, appearance (wrinkles), and moisture content at the end of the study period.
View Original PubMed Abstract ↓

Astaxanthin (AST), a naturally-occurring keto-carotenoid found in several species of bacteria and microalgae, has demonstrated diverse biological activities in vitro and in vivo. There is growing commercial interest in the application of astaxanthin in nutraceuticals and cosmeceuticals, due to its purported photoprotective, DNA repair, antioxidant, and anti-inflammatory benefits. This systematic review therefore aimed to summarize current clinical evidence on the effects of astaxanthin supplementation on skin health. Using the following combinations of broad Major Exploded Subject Headings (MesH) terms or text words [astaxanthin OR AST OR ASX OR carotenoid OR xanthophyll] AND [skin OR derm*], a comprehensive search of PubMed, EMBASE, Medline, Clinicaltrials.gov, and Google Scholar databases found a total of eleven clinical studies. There were six randomized, placebo-controlled, double-blind trials, while the rest were prospective, open-label studies. In many of the randomized, controlled trials reviewed, AST supplementation improved skin texture, appearance (wrinkles), and moisture content at the end of the study period. AST also appeared to protect against UV-induced skin damage. No serious adverse events were reported in any of the studies. However, most available studies had a relatively small sample size and were conducted on healthy Japanese females. Many of the studies were also funded by commercial entities, with potential conflicts of interests. This was difficult to account for in our analyses. Overall, there is some clinical data to support the benefits of astaxanthin supplementation (in the range of 3 to 6 mg/d) on skin health, especially for photoaged skin.

04
META-ANALYSIS Nutrients (2026) PMID: 42075102 ↗
The Effects of Seaweed and Microalgae Supplementation on Exercise Performance and Recovery: A Systematic Review and Meta-Analysis.
Clinical Trial Synthesis 2026 Meta-Analysis published in Nutrients involving n = 822 participants (SMD 0.88). Key conclusion: Conclusions: Algae-derived supplements-particularly Spirulina and Chlorella-may modestly enhance aerobic exercise performance and attenuate exercise-induced muscle damage under certain conditions.
View Original PubMed Abstract ↓

Objective: Seaweed and microalgae provide antioxidants, polyunsaturated fatty acids, and bioactive compounds that may enhance exercise performance and accelerate recovery. However, evidence remains inconsistent. This systematic review and meta-analysis aimed to evaluate the effects of algae-derived supplementation on exercise performance and physiological recovery outcomes in healthy and athletic adults. Methods: This review was registered in PROSPERO (CRD420251166723) and conducted in accordance with PRISMA 2020 guidelines. PubMed, Web of Science, Embase, Cochrane Library, EBSCO, and CNKI were systematically searched for randomized controlled trials (RCTs) evaluating algae supplementation in exercise contexts. Inclusion and exclusion criteria were defined based on the PICOS framework. Primary outcomes included VO2max, Time to exhaustion (TTE), maximal power output (WRmax), Time-Trial (TT) performance, and creatine kinase (CK). Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup, sensitivity, and publication bias analyses were performed. Results: Twenty-two RCTs (n = 822) investigating Spirulina, Chlorella, brown-algal polysaccharides, or astaxanthin met inclusion criteria. Algae supplementation showed a suggestive improvement in VO2max (SMD = 0.88, 95% CI: 0.00-1.75) and significantly improved in TTE (SMD = 1.06, 95% CI: 0.16-1.96), with smaller effects on WRmax (SMD = 0.29, 95% CI: 0.03-0.55), and no significant benefit for TT performance (SMD = -0.27, 95% CI: -0.74 to 0.21). Regarding recovery, CK concentrations were significantly reduced (SMD = -0.78, 95% CI: -1.28 to -0.28). Subgroup analysis suggested greater effects for Chlorella supplementation, higher dosages, and aerobic training contexts; reductions in muscle-damage markers were more evident following resistance exercise. Sensitivity analyses supported the robustness of the main findings with minimal evidence of publication bias. Conclusions: Algae-derived supplements-particularly Spirulina and Chlorella-may modestly enhance aerobic exercise performance and attenuate exercise-induced muscle damage under certain conditions. Eff

05
CLINICAL STUDY Scientific reports (2026) PMID: 41673418 ↗
Exploratory pilot trial of astaxanthin supplementation in PCOS patients at risk of OHSS with focus on RAGE-NFκB pathway.
Clinical Trial Synthesis 2026 Randomized Controlled Trial (RCT) published in Scientific reports involving n = 22 participants. Key conclusion: These findings suggest that AST supplementation may improve COS outcomes and favorably modulate inflammatory pathways, with potential to reduce OHSS risk in high-risk PCOS patients.
View Original PubMed Abstract ↓

Polycystic ovary syndrome (PCOS) is a major risk factor for ovarian hyperstimulation syndrome (OHSS) during controlled ovarian stimulation (COS). Oxidative stress and inflammation, mediated by the advanced glycation end products (AGE)-receptor for AGE (RAGE)-nuclear factor kappa-B (NFκB) pathway, contribute to OHSS development and impaired oocyte quality. Astaxanthin (AST), a potent antioxidant, may modulate this pathway. In this exploratory pilot trial using a triple‑blind, randomized, placebo‑controlled design, 44 PCOS patients at high risk for OHSS were assigned to receive AST (n = 22) or placebo (n = 22) adjunct to the COS regimen. COS was performed using a gonadotropin-releasing hormone (GnRH) antagonist protocol with individualized gonadotropin dosing. Stimulation characteristics, gonadotropin dose, and follicle distribution were comparable between groups. The mean number of retrieved oocytes was slightly higher with AST, and the oocyte maturity rate (OMR) was significantly greater. Estradiol and progesterone levels on trigger day were lower in the AST group, though not statistically significant. Molecular analyses showed reduced RAGE expression, a lower phosphorylated inhibitor of kappa-B (pIκB)/inhibitor of kappa-B (IκB) ratio in granulosa cells (GCs), and significantly decreased interleukin-6 (IL-6) in follicular fluid (FF), with vascular endothelial growth factor (VEGF) showing a downward trend. These findings suggest that AST supplementation may improve COS outcomes and favorably modulate inflammatory pathways, with potential to reduce OHSS risk in high-risk PCOS patients. However, this pilot trial was not powered enough to confirm the primary OHSS endpoint, and larger studies are required for validation.Trial registration: Registration ID: IRCT20231028059882N2; Registration date: 2024-06-15; Update date: 2025-03-16; Direct Access Link: https://irct.behdasht.gov.ir/trial/77250 . © 2026. The Author(s).

06
SYSTEMATIC REVIEW Nutrients (2025) PMID: 41515122 ↗
Nutritional Supplementation for Myopia Prevention and Control: A Systematic Review of Randomized Controlled Trials.
Clinical Trial Synthesis 2025 Systematic Review published in Nutrients. Key conclusion: CONCLUSIONS: Nutritional supplementation may improve visual function and retinal antioxidant status but lacks strong evidence for slowing myopia progression.
View Original PubMed Abstract ↓

BACKGROUND/OBJECTIVES: Nutritional supplementation has been proposed as a potential adjunct strategy in myopia prevention and control through antioxidative, anti-inflammatory, and extracellular matrix-regulating mechanisms. This systematic review aimed to evaluate randomized controlled trial (RCT) evidence on the effects of carotenoids, anthocyanins, polyunsaturated fatty acids, and combined nutraceutical formulations on refractive outcomes, axial length, macular pigment optical density (MPOD), visual function, and symptoms of visual fatigue. METHODS: The review was registered in PROSPERO (CRD420251149727) and conducted in accordance with PRISMA 2020 and AMSTAR-2 guidelines. PubMed, Web of Science, and Scopus were searched up to 5 August 2025. Eligible studies were RCTs involving individuals with myopia or at risk of myopia, comparing nutritional supplementation with placebo or active controls. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. RESULTS: Nine RCTs were included. Carotenoids such as crocetin, lutein, zeaxanthin, and astaxanthin produced modest benefits, including improved MPOD, reduced visual fatigue, and-in one pediatric trial-slightly less axial elongation. Anthocyanin-rich extracts improved mesopic contrast sensitivity and subjective asthenopia. A combined carotenoid-polyphenol formulation enhanced accommodative facility. However, no consistent clinically meaningful reduction in myopia progression was observed. Trials were generally small, heterogeneous, and short in duration. CONCLUSIONS: Nutritional supplementation may improve visual function and retinal antioxidant status but lacks strong evidence for slowing myopia progression. Larger, long-term RCTs are needed before recommending supplementation for routine myopia management.

07
META-ANALYSIS BMC complementary medicine and therapies (2025) PMID: 41437050 ↗
Effects of carotenoid supplementation on liver enzymes in adults: a GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials.
Clinical Trial Synthesis 2025 Meta-Analysis published in BMC complementary medicine and therapies involving n = 757 participants; statistical significance reported at p = 0.089 (MD -2.25). Key conclusion: CONCLUSION: Carotenoid supplementation might be beneficial in reducing liver enzymes, especially in non-healthy participants and in those with a BMI ≥ 25 kg/m2.
View Original PubMed Abstract ↓

BACKGROUND AND AIMS: Carotenoids are known for their beneficial effects in improving chronic diseases through their antioxidant properties. However, there has been no meta-analysis on the effects of carotenoids on liver enzymes and the evidence is inconsistent. So, this study aimed to evaluate the effects of carotenoid supplementation on liver enzyme levels in adults. METHODS: Through November 2024, the PubMed, Scopus and Web of Science electronic databases were searched for eligible trials evaluating the carotenoid supplementation effects on the Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP) and Gamma-glutamyl transferase (GGT). The 95% confidence intervals (CIs) and weighted mean differences (WMDs) were calculated using the random effects model. As part of standard methods, dose-response, meta-regressions, sensitivity, and publication bias analyses were performed. Evidence certainty was assessed using GRADE (Grading of Recommendations for Assessment, Development, and Evaluation). RESULTS: Of the 15 studies (20 arms; n = 757), 7 included healthy participants, while 8 involved non-healthy individuals, including 4 studies on prediabetes or diabetes. Pooled estimates indicated non-significant effects of carotenoid supplementation on all enzymes including ALT (WMD: -2.25 IU/L, 95%CI: -4.84,0.34, P = 0.089), AST (WMD: -0.46 IU/L, 95%CI: -1.25,0.34, P = 0.259), ALP (WMD: -0.34 IU/L, 95%CI: -6.89,6.21, P = 0.918) and GGT (WMD: -0.43 IU/L, 95%CI: -3.06,2.21, P = 0.751) levels non-significantly. Significant reductions in ALT levels occurred in < 12 weeks (P = 0.028), BMI ≥ 25 (P = 0.045), and among non-healthy participants (P = 0.015). AST levels were significantly reduced in non-healthy participants (P = 0.003) with ages > 50 (P = 0.003) as well as GGT levels (P = 0.011) in non-healthy participants. CONCLUSION: Carotenoid supplementation might be beneficial in reducing liver enzymes, especially in non-healthy participants and in those with a BMI ≥ 25 kg/m2. However, more trials with standard methods are required. PROSPERO REGISTERATION CODE: CRD42024612956. © 2025. The Author(s).

08
RANDOMIZED TRIAL (RCT) BMC cardiovascular disorders (2025) PMID: 41162864 ↗
Impact of astaxanthin on oxidative markers, uric acid, and clinical symptoms in heart failure: a randomized clinical trial.
Clinical Trial Synthesis 2025 Randomized Controlled Trial (RCT) published in BMC cardiovascular disorders involving n = 80 participants; statistical significance reported at p = 0.002. Key conclusion: CONCLUSION: These findings suggest that ASX supplementation may be effective in improving oxidative stress biomarkers and clinical status in patients with HF.
View Original PubMed Abstract ↓

BACKGROUND AND AIMS: Chronic heart failure (HF) is often linked to increased oxidative stress and metabolic issues like high uric acid, which can worsen outcomes. Astaxanthin (ASX), a strong antioxidant, may help reduce these harmful effects. This study aimed to investigate the effects of ASX supplementation on oxidative stress markers as the primary outcome and clinical symptoms in patients with HF. METHODS: In this randomized, double-blind, placebo-controlled clinical trial, 80 patients with HF were enrolled and randomly assigned to receive either ASX (20 mg/day) or a placebo (20 mg/day of maltodextrin) for 8 weeks. Biomarkers including total antioxidant capacity (TAC), malondialdehyde (MDA), superoxide dismutase (SOD), serum UA, and clinical symptoms (dyspnea, fatigue, appetite) were assessed pre-and post-intervention. RESULTS: After eight weeks, compared to the placebo group, participants receiving ASX supplementation showed a significant increase in TAC (0.12 vs. -0.04 mmol/L, P = 0.002) and SOD levels (156.92 vs. 36.14 U/mL, P < 0.001). In contrast, the ASX group demonstrated significantly greater reductions in MDA (-2.19 vs. -0.68 nmol/L, P < 0.001) and serum UA levels (-1.82 vs. -0.63 mg/dl, P = 0.003) compared to placebo. Furthermore, among ASX treated patients, improvements in dyspnea and fatigue were statistically significant (P < 0.001), while the increase in appetite was only marginally significant (P = 0.071). CONCLUSION: These findings suggest that ASX supplementation may be effective in improving oxidative stress biomarkers and clinical status in patients with HF. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20200429047235N3. Registered on 26 March 2024, prior to the enrollment of the first participant. http://irct.behdasht.gov.ir/trial/75913 . © 2025. The Author(s).

09
RANDOMIZED TRIAL (RCT) Obesity (Silver Spring, Md.) (2025) PMID: 40671417 ↗
Benefits of Krill Oil Supplementation During Alternate-Day Fasting in Adults With Overweight and Obesity: A Randomized Trial.
Clinical Trial Synthesis 2025 Randomized Controlled Trial (RCT) published in Obesity (Silver Spring, Md.) involving n = 25 participants; statistical significance reported at p = 0.05. Key conclusion: CONCLUSIONS: KO supplementation during body weight loss attenuates the decline in FFM and muscle strength.
View Original PubMed Abstract ↓

OBJECTIVE: To investigate the effect of krill oil (KO) supplementation during alternate-day fasting (ADF) on body composition and muscle function in healthy adults with overweight. METHODS: In a randomized trial, during the 8-week ADF, participants consumed four capsules per day containing krill oil (KO group) or vegetable oil (placebo group). Each capsule of KO contained 191 mg EPA, 94 mg DHA, 78 mg choline, and 100 mcg astaxanthin. Body mass, fat-free mass (FFM), and handgrip strength (HGS) were measured before and after the intervention. Data were analyzed using ANOVA. RESULTS: The study was completed by 41 (25 women and 16 men) participants (age: 39 ± 10 years, BMI: 31.1 ± 4.2 kg/m2). Body weight reduction was not different (p > 0.05) between groups (KO, -4.6 ± 1.4 kg; Placebo, -4.5 ± 1.9 kg). The KO group had no change (p > 0.05) in FFM (-0.2 ± 0.9 kg) or HGS (-0.2 ± 0.5 kg). The placebo group experienced a reduction (p < 0.05) in FFM (-1.2 ± 2.0 kg) and HGS (-0.9 ± 0.7 kg). Changes in FFM and HGS were different (p < 0.05) between groups. CONCLUSIONS: KO supplementation during body weight loss attenuates the decline in FFM and muscle strength. TRIAL REGISTRATION: ClinicalTrials.gov Identifier (NCT06001632). © 2025 The Author(s). Obesity published by Wiley Periodicals LLC on behalf of The Obesity Society.

10
RANDOMIZED TRIAL (RCT) Food & function (2025) PMID: 40569081 ↗
Astaxanthin supplement improves clinical outcomes, quality of life, and inflammatory factors in patients with rheumatoid arthritis: a randomized clinical trial.
Clinical Trial Synthesis 2025 Randomized Controlled Trial (RCT) published in Food & function involving n = 30 participants; statistical significance reported at p = 0.05. Key conclusion: Including it as part of their treatment plan could significantly aid in managing their condition.
View Original PubMed Abstract ↓

Rheumatoid Arthritis (RA) is a chronic, systemic inflammatory disease that results in joint destruction and progressive disability. This study aimed to determine the effect of astaxanthin (ASX) on clinical outcomes, quality of life, and inflammatory factors in patients with RA. In this randomized, triple-blind, placebo-controlled clinical trial, 60 patients with RA were randomly allocated into two groups and given either 20 mg day-1 of ASX supplement in the intervention group (n = 30) or placebo in the control group (n = 30) for 8 weeks. Fasting blood samples were obtained from patients at the beginning and end of the intervention to measure the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6). Clinical symptoms were also measured, including the pain intensity based on the visual analogue scale (VAS), Disease Activity Score 28 (DAS-28), and Health Assessment Questionnaire (HAQ). In the intervention group compared to the control group after the intervention, DAS-28, HAQ, ESR, and CRP levels were significantly reduced (P < 0.05), and the pain intensity was marginally significantly reduced. The significant differences in DAS-28, HAQ, and ESR levels persisted even after adjusting for baseline values and other covariates. However, no significant differences in the pain intensity and CRP levels were found after controlling for confounding factors (P > 0.05). The IL-6 level did not change in either group by the end of the study, and the difference between the two groups also was not statistically significant (P > 0.05). This study demonstrated the beneficial effects of ASX on some important clinical outcomes, quality of life, and inflammatory factors in patients with RA. Including it as part of their treatment plan could significantly aid in managing their condition.

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