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Updated 14 February 2013

Your guide to riboflavin (vitamin B2)

Riboflavin is a water-soluble B vitamin involved in vital metabolic processes in the body. It is necessary for normal cell function, growth, and energy production.

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RELATED TERMS

7,8-dimethyl-10 (1'-D-ribityl) isoalloxazine, Ashbya gossypii, B-complex vitamin, Dolo-Neurotrat, FAD, flavin, flavin adenine dinucleotide, flavin mononucleotide, flavine, FMN, glycosylated riboflavin, lactoflavin, riboflavin 5'-monophosphate, riboflavin-5-phosphate, riboflavine, riboflavinum D 2914A, vitamin B2, vitamin G.

BACKGROUND

Riboflavin is a water-soluble B vitamin involved in vital metabolic processes in the body. It is necessary for normal cell function, growth, and energy production. Small amounts of riboflavin are present in most animal and plant tissues. The most common forms of riboflavin available in supplements are riboflavin and riboflavin 5'-monophosphate. Riboflavin is most commonly found in multivitamin and vitamin B-complex preparations.

Healthy individuals who eat a balanced diet rarely need riboflavin supplements. Especially good dietary sources of riboflavin are milk (and other dairy products), eggs, enriched cereals/grains, meats, liver, and green vegetables, such as asparagus or broccoli. Intake may be lower in vegans than in non-vegetarians or lacto-ovo-vegetarians. Deficiencies can occur in certain parts of the world due to seasonal changes in dietary intakes. Other groups susceptible to riboflavin deficiency include the elderly, those with chronic illness, the poor, and alcoholics.

Although riboflavin is an essential nutrient with a potential for deficiency in some populations, there is recent concern about high intakes of riboflavin (for example, in patients using hundreds of milligrams for migraine prevention). These levels should be used only under the supervision of a health care provider. Unused excess riboflavin is eliminated in the urine, giving it a yellow-green color.

EVIDENCE TABLE

Conditions

Uses
disclaimer: 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.
Grade*

Neonatal jaundice (yellowish skin and eyes in newborn infants)

Phototherapy light used to treat jaundice may break down riboflavin. Riboflavin supplementation is thus included in phototherapy treatment of neonatal jaundice.

A

Riboflavin deficiency (ariboflavinosis)

Although riboflavin deficiency is relatively uncommon in developed countries, its rapid excretion in the urine means that unless dietary intakes are constant, deficiency can occur. Riboflavin supplementation corrects riboflavin deficiency by restoring physiologic levels of the vitamin.

A

Anemia

Studies suggest that correction of riboflavin deficiency in individuals who are both riboflavin-deficient and iron-deficient appears to improve response to iron therapy. Additional research is needed in this area.

C

Cancer prevention

Low riboflavin status is associated with risk of esophageal cancer. Some research suggests riboflavin may play a role in the prevention of esophageal cancer. Further studies are needed before a conclusion can be made.

C

Cataracts

Low riboflavin levels may be a risk factor for developing cataracts. Preliminary study suggests that a combination of riboflavin and zinc may prevent cataracts in the healthy elderly. Additional evidence is needed before a clear conclusion can be made.

C

Cognitive function

Adequate levels of nutrients, including riboflavin, may be required for normal cognitive function. Further research is needed before a conclusion can be made.

C

Depression

Treatment with B vitamins, including riboflavin, may decrease symptoms of depression in patients taking tricyclic antidepressants. Further research is needed in this area.

C

Encephalopathy (brain disorder)

Some research suggests that riboflavin treatment may lead to slight improvements in motor function, cognitive behavior, and diarrhea in patients with encephalopathy. Additional research is needed.

C

Eye disorders (adjunct to UV light for keratoconus)

Some research suggests that a combination of riboflavin and UV light applied directly to the eye may reduce the progression of keratoconus, a degenerative condition of the cornea. Additional research is needed in this area.

C

Headache (post-transplant and migraine)

Studies suggest that high-dose riboflavin may be beneficial in preventing migraine headaches in adults and in relieving post-transplant headaches. Further study is needed before firm conclusions can be made.

C

Hyperhomocysteinemia (high blood homocysteine)

Low riboflavin status may be associated with increased homocysteine levels in the blood. Riboflavin is commonly included in B vitamin supplements to reduce blood homocysteine levels in individuals with high homocysteine. Further studies are needed to clarify the relationship between riboflavin and homocysteine levels.

C

Malaria

It remains unclear if riboflavin supplementation affects malarial infections. Additional research is needed in this area.

C

Preeclampsia (high blood pressure and fluid retention during pregnancy)

Limited study has reported an association between low riboflavin levels and an increased risk of preeclampsia (high blood pressure in pregnancy). However, it is not clear if low riboflavin levels are a cause or consequence of this condition, or if additional supplementation is needed in pregnant women at risk of preeclampsia or eclampsia (beyond the routine use of prenatal vitamins). Additional research is needed.

C

*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).

TRADITION

The below uses are based on tradition, scientific theories, or limited research. 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. There may be other proposed uses that are not listed below. Acne, aging, alcohol dependence, anorexia (eating disorder), antimicrobial, antioxidant, ataxia, atherosclerosis (hardening of the arteries), athletic performance, breast cancer, burning eyes, burning feet syndrome, burns, cancer, canker sores, carpal tunnel syndrome, cervical cancer, colon cancer, congenital methemoglobinemia (red blood cell disorder), congestive heart failure, Crohn's disease, excess tearing, dermatitis, dementia, diabetes, digestion disorders, eczema, exercise performance enhancement, eye strain/fatigue, fatigue, gastroesophageal reflux disease (GERD), glaucoma, glossitis (tongue inflammation), growth disorders, healthy hair, heart disease, high blood pressure, HIV, immune system function, kidney failure, kwashiorkor (malnutrition due to insufficient dietary protein), lactic acidosis, leg cramps, liver disease, liver disorders, memory loss, mitochondrial disorders, mood disorders, mouth cancer, multiple acylcoenzyme A dehydrogenase deficiency, multiple sclerosis (MS), neuropathy, osteoporosis, peptic ulcer disease (PUD), postoperative muscle cramps, neural tube defects (birth defects), pain, red blood cell aplasia, reproduction disorders, rheumatoid arthritis, sickle cell anemia, skin disorders, stress, stroke, toxicity (paraquat), ureteral colic pain, vitality problems, weight loss.

DOSING

disclaimer: 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 (over 18 years old)

The U.S. Recommended Dietary Allowance (RDA) for adults is 1 milligram for female adolescents (14-18 years old); 1.3 milligrams for male adolescents (14-18 years old); 1.1 milligrams for female adults (older than 18 years); 1.3 milligrams for male adults (older than 18 years); 1.4 milligrams for pregnant women (any age); and 1.6 milligrams for breastfeeding women (any age).

For anemia, 1 milligram has been taken by mouth daily for two months, in combination with iron and/or folate. Five milligrams has been taken by mouth twice daily for eight weeks.

For cancer prevention, the following doses have been taken by mouth: 80 milligrams weekly for up to 20 months; 5 milligrams daily for 100 days; or 5 milligrams daily for up to nine years.

For cognitive function, 25 milligrams has been taken by mouth daily.

For encephalopathy, riboflavin of unknown dose and duration has been taken by mouth.

For headache, the following doses have been taken by mouth: 200 milligrams daily for four weeks; 400 milligrams daily for three months.

For hyperhomocysteinemia, 1.6 milligrams has been taken by mouth daily for 12 weeks.

For preeclampsia, 15 milligrams has been taken by mouth daily for unknown duration.

For riboflavin deficiency (ariboflavinosis), doses of up to 25 milligrams have been taken by mouth for up to 12 weeks. Doses of 0.6-1.2 milligrams have been taken by mouth daily for up to 12 months. Good dietary sources of riboflavin are milk and other dairy products, eggs, enriched cereals/grains, meats, liver, and green vegetables, such as asparagus or broccoli. Riboflavin is easily destroyed by exposure to light (for example, riboflavin in milk stored in clear glass bottles).

Children (under 18 years old)

The U.S. Recommended Dietary Allowance (RDA) for infants and children is 0.3 milligrams for 0-6 months old; 0.4 milligrams for 7-12 months old; 0.5 milligrams for 1-3 years old; 0.6 milligrams for 4-8 years old; 0.9 milligrams for 9-13 years old; 1 milligram for female adolescents (14-18 years old); and 1.3 milligrams for male adolescents (14-18 years old).

For anemia, 6 milligrams of riboflavinin in combination with ferrous sulfate has been taken by mouth daily.

For riboflavin deficiency, 5 milligrams has been taken by mouth five days weekly for one year. Two milligrams has been taken by mouth daily for two months. Fifteen milligrams has been taken by mouth twice weekly for 12 weeks. A daily dose of 2.5-5 milligrams has been taken by mouth for six weeks. Two milligrams followed by 0.5-1.5 milligrams daily has been taken by mouth for 14 days.

SAFETY

disclaimer: 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

Reports of allergy or anaphylaxis associated with riboflavin supplementation are rare. Avoid with known allergy or sensitivity.

Side Effects and Warnings

Riboflavin is an essential vitamin required in the diet. It is likely safe at levels normally found in food and in commonly used doses of multivitamin or riboflavin supplements (up to approximately 50 milligrams daily).

Nevertheless, the sensitivity of riboflavin to light may pose potential risks, including when used in certain eye treatments. Possible reactions to very high doses of riboflavin include burning/prickling sensations, diarrhea, increased production and yellow discoloration of urine, itching, and numbness.

Riboflavin deficiency (ariboflavinosis) may be associated with weakness, throat soreness or swelling, tongue swelling (glossitis), angular stomatitis/cheilosis (skin cracking or sores at the corners of the mouth), dermatitis (skin irritation), and anemia. Particular groups of people may be particularly susceptible to riboflavin deficiency, including the elderly, those with chronic illnesses, the poor, and those with alcohol dependence.

Use caution when high doses (hundreds of milligrams) are used without medical supervision or for longer periods of time (weeks), due to a lack of safety information. Intake of riboflavin in excess of requirement increases levels in blood, tissue, and urine.

Reports of allergy or anaphylaxis associated with riboflavin supplementation are rare. Avoid with known allergy or sensitivity.

Riboflavin is generally regarded as safe during pregnancy and breastfeeding and is included in many multi-vitamin supplements. Avoid high doses of riboflavin (hundreds of milligrams) based on lack of safety information.

Pregnancy and Breastfeeding

Riboflavin is generally regarded as safe during pregnancy and breastfeeding and is included in many multi-vitamin supplements. The safety of high dose riboflavin (hundreds of milligrams) has not been established and should be avoided.

INTERACTIONS

disclaimer: Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. 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.

Interactions with Drugs

Riboflavin may interact with alcohol, antibiotics, anticancer agents, anticholinergics, antimalarial agents, antiseizure agents, antithyroid therapy, bone agents, boric acid, cardiovascular agents, chemotherapeutics, contraceptives, diuretics (thiazide), exercise performance enhancement agents, phenobarbital, phenothiazine, probenecid, tamoxifen, or tricyclic antidepressants (such as amitriptyline and imipramine).

Interactions with Herbs and Dietary Supplements

Riboflavin may interact with animal source foods, antibacterials, anticancer agents, anticholinergics, antidepressants, antimalarials, antiseizure agents, antithyroid therapy, B-vitamins, bone agents, calcium-enriched foods, carbohydrate enriched diet, cardiovascular agents, chemotherapeutics, diuretics, exercise performance enhancement agents, hormonal agents, iron, lipoic acid, low fat intakes, milk, probiotics, spinach, vegetarian diet, vitamin A, vitamin C, weanimix (weaning food), wine, yogurt, or zinc.

ATTRIBUTION

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

  • Angkatavanich J, Suthutvoravut U, Panijpan B, et al. Effects of multivitamin supplementation for improvement of thiamin, riboflavin, and retinol nutrition in pediatric patients. J Med Assoc Thai 1993;76 Suppl 2:138-145. View abstract
  • Breen C, Crowe A, Roelfsema HJ, et al. High-dose riboflavin for prophylaxis of migraine. Can Fam Physician 2003;49:1291-1293. View abstract
  • Capo-chichi CD, Gueant JL, Lefebvre E, et al. Riboflavin and riboflavin-derived cofactors in adolescent girls with anorexia nervosa. Am J Clin Nutr 1999;69(4):672-678. View abstract
  • Fischer Walker CL, Baqui AH, Ahmed S, et al. Low-dose weekly supplementation of iron and/or zinc does not affect growth among Bangladeshi infants. Eur J Clin Nutr. 2009;63(1):87-92. View abstract
  • Ma AG, Schouten EG, Zhang FZ, et al. Retinol and riboflavin supplementation decreases the prevalence of anemia in Chinese pregnant women taking iron and folic acid supplements. J Nutr 2008;138(10):1946-50. View abstract
  • MacLennan SC, Wade FM, Forrest KM, et al. High-dose riboflavin for migraine prophylaxis in children: a double-blind, randomized, placebo-controlled trial. J Child Neurol 2008;23(11):1300-4. View abstract
  • Madigan SM, Tracey F, McNulty H, et al. Riboflavin and vitamin B-6 intakes and status and biochemical response to riboflavin supplementation in free-living elderly people. Am J Clin Nutr 1998;68(2):389-395. View abstract
  • McNulty H, Dowey le RC, Strain JJ, et al. Riboflavin lowers homocysteine in individuals homozygous for the MTHFR 677C->T polymorphism. Circulation 2006;113(1):74-80. View abstract
  • Munoz N, Wahrendorf J, Bang LJ, et al. No effect of riboflavine, retinol, and zinc on prevalence of precancerous lesions of oesophagus. Randomised double-blind intervention study in high-risk population of China. Lancet 1985;2(8447):111-114. View abstract
  • Okuda J, Horiguchi N. Nutritional and ariboflavinosis-curing effects of riboflavin-5'-monobutyrate and monopalmitate. Chem Pharm Bull (Tokyo) 1980;28(1):8-13. View abstract
  • Pascale JA, Mims LC, Greenberg MH, et al. Riboflaven and bilirubin response during phototherapy. Pediatr Res 1976;10(10):854-856. View abstract
  • Rivlin RS. Riboflavin and cancer: a review. Cancer Res 1973;33(9):1977-1986. View abstract
  • Schoenen J, Jacquy J, Lenaerts M. Effectiveness of high-dose riboflavin in migraine prophylaxis. A randomized controlled trial. Neurology 1998;50(2):466-470. View abstract
  • Traunmuller F, Ramharter M, Lagler H, et al. Normal riboflavin status in malaria patients in Gabon. Am J Trop Med Hyg 2003;68(2):182-185. View abstract
  • Yoon HR, Hahn SH, Ahn YM, et al. Therapeutic trial in the first three Asian cases of ethylmalonic encephalopathy: response to riboflavin. J Inherit Metab Dis 2001;24(8):870-873. View abstract

disclaimer: Natural Standard Bottom Line Monograph, Copyright © 2011 (www.naturalstandard.com). 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. disclaimer: While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy. disclaimer: The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Copyright © 2011 Natural Standard (www.naturalstandard.com)



Copyright © 2011 Natural Standard (www.naturalstandard.com)

 
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