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Riboflavin (vitamin B2)

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Also listed as: Vitamin B2
Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

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, riboflavina, 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 people 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 people using hundreds of milligrams for migraine prevention). These levels should be used only under the supervision of a healthcare provider. Unused excess riboflavin is eliminated in the urine, giving it a yellow-green color.
  • Riboflavin has been studied for its use with migraine headaches, cataracts, high homocysteine (amino acid) in the blood, depression, and other disorders. It also has uses for iron-deficiency anemia and it can be used as a tracer to determine if medications have been taken.

Evidence Table

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 *


Light therapy used to treat jaundice may break down riboflavin. Thus riboflavin is included in light therapy treatment of neonatal jaundice.

A


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 levels of the vitamin.

A


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


Low riboflavin status is associated with risk of esophageal (throat) 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


Low riboflavin levels may be a risk factor for developing cataracts. Early research 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


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

C


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

C


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

C


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

C


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

C


In children with kwashiorkor, the effects of micronutrient supplementation have been studied. Research has shown, after taking a combination product containing high dose riboflavin, the number of people with kwashiorkor decreased. Further research is needed for firm conclusions to be made.

C


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

C


Riboflavin has been studied for migraine prevention and treatment. An effect was lacking in preventing migraines in children. The evidence for riboflavin use in adults is unclear and further research is required.

C


Limited research has reported an association between low riboflavin levels and an increased risk of pre-eclampsia (high blood pressure in pregnancy). However, it is unclear if low riboflavin levels are a cause or result of this condition, or if additional supplementation is needed in pregnant women at risk of pre-eclampsia 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 for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

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 (blood products), antioxidant, ataxia (uncoordinated movement), atherosclerosis (hardening of the arteries), breast cancer, burning eyes, burning feet syndrome, burns, cancer (kidney cell and general), canker sores, carpal tunnel syndrome, cervical cancer, colon cancer, congenital methemoglobinemia (red blood cell disorder), Crohn's disease, dementia, dermatitis, diabetes, digestion disorders, eczema, excess tearing, exercise performance enhancement, fatigue, gastroesophageal reflux disease (GERD), glaucoma, glossitis (tongue inflammation), growth disorders, healthy hair, heart disease, heart failure, high blood pressure, HIV, HIV (medication side effects), immune system function, kidney failure, lactic acidosis, leg cramps, liver disorders, memory loss, mitochondrial disorders, mood disorders, mouth cancer, multiple acylcoenzyme A dehydrogenase deficiency (metabolic disease), multiple sclerosis (MS), neural tube defects (birth defects), neuropathy, osteoporosis, pain, peptic ulcer disease (PUD), postoperative muscle cramps, red blood cell aplasia (decrease in red blood cells), reproduction disorders, rheumatoid arthritis, sickle cell anemia, skin disorders, stress, stroke, toxicity (paraquat), ureteral colic pain (pain with kidneys), vitality problems, weight loss.

Dosing

Adults (18 years and older)

  • 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).
  • 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).
  • For anemia, 1 milligram has been taken by mouth daily for two months, in combination with iron and/or folate and 5 milligrams has been taken by mouth twice daily for eight weeks.
  • For cancer prevention, 80 milligrams has been taken by mouth weekly for up to 20 months and 5 milligrams has been taken by mouth daily for up to nine years.
  • For cognitive function, 25 milligrams has been taken by mouth daily lacking evidence of benefit.
  • For hyperhomocysteinemia (high blood homocysteine), 1.6 milligrams has been taken by mouth daily for 12 weeks.
  • For migraine, 200-400 milligrams has been taken by mouth daily for up to three months. 25 milligram dose has also been taken by mouth for three months.
  • For pre-eclampsia, 15 milligrams has been taken by mouth daily for an unknown duration.
  • For riboflavin deficiency (ariboflavinosis), doses of up to 25 milligrams have been taken by mouth daily for up to 12 weeks. 0.6-1.2 milligrams have been taken by mouth daily for up to 12 months.

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. 2-5 milligrams has been taken by mouth daily for up to two months. 15 milligrams has been taken by mouth twice weekly for 12 weeks. 2 milligrams followed by 0.5-1.5 milligrams daily has been taken by mouth for 14 days.

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 products that contain riboflavin.

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 about 50 milligrams daily).
  • Riboflavin may cause diarrhea, eye damage (cornea), increased amounts of urine, itching, light sensitivity, numbness, prickling or burning sensations, and yellow urine (high doses).
  • Use cautiously in people with stomach or intestine disorders due to reports of diarrhea.
  • Avoid taking high doses of riboflavin (hundreds of milligrams) without medical supervision or for long periods of time (weeks), due to a lack of safety information.
  • Avoid in people with known allergy or sensitivity to products that contain riboflavin.

Pregnancy and Breastfeeding

  • 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) due to a lack of evidence for safety.

Interactions

Interactions with Drugs

  • Riboflavin may interact with agents for skin disorders, agents for the heart, agents for worm infections, agents that increase sensitivity to the sun, alcohol, Alzheimer's agents, antibiotics, anticancer agents, anticholinergics, antifungal agents, antimalarial agents, antiseizure agents, antithyroid therapy, bone agents, chlorpromazine, contraceptives (birth control), diuretics (thiazide), exercise performance enhancement agents, iron salts, nervous system agents, phenobarbital, phenothiazine, probenecid, stomach and intestine agents, tamoxifen, or tricyclic antidepressants (such as amitriptyline and imipramine).

Interactions with Herbs and Dietary Supplements

  • Riboflavin may interact with Alzheimer's, anticancer, antifungal, antimalarial, antiseizure, exercise performance enhancement, bone, depression, heart, hormonal, nervous system, stomach and intestine disorder, thyroid, or worm infection herbs and supplements; in addition to antibacterials, anticholinergics, B-vitamins, boric acid, diuretics, herbs and supplements that increase sensitivity to the sun, iron, lipoic acid, probiotics, spinach, vitamin A, vitamin C, 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).

Bibliography
  1. 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.
  2. Holland S, Silberstein SD, Freitag F, et al. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 4-24-2012;78(17):1346-1353.
  3. Koller T, Mrochen M, and Seiler T. Complication and failure rates after corneal crosslinking. J Cataract Refract.Surg. 2009;35(8):1358-1362.
  4. 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.
  5. Macdonald LE, Brett J, Kelton D, et al. A systematic review and meta-analysis of the effects of pasteurization on milk vitamins, and evidence for raw milk consumption and other health-related outcomes. J Food Prot. 2011;74(11):1814-1832.
  6. 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.
  7. Odigwe CC, Smedslund G, Ejemot-Nwadiaro RI, et al. Supplementary vitamin E, selenium, cysteine and riboflavin for preventing kwashiorkor in preschool children in developing countries. Cochrane.Database.Syst.Rev. 2010;(4):CD008147.
  8. Pringsheim T, Davenport W, Mackie G, et al. Canadian Headache Society guideline for migraine prophylaxis. Can.J Neurol.Sci 2012;39(2 Suppl 2):S1-59.
  9. Rogovik AL, Vohra S, and Goldman RD. Safety considerations and potential interactions of vitamins: should vitamins be considered drugs? Ann.Pharmacother. 2010;44(2):311-324.
  10. Schmitz JM, Mooney ME, Moeller FG, et al. Levodopa pharmacotherapy for cocaine dependence: choosing the optimal behavioral therapy platform. Drug Alcohol Depend. 4-1-2008;94(1-3):142-150.
  11. Szentmary N, Goebels S, Bischoff M, et al. [Photodynamic therapy for infectious keratitis]. Ophthalmologe 2012;109(2):165-170.
  12. Torheim LE, Ferguson EL, Penrose K, et al. Women in resource-poor settings are at risk of inadequate intakes of multiple micronutrients. J Nutr 2010;140(11):2051S-2058S.
  13. Vlaming ML, Lagas JS, and Schinkel AH. Physiological and pharmacological roles of ABCG2 (BCRP): recent findings in Abcg2 knockout mice. Adv.Drug Deliv.Rev. 1-31-2009;61(1):14-25.
  14. Werbach MR. Melatonin for the treatment of gastroesophageal reflux disease. Altern Ther Health Med 2008;14(4):54-58.
  15. Wittig-Silva C, Whiting M, Lamoureux E, et al. A randomized controlled trial of corneal collagen cross-linking in progressive keratoconus: preliminary results. J Refract.Surg. 2008;24(7):S720-S725.

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


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.

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