eMedicine Specialties > Endocrinology > Metabolic Disorders

Riboflavin Deficiency: Treatment & Medication

Author: Mark R Allee, MD, Associate Professor, Department of Medicine, University of Oklahoma Health Sciences Center
Coauthor(s): Mary Zoe Baker, MD, Professor, Department of Medicine, Section of Endocrinology, Metabolism and Hypertension, University of Oklahoma; Medical Director, University of Oklahoma Physicians, Medicine Specialty Clinic, General Medicine Clinic and Medicine Residents' Clinic
Contributor Information and Disclosures

Updated: May 18, 2009

Treatment

Medical Care

See Medication.

Medication

Treatment for riboflavin deficiency consists of riboflavin replenishment, with care taken not to overlook coexisting B-complex deficiencies. Multivitamins have no documented role, because the physician must establish the presence of individual vitamin deficiencies and correct them appropriately. This prevents toxicities and masking of the clinical picture.

Vitamins

Essential for normal deoxyribonucleic acid (DNA) synthesis and metabolism.


Riboflavin (vitamin B-2)

Except in malabsorption syndromes, riboflavin is readily absorbed from the upper GI tract. The extent of GI absorption is increased when the drug is administered with food and is decreased in patients with hepatitis, cirrhosis, and biliary obstruction. Free riboflavin is present in the retina. In blood, about 60% of FAD and FMN are protein bound. The biologic half-life is about 66-84 min following PO or IM administration of a single large dose in healthy individuals. Only about 9% of the drug is excreted unchanged; the fate of the remainder is unknown. Excretion appears to involve renal tubular secretion as well as glomerular filtration. Amounts in excess of the body's needs are excreted in urine.

Adult

6-30 mg PO divided daily for replacement when deficiency is suspected

Pediatric

<3 years: Not established
3-12 years: 3-10 mg PO divided daily
>12 years: Administer as in adults

Tricyclic antidepressants, phenothiazines, probenecid antimalarial drugs, and alcohol decrease effects; tobacco decreases absorption of (smokers may require supplemental riboflavin); contraceptives increase catabolism

Pregnancy

A - Fetal risk not revealed in controlled studies in humans

Precautions

As a photosynthesizing agent, riboflavin is destroyed by light; combination of light, oxygen, and riboflavin can lead to formation of free radicals and, consequently, cataracts; patients with cataracts are advised to use no more than 10 mg daily; riboflavin is a water-soluble vitamin and is considered nontoxic and with no known adverse effects; because of light-sensitivity, fruits and vegetables stored in clear glass or uncovered lose riboflavin content rather quickly; should be taken with food since only about 15% is absorbed when taken alone on an empty stomach; excess riboflavin is excreted in urine, giving the urine a fluorescent yellow-green tint

More on Riboflavin Deficiency

Overview: Riboflavin Deficiency
Differential Diagnoses & Workup: Riboflavin Deficiency
Treatment & Medication: Riboflavin Deficiency
Follow-up: Riboflavin Deficiency
Multimedia: Riboflavin Deficiency
References
Further Reading
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References

  1. 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. Oct 2008;138(10):1946-50. [Medline].

  2. Yazdanpanah N, Uitterlinden AG, Zillikens MC, et al. Low dietary riboflavin but not folate predicts increased fracture risk in postmenopausal women homozygous for the MTHFR 677 T allele. J Bone Miner Res. Jan 2008;23(1):86-94. [Medline].

  3. McNulty H, Scott JM. Intake and status of folate and related B-vitamins: considerations and challenges in achieving optimal status. Br J Nutr. Jun 2008;99 Suppl 3:S48-54. [Medline].

  4. Robitaille J, Carmichael SL, Shaw GM, et al. Maternal nutrient intake and risks for transverse and longitudinal limb deficiencies: data from the National Birth Defects Prevention Study, 1997-2003. Birth Defects Res A Clin Mol Teratol. Apr 6 2009;[Medline].

  5. Smedts HP, Rakhshandehroo M, Verkleij-Hagoort AC, et al. Maternal intake of fat, riboflavin and nicotinamide and the risk of having offspring with congenital heart defects. Eur J Nutr. Oct 2008;47(7):357-65. [Medline].

  6. Hoey L, McNulty H, Strain J. Studies of biomarker responses to intervention with riboflavin: a systematic review. Am J Clin Nutr. Apr 29 2009;[Medline].

  7. Powers HJ. Riboflavin (vitamin B-2) and health. Am J Clin Nutr. Jun 2003;77(6):1352-60. [Medline]. [Full Text].

  8. Russell, RM. Vitamin and trace mineral deficiency and excess. In: Kasper DL, Braunwald E, Fauci AS, et al, eds. Harrison's Principles of Internal Medicine. 16th ed. New York, NY: McGraw-Hill; 2005:403-11.

  9. Schoenen J, Lenaerts M, Bastings E. High-dose riboflavin as a prophylactic treatment of migraine: results of an open pilot study. Cephalalgia. Oct 1994;14(5):328-9. [Medline].

  10. Winters LR, Yoon JS, Kalkwarf HJ. Riboflavin requirements and exercise adaptation in older women. Am J Clin Nutr. Sep 1992;56(3):526-32. [Medline]. [Full Text].

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Keywords

riboflavin deficiency, vitamin deficiency, riboflavin, vitamin B2, vitamin B-2, B complex, vitamin B complex, vitamin B deficiency, B complex vitamins, vitamin G, riboflavin 5' phosphate, flavin mononucleotide, FMN, riboflavin 5' adenosine diphosphate, flavin adenine dinucleotide, apoenzyme proteins, flavoprotein enzymes, cheilosis, lactochrome, vitamin F, thiamine, vitamin B-1, vitamin B1

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Contributor Information and Disclosures

Author

Mark R Allee, MD, Associate Professor, Department of Medicine, University of Oklahoma Health Sciences Center
Mark R Allee, MD is a member of the following medical societies: American College of Physicians
Disclosure: Nothing to disclose.

Coauthor(s)

Mary Zoe Baker, MD, Professor, Department of Medicine, Section of Endocrinology, Metabolism and Hypertension, University of Oklahoma; Medical Director, University of Oklahoma Physicians, Medicine Specialty Clinic, General Medicine Clinic and Medicine Residents' Clinic
Mary Zoe Baker, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, American Chemical Society, and American College of Physicians-American Society of Internal Medicine
Disclosure: Nothing to disclose.

Medical Editor

Stanley Wallach, MD, Executive Director, American College of Nutrition; Clinical Professor, Department of Medicine, New York University School of Medicine
Stanley Wallach, MD is a member of the following medical societies: American Society for Bone and Mineral Research, American Society for Clinical Investigation, American Society for Clinical Nutrition, American Society for Nutritional Sciences, Association of American Physicians, and Endocrine Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Don S Schalch, MD, Professor Emeritus, Department of Internal Medicine, Division of Endocrinology, University of Wisconsin Hospitals and Clinics
Don S Schalch, MD is a member of the following medical societies: American Diabetes Association, American Federation for Medical Research, Central Society for Clinical Research, and Endocrine Society
Disclosure: Nothing to disclose.

CME Editor

Mark Cooper, MBBS, PhD, FRACP, Head, Diabetes & Metabolism Division, Baker Heart Research Institute, Professor of Medicine, Monash University
Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD, Professor of Medicine, St Louis University School of Medicine
George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation
Disclosure: Nothing to disclose.

 
 
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