Riboflavin, also known as vitamin B2, plays a role in the metabolism of carbohydrates. A riboflavin deficiency generally does not occur alone, but with other B-vitamin deficiencies. Once known as vitamin G, a person generally experiences a deficiency of this vitamin due to inadequate intake of foods that contain it, such as fortified milk, cereals and other animal products. While this specific vitamin deficiency is not often heard about, there are authorities that make the claim that it is America's most common nutrient deficiency, reports Dr. Mark R. Allee on eMedicine Medscape.
How a Person Becomes Deficient
Not getting enough dietary riboflavin may result in a deficiency. Since this vitamin is water-soluble, the body does not store ample amounts of it. The kidneys, heart and liver have only very minute reserves. Because of this a person has to constantly supply their body with this vitamin.
There are also secondary causes that may result in this deficiency. These include malabsorption syndromes, hemodialysis, long-term barbiturate use, chronic diarrhea, liver disorders, peritoneal dialysis and chronic alcoholism. Many of these secondary causes may cause this deficiency due to not allowing the proximal small intestine (where this vitamin is absorbed) to absorb it well enough to keep an adequate amount of it in the body.
Signs and Symptoms
Dermatological conditions are commonly associated with this vitamin deficiency. Fissuring or chapping of the lips is often seen. The patient's tongue may be red and sore. The vulva, scrotum and philtrum may have scaly, oily skin rashes.
Certain developmental abnormalities have been associated, such as cleft palate, congenital heart defects and growth retardation in children and infants.
Other possible signs and symptoms may include itchy and red eyes, migraines, fatigue, night blindness and photophobia.
Dangers and Complications of Deficiency
In addition to signs and symptoms, there are some complications that may occur with this deficiency. These include:
Cataracts: This condition is characterized by the eye's lens clouding and the vision becoming affected. Blurry vision, glare, double vision, poor night vision and colors seeming to fade are common symptoms.
Peripheral neuropathy: This condition is characterized by the peripheral nerves not working properly due to damage. A nerve group or a single nerve may be damaged. Numbness, pain and tingling in the legs and arms are generally the first symptoms. Muscle problems may follow as the condition progresses, followed by organ problems, such as digestive or cardiac symptoms.
Mild anemia: This complication may be secondary if this vitamin deficiency interferes with the absorption of iron. Mild anemia may not cause any symptoms, or the patient may experience fatigue, dizziness, shortness of breath, paleness, chest pain, extremity coldness, weakness, irritability, depression, brittle nails or irregular heartbeat.
Malignancy: The associated malignancies are cervical and esophageal dysplasia. Both of these are considered precancerous conditions.
Correcting the Deficiency Through Diet
There are dietary changes that can be made to help in correcting a riboflavin deficiency. If a patient has this deficiency, he or she should work with his or her doctor to make the necessary changes to ensure this deficiency is safely and effectively addressed.
According to the Linus Pauling Institute the following are the recommended daily allowances for riboflavin:
- Infants 0 to 6 months: 0.3 AI per day
- Infants 7 to 12 months: 0.4 AI per day
- Children 1 to 3 years: 0.5 mg per day
- Children 4 to 8 years: 0.6 mg per day
- Children 9 to 13 years: 0.9 mg per day
- Adolescents 14 to 18 years: 1.3 mg per day for males and 1.0 mg per day for females
- Adults over 19 years: 1.3 mg per day for males and 1.1 mg per day for females
- Pregnant women of all ages: 1.4 mg per day
- Breastfeeding women of all ages: 1.6 mg per day
Riboflavin can be found in good amounts in mushrooms and spinach. Other good food sources of this vitamin include romaine lettuce, chard, broccoli, venison, chicken eggs, cow's milk, asparagus, mustard greens, collard greens, turnip greens and yogurt.
Since this vitamin deficiency rarely occurs alone, treatment will also typically include treating and normalizing the coexisting B-vitamin deficiencies. Each vitamin deficiency is generally treated individually and because of this, multivitamins are generally not effective. However, supplementation of the individual deficient vitamins, in addition to dietary changes, may be recommended by the patient's physician to ensure the patient's B-vitamin deficiencies are corrected.
Allee, M.R. MD et al. (2009). Riboflavin Deficiency. Retrieved on June 15, 2011 from eMedicine Medscape: https://emedicine.medscape.com/article/125193-overview
Linus Pauling Institute. (2007). Riboflavin. Retrieved on June 15, 2011 from the Linus Pauling Institute: https://lpi.oregonstate.edu/infocenter/vitamins/riboflavin/
The Merck Manuals Online Medical Library. (2007). Riboflavin. Retrieved on June 15, 2011 from The Merck Manuals Online Medical Library: https://www.merckmanuals.com/professional/sec01/ch004/ch004e.html