You are in: eMedicine Specialties > Endocrinology > Metabolic Disorders Riboflavin DeficiencyArticle Last Updated: Jun 11, 2007AUTHOR AND EDITOR INFORMATIONSection 1 of 11
  Author: Mark R Allee, MD, Assistant Professor, Department of Medicine, University of Oklahoma Health Sciences Center Mark R Allee is a member of the following medical societies: American College of Physicians 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 Editors: Stanley Wallach, MD, Executive Director, American College of Nutrition, Clinical Professor, Department of Medicine, New York University School of Medicine; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine; Don S Schalch, MD, Professor Emeritus, Department of Internal Medicine, Division of Endocrinology, University of Wisconsin Hospitals and Clinics; Mark Cooper, MD, Head, Vascular Division, Baker Medical Research Institute; Professor of Medicine, Monash University; George T Griffing, MD, Professor of Medicine, Director of General Internal Medicine, St Louis University Author and Editor Disclosure Synonyms and related keywords: vitamin B-2, vitamin G, riboflavin 5' phosphate, flavin mononucleotide, FMN, riboflavin 5' adenosine diphosphate, flavin adenine dinucleotide, FAD, apoenzyme proteins, flavoprotein enzymes, cheilosis, cheilitis, lactochrome, vitamin F, thiamine, vitamin B-1 INTRODUCTIONSection 2 of 11
  BackgroundRibloflavin, or vitamin B-2, was initially isolated from milk whey in 1879. Originally called lactochrome, it was also once known as vitamin G. Riboflavin is important for energy production, enzyme function, and normal fatty acid and amino acid synthesis and is necessary for the reproduction of glutathione, a free radical scavenger. The water-soluble B factor consists of 2 separate ingredients; one is unstable when heated, while the other remains stable. The less stable factor was named vitamin F (thiamine), while the heat-stable product was labeled vitamin G. They were later renamed vitamins B-1 and B-2, respectively. PathophysiologyRiboflavin functions in several different enzyme systems. Two derivatives, riboflavin 5' phosphate (flavin mononucleotide [FMN]) and riboflavin 5' adenosine diphosphate (flavin adenine dinucleotide [FAD]), are the coenzymes that unite with specific apoenzyme proteins to form flavoprotein enzymes. Most of the flavin coenzyme systems help to regulate cellular metabolism, whereas others are specifically involved in carbohydrate or amino acid metabolism systems. Riboflavin also appears to have a role in fat metabolism. FrequencyUnited StatesWater-soluble riboflavin is not stored in ample amounts; minute reserves are stored in the liver, kidneys, and heart. A constant supply is needed. Deficiency in this vitamin is usually part of a multiple-nutrient deficiency and does not occur in isolation. Some authorities claim that riboflavin deficiency is the most common nutrient deficiency in America. Milk and other dairy products make the greatest contributions of riboflavin in western diets. Other common dietary sources include cereals, meats, and dark green vegetables (spinach, asparagus and broccoli). Deficiency can occur with a diet deficient in these riboflavin-rich foods. Glass milk containers promote degradation of the vitamin from exposure to light. Deficiency is uncommon in the United States with fortification of many food including grains and cereals. Daily consumption of breakfast cereal and milk would be expected to maintain an adequate intake of riboflavin. CLINICALSection 3 of 11
HistoryRiboflavin deficiency is usually associated with other vitamin B complex deficiencies, and isolated deficiency is rare. However, it has been associated with multiple clinical manifestations.
DIFFERENTIALSSection 4 of 11
Pyridoxine Deficiency WORKUPSection 5 of 11
Lab Studies
TREATMENTSection 6 of 11
Medical CareSee Medication. MEDICATIONSection 7 of 11
Treatment consists of riboflavin replenishment, being careful 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.
Drug Category: VitaminsEssential for normal DNA synthesis and metabolism.
FOLLOW-UPSection 8 of 11
Further Inpatient CareNone recommended MISCELLANEOUSSection 9 of 11
Medical/Legal Pitfalls
MULTIMEDIASection 10 of 11
REFERENCESSection 11 of 11
Article Last Updated: Jun 11, 2007 | ||||||||||||||||||||||||||||||
