Dr C P Ravikumar

Riboflavin is an unsung hero in nutrition. It has been proven to improve growth, healing, energy production, cellular function and metabolism. It is also known to have protective and antioxidant properties as well. There is ongoing research on the use of riboflavin for its ability to lessen the symptoms of migraines as well as its role in cancer prevention.

Required Daily amount
The daily recommended dietary allowances (RDAs) of  Vitamin B2 are:

Age Male Female Pregnancy Lactation
0 – 6 months 0.3 mg 0.3 mg
7 – 12 months 0.4 mg o.4 mg
1 – 3 years 0.5 mg 0.5 mg
4 – 8 years 0.6 mg 0.6 mg
9 – 13 years 0.9 mg 0.9 mg
14 – 18 years 1.3 mg 1.0 mg 1.4 mg 1.6 mg
19 – 50 years 1.3 mg 1.1 mg 1.4 mg 1.6 mg

Natural Sources of Vitamin B2Sources of Riboflavin
    Riboflavin is a type of Vitamin B that is present in
  • milk
  • meats
  • egg,
  • fish,
  • nuts,
  • legumes,
  • dark green leafy vegetables,
  • cheese and dairy products
In India, Riboflavin rich foods include
  • soya bean
  • moong dal
  • bajra (pearl millet)
  • green peas

Supplements of Vitamin B2
Riboflavin is available in many dietary multi-vitamin and multi- mineral supplements. 

Health Benefits of Vitamin B2
There are studies that have demonstrated mild effectiveness of riboflavin in the prevention of migraine headaches.

Deficiency of Vitamin B2
a. Dietary Causes
In western countries, the rising vegan diet trend, may lead to an increased in riboflavin deficiency, and those opting for dairy-free diets may need to supplement their intake with riboflavin tablets, or vitamin supplements as a whole. This is especially true for vegetarian athletes who need to find good resources of vitamin B2 to add to their diet.
In developing countries like India, the prevalent problem of malnutrition, due to inadequate access to wholesome meals, may lead to riboflavin deficiency, especially in pregnancy leading to complications in new borns also.
In addition to reduced intake of vitamin B2, some children may have concurrent issues with the lining of the stomachs and intestines, thyroid or liver functioning, which may cause decreased absorption or metabolism of the nutrients from food.

b. Genetic Causes
There is also a rare, genetic condition, Brown–Vialetto–Van Laere syndrome,where due a decreased production of the substance that helps in riboflavin transportation in the intestine, vitamin b2 deficiency occurs in infancy, leading to decreased muscle and nerve functions, especially in the inner ear and the brainstem.

c. Degradation of Vitamin B2
Some infants born with jaundice (hyperbilirubinemia) are prescribed phototherapy (light therapy). Riboflavin is known to deplete quickly in light, therefore its levels may drop in these babies, if supplements are not given. Heating, cooking, and processing foods, and boiling them in water, destroy riboflavin. As vitamin B2 is water-soluble, it dissolves into cooking water.

Symptoms of Riboflavin deficiency
Due to low dietary intake of riboflavin during pregnancy, infants may be born riboflavin deficient.
In school children, levels of riboflavin are dependent on adequate, whole some nutrition. Adolescent girls show a tendency to develop riboflavin deficiencies, as compared to boys.
Some of the common symptoms seen are:
  • Lethargy, irritability, low birth weight, stunted growth in babies
  • Ariboflavinosis: Lips become dry and cracked, with inflammations at the corners of the mouth (known as angular cheilitis). Tongue becomes dry and turns magenta or black (glossitis), itchy and scaly skin, particularly around genital areas, face ears and scalp
  • Eyes sensitive to light
  • Sore throat
  • Children with Brown–Vialetto–Van Laere syndrome, may present with deafness, color blindness, epilepsy, difficulty in muscle co-ordination or paralysis

Diagnosis of Riboflavin deficiency
Signs of riboflavin deficiency can be picked up by pediatricians on examination of infants and children. Nervous system disorders can be diagnosed by clinical neurologists or pediatric neurologists. A blood test can be done to get a measurement of vitamin B2 in the body.

Management of Riboflavin Deficiency
Ensuring adequate nutrition is key to preventing vitamin deficiencies. Fortified cereals, dairy products and formula milk can also be given. Oral supplements with Riboflavin can also be prescribed. If the child develops neurological symptoms of deficiency, these may be managed effectively by a clinical neurologist or child neurologist, along with robust nutrition, speech and physiotherapy care.

Disclaimer: The above information is for awareness and education purposes only and cannot be used for diagnosis or treatment of any condition. Please consult with a physician for any concerns or questions

Dr C P Ravikumar

Dr C P Ravikumar

CONSULTANT – PEDIATRIC NEUROLOGY
Aster CMI Hospital, Bangalore