Riboflavin Deficiency

Definition

Riboflavin deficiency occurs when the chronic failure to eat sufficient amounts of foods that contain riboflavin produces lesions of the skin, lesions of smooth surfaces in the digestive tract, or nervous disorders.

Description

Riboflavin, also called vitamin B₂, is a water-soluble vitamin. The recommended dietary allowance (RDA) for riboflavin is 1.7 mg/day for an adult man and 1.3 mg/day for an adult woman. The best sources of this vitamin are meat, dairy products, and dark green vegetables, especially broccoli. Grains and legumes (beans and peas) also contribute riboflavin to the diet. Riboflavin is required for the processing of dietary fats, carbohydrates, and proteins to convert these nutrients to energy. Riboflavin is also used for the continual process of renewal and regeneration of all cells and tissues in the body.

Riboflavin is sensitive to light. For this reason, commercially available milk is sometimes supplied in cartons, rather than in clear bottles. Riboflavin is not rapidly destroyed by cooking. Milk contains about 1.7 mg riboflavin/kg. Cheese contains about 4.3 mg/kg, while beef has 2.4 mg/kg and broccoli has about 2.0 mg/kg. Apples, a food that is low in all nutrients, except water, contains only 0.1 mg riboflavin per kg.

Causes and symptoms

A deficiency only in riboflavin has never occurred in the natural environment. In contrast, diseases where people are deficient in one vitamin, such as thiamin, vitamin C, and vitamin D, for example, have been clearly documented. Poorer populations in the United States may be deficient in riboflavin, but when this happens, they are also deficient in a number of other nutrients as well. When riboflavin deficiency is actually detected, it is often associated with low consumption of milk, chronic alcoholism, or chronic diarrhea.

The symptoms of riboflavin deficiency include:

• swelling and fissuring of the lips (cheilosis)
• ulceration and cracking of the angles of the mouth (angular stomatitisis)
• oily, scaly skin rashes on the scrotum, vulva, or area between the nose and lips
• inflammation of the tongue
• red, itchy eyes that are sensitive to light

The nervous symptoms of riboflavin deficiency include:

• numbness of the hands
• decreased sensitivity to touch, temperature, and vibration

Diagnosis

Riboflavin status is diagnosed using a test conducted on red blood cells that measures the activity of an enzyme called glutathione reductase. An extract of the red blood cells is placed in two test tubes. One test tube contains no added riboflavin, while the second test tube contains a derivative of riboflavin, called flavin adenine dinucleotide. The added riboflavin derivative results in little or no stimulation of enzyme activity in patients with normal riboflavin levels. A stimulation of 20% or less is considered normal. A stimulation of over 20% means that the patient is deficient in riboflavin.

Treatment

Riboflavin deficiency can be treated with supplemental riboflavin (0.5 mg/kg body weight per day) until the symptoms disappear.

Prognosis

The prognosis for correcting riboflavin deficiency is excellent.

Prevention

Riboflavin deficiency can be prevented by including milk, cheese, yogurt, meat, and/or certain vegetables in the daily diet. Of the vegetables, broccoli, asparagus, and spinach are highest in riboflavin. These vegetables have a riboflavin content that is similar to that of milk, yogurt, or meat.

Resources

BOOKS

Brody, Tom. Nutritional Biochemistry. San Diego: Academic Press, 1998.

KEY TERMS

Recommended dietary allowance— The recommended daily allowances (RDAs) are quantities of nutrients of the diet that are required to maintain human health. RDAs are established by the Food and Nutrition Board of the National Academy of Sciences and may be revised every few years. A separate RDA value exists for each nutrient. The RDA values refer to the amount of nutrient needed to maintain health in a population of people. The actual amounts of each nutrient required to maintain health in any specific individual differs from person to person.

Water-soluble vitamin— Water-soluble vitamins can be dissolved in water or juice. Fat-soluble vitamins can be dissolved in oil or in melted fat.