Riboflavin deficiency and toxicity Domina Petric, MD Riboflavin deficiency 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 2 Signs of riboflavin
deficiency overview Organ system/function Appetite Growth Dermatologic Muscular Gastrointestinal Skeletal Vital organs Erythrocytes Nervous Males Females Fetal Retinal
Corneal Signs Decreased Decreased Cheilitis, stomatitis Weakness Inflammation, ulcer Deformities Hepatic steatosis Anemia Ataxia, paralysis Sterility Decreased fertility Malformations, death
Photophobia Decreased vascularization 3 Factors contributing to riboflavin deficiency 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 4
Inadequate diet Inadequate diet is the most important cause of riboflavin deficiency. This involves the low consumption of milk, which is the most important source of the vitamin available in most diets. In industrialized countries, riboflavin deficiency occurs most frequently among alcoholics, whose dietary practices are often faulty, leading to this and other deficiencies. 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008. 5 Enhanced catabolism Catabolic conditions associated with illness or vigorous physical exercise and involving nitrogen loss increase riboflavin losses. 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008. 6 Alcohol High intakes of alcohol appear to antagonize the utilization of FAD from foods. 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
7 Phototherapy Phototherapy of infants with hyperbilirubinemia often leads to riboflavin deficiency (by photodestruction of the vitamin) if such therapy does not also include the administration of riboflavin. 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
8 Exercise Physical exercise can produce abnormalities in a variety of biochemical markers of riboflavin status such as increased erythrocyte glutathione reductase activity coefficient and reduced urinary riboflavin. There is no evidence that such abnormalities lead to impairments in physiological performance. 02/27/2020
Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 9 Other Reduced riboflavin status among some women using oral contraceptive agents. Patients receiving diuretics or undergoing hemodialysis experience enhanced loss of riboflavin (as well as other watersoluble vitamins). 02/27/2020
Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 10 Deficiency signs 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 11 Deficiency signs
Uncomplicated riboflavin deficiency becomes manifest in humans only after 3 to 4 months of deprivation of the vitamin. 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 12
Deficiency signs cheilosis/cheilitis angular stomatitis glossitis hyperemia and edema of the oral mucosa seborrheic dermatitis around the nose and mouth and
scrotum/vulva normocytic, normochromic anemia with reticulocytopenia, leukopenia and thrombocytopenia 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 13
Cheilosis Sabkadentist.com 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 14 Seborrheic dermatitis Noskinproblems.com 02/27/2020
Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 15 Deficiency signs Riboflavin-deficient patients also experience neurological dysfunction: Peripheral neuropathy of the extremities characterized by hyperesthesia, coldness and pain, as well as decreased sensitivity to touch, temperature, vibration and position. 02/27/2020
Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 16 Subclinical deficiency 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 17
Subclinical deficiency Riboflavin deficiency has been reported to enhance carcinogenesis. This effect is thought to be due to diminished antioxidant protection, increasing the activation of carcinogens and oxidative damage to DNA, and/or diminished folate metabolism, reducing DNA synthesis, repair and methylation. 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
18 Subclinical deficiency Subclinical riboflavin deficiency may actually be beneficial under certain conditions. 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 19
Protection against malaria Because growth of the malarial parasite (Plasmodium spp.) in the erythrocytes of infected hosts causes oxidative stress in those cells, riboflavin deficiency is protective against propagation of the infection.
02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 20 Protection against tryptophan deficiency-induced cataract Riboflavin deficiency has been shown to protect the rat from the cataractogenic effect of a lowtryptophan diet. The metabolic basis of this effect may involve the lack of formation of a riboflavinyl tryptophan adduct that
accelerates the photo-oxidation of the amino acid to a prooxidative form. 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 21 Riboflavin toxicity 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
22 Riboflavin toxicity The toxicity of riboflavin is very low and problems of hypervitaminosis are not expected. Probably because it is not well absorbed, high oral doses of riboflavin are essentially nontoxic. 02/27/2020 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
23 Literature Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 02/27/2020 24
