Riboflavin deficiency and toxicity

Riboflavin deficiency and toxicity

1. Domina Petric, MD
Riboflavin deficiency and
toxicity

2. Riboflavin deficiency
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
24/16/2018

3. Signs of riboflavin deficiency overview
Organ system/function Signs
Appetite Decreased
Growth Decreased
Dermatologic Cheilitis, stomatitis
Muscular Weakness
Gastrointestinal Inflammation, ulcer
Skeletal Deformities
Vital organs Hepatic steatosis
Erythrocytes Anemia
Nervous Ataxia, paralysis
Males Sterility
Females Decreasedfertility
Fetal Malformations, death
Retinal Photophobia
Corneal Decreased vascularization 3

4. Factors contributingto
riboflavindeficiency
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
4

5. Inadequate diet
•Inadequate diet is the mostimportant cause
of riboflavin deficiency.
•This involves the low consumption of
milk, which is the most important source of
thevitamin available in most diets.
•In industrializedcountries, riboflavin
deficiency occurs mostfrequently among
alcoholics,whose dietarypractices are often
faulty, leading to this andother deficiencies.
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
5

6. Enhanced catabolism
Catabolic conditions
associated with illness or
vigorous physical exercise
and involving nitrogen loss
increase riboflavinlosses.
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
6

7. Alcohol
High intakes of alcohol
appear to antagonize
the utilization of FAD
from foods.
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
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8. Phototherapy
Phototherapy of infants with
hyperbilirubinemia often leads to
riboflavindeficiency (by
photodestructionof the vitamin)
if such therapy does not also
include the administration of
riboflavin.
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
8

9. Exercise
•Physical exercise can produce
abnormalities in a variety of biochemical
markers ofriboflavin status such as
increased erythrocyteglutathione
reductase activity coefficient and
reduced urinary riboflavin.
•There is noevidence that such
abnormalities lead to impairments in
physiological performance.
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
9

10. Other
•Reduced riboflavin status among
somewomen using oral
contraceptive agents.
•Patients receiving diuretics or
undergoing hemodialysis
experience enhanced loss of
riboflavin (as well as other water-
soluble vitamins).
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
10

11. Deficiency signs
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
11

12. Deficiency signs
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
12

13. Deficiency signs
cheilosis/cheilitisangular 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
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
13

14. Cheilosis
Sabkadentist.com
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
14

15. Seborrheic dermatitis
Noskinproblems.com
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
15

16. Deficiency signs
Riboflavin-deficient patientsalso
experience neurological dysfunction:
•Peripheralneuropathyof the
extremities characterized by
hyperesthesia,coldness and pain, as
well as decreased sensitivity to
touch, temperature, vibration and
position.
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
16

17. Subclinical deficiency
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
17

18. Subclinical deficiency
•Riboflavin deficiency has been reported
to enhancecarcinogenesis.
•This effect is thought to be due to
diminished antioxidant protection,
increasing theactivation of carcinogens
and oxidative damage toDNA, and/or
diminished folate metabolism, reducing
DNA synthesis, repair andmethylation.
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
18

19. Subclinical deficiency
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
19

20. Protection against malaria
Because growthof the
malarial parasite
(Plasmodium spp.)in
the erythrocytes of
infected hosts causes
oxidative stress in those
cells, riboflavin
deficiency is protective
against propagationof
the infection.
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
20

21. Protection against tryptophan
deficiency-inducedcataract
•Riboflavin deficiency has been shown
to protect the rat from the
cataractogeniceffectof a low-
tryptophan diet.
•The metabolic basis ofthis effect may
involve the lack of formation ofa
riboflavinyltryptophan adduct that
accelerates the photo-oxidation of the
amino acid to aprooxidativeform.
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
21

22. Riboflavin toxicity
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
22

23. Riboflavin toxicity
The toxicity of riboflavin is very low
and problems of hypervitaminosis
are not expected.
Probablybecause it is not well
absorbed, high oral doses of
riboflavin are essentially nontoxic.
4/16/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
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24. •Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Literature
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