Vitamin B2

Vitamin B2 belonging to the water-soluble vitamins acts as an antioxidant agent. Vitamin B2 increases the production of glutathione, a potent free radical scavenger that shields cells from oxidative damage. Within metabolic pathways, it serves as an electron carrier in redox processes through the cofactors FAD and FMN. Riboflavin deficiency can cause metabolic disruption, which may have particular functional effects.

To support healthy growth and reproductive functions, vitamin B2 must be consumed in enough amounts.

Vitamin B2 is available in the form of tablets and capsules.

Tablets/ capsules are to be swallowed whole with water/liquid, as applicable. It is best absorbed when taken between meals.

Vitamin B2 can be used as a supplement to support several biological functions, including ATP synthesis, immune system function, tissue repair, and general growth, particularly the health of the skin, nails, and hair. It also supports the metabolism of carbohydrates, proteins, and lipids. It increases the life expectancy of red blood cells, helps with fatty acid oxidation, and activates folate and vitamin B6. The process of active or facilitated transport is used to absorb vitamin B2 primarily through the small intestine. Before it is absorbed, FMN and FAD must be degraded to riboflavin by non-specific pyrophosphatases, essential for synthesising and metabolising neurotransmitters.

Riboflavin as a supplement is also essential for development and growth, especially during breastfeeding, reproduction, and the early stages of pregnancy.

Vitamins and natural supplements should not replace a balanced diet

This product is not intended to diagnose, treat or prevent any disease(s).

Vitamin B2 may be useful as a supplement for the following health benefits:

• Wound healing: Riboflavin shortage reduces wound healing, increases the time it takes for wounds to be epithelised, and lowers the tensile strength of incision wounds in living tissue. Significant reductions in total collagen levels also indicate that riboflavin deficiency will hinder wound healing.
• Prophylaxis in migraine: Riboflavin is a well-tolerated and safe treatment option for reducing migraine symptoms in adults, according to studies. However, little evidence supports vitamin B2 as an adjuvant therapy for migraine in adults and children.
• Age-related cataract prevention: Riboflavin appears protective against the onset of age-related lens opacification when consumed in higher doses. Lens opacities have been associated with lower levels of riboflavin, according to study evidence confirmed in human studies.
• Congestive heart failure: Taking riboflavin supplements can lower blood pressure and homocysteine levels. Reducing the levels of homocysteine can reduce the risk of coronary heart disease and stroke by 25%, according to a study.
• According to experts, Riboflavin may act as a coenzyme with Anticarcinogenesis: various cytochrome P450 enzymes to lessen the DNA damage that many carcinogens can cause. The antioxidant effect of vitamin B2 decreases when riboflavin levels drop, increasing the activation of carcinogens and oxidative DNA damage. more particularly in colorectal cancer and oesophageal squamous cell carcinoma.
• Fertility and pregnancy: The development of the fetus and embryos depends on adequate riboflavin status. In addition, women who don't consume enough riboflavin during pregnancy may be at higher risk for preeclampsia. Vitamin B2 may also be protective against postpartum depression.
• Sickle cell anaemia: Patients with sickle cell anaemia who received riboflavin supplementation (5 mg twice a day for 8 weeks) showed improvements in their homological parameters, which may indicate that riboflavin promotes erythropoiesis.

Vitamin B2 is commonly administered orally before or after meals for all oral solid forms.

The dosage and duration of treatment should be as per the clinical judgment of the treating healthcare professional.

Vitamins and natural supplements should not replace a balanced diet

This product is not intended to diagnose, treat or prevent any disease(s).

• Capsule: 50mg, 400mg
• Tablet: 25mg, 50mg,100 mg 

Dosage Adjustment in Adult Patients

Riboflavin Deficiency

Supplementation is recommended for adults with riboflavin deficiency syndromes

6-30 mg/day PO in divided doses.

Vitamin B2 is available in the form of tablets and capsules. Vitamin B2 is also frequently sold in combination with other water-soluble multivitamins.

• Limit the consumption of foods like and beverages that include caffeine, such as coffee, tea and chocolate as this substance could hinder the absorption of vitamin B2.
• Limit alcoholic beverages.
• Stay within your daily calorie needs.

The dietary restriction should be individualized as per patient requirements.

Recommended Daily Allowance (RDA)

The RDA set for men is 1.3 mg/day and 1.1 mg/day for women.

Upper Tolerable Intake (UTL):

No UTL is set for riboflavin, as data concerning adverse effects is insufficient.

The treating healthcare professional must closely keep a watch and monitor for signs and symptoms of adverse reactions, such as allergic responses or gastrointestinal disturbances. It is recommended to discontinue the use of vitamin B2 in case of allergies.

Vitamin B2 supplements should be used with caution by people who have kidney problems as they may influence excretion rates.

Vitamin B2 is safe to use during pregnancy. However, it should be used cautiously when administrating in large doses.

Vitamin B2 supplementation is reported to be well-tolerated and safe to use.

The adverse reactions related to Vitamin B2 can be categorised as

Common: Yellow-orange discolouration of urine.

Less Common: Diarrhoea and polyuria.

Rare: Anaphylaxis.

• Antibiotics: Antibiotic drugs can reduce endogenous production of B group vitamins — increase intake of vitamin B2.
• Oral contraceptive pill: The oral contraceptive pill may increase demand for vitamin B2— consider increasing intake with long-term use.
• Tricyclic antidepressants: Reduce the absorption of riboflavin — may increase riboflavin requirements.
• Amitriptyline: Increases the renal excretion of riboflavin— consider increased dietary intake with long-term use.

The common side effects associated with Vitamin B2 include

• Rash, itching/swelling
• Yellow or orange urine
• Severe dizziness
• Trouble breathing
• Hives
• Diarrhoea
• Stomach cramps
• Nausea

The use of vitamin B2 should be prudent in the following group of special populations

• Pregnancy: As riboflavin crosses the placenta during pregnancy, greater consumption is required. The need for vitamin B2 may be lower in non-pregnant women than in pregnant women.

The RDA for pregnant is 1.4 mg/day.

• Paediatrics: Vitamin B2 has improved growth, healing, energy production, cellular function and metabolism.

Dosage Adjustment for Paediatric Patients

The RDA for paediatric 0.3-1.3 mg/day

Riboflavin Deficiency

<3 years: Not established

3-12 years: 3-10 mg/day PO in divided doses

≥12 years: 6-30 mg/day PO in divided doses

• Geriatrics: Vitamin B2 is a potent antioxidant and has been known to provide some level of protection against oxidative damage which contributes to the pathology of Alzheimer’s disease as well as general cognitive loss associated with ageing.

A high amount of vitamin B2 supplement is required with advancing age due to the lower efficiency of vitamin B2 absorption by the enterocytes.

• Lactating mothers: Breast milk contains riboflavin; concentrations may be affected by inadequate maternal supplementation; non-nursing women may have lower requirements than nursing women.

The RDA for lactating mothers is 1.6 mg/day.

Dosage Adjustment in Kidney Impairment

Riboflavin deficiency is uncommon in dialysis patients.

There are no specific dosage adjustments provided.

Dosage Adjustment in Hepatic Impairment

There are no specific dosage adjustments provided.

The human body excretes excess vitamin B2 in the urine.

An overdose of Vitamin B2 is also very rare. Even at the high doses (e.g. 400 mg) used in some trials, no adverse effects are noted, and riboflavin remains non-toxic.

There is no specific treatment in the event of an overdose. In the event of an overdose, the patient should be symptomatically treated, and supportive measures instituted as required.

The physician should be vigilant about the knowledge about the identification and treatment of overdosage of vitamin B2.

Biochemistry profile of vitamin B2

Riboflavin, also known as vitamin B2, is made up of a sugar group called ribitol and a tricyclic heterocyclic isoalloxazine flavin group. Flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD) enzymes are the primary coenzyme forms of riboflavin. Important intermediaries in the transport of electrons during redox reactions include FMN and FAD. As they act as coenzymes, oxidases and dehydrogenases often attach to FAD and FMN. These enzymes are crucial in the catalysis of oxidation and reduction reactions, where molecules transfer electrons. Due to their ability to transport electrons, FAD and FMN are essential components of numerous metabolic pathways and play a role in cells' physiological and overall energy generation.

Kinetic profile:

• Absorption: The proximal small intestine is where vitamin B2 is primarily absorbed, and riboflavin transporter 3 (RFVT3) facilitates this process by acting as a specialised transporter. Since RFVT3 actively mediates this saturable, limited-capacity absorption process, riboflavin from the diet is effectively absorbed into the bloodstream. Riboflavin can be transported to different tissues after being absorbed in order to carry out its essential coenzyme functions.
• Distribution: The liver, spleen, heart, and kidneys do not have a large amount of riboflavin, or vitamin B2, stored inside. Instead, it is mostly supplied by the bloodstream to different tissues. Through this adequate transportation, the body receives a consistent supply of riboflavin to support vital metabolic and enzymatic processes.
• Metabolism: Mainly metabolised in the small intestine, liver, heart, and kidney, flavokinase phosphorylates riboflavin to create FMN by ATP-dependent phosphorylation. As too much FMN inhibits the synthesis of FAD, which is the crucial flavocoenzyme, flavoproteins are formed.
• Excretion: The body does not store significant levels of riboflavin in tissues when there is an overabsorption of the vitamin. Instead, urine is the primary method of eliminating extra Riboflavin. By preventing excessive buildup and maintaining the body's riboflavin balance, this effective removal process ensures that vital internal processes are not affected by excessive levels.

1. Braun L, Cohen M. October 1, 2014.Herbs and Natural Supplements; 4^th Edition Vol-2. Australia. Elsevier.
2. https://reference.medscape.com/drug/riboflavin-vitamin-b2-344427#5https://ods.od.nih.gov/factsheets/Riboflavin-Consumer/
3. https://www.ncbi.nlm.nih.gov/books/NBK114322/
4. https://ods.od.nih.gov/factsheets/Riboflavin-HealthProfessional/
5. https://www.ncbi.nlm.nih.gov/books/NBK525977/
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