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RIBOFLAVIN IN FOCUSNEEDS®
Riboflavin (vitamin B2) cannot be manufactured by humans and is obtained exclusively from the diet. Riboflavin is an enzyme cofactor in a wide range of enzymes, especially those in energy metabolism. Riboflavin deficiency is rare today outside of cases of extreme malnutrition, people with poor diets consists mostly of white polished grains, or with chronic diarrhea. Signs and symptoms usually involve the blood (anemia) and skin (painful, fissured rashes, including in the mouth). While, riboflavin is present in a wide variety of foods, it is supplemented in individuals with a variety of disorders mostly to provide high levels that serve to force riboflavin-containing enzymes to increase their activity. In particular, riboflavin is often used in brain disorders associated with mitochondrial dysfunction, such as autism and migraine. Riboflavin essentially has not been well studied in ADD/ADHD, however, this condition is well-established to be associated with mitochondrial dysfunction. Riboflavin is also important for eye health and may lower the risk of developing cataracts. Riboflavin is water-soluble and non-toxic. Nausea is common, and the urine is bright yellow with a characteristic odor. While studies are few, the clinical experience of many physicians, and the generally benign nature of riboflavin supplementation, have convinced some experts to offer riboflavin supplementation to their patients with a variety of brain disorders.
Riboflavin, also known as vitamin B2, is one of the eight B-complex vitamins. Riboflavin cannot be manufactured by humans and is thus a true vitamin, obtained exclusively from the diet.
Riboflavin is an enzyme cofactor, which means that it is a necessary component for enzyme function. Riboflavin is a cofactor in a wide range of enzymes, including enzymes in the electron transport chain, fatty acid metabolism, Krebs cycle, branched-chain amino acid catabolism, and glutathione antioxidant pathway. In addition, riboflavin is required for the activation of many other vitamins and minerals, including vitamins A, niacin, pyridoxine, folate, and iron. Many, but not all, of these roles are in energy production.
Riboflavin deficiency is generally found today in cases of extreme malnutrition. Outside of that context, riboflavin deficiency can be found in people whose diet consists mostly of white polished grains (not whole grains), or with substantial GI malabsorption such as chronic diarrhea. Signs and symptoms usually involve the blood (anemia) and skin (painful, fissured rashes, including in the mouth).
Riboflavin is supplemented in individuals with mitochondrial disease or dysfunction mostly to provide extraordinary levels that serve to force riboflavin-containing enzymes to increase their activity. The Recommended Daily Allowance (RDA) for riboflavin is about 1 mg, but higher doses are generally used in disorders of energy metabolism. Those suffering from migraines may find that taking riboflavin may help, with most studies showing some degree of benefit per a recent [PMID 28485121]. Studies often use 400 mg of riboflavin a day for migraine prevention, but lower doses may be appropriate for pre-adolescents and people sensitive to developing nausea.
Riboflavin is often supplemented in other conditions associated with mitochondrial dysfunction, including autism. However, in the related condition of ADD/ADHD, also associated with mitochondrial dysfunction (see the Frequently Asked Questions below), the supplementation of riboflavin has not been well studied. One study noted a lower dietary intake of riboflavin among children with ADHD [PMID 30485932]. In a study in ADHD adults, lower levels of blood riboflavin were associated with ADHD and the severity of the condition [PMID 27990293].
Riboflavin is also important for eye health, in part as this vitamin is needed to protect glutathione, which is an important antioxidant in the eye. The U.S. National Library of Medicine (NLM) reports that eating a diet rich in riboflavin can lower the risk of developing cataracts. Due to its role in the maturation of vitamins, taking riboflavin can also reduce homocysteine levels in the blood by 26 to 40 percent, according to the NLM.
While any supplement taken into the stomach can cause nausea, riboflavin is well known for this. Thus, medical care providers often recommend a lower dose at first, which is increased over time. However, riboflavin is water-soluble and excessive amounts are excreted by the kidneys, so toxicity is unlikely. A dose of 400 mg a day has been recommended for the treatment of migraine and causes no known toxicity. Per a review article regarding 11 trials of high-dose riboflavin for migraine, “adverse reactions with riboflavin have generally been mild” [PMID 28485121]. Riboflavin can also make the yellow glow a bright yellow color and the urine has a characteristic odor.
Laboratory testing can reveal the presence of a deficiency of this nutrient, but is generally not likely to have clinically utility.
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