Have you ever taken a multivitamin and then noticed that your urine was fluorescent yellow a few hours later? It’s from the riboflavin (or vitamin B2). The effect is harmless, but makes for interesting conversation for 12-year-olds. This phenomenon happens because riboflavin is actually a dye. Its Latin-based name is derived from ribose, which means sugar, and flavus, which means yellow. In fact, it’s used as a colorant in some foods, including baby food, cheese, and cereal. When used this way, it is called E101; the “E” stands for Europe. Because riboflavin really is fluorescent (!) under ultraviolet light, engineers in various industries use it to detect leaks. Don’t worry, though, you won’t glow in the dark if it’s in your system. In fact, it’s vital.
As a B vitamin, riboflavin works in concert with the other Bs. It plays a role in your body’s creation of energy. Riboflavin supports mitochondrial function. Remember that mitochondria are the tiny powerhouses in each of your cells that create energy from the ATP molecule. Riboflavin also works hard to improve thyroid hormone levels, and that in turn affects metabolism, helping you burn calories. If you already have hypothyroidism (low thyroid hormone), you have a problem converting your riboflavin into a usable form that works for you, so talk to your doctor about taking more of this important B vitamin.
This nutrient also protects your nerves and helps you cope with life if you eat stress for breakfast, lunch, and dinner. It’s also helpful if you grind your teeth. Seriously, tooth grinding can occur in people who are stressed out and riboflavin deficient. The reason it works so effectively in this case is because this B vitamin makes your adrenal glands function better and produce antistress hormones that help you cope with whatever is going on in your life.
Riboflavin is needed to make the nutrient glutathione, a powerful free radical scavenger. In fact, a doctor can measure glutathione reductase activity in your red blood cells to assess your riboflavin nutritional status. Another way to do this is by testing micronutrients. Women are especially at risk of running low because the many drug muggers of riboflavin include estrogen-containing drugs such as oral contraceptives and hormone replacement therapy.
Riboflavin is great for tired or overweight women, especially those who have migraines, too. This is incredible because millions of dollars are spent on migraine medications that only help temporarily and never solve the problem. One way we think riboflavin works is by supporting mitochondrial function in the brain. Your mitochondria can also be called your powerhouses because they generate energy and burn fat and sugar. Riboflavin is the precursor to two important coenzymes—FAD (flavin adenine dinucleotide) and FMN (flavin mononucleotide). When shopping for riboflavin, you often see references to these two compounds, so get familiar with them. They are life sustaining and absolutely essential in powering the energy-producing mitochondrial chain of events, or what is called the electron transport chain. In other words, the party can’t get started producing energy unless enough riboflavin is present and can morph into FAD and FMN. A deficiency of riboflavin starves the brain of oxygen and energy. That’s when the migraine pain sets in and you have to call your boss and tell him or her you’re down for the count.
Medical science has known about the potential benefits of riboflavin as a treatment for migraines for quite some time. Back in 1998 a randomized, placebo-controlled trial looked at the B vitamin’s effect on people who frequently suffered with migraines. Researchers gave the participants 400 mg of riboflavin every day for 3 months. The scientists concluded that riboflavin was significantly better than placebo in reducing the number of headaches, though it took almost 3 months for optimal benefits.
Another study published in the 2004 issue of the European Journal of Neurolog y also found that riboflavin helped decrease the frequency of migraines. The aim of this study was to investigate riboflavin’s preventive powers. Participants were given 400 mg of riboflavin per day, and researchers evaluated headache frequency, duration, and intensity, and the need for antimigraine drugs. After 6 months, headache frequency was cut in half and the need for drugs also decreased from 7 pills to an average of 4.5 pills per month. Researchers concluded that “riboflavin is a safe and well-tolerated alternative in migraine prophylaxis.”
There are few things worse than chronic head pain. After all, your head is your motherboard, so if this little tidbit of information helps you get your life back, then I’m totally tickled! Riboflavin is cheap and easy to find anywhere. The only thing to remember is that if you take too much of one B vitamin, you tilt your Bs out of balance and can develop a relative deficiency of the others. Taking a B complex may be necessary while you drive up your level of riboflavin. Be sure to read the other chapters about the rest of the B vitamins, too, because you want to be aware of the symptoms of any vitamin deficiency, just in case it happens.
Migraines do seem to occur more frequently in people who are deficient in riboflavin. I recall telling this little secret to a woman named Alice at the pharmacy one evening as I was filling her prescription for Imitrex (sumatriptan), a medication that helps relieve migraines. I suggested riboflavin. Alice took my advice and immediately purchased a bottle. I also told her to stop drinking diet sodas because they contain artificial sweeteners, some of which have been associated with headaches in some people.
Soon after, I received an e-mail from Alice expressing gratitude. For the first time in 7 years, she had gone 6 days in a row without a headache, and she felt more energetic. In her words: “I can now fully enjoy my life again. I feel like I am getting to know my children again after all these years. I can focus on them and play with them, and it is all because of you.”
It is really gratifying to help people, and it is wonderful to know that this woman no longer needs to fill her Imitrex prescription every month.
The benefits of riboflavin do not stop there, however. Riboflavin (and biotin) help create luxurious hair, pretty skin, and strong nails. Pregnant women may derive benefit from added riboflavin because it helps the developing fetus grow properly and it prevents pregnancy cramps. A deficiency of riboflavin during pregnancy can increase the risk of preeclampsia fivefold. Preeclampsia occurs in 5 to 8 percent of pregnant women and causes high blood pressure in both mom and baby. Riboflavin is found in prenatal vitamins because it may help prevent the condition. Make sure your formula contains it; you can ask your pharmacist. You can also ask your obstetrician-gynecologist whether you need additional riboflavin, more than is already in your prescribed formula.
Your body needs riboflavin to help digest foods and activate other B vitamins, such as B6 and niacin. If you’re a big meat eater, you need extra riboflavin to digest the fat and protein in your meals. Riboflavin helps make red blood cells, so if you run out of riboflavin, you may subsequently develop iron deficiency anemia and become fatigued. This is superbly interesting to me because I have known so many people who are iron deficient and can’t get better even after taking iron supplements for months and months. I’ve learned that they either have leaky guts (and can’t absorb the supplements from the gut) or, and this is the biggie, they are riboflavin deficient! So listen carefully if you find that you are the poster child for iron deficiency or you know for sure that you have trouble absorbing iron. You should ask your doctor if you can take the higher dosage (like the drug mugger dose) of riboflavin I recommend below, along with your iron supplement.
You don’t often hear of riboflavin deficiency because the symptoms are hard to pin down and easy to cover up with medication. For example, some people have a decreased sensitivity to touch, temperature, vibration, or position that may occur in the hands, legs, or feet. It may be very subtle and fly under the radar because they just accept their bizarre circumstances (which cause no pain). Riboflavin deficiency is fairly common in elderly people and in those with anorexia, bulimia, HIV, inflammatory bowel disorders, chronic diarrhea, celiac disease, diabetes, and heart disease. And, of course, if you push other B vitamins, then you can get a relative deficiency of riboflavin (which can also go unnoticed for months or years).
If you have watery, fatigued, or bloodshot eyes (and it’s not because you’re up late writing books!), it’s possible that you are just short on riboflavin. Riboflavin deficiency can cause tearing, itching, or burning in or around the eyes; blurred vision; and sensitivity to light. If you have a deficiency, people might assume you are hung over or exhausted because your eyes look so bloodshot.
The skin is also affected by riboflavin deficiency. People with a deficiency can develop sores on the tongue or the corners of their lips, which could crack. Their skin may start to dry out or peel, and this can occur anywhere. Redness and rash are very common with a riboflavin deficiency. A rash can sometimes occur in the most unfortunate places, like the groin. Some people use riboflavin supplements to ease rosacea, as it helps prevent pustule formation by improving the skin’s tone and secretions.
Acid Blockers
Cimetidine (Tagamet)
Esomeprazole (Nexium)
Famotidine (Pepcid and Pepcid Complete)
Nizatidine (Axid)
Omeprazole (Prilosec OTC)
Pantoprazole (Protonix)
Ranitidine (Zantac)
Rabeprazole (Aciphex)
Ranitidine (Zantac)
Antacids
Aluminum and magnesium hydroxide (Maalox, Mylanta)
Aluminum carbonate gel (Basaljel)
Aluminum hydroxide (Amphojel, AlternaGEL)
Calcium carbonate (Tums, Titralac, Rolaids)
Magnesium hydroxide (Phillips’ Milk of Magnesia)
Sodium bicarbonate (Alka-Seltzer, baking soda)
Antibiotics (all of them, just a few examples here)
Amoxicillin (Amoxil)
Azithromycin (Z-Pak)
Cefaclor (Ceclor)
Cefdinir (Omnicef)
Cephalexin (Keflex)
Ciprofloxacin (Cipro)
Clarithromycin (Biaxin)
Doxycycline (Doryx)
Erythromycin (E.E.S.)
Levofloxacin (Levaquin)
Minocycline (Minocin)
Sulfamethoxazole and trimethoprim (Bactrim Septra)
Phenobarbital (Solfoton)
Antidepressants, Tricyclic
Amitriptyline (Elavil)
Desipramine (Norpramin)
Doxepin (Sinequan)
Imipramine (Tofranil)
Nortriptyline (Pamelor)
Antimetabolites
Methotrexate (Rheumatrex, Trexall)
Antinausea Drugs
Promethazine (Phenergan)
Antivirals
Delavirdine (Rescriptor)
Foscarnet (Foscavir)
Lamivudine (Epivir)
Nevirapine (Viramune)
Zidovudine, AZT (Retrovir)
Zidovudine and Lamivudine (Combivir)
Blood Pressure Drugs
Diuretics, loop:
Bumetanide (Bumex)
Ethacrynic acid (Edecrin)
Furosemide (Lasix)
Torsemide (Demadex)
Diuretics, potassium-sparing: diuretics (possibly, however this is not conclusive)
Diuretics, sulfonamide:
Indapamide (Lozol)
Diuretics, thiazide:
Any combination drug that contains HCTZ or hydrochlorothiazide (dozens of drugs contain this)
Chlorothiazide (Diuril)
Chlorthalidone (Hygroton)
Hydrochlorothiazide or HCTZ (Hydrodiuril)
Methyclothiazide (Enduron)
Metolazone (Zaroxolyn)
Cancer Drugs
Doxorubicin (Adriamycin)
Hormone Replacement Therapy/Oral Contraceptives
Estradiol (Estrace, Climara, Estraderm, Estring, Activella, Femring, CombiPatch, EstroGel, Menostar, and many others)
Estradiol and testosterone (Estratest, Depo-Testadiol)
Estrogen-containing drugs, such as oral contraceptives
Estrogens, conjugated (Premphase, Prempro)
Ethinyl estradiol (found in many birth control pills)
Levonorgestrel (found in many birth control pills and Plan B)
Norethindrone (found in many birth control pills)
Nonsteroidal Aromatase Inhibitors for breast cancer
Anastrozole (Arimidex)
Chlorpromazine (Thorazine)
Fluphenazine (Prolixin)
Haloperidol (Haldol)
Thioridazine (Mellaril)
Trifluoperazine (Stelazine)
SERMs (Selective Estrogen Receptor Modulators—used for breast cancer)
Raloxifene (Evista)
Tamoxifen (Nolvadex)
Toremifene (Fareston)
Sulfonamides
MISC:
Alcohol
Anorexia
Estrogen dominance
High dosages of any other B vitamins
Dairy products, lean meats, beef liver, crimini mushrooms, spinach, asparagus, Swiss chard, mustard greens, broccoli, collard greens, turnip greens, eggs, whole grains, yogurt, green beans, cabbage, strawberries, cauliflower, goat’s milk, raspberries, brussels sprouts, summer squash, tempeh, plums, soybeans (cooked), and almonds.
Unless advised otherwise by your health-care provider, you’ll want to get the following doses as part of a B complex supplement. B vitamins work together, and it’s easy to tip them out of balance by taking supplements of individual Bs.
For general health: R5P (riboflavin 5’-phosphate): 50–200 mg per day
Drug mugger dose: 200–400 mg per day
Migraines: Usually 200 mg twice daily for 60 days, then reduce to maintenance level of 25–50 mg daily
Riboflavin may be taken without regard to meals, but most people take their B vitamins with food to maximize absorption and minimize tummy upset. If you enjoy strenuous exercise or have a lot of stress in your life, you will probably need a higher amount than the average person. If you have a genetic polymorphism (a defect of sorts) that prevents you from activating riboflavin to its bioavailable form (R5P), then you’ll need to take the active form of this nutrient. You can get genetically tested if you suspect you have this genetic defect. Vitamins you buy in the store aren’t active until your body carries out a few chemical reactions on them. Polymorphism prevents this simple process. I’m telling you this because when you buy riboflavin (or CoQ10, pyridoxine, or folic acid), you have two choices. You can buy these nutrients and have your body convert them for you, or you can buy the body-ready form (usually at a lower dose than the precursor). You saw an example of this in Chapter 8 on CoQ10. CoQ10 is widely available, and so is its active body-ready version, ubiquinol. Similarly, when riboflavin is activated in your body, it becomes R5P; you can buy supplements in this activated form.
Riboflavin also helps vision, but taking too much of it could backfire and cause cataracts or poor nighttime vision. Other possible reactions to high doses of riboflavin may include itching, numbness, burning, prickly sensations, and sensitivity to light.
Riboflavin is activated to R5P in the intestines, where it is then absorbed, so having a healthy gut goes a long way toward improving and maintaining your level of this important B vitamin. Probiotic supplements can help keep your gut in a healthy state. In addition, you can’t activate riboflavin to R5P without sufficient amounts of digestive acid, which is sold in supplemental form at health food stores (look for betaine hydrochloride or trimethylglycine). You can find out if you make enough stomach acid with a gastrin test, which is a blood test. For more information, see Chapter 17, Probiotics, on page 221.
The B vitamins are interdependent, and it’s very easy to tilt your Bs out of balance. If you take too much riboflavin, you may become deficient, so to speak, in your other B vitamins. So whenever you take a single B vitamin, it’s wise to also take a B complex so that the other Bs are on board.
B-2 by Source Naturals: These hypoallergenic tablets contain 100 mg of riboflavin. The product is easy to find at health food stores.
B-2 by NOW: This formula offers 100 mg riboflavin in an easy-to-swallow capsule. It is also easy to find at health food stores.
Riboflavin 5’ Phosphate by Thorne Research: This is activated riboflavin! If you take this product, your body doesn’t have to expend energy to convert plain riboflavin into R5P. The nutrient is instantly bioavailable. This matters for many people who have digestive disorders, take a lot of medicine, or don’t have enough acid or normal flora in their intestinal tracts.
Riboflavin-5-Phosphate by Douglas Labs: This, too, is activated riboflavin. This product is sold through your health-care practitioner; it is not found in health food stores or pharmacies. You can search online or have your doctor fax his or her license to Douglas Labs to order it for you.
B-2 by Bluebonnet: This products offers 100 mg riboflavin. It is kosher and free of sugar and allergens such as milk, eggs, fish, wheat, soy, corn, and gluten.
Vitamin B2 by Solgar: These vegicaps are kosher and free of all allergens. This brand is widely available.
Migra-Eeze by Life Extension: This multitasking formula contains a powerful blend of herbs and vitamins designed to help with headaches. Two softgels contain 400 mg riboflavin (some of which is in the body-ready R5P form), along with butterbur and ginger, two herbs known to help reduce the frequency and pain of migraine headaches. This product is free of milk, egg, fish, peanuts, crustaceans, shellfish (lobster, crab, shrimp), tree nuts, wheat, yeast, gluten, corn, rice, and artificial sweeteners, flavors, colors, and preservatives. It is sold online at www.vitacost.com and www.lifeextension.com.