Vitamin B2 - Riboflavin

Chemical Name

C17H20N4O6

Immune support

Riboflavin, also known as vitamin B2, is a micronutrient with a key role in maintaining human health. It has also been shown to enhance host resistance to viral and bacterial infections

Other uses

Cataracts. People who eat more riboflavin as part of their diet seem to have a lower risk of developing cataracts. Also, taking supplements containing riboflavin plus niacin seems to help prevent cataracts.
High amounts of homocysteine in the blood (hyperhomocysteinemia). Taking riboflavin by mouth for 12 weeks decreases levels of homocysteine by up to 40% in some people. Also, taking riboflavin along with folic acid and pyridoxine seems to lower homocysteine levels by 26% in people with high homocysteine levels caused by drugs that are used to prevent seizures.
Migraine headaches. Taking high-dose riboflavin by mouth seems to reduce the number of migraine headache attacks, by about 2 attacks per month. Taking riboflavin in combination with other vitamin sand minerals seems to also reduce the amount of pain experienced during a migraine.

How it works

Riboflavin is required for the proper development of many things in the body including the skin, lining of the digestive tract, blood cells, and brain function.

Safety

Riboflavin is LIKELY SAFE for most people when taken by mouth. In some people, riboflavin can cause the urine to turn a yellow-orange color. It may also cause diarrhea.


Special Precautions & Warnings:

Children: Riboflavin is LIKELY SAFE for most children when taken by mouth in appropriate amounts as recommended by the Food and Nutrition Board for the National Institute of Medicine (see dosing section below).

Pregnancy and breast-feeding: Riboflavin is LIKELY SAFE when taken by mouth and used appropriately for pregnant or breast-feeding women. The recommended amounts are 1.4 mg per day for pregnant women and 1.6 mg per day in breast-feeding women. Riboflavin is POSSIBLY SAFE when taken by mouth in larger doses, short-term. Some research shows that riboflavin is safe when taken at a dose of 15 mg once every 2 weeks for 10 weeks.


Hepatitis, Cirrhosis, Billary obstruction: Riboflavin absorption is decreased in people with these conditions.


Interactions with medications

Antibiotics (Tetracycline antibiotics)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Riboflavin might decrease the amount of tetracyclines that the body can absorb. Taking riboflavin along with tetracyclines might decrease the effectiveness of tetracyclines. To avoid this interaction, take riboflavin 2 hours before or 4 hours after taking tetracyclines.


Some tetracyclines include demeclocycline (Declomycin), minocycline (Minocin), and tetracycline (Achromycin).


Drying medications (Anticholinergic drugs)

Interaction Rating = Minor Be watchful with this combination.

Talk to your health provider.

Some drying medications can affect the stomach and intestines. Taking these drying medications with riboflavin (vitamin B2) can increase the amount of riboflavin that is absorbed in the body. But it's not known if this interaction is important.


Some of these drying medications include atropine, scopolamine, and some medications used for allergies (antihistamines), and for depression (antidepressants).


Medications for depression (Tricyclic antidepressants)

Interaction Rating = Minor Be watchful with this combination.

Talk to your health provider.

Some medications for depression can decrease the amount of riboflavin in the body. This interaction is not a big concern because it only occurs with very large amounts of some medications for depression. Some medications used for depression include amitriptyline (Elavil) or imipramine (Tofranil, Janimine), and others.


Phenobarbital (Luminal)

Interaction Rating = Minor Be watchful with this combination.

Talk to your health provider.

Riboflavin is broken down by the body. Phenobarbital might increase how quickly riboflavin is broken down in the body. It is not clear if this interaction is significant.


Probenecid (Benemid)

Interaction Rating = Minor Be watchful with this combination.

Talk to your health provider.


Probenecid (Benemid) can increase how much riboflavin is in the body. This might cause there to be too much riboflavin in the body. But it's not known if this interaction is a big concern.


Interactions with Herbs, Supplements, and Foods

Blond psyllium

Psyllium reduces absorption of riboflavin from supplements in healthy women. It isn't clear whether this occurs with dietary riboflavin, or whether it's really important to health.


Boron

A form of boron, called boric acid, can reduce the solubility of riboflavin in water. This might reduce the absorption of riboflavin.


Folic acid

In people with a condition called methylenetetrahydrofolate reductase (MTHFR) deficiency, taking folic acid might make riboflavin deficiency worse. Folic acid might lower blood levels of riboflavin in people with this condition.


Iron

Riboflavin supplements may improve the way iron supplements work in some people who don't have enough iron. This effect is probably important only in people with riboflavin deficiency.


Food

Absorption of riboflavin supplements may be increased when taken with food.

References

Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.

Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.

Tyler VE. Herbs of Choice. Binghamton, NY: Pharmaceutical Products Press, 1994.

Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.

Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed., Binghamton, NY: Haworth Herbal Press, 1993.

McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

Young DS. Effects of Drugs on Clinical Laboratory Tests 4th ed. Washington: AACC Press, 1995.

Hardman JG, Limbird LL, Molinoff PB, eds. Goodman and Gillman's The Pharmacological Basis of Therapeutics, 9th ed. New York, NY: McGraw-Hill, 1996.

Gupta SK, Gupta RC, Seth AK, Gupta A. Reversal of fluorosis in children. Acta Paediatr Jpn 1996;38:513-9.

Kunsman GW, Levine B, Smith ML. Vitamin B2 interference with TDx drugs-of-abuse assays. J Forensic Sci 1998;43:1225-7.

Sandor PS, Afra J, Ambrosini A, Schoenen J. Prophylactic treatment of migraine with beta-blockers and riboflavin: differential effects on the intensity dependence of auditory evoked cortical potentials. Headache 2000;40:30-5.

Schoenen J, Lenaerts M, Bastings E. High-dose riboflavin as a prophylactic treatment of migraine: results of an open pilot study. Cephalalgia 1994;14:328-9.

Schoenen J, Jacquy J, Lenaerts M. Effectiveness of high-dose riboflavin in migraine prophylaxis. A randomized controlled trial. Neurology 1998;50:466-70.

Fouty B, Frerman F, Reves R. Riboflavin to treat nucleoside analogue-induced lactic acidosis. Lancet 1998;352:291-2.

Blot WJ, Li JY, Taylor PR. Nutritional intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst 1993;85:1483-92.

Mark SD, Wang W, Fraumeni JF Jr, et al. Do nutritional supplements lower the risk of stroke or hypertension? Epidemiology 1998;9:9-15.

Kastrup EK. Drug Facts and Comparisons. 1998 ed. St. Louis, MO: Facts and Comparisons, 1998.

Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706.

Hill MJ. Intestinal flora and endogenous vitamin synthesis. Eur J Cancer Prev 1997;6:S43-5.

Sanpitak N, Chayutimonkul L. Oral contraceptives and riboflavin nutrition. Lancet 1974;1:836-7.

Nimmo WS. Drugs, diseases, and altered gastric emptying. Clin Pharmacokinet 1967;1:189-203.

Wang GQ, Dawsey SM, Li JY, et al. Effects of vitamin/mineral supplementation on the prevalence of histological dysplasia and early cancer of the esophagus and stomach: results from the General Population Trial in Linxian, China. Cancer Epidemiol Biomarkers Prev 1994;3:161-6.

Sperduto RD, Hu TS, Milton RC, et al. The Linxian cataract studies. Two nutrition intervention trials. Arch Ophthalmol 1993;111:1246-53.

Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182

Kulkarni PM, Schuman PC, Merlino NS, Kinzie JL. Lactic acidosis and hepatic steatosis in HIV seropositive patients treated with nucleoside analogues. Natl AIDS Treatment Advocacy Project. Dig Disease Week Liver Conf, San Diego,CA. 2000;May 21-4:Rep11.

Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://books.nap.edu/books/0309065542/html/.

Cumming RG, Mitchell P, Smith W. Diet and cataract: the Blue Mountains Eye Study. Ophthalmology 2000;10:450-6.

Sazawal S, Black RE, Menon VP, et al. Zinc supplementation in infants born small for gestational age reduces mortality: a prospective, randomized, controlled trial. Pediatrics 2001;108:1280-6.

Mooij PN, Thomas CM, Doesburg WH, Eskes TK. Multivitamin supplementation in oral contraceptive users. Contraception 1991;44:277-88.

Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..

Fishman SM, Christian P, West KP. The role of vitamins in the prevention and control of anaemia. Public Health Nutr 2000;3:125-50..

McCormick DB. Riboflavin. In: Shils ME, Olson JA, Shike M, Ross AC, eds. Modern Nutrition in Health and Disease. 9th ed. Baltimore, MD: Williams & Wilkins, 1999. pg.391-9.

Pinto J, Raiczyk GB, Huang YP, Rivlin RS. New approaches to the possible prevention of side effects of chemotherapy by nutrition. Cancer 1986;58:1911-4..

Roe DA, Kalkwarf H, Stevens J. Effect of fiber supplements on the apparent absorption of pharmacological doses of riboflavin. J Am Diet Assoc 1988;88:211-3..

Dalton SD, Rahimi AR. Emerging role of riboflavin in the treatment of nucleoside analogue-induced type B lactic acidosis. AIDS Patient Care STDS 2001;15:611-4..

Yanagawa N, Shih RN, Jo OD, Said HM. Riboflavin transport by isolated perfused rabbit renal proximal tubules. Am J Physiol Cell Physiol 2000;279:C1782-6..

Jusko WJ, Levy G. Effect of probenecid on riboflavin absorption and excretion in man. J Pharm Sci 1967;56:1145-9.

Jusko WJ, Levy G, Yaffe SJ, Gorodischer R. Effect of probenecid on renal clearance of riboflavin in man.J Pharm Sci 1970;59:473-7.

Pinto J, Huang YP, Rivlin RS. Inhibition of riboflavin metabolism in rat tissues by chlorpromazine, imipramine and amitriptyline. J Clin Invest 1981;67:1500-6.

Pinto J, Huang YP, Pelliccione N, Rivlin RS. Cardiac sensitivity to the inhibitory effects of chlorpromazine, imipramine, and amitriptyline upon formation of flavins. Biochem Pharmacol 1982;31:3495-9..

Pelliccione N, Pinto J, Huang YP, Rivlin RS. Accelerated development of riboflavin deficiency by treatment with chlorpromazine. Biochem Pharmacol 1983;32:2949-53..

Raiczyk GB, Dutta P, Pinto J. Chlorpromazine and quinacrine inhibit flavin adenine dinucleotide biosynthesis in skeletal muscle. Physiologist 1985;28:322.

Dutta P, Pinto J, Rivlin R. Antimalarial effects of riboflavin deficiency. Lancet 1985;2:1040-3.

Ahmed F, Bamji MS, Iyengar L. Effect of oral contraceptive agents on vitamin nutrition status. Am J Clin Nutr 1975;28:606-15..

Briggs M. Oral contraceptives and vitamin nutrition (letter). Lancet 1974;1:1234-5.

Newman LJ, Lopez R, Cole HS, et al. Riboflavin deficiency in women taking oral contraceptive agents. Am J Clin Nutr 1978;31:247-9..

Roe DA, Bogusz S, Sheu J, et al. Factors affecting riboflavin requirements of oral contraceptive users and non-users. Am J Clin Nutr 1982;35:495-501..

Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..

Ogura R, Ueta H, Hino Y, et al. Riboflavin deficiency caused by treatment with adriamycin. J Nutr Sci Vitaminol 1991;37:473-7..

Raiczyk GB, Pinto J. Inhibition of flavin metabolism by adriamycin in skeletal muscle. Biochem Pharmacol 1988;37:1741-4..

Pinto J, Huang YP, Pelliccione N, Rivlin RS. Adriamycin inhibits flavin synthesis in heart: possible relation to cardiotoxicity of anthracyclines (abstract). Clin Res 1983;31;467A.

Ohkawa H, Ohishi N, Yagi K. Hydroxylation of the 7- and 8-methyl groups of riboflavin by the microsomal electron transfer system of rat liver. J Biol Chem 1983;258:5629-33..

Hamajima S, Ono S, Hirano H, Obara K. Induction of the FAD synthetase system in rat liver by phenobarbital administration. Int J Vit Nutr Res 1979;49:59-63..

Vir SC, Love AH. Riboflavin nutriture of oral contraceptive users. Int J Vitam Nutr Res 1979;49:286-90..

Negri E, Franceschi S, Bosetti C, et al. Selected micronutrients and oral and pharyngeal cancer. Int J Cancer 2000;86:122-7..

Bell IR, Edman JS, Morrow FD, et al. Brief communication. Vitamin B1, B2, and B6 augmentation of tricyclic antidepressant treatment in geriatric depression with cognitive dysfunction. J Am Coll Nutr 1992;11:159-63..

Skalka HW, Prchal JT. Cataracts and riboflavin deficiency. Am J Clin Nutr 1981;34:861-3..

Hernandez BY, McDuffie K, Wilkens LR, et al. Diet and premalignant lesions of the cervix: evidence of a protective role for folate, riboflavin, thiamin, and vitamin B12. Cancer Causes Control 2003;14:859-70.

Sandor PS, Di Clemente L, Coppola G, et al. Efficacy of coenzyme Q10 in migraine prophylaxis: A randomized controlled trial. Neurology 2005;64:713-5.

Boehnke C, Reuter U, Flach U, et al. High-dose riboflavin treatment is efficacious in migraine prophylaxis: an open study in a tertiary care centre. Eur J Neurol 2004;11:475-7.

Maizels M, Blumenfeld A, Burchette R. A combination of riboflavin, magnesium, and feverfew for migraine prophylaxis: a randomized trial. Headache 2004;44:885-90.

Jacques PF, Taylor A, Moeller S, et al. Long-term nutrient intake and 5-year change in nuclear lens opacities. Arch Ophthalmol 2005;123:517-26.

Holland S, Silberstein SD, Freitag F, et al. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 2012;78:1346-53.

Pringsheim T, Davenport W, Mackie G, et al. Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol.Sci 2012;39:S1-59.

Leeson LJ, Weidenheimer JF. Stability of tetracycline and riboflavin. J Pharm Sci. 1969;58(3):355-7.

Fairweather-Tait SJ, Powers HJ, Minski MJ, et al. Riboflavin deficiency and iron absorption in adult Gambian men. Ann Nutr Metab. 1992;36(1):34-40.

Shargel L, Mazel P. Effect of riboflavin deficiency on phenobarbital and 3-methylcholanthrene induction of microsomal drug-metabolizing enzymes of the rat. Biochem Pharmacol. 1973;22(19):2365-73.

Sun-Edelstein, C. and Mauskop, A. Foods and supplements in the management of migraine headaches. Clin J Pain 2009;25(5):446-452.

Kamangar, F., Qiao, Y. L., Yu, B., Sun, X. D., Abnet, C. C., Fan, J. H., Mark, S. D., Zhao, P., Dawsey, S. M., and Taylor, P. R. Lung cancer chemoprevention: a randomized, double-blind trial in Linxian, China. Cancer Epidemiol.Biomarkers Prev. 2006;15(8):1562-1564.

Tepper, S. J. Complementary and alternative treatments for childhood headaches. Curr Pain Headache Rep. 2008;12(5):379-383.

Premkumar, V. G., Yuvaraj, S., Sathish, S., Shanthi, P., and Sachdanandam, P. Anti-angiogenic potential of CoenzymeQ10, riboflavin and niacin in breast cancer patients undergoing tamoxifen therapy. Vascul.Pharmacol. 2008;48(4-6):191-201.

Woolhouse, M. Migraine and tension headache--a complementary and alternative medicine approach. Aust Fam.Physician 2005;34(8):647-651.

Modi, S. and Lowder, D. M. Medications for migraine prophylaxis. Am Fam.Physician 1-1-2006;73(1):72-78.

Stott, D. J., MacIntosh, G., Lowe, G. D., Rumley, A., McMahon, A. D., Langhorne, P., Tait, R. C., O'Reilly, D. S., Spilg, E. G., MacDonald, J. B., MacFarlane, P. W., and Westendorp, R. G. Randomized controlled trial of homocysteine-lowering vitamin treatment in elderly patients with vascular disease. Am.J Clin.Nutr 2005;82(6):1320-1326.

McNulty, H., Pentieva, K., Hoey, L., and Ward, M. Homocysteine, B-vitamins and CVD. Proc.Nutr Soc. 2008;67(2):232-237.

Kabat, G. C., Miller, A. B., Jain, M., and Rohan, T. E. Dietary intake of selected B vitamins in relation to risk of major cancers in women. Br.J.Cancer 9-2-2008;99(5):816-821.

Bates, C. J., Powers, H. J., Lamb, W. H., Gelman, W., and Webb, E. Effect of supplementary vitamins and iron on malaria indices in rural Gambian children. Trans.R.Soc.Trop.Med.Hyg. 1987;81(2):286-291.

Powers, H. J., Bates, C. J., Prentice, A. M., Lamb, W. H., Jepson, M., and Bowman, H. The relative effectiveness of iron and iron with riboflavin in correcting a microcytic anaemia in men and children in rural Gambia. Hum.Nutr.Clin.Nutr. 1983;37(6):413-425.

Charoenlarp, P., Pholpothi, T., Chatpunyaporn, P., and Schelp, F. P. The effect of riboflavin on the hematologic changes in iron supplementation of schoolchildren. Southeast Asian J.Trop.Med.Public Health 1980;11(1):97-103.

Bates, C. J., Evans, P. H., Allison, G., Sonko, B. J., Hoare, S., Goodrich, S., and Aspray, T. Biochemical indices and neuromuscular function tests in rural Gambian schoolchildren given a riboflavin, or multivitamin plus iron, supplement. Br.J.Nutr. 1994;72(4):601-610.

Qu, C. X., Kamangar, F., Fan, J. H., Yu, B., Sun, X. D., Taylor, P. R., Chen, B. E., Abnet, C. C., Qiao, Y. L., Mark, S. D., and Dawsey, S. M. Chemoprevention of primary liver cancer: a randomized, double-blind trial in Linxian, China. J Natl.Cancer Inst. 8-15-2007;99(16):1240-1247.

Blot, W. J., Li, J. Y., Taylor, P. R., Guo, W., Dawsey, S. M., and Li, B. The Linxian trials: mortality rates by vitamin-mineral intervention group. Am J Clin Nutr 1995;62(6 Suppl):1424S-1426S.

Taylor, P. R., Li, B., Dawsey, S. M., Li, J. Y., Yang, C. S., Guo, W., and Blot, W. J. Prevention of esophageal cancer: the nutrition intervention trials in Linxian, China. Linxian Nutrition Intervention Trials Study Group. Cancer Res 4-1-1994;54(7 Suppl):2029s-2031s.

Hustad, S., Ueland, P. M., Vollset, S. E., Zhang, Y., Bjorke-Monsen, A. L., and Schneede, J. Riboflavin as a determinant of plasma total homocysteine: effect modification by the methylenetetrahydrofolate reductase C677T polymorphism. Clin Chem 2000;46(8 Pt 1):1065-1071.

Silberstein, S. D., Goadsby, P. J., and Lipton, R. B. Management of migraine: an algorithmic approach. Neurology 2000;55(9 Suppl 2):S46-S52.

Massiou, H. [Prophylactic treatments of migraine]. Rev.Neurol.(Paris) 2000;156 Suppl 4:4S79-4S86.

Head, K. A. Natural therapies for ocular disorders, part two: cataracts and glaucoma. Altern.Med.Rev. 2001;6(2):141-166.

Sanchez-Castillo, C. P., Lara, J., Romero-Keith, J., Castorena, G., Villa, A. R., Lopez, N., Pedraza, J., Medina, O., Rodriguez, C., Chavez-Peon, Medina F., and James, W. P. Nutrition and cataract in low-income Mexicans: experience in an Eye camp. Arch.Latinoam.Nutr 2001;51(2):113-121.

Lin, P., Chen, Z., Hou, J., Liu, T., and Wang, J. [Chemoprevention of esophageal cancer]. Zhongguo Yi Xue Ke.Xue Yuan Xue Bao 1998;20(6):413-418.

Ding, Z., Gao, F., and Lin, P. [Long-term effect of treating patients with precancerous lesions of the esophagus]. Zhonghua Zhong.Liu Za Zhi 1999;21(4):275-277.

Yoon, H. R., Hahn, S. H., Ahn, Y. M., Jang, S. H., Shin, Y. J., Lee, E. H., Ryu, K. H., Eun, B. L., Rinaldo, P., and Yamaguchi, S. Therapeutic trial in the first three Asian cases of ethylmalonic encephalopathy: response to riboflavin. J Inherit.Metab Dis 2001;24(8):870-873.

McNulty, H., McKinley, M. C., Wilson, B., McPartlin, J., Strain, J. J., Weir, D. G., and Scott, J. M. Impaired functioning of thermolabile methylenetetrahydrofolate reductase is dependent on riboflavin status: implications for riboflavin requirements. Am J Clin Nutr 2002;76(2):436-441.

Hustad, S., McKinley, M. C., McNulty, H., Schneede, J., Strain, J. J., Scott, J. M., and Ueland, P. M. Riboflavin, flavin mononucleotide, and flavin adenine dinucleotide in human plasma and erythrocytes at baseline and after low-dose riboflavin supplementation. Clin Chem 2002;48(9):1571-1577.

Apeland, T., Mansoor, M. A., Pentieva, K., McNulty, H., Seljeflot, I., and Strandjord, R. E. The effect of B-vitamins on hyperhomocysteinemia in patients on antiepileptic drugs. Epilepsy Res 2002;51(3):237-247.

Wollensak, G., Sporl, E., and Seiler, T. [Treatment of keratoconus by collagen cross linking]. Ophthalmologe 2003;100(1):44-49.

Moat, S. J., Ashfield-Watt, P. A., Powers, H. J., Newcombe, R. G., and McDowell, I. F. Effect of riboflavin status on the homocysteine-lowering effect of folate in relation to the MTHFR (C677T) genotype. Clin Chem 2003;49(2):295-302.

Navarro, M. and Wood, R. J. Plasma changes in micronutrients following a multivitamin and mineral supplement in healthy adults. J Am Coll Nutr 2003;22(2):124-132.

Wollensak, G., Spoerl, E., and Seiler, T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol. 2003;135(5):620-627.

Hunt, I. F., Jacob, M., Ostegard, N. J., Masri, G., Clark, V. A., and Coulson, A. H. Effect of nutrition education on the nutritional status of low-income pregnant women of Mexican descent. Am J Clin Nutr 1976;29(6):675-684.

Powers, H. J. Riboflavin (vitamin B-2) and health. Am J Clin Nutr 2003;77(6):1352-1360.

Dyer, A. R., Elliott, P., Stamler, J., Chan, Q., Ueshima, H., and Zhou, B. F. Dietary intake in male and female smokers, ex-smokers, and never smokers: the INTERMAP study. J Hum.Hypertens. 2003;17(9):641-654.

Park, Y. H., de Groot, L. C., and van Staveren, W. A. Dietary intake and anthropometry of Korean elderly people: a literature review. Asia Pac.J Clin Nutr 2003;12(3):234-242.

Bwibo, N. O. and Neumann, C. G. The need for animal source foods by Kenyan children. J Nutr 2003;133(11 Suppl 2):3936S-3940S.

Macdonald, H. M., McGuigan, F. E., Fraser, W. D., New, S. A., Ralston, S. H., and Reid, D. M. Methylenetetrahydrofolate reductase polymorphism interacts with riboflavin intake to influence bone mineral density. Bone 2004;35(4):957-964.

Brosnan, J. T. Homocysteine and cardiovascular disease: interactions between nutrition, genetics and lifestyle. Can.J Appl.Physiol 2004;29(6):773-780.

Strain, J. J., Dowey, L., Ward, M., Pentieva, K., and McNulty, H. B-vitamins, homocysteine metabolism and CVD. Proc.Nutr Soc 2004;63(4):597-603.

Ciliberto, H., Ciliberto, M., Briend, A., Ashorn, P., Bier, D., and Manary, M. Antioxidant supplementation for the prevention of kwashiorkor in Malawian children: randomised, double blind, placebo controlled trial. BMJ 5-14-2005;330(7500):1109.

Sandor, P. S. and Afra, J. Nonpharmacologic treatment of migraine. Curr Pain Headache Rep 2005;9(3):202-205.

Siassi, F. and Ghadirian, P. Riboflavin deficiency and esophageal cancer: a case control-household study in the Caspian Littoral of Iran. Cancer Detect.Prev 2005;29(5):464-469.

McNulty, H., Dowey le, R. C., Strain, J. J., Dunne, A., Ward, M., Molloy, A. M., McAnena, L. B., Hughes, J. P., Hannon-Fletcher, M., and Scott, J. M. Riboflavin lowers homocysteine in individuals homozygous for the MTHFR 677C->T polymorphism. Circulation 1-3-2006;113(1):74-80.

Neugebauer, J., Zanre, Y., and Wacker, J. Riboflavin supplementation and preeclampsia. Int J Gynaecol.Obstet. 2006;93(2):136-137.

Bugiani, M., Lamantea, E., Invernizzi, F., Moroni, I., Bizzi, A., Zeviani, M., and Uziel, G. Effects of riboflavin in children with complex II deficiency. Brain Dev 2006;28(9):576-581.

Caporossi, A., Baiocchi, S., Mazzotta, C., Traversi, C., and Caporossi, T. Parasurgical therapy for keratoconus by riboflavin-ultraviolet type A rays induced cross-linking of corneal collagen: preliminary refractive results in an Italian study. J Cataract Refract.Surg. 2006;32(5):837-845.

Wollensak, G. Crosslinking treatment of progressive keratoconus: new hope. Curr Opin Ophthalmol. 2006;17(4):356-360.

Stracciari, A., D'Alessandro, R., Baldin, E., and Guarino, M. Post-transplant headache: benefit from riboflavin. Eur.Neurol. 2006;56(4):201-203.

Premkumar, V. G., Yuvaraj, S., Vijayasarathy, K., Gangadaran, S. G., and Sachdanandam, P. Effect of coenzyme Q10, riboflavin and niacin on serum CEA and CA 15-3 levels in breast cancer patients undergoing tamoxifen therapy. Biol Pharm Bull. 2007;30(2):367-370.

Singh, A., Moses, F. M., and Deuster, P. A. Vitamin and mineral status in physically active men: effects of a high-potency supplement. Am J Clin Nutr 1992;55(1):1-7.

Gariballa, S. and Ullegaddi, R. Riboflavin status in acute ischaemic stroke. Eur.J Clin Nutr 2007;61(10):1237-1240.

Srihari, G., Eilander, A., Muthayya, S., Kurpad, A. V., and Seshadri, S. Nutritional status of affluent Indian school children: what and how much do we know? Indian Pediatr. 2007;44(3):204-213.

Ito, K., Hiraku, Y., and Kawanishi, S. Photosensitized DNA damage induced by NADH: site specificity and mechanism. Free Radic.Res 2007;41(4):461-468.

Premkumar, V. G., Yuvaraj, S., Vijayasarathy, K., Gangadaran, S. G., and Sachdanandam, P. Serum cytokine levels of interleukin-1beta, -6, -8, tumour necrosis factor-alpha and vascular endothelial growth factor in breast cancer patients treated with tamoxifen and supplemented with co-enzyme Q(10), riboflavin and niacin. Basic Clin Pharmacol Toxicol 2007;100(6):387-391.

Riboflavin deficiency, galactose metabolism and cataract. Nutr Rev. 1976;34(3):77-79.

Koller, T. and Seiler, T. [Therapeutic cross-linking of the cornea using riboflavin/UVA]. Klin Monbl.Augenheilkd. 2007;224(9):700-706.

Fischer Walker, C. L., Baqui, A. H., Ahmed, S., Zaman, K., El, Arifeen S., Begum, N., Yunus, M., Black, R. E., and Caulfield, L. E. Low-dose weekly supplementation of iron and/or zinc does not affect growth among Bangladeshi infants. Eur.J Clin Nutr 2009;63(1):87-92.

Lynch, S. Influence of infection/inflammation, thalassemia and nutritional status on iron absorption. Int J Vitam.Nutr Res 2007;77(3):217-223.

Sporl, E., Raiskup-Wolf, F., and Pillunat, L. E. [Biophysical principles of collagen cross-linking]. Klin Monbl.Augenheilkd. 2008;225(2):131-137.

Premkumar, V. G., Yuvaraj, S., Shanthi, P., and Sachdanandam, P. Co-enzyme Q10, riboflavin and niacin supplementation on alteration of DNA repair enzyme and DNA methylation in breast cancer patients undergoing tamoxifen therapy. Br.J Nutr 2008;100(6):1179-1182.

McNulty, H. and Scott, J. M. Intake and status of folate and related B-vitamins: considerations and challenges in achieving optimal status. Br J Nutr 2008;99 Suppl 3:S48-S54.

Figueiredo, J. C., Levine, A. J., Grau, M. V., Midttun, O., Ueland, P. M., Ahnen, D. J., Barry, E. L., Tsang, S., Munroe, D., Ali, I., Haile, R. W., Sandler, R. S., and Baron, J. A. Vitamins B2, B6, and B12 and risk of new colorectal adenomas in a randomized trial of aspirin use and folic acid supplementation. Cancer Epidemiol Biomarkers Prev 2008;17(8):2136-2145.

Liu, G., Lu, C., Yao, S., Zhao, F., Li, Y., Meng, X., Gao, J., Cai, J., Zhang, L., and Chen, Z. Radiosensitization mechanism of riboflavin in vitro. Sci China C.Life Sci 2002;45(4):344-352.

Ma, A. G., Schouten, E. G., Zhang, F. Z., Kok, F. J., Yang, F., Jiang, D. C., Sun, Y. Y., and Han, X. X. Retinol and riboflavin supplementation decreases the prevalence of anemia in Chinese pregnant women taking iron and folic Acid supplements. J Nutr 2008;138(10):1946-1950.

Evers, S. [Alternatives to beta blockers in preventive migraine treatment]. Nervenarzt 2008;79(10):1135-40, 1142.

Wittig-Silva, C., Whiting, M., Lamoureux, E., Lindsay, R. G., Sullivan, L. J., and Snibson, G. R. A randomized controlled trial of corneal collagen cross-linking in progressive keratoconus: preliminary results. J Refract.Surg. 2008;24(7):S720-S725.

MacLennan, S. C., Wade, F. M., Forrest, K. M., Ratanayake, P. D., Fagan, E., and Antony, J. High-dose riboflavin for migraine prophylaxis in children: a double-blind, randomized, placebo-controlled trial. J Child Neurol. 2008;23(11):1300-1304.

Koller, T., Mrochen, M., and Seiler, T. Complication and failure rates after corneal crosslinking. J Cataract Refract.Surg. 2009;35(8):1358-1362.

Odigwe, C. C., Smedslund, G., Ejemot-Nwadiaro, R. I., Anyanechi, C. C., and Krawinkel, M. B. Supplementary vitamin E, selenium, cysteine and riboflavin for preventing kwashiorkor in preschool children in developing countries. Cochrane.Database.Syst.Rev. 2010;(4):CD008147.

Lin, P., Zhang, J., Rong, Z., Han, R., Xu, S., Gao, R., Ding, Z., Wang, J., Feng, H., and Cao, S. Studies on medicamentous inhibitory therapy for esophageal precancerous lesions--3- and 5-year inhibitory effects of antitumor-B, retinamide and riboflavin. Proc.Chin Acad Med Sci Peking.Union Med Coll 1990;5(3):121-129.

Lin, P. [Medicamentous inhibitory therapy of precancerous lesions of the esophagus--3 and 5 year inhibitory effect of antitumor B, retinamide and riboflavin]. Zhongguo Yi Xue Ke.Xue Yuan Xue Bao 1990;12(4):235-245.

Hoppel, C. L. and Tandler, B. Riboflavin deficiency. Prog.Clin Biol.Res 1990;321:233-248.

Turkki, P. R., Ingerman, L., Schroeder, L. A., Chung, R. S., Chen, M., Russo-McGraw, M. A., and Dearlove, J. Riboflavin intakes and status of morbidly obese females during the first postoperative year following gastroplasty. J Am Coll Nutr 1990;9(6):588-599.

Suboticanec, K., Stavljenic, A., Schalch, W., and Buzina, R. Effects of pyridoxine and riboflavin supplementation on physical fitness in young adolescents. Int J Vitam.Nutr Res. 1990;60(1):81-88.

Desai, I. D., Doell, A. M., Officiati, S. A., Bianco, A. M., Van, Severen Y., Desai, M. I., Jansen, E., and de Oliveira, J. E. Nutritional needs assessment of rural agricultural migrants of southern Brazil: designing, implementing and evaluating a nutrition education program. World Rev.Nutr Diet. 1990;61:64-131.

Hargreaves, M. K., Baquet, C., and Gamshadzahi, A. Diet, nutritional status, and cancer risk in American blacks. Nutr Cancer 1989;12(1):1-28.

Wang, Z. Y. [Chemoprevention in the high incidence area of lung cancer]. Zhonghua Zhong.Liu Za Zhi 1989;11(3):207-210.

Munoz, N., Wahrendorf, J., Bang, L. J., Crespi, M., Thurnham, D. I., Day, N. E., Ji, Z. H., Grassi, A., Yan, L. W., Lin, L. G., and . No effect of riboflavine, retinol, and zinc on prevalence of precancerous lesions of oesophagus. Randomised double-blind intervention study in high-risk population of China. Lancet 7-20-1985;2(8447):111-114.

Zaridze, D. G., Kuvshinov, J. P., Matiakin, E., Polakov, B. I., Boyle, P., and Blettner, M. Chemoprevention of oral and esophageal cancer in Uzbekistan, Union of Soviet Socialist Republics. Natl.Cancer Inst.Monogr 1985;69:259-262.

van der Beek, E. J., van, Dokkum W., Schrijver, J., Wedel, M., Gaillard, A. W., Wesstra, A., van de Weerd, H., and Hermus, R. J. Thiamin, riboflavin, and vitamins B-6 and C: impact of combined restricted intake on functional performance in man. Am J Clin Nutr 1988;48(6):1451-1462.

Lin, P. Z., Zhang, J. S., Cao, S. G., Rong, Z. P., Gao, R. Q., Han, R., and Shu, S. P. [Secondary prevention of esophageal cancer--intervention on precancerous lesions of the esophagus]. Zhonghua Zhong.Liu Za Zhi 1988;10(3):161-166.

Wahrendorf, J., Munoz, N., Lu, J. B., Thurnham, D. I., Crespi, M., and Bosch, F. X. Blood, retinol and zinc riboflavin status in relation to precancerous lesions of the esophagus: findings from a vitamin intervention trial in the People's Republic of China. Cancer Res 4-15-1988;48(8):2280-2283.

Pinto, J. T. and Rivlin, R. S. Drugs that promote renal excretion of riboflavin. Drug Nutr Interact. 1987;5(3):143-151.

Powers, H. J., Bates, C. J., Eccles, M., Brown, H., and George, E. Bicycling performance in Gambian children: effects of supplements of riboflavin or ascorbic acid. Hum.Nutr Clin Nutr 1987;41(1):59-69.

Holmlund, D. and Sjodin, J. G. Treatment of ureteral colic with intravenous indomethacin. J Urol. 1978;120(6):676-677.

Rudolph, N., Parekh, A. J., Hittelman, J., Burdige, J., and Wong, S. L. Postnatal decline in pyridoxal phosphate and riboflavin. Accentuation by phototherapy. Am J Dis Child 1985;139(8):812-815.

Lo, C. S. Riboflavin status of adolescent southern Chinese: riboflavin saturation studies. Hum.Nutr Clin Nutr 1985;39(4):297-301.

Hovi, L., Hekali, R., and Siimes, M. A. Evidence of riboflavin depletion in breast-fed newborns and its further acceleration during treatment of hyperbilirubinemia by phototherapy. Acta Paediatr.Scand. 1979;68(4):567-570.

Bamji, M. S., Sarma, K. V., and Radhaiah, G. Relationship between biochemical and clinical indices of B-vitamin deficiency. A study in rural school boys. Br J Nutr 1979;41(3):431-441.

Bamji, M. S. Vitamin deficiencies in rice-eating populations. Effects of B-vitamin supplements. Experientia Suppl 1983;44:245-263.

Bates, C. J., Flewitt, A., Prentice, A. M., Lamb, W. H., and Whitehead, R. G. Efficacy of a riboflavin supplement given at fortnightly intervals to pregnant and lactating women in rural Gambia. Hum.Nutr Clin Nutr 1983;37(6):427-432.

Cherstvova, L. G. [Biological role of vitamin B2 in iron deficiency anemia]. Gematol.Transfuziol. 1984;29(6):47-50.

Schindel, L. The placebo dilemma. Eur.J Clin Pharmacol 5-31-1978;13(3):231-235.

Benton, D., Haller, J., and Fordy, J. Vitamin supplementation for 1 year improves mood. Neuropsychobiology 1995;32(2):98-105.

Trygg, K., Lund-Larsen, K., Sandstad, B., Hoffman, H. J., Jacobsen, G., and Bakketeig, L. S. Do pregnant smokers eat differently from pregnant non-smokers? Paediatr.Perinat.Epidemiol 1995;9(3):307-319.

van der Beek, E. J., van, Dokkum W., Wedel, M., Schrijver, J., and Van den Berg, H. Thiamin, riboflavin and vitamin B6: impact of restricted intake on physical performance in man. J Am Coll Nutr 1994;13(6):629-640.

Bates, C. J., Prentice, A. M., and Paul, A. A. Seasonal variations in vitamins A, C, riboflavin and folate intakes and status of pregnant and lactating women in a rural Gambian community: some possible implications. Eur.J Clin Nutr 1994;48(9):660-668.

Chen, R. D. [Chemoprevention of cervical cancer--intervention study of cervical precancerous lesions by retinamide II and riboflavin]. Zhonghua Zhong.Liu Za Zhi 1993;15(4):272-274.

Zaridze, D., Evstifeeva, T., and Boyle, P. Chemoprevention of oral leukoplakia and chronic esophagitis in an area of high incidence of oral and esophageal cancer. Ann.Epidemiol 1993;3(3):225-234.

Ajayi, O. A., George, B. O., and Ipadeola, T. Clinical trial of riboflavin in sickle cell disease. East Afr.Med J 1993;70(7):418-421.

Igbedioh, S. O. Undernutrition in Nigeria: dimension, causes and remedies for alleviation in a changing socio-economic environment. Nutr Health 1993;9(1):1-14.

Heseker, H. and Kubler, W. Chronically increased vitamin intake and vitamin status of healthy men. Nutrition 1993;9(1):10-17.

Powers, H. J. Riboflavin-iron interactions with particular emphasis on the gastrointestinal tract. Proc.Nutr Soc 1995;54(2):509-517.

Rosado, J. L., Bourges, H., and Saint-Martin, B. [Vitamin and mineral deficiency in Mexico. A critical review of the state of the art. II. Vitamin deficiency]. Salud Publica Mex. 1995;37(5):452-461.

Zempleni, J., Galloway, J. R., and McCormick, D. B. Pharmacokinetics of orally and intravenously administered riboflavin in healthy humans. Am J Clin Nutr 1996;63(1):54-66.

Williams, P. G. Vitamin retention in cook/chill and cook/hot-hold hospital food-services. J Am Diet.Assoc. 1996;96(5):490-498.

Zempleni, J., Galloway, J. R., and McCormick, D. B. The identification and kinetics of 7 alpha-hydroxyriboflavin (7-hydroxymethylriboflavin) in blood plasma from humans following oral administration of riboflavin supplements. Int J Vitam.Nutr Res 1996;66(2):151-157.

Porcelli, P. J., Adcock, E. W., DelPaggio, D., Swift, L. L., and Greene, H. L. Plasma and urine riboflavin and pyridoxine concentrations in enterally fed very-low-birth-weight neonates. J Pediatr.Gastroenterol.Nutr 1996;23(2):141-146.

Ito, K. and Kawanishi, S. [Photosensitized DNA damage: mechanisms and clinical use]. Nihon Rinsho 1996;54(11):3131-3142.

Wynn, M. and Wynn, A. Can improved diet contribute to the prevention of cataract? Nutr Health 1996;11(2):87-104.

Kodentsova, V. M., Pustograev, N. N., Vrzhesinskaia, O. A., Kharitonchik, L. A., Pereverzeva, O. G., Iakushina, L. M., Trofimenko, L. S., and Spirichev, V. B. [Comparison of metabolism of water-soluble vitamins in healthy children and in children with insulin-dependent diabetes mellitus depending upon the level of vitamins in the diet]. Vopr.Med Khim. 1996;42(2):153-158.

D'Avanzo, B., Ron, E., La, Vecchia C., Francaschi, S., Negri, E., and Zleglar, R. Selected micronutrient intake and thyroid carcinoma risk. Cancer 6-1-1997;79(11):2186-2192.

Spirichev, V. B., Kodentsova, V. M., Isaeva, V. A., Vrzhesinskaia, O. A., Sokol'nikov, A. A., Blazhevvich, N. V., and Beketova, N. A. [Vitamin status of the population from regions suffering from the accident at the Chernobyl power plant, and its correction with multivitamins "Duovit" and "Undevit" and multivitamin premix 730/4 of the firm "Roche"]. Vopr.Pitan. 1997;(3):11-16.

Wadhwa, A., Sabharwal, M., and Sharma, S. Nutritional status of the elderly. Indian J Med Res 1997;106:340-348.

Solomons, N. W. Micronutrients and urban life-style: lessons from Guatemala. Arch.Latinoam.Nutr 1997;47(2 Suppl 1):44-49.

Mattimoe, D. and Newton, W. High-dose riboflavin for migraine prophylaxis. J Fam.Pract. 1998;47(1):11.

Sammon, A. M. and Alderson, D. Diet, reflux and the development of squamous cell carcinoma of the oesophagus in Africa. Br J Surg. 1998;85(7):891-896.

Madigan, S. M., Tracey, F., McNulty, H., Eaton-Evans, J., Coulter, J., McCartney, H., and Strain, J. J. Riboflavin and vitamin B-6 intakes and status and biochemical response to riboflavin supplementation in free-living elderly people. Am J Clin Nutr 1998;68(2):389-395.

Pascale, J. A., Mims, L. C., Greenberg, M. H., Gooden, D. S., and Chronister, E. Riboflaven and bilirubin response during phototherapy. Pediatr.Res 1976;10(10):854-856.

Lakshmi, A. V. Riboflavin metabolism--relevance to human nutrition. Indian J Med Res 1998;108:182-190.

Naghashpour M, Majdinasab N, Shakerinejad G, et al. Riboflavin supplementation to patients with multiple sclerosis does not improve disability status nor is riboflavin supplementation correlated to homocysteine. Int J Vitam Nutr Res. 2013;83(5):281-90.

Gaul C, Diener HC, Danesch U; Migravent Study Group. Improvement of migraine symptoms with a proprietary supplement containing riboflavin, magnesium and Q10: a randomized, placebo-controlled, double-blind, multicenter trial. J Headache and Pain. 2015;16:516.

Wilson CP, Ward M, McNulty H, et al. Riboflavin offers a targeted strategy for managing hypertension in patients with the MTHFR 677TT genotype: a 4-y follow-up. Am J Clin Nutr. 2012;95(3):766-72.

Wilson CP, McNulty H, Ward M, et al. Blood pressure in treated hypertensive individuals with the MTHFR 677TT genotype is responsive to intervention with riboflavin: findings of a targeted randomized trial. Hypertension. 2013;61(6):1302-8.

Dietary reference intakes (DRIs): estimated average requirements. Food and Nutrition Board, Institute of Medicine, National Academics. https://www.nal.usda.gov/sites/default/files/fnic_uploads//recommended_intakes_individuals.pdf Accessed July 24, 2017.