• Free riboflavin: This is the basic unmodified, free form. It is found in foods like milk and eggs.
• Flavin mononucleotide (FMN): This phosphorylated form activates other vitamins, such as vitamin B6.
• Flavin adenine dinucleotide (FAD): FAD is the most common form in body tissues and is vital for energy production.

1. Fights Migraine

2. Maintains Healthy Vision

3. Prevents Anemia

4. Protects the Brain and Nerves

5. Reduces Cancer Risk

6. Supports Immunity

7. Helps With Fetal Development

8. Supports Mitochondria and Energy Production

9. Maintains Skin and Hair Health

10. Lowers Blood Pressure

• Age: Older people experience decreased absorption and dietary intake of riboflavin.
• Alcoholism: Alcohol interferes with riboflavin absorption and utilization. It is also a diuretic, which increases the loss of riboflavin as fluid loss increases.
• Chronic diseases affecting nutrient absorption: These include recurrent diarrhea, liver disorders, chronic alcohol use disorder, and malabsorption disorders that impair food absorption.
• Pregnancy and lactation: Pregnant and lactating women have increased riboflavin requirements and may be at higher risk of deficiency, especially in developing countries.
• Veganism and strict vegetarianism: Vegetarians do not consume dairy or meat products and thus could be at an increased risk of riboflavin deficiency.
• Oral contraceptives: Oral contraceptives may interfere with riboflavin metabolism.
• Increased energy needs: Athletes require more riboflavin.
• Genes affecting riboflavin transport or metabolism: Individuals with mutations in riboflavin transporter genes (e.g., SLC52A2 and SLC52A3) may have impaired riboflavin absorption and utilization, leading to deficiency even with adequate dietary intake.
• Certain procedures: For example, hemodialysis and peritoneal dialysis, which filter the blood, can contribute to riboflavin deficiency.

• Oral and throat symptoms (sore throat, chapped lips, sores at corners of the mouth, magenta-colored and swollen tongue)
• Skin issues (rashes, acne, wrinkles, slow wound healing, scaly skin)
• Eye problems (light sensitivity, itchy or watery eyes, pink eye, impaired vision, night blindness, cataracts)
• Neurological symptoms (seizures, decreased or absent reflexes, nervous system degeneration)
• Normochromic normocytic anemia due to impaired iron absorption and utilization
• General symptoms (fatigue due to iron malabsorption, stunted growth in children, migraine, depression)
• Reproductive issues (fetal development issues, birth defects, preeclampsia in pregnant women)
• Impaired metabolism of other B vitamins, as well as altered fat and carbohydrate metabolism
• Digestive issues (inability to digest carbohydrates, fats, and proteins; slowed digestion; diarrhea)
• Hair loss

• Raw lamb liver (3.63 mg)
• Cooked beef liver (3.42 mg)
• Cooked beef kidneys (2.97 mg)

• Whole eggs (1.98 mg) (both egg whites and yolks are high in riboflavin)

• Almonds (1.14 mg)
• Sunflower seeds (0.355 mg)
• Hulled hemp seeds (0.285 mg)

• King mackerel (0.58 mg)
• Anchovies (0.363 mg)
• Tuna (0.306 mg)

• Crude wheat germ (0.499 mg)
• Raw oat bran (0.22 mg)

• Kale (0.347 mg)
• Spinach (0.189 mg)
• Asparagus (0.141 mg)

• Whole-milk plain yogurt (0.243 mg)
• Low-fat cheese (0.234 mg)
• Low-fat milk (0.14 mg)

• Kidney beans (0.219 mg)
• Lentils (0.211 mg)
• Green peas (0.132 mg)

• Yeast extract spread (17.5 mg)
• White mushrooms (0.402 mg)
• Cooked quinoa (0.11 mg)
• Fortified breakfast cereals (check individual labels for riboflavin content)
• Fortified bread products
• Fortified pasta

Recipe: Riboflavin-Rich Meatballs

• 1 pound ground beef
• 0.25 pound (about 4 ounces) beef liver, finely minced or ground
• 2 large eggs
• ½ cup almond flour
• ½ cup freshly grated Parmesan cheese
• 2 cloves garlic, minced
• 2 teaspoons dried oregano
• Salt and pepper to taste
• 2 tablespoons cooking fat (choose: olive oil, avocado oil, butter or ghee from 100 percent grass-fed cows, or coconut oil)

• Traditional method: In a large bowl, combine the ground beef, minced beef liver, eggs, almond flour, Parmesan cheese, garlic, oregano, salt, and pepper. Mix well by hand.
• Food processor method: Place all ingredients in a food processor and pulse until well combined. This will create a smoother, softer texture for the meatballs.

1. Form the mixture into small meatballs about 1 inch in diameter.
2. Heat your chosen cooking fat in a large skillet over medium heat. Cook the meatballs in batches, turning occasionally, until browned on all sides and cooked through (about 8 to 10 minutes per batch).
3. Remove meatballs from the skillet and serve as desired.

• Serve with marinara sauce over spaghetti squash for a low-carb option
• Add to your favorite pasta dish with tomato- or cream-based sauce
• Serve as an appetizer with a side of Greek yogurt-based dip
• Include in a meatball sub sandwich with melted cheese
• Add to a vegetable soup for extra protein and flavor
• Serve over a bed of sautéed vegetables like zucchini noodles or riced cauliflower
• Use as a protein addition to salads
• Pair with a side of roasted vegetables for a simple, nutritious meal
• Serve with a side of tzatziki sauce and Greek salad for a Mediterranean-inspired meal
• Add to a stir-fry with mixed vegetables and serve over brown rice

• Eat a diverse diet: Eating a varied diet with multiple sources of riboflavin ensures you get enough of this vitamin while also providing other essential nutrients that work synergistically with riboflavin.
• Store properly: Riboflavin-rich foods, especially milk and dairy products, are sensitive to light and should be stored away from light to prevent degradation of the vitamin.
• Choose the right cooking method: Riboflavin, being water-soluble, is lost more in cooking water when foods are boiled compared to methods such as steaming or baking.
• Combine with other foods: Riboflavin’s absorption rate is proportional to its intake and increases when consumed with other foods. While most forms of riboflavin are water-soluble, consuming them with a small amount of healthy fat can enhance the absorption of fat-soluble vitamins that often work in concert with riboflavin.
• Avoid alcohol: Drinking alcohol can impair riboflavin absorption.
• Supplement wisely: If using supplements, take them with meals to enhance absorption.
• Address underlying conditions: Certain health conditions, such as lactose intolerance, celiac disease, malignancy, and malabsorption disorders, can impair nutrient absorption. Managing these conditions can help improve riboflavin levels.
• Consider genetic factors: People with genetic variations affecting riboflavin transport or metabolism may require higher intakes or specific forms of the vitamin.
• Maintain a healthy gut: A healthy gut microbiome can contribute to riboflavin production and absorption. Consuming prebiotics and probiotics may be beneficial.
• Consume small amounts: Consuming smaller portions of riboflavin-containing food frequently may also improve overall absorption, as the body usually absorbs 27 milligrams of riboflavin in a single instance.

• Vitamin B1 (thiamine): Thiamine works with riboflavin in energy metabolism.
• Vitamin B3 (niacin): Riboflavin is essential for converting tryptophan to niacin.
• Vitamin B6 (pyridoxine): Riboflavin plays a role in vitamin B6 metabolism.
• Vitamins B9 (folate) and B12 (cobalamin): Both folate and cobalamin collaborate with riboflavin in various metabolic processes.
• Iron: Riboflavin enhances iron absorption, utilization, and mobilization from tissues. Combining iron with riboflavin can be particularly effective in treating certain types of anemia.
• Zinc: Zinc and riboflavin work together in antioxidant processes. Zinc serves as a cofactor for key enzymes essential for the proper functioning of the body’s antioxidant defense system, while riboflavin’s strong antioxidant properties help fight oxidative stress and reperfusion oxidative injury (injury occurring as blood returns after a period of low oxygen). In addition, riboflavin kinase, the enzyme that plays a crucial role in the metabolism of riboflavin, is zinc-dependent.
• Magnesium: FAD synthase, an enzyme requiring magnesium, converts FMN to FAD. Combining magnesium with riboflavin has shown promise in migraine prevention.
• Coenzyme Q10: Coenzyme Q10 (CoQ10) and riboflavin collaborate in the electron transport chain for energy production. Specifically, CoQ10 is a key part of the mitochondrial electron transport chain, situated in the inner mitochondrial membrane. Research indicates that combining CoQ10 with riboflavin may amplify their individual benefits, especially in addressing mitochondrial disorders.

• Tablets or capsules: These are the most common form of riboflavin supplements and are taken orally with water. Tablets of 25 milligrams, 50 milligrams, and 100 milligrams are available.
• Softgels: Softgels are another oral form of riboflavin supplements. They may contain riboflavin along with other nutrients or oils for better absorption.
• Liquid supplements
• Multivitamin or multimineral supplements: Riboflavin is frequently included in multivitamin and multimineral supplements, alongside other B vitamins and essential nutrients.

• Probiotics: Certain probiotic strains can produce riboflavin in the gut, but their output is insufficient to meet dietary needs.
• Intravenous (IV) administration: In severe deficiency or malabsorption cases, riboflavin can be administered intravenously, bypassing the digestive system for direct delivery into the bloodstream.
• Intramuscular injections: Sometimes used in clinical settings to rapidly correct deficiency, intramuscular injections may be preferred when oral administration is not feasible or effective.
• Topical applications: Riboflavin is used in some skin care products for its potential antioxidant benefits.
• Transdermal patches: Transdermal patches are medicated adhesive patches that deliver a specific dose of medication through the skin into the bloodstream over time, providing controlled release. While not commonly used, transdermal patches for riboflavin are available.
• Nasal sprays: Some studies have explored nasal delivery of riboflavin, particularly for migraine prevention.
• Fortified personal care products: Some shampoos and hair care products are fortified with riboflavin, although their efficacy requires further investigation.

• Physical activity: Athletes and those engaging in regular intense exercise may need more riboflavin.
• Stress: Periods of high stress can increase the body’s demand for B vitamins.
• Illness: Certain health conditions can increase riboflavin needs or impair its absorption.
• Smoking: Smokers may have higher riboflavin requirements.
• Certain medications: Some drugs can interfere with riboflavin absorption or increase its excretion.

• Erythrocyte glutathione reductase activity coefficient (EGRAC): EGRAC is considered the gold standard for assessing riboflavin status. It measures the activity of glutathione reductase, an enzyme dependent on FAD. An EGRAC value of 1.2 or less indicates adequate riboflavin status; 1.2 to 1.4 suggests marginal deficiency; and greater than 1.4 indicates riboflavin deficiency. This test is sensitive but requires specialized laboratory equipment.
• Urinary riboflavin excretion: This method measures the amount of riboflavin excreted in urine over 24 hours. Levels below 40 milligrams a day suggest deficiency. This method can reflect recent intake but may not accurately represent long-term status.
• Plasma or serum riboflavin levels: This is the direct measurement of riboflavin in blood. It is less commonly used due to the rapid fluctuations in blood levels after meals, but it can be useful in conjunction with other tests. There is no official reference range.
• Riboflavin loading test: A riboflavin loading test involves giving a dose of riboflavin and measuring urinary excretion. It can help differentiate between dietary deficiency and absorption issues.
• Measurement of FAD in red blood cells: This provides information on long-term riboflavin status and is less affected by recent dietary intake compared to plasma levels.
• Fluorometric assay: Fluorometric assay uses riboflavin’s natural fluorescence to measure levels in various biological samples.
• High-performance liquid chromatography (HPLC): HPLC is a precise method for measuring riboflavin and its coenzyme forms in biological samples.
• Clinical assessment: Clinical signs and symptoms can be used alongside lab tests to assess riboflavin status, providing valuable clues despite not being a direct measurement.
• Genetic testing: When riboflavin transporter deficiency is suspected, genetic tests can identify mutations in relevant genes.

• Bright yellow urine: This is the most common and harmless sign of high riboflavin intake. The gastrointestinal tract absorbs the riboflavin, which then travels through the blood and is filtered by the kidneys into the urine. As riboflavin is a water-soluble vitamin, any excess is excreted through the kidneys, resulting in bright yellow urine.
• Gastrointestinal distress: Very high doses may cause diarrhea, nausea, abdominal pain, or other types of gastrointestinal distress in some individuals. This is more likely with large, single doses rather than cumulative intake over time.
• Increased sensitivity to light: Some individuals may experience increased photosensitivity.
• DNA strand breaks: Excess riboflavin may raise the risk of DNA strand breaks when chromium, a carcinogen, is present.
• Skin reactions: In rare cases, very high doses might cause itching or numbness.
• Numbness or tingling

• Anticholinergic drugs: These medications, used to treat various conditions, including depression and gastrointestinal spasms, may reduce riboflavin absorption. Examples include oxybutynin and ipratropium.
• Antidepressants: Certain antidepressants, particularly tricyclic antidepressants, may reduce riboflavin levels. Examples include amitriptyline and imipramine.
• Antipsychotic medications: Some antipsychotics, especially phenothiazines, lower riboflavin levels in the body. Examples include chlorpromazine and thioridazine.
• Barbiturates: Barbiturates, such as primidone and phenobarbital, are occasionally prescribed for conditions like seizures. They are classified as depressant drugs, which reduce brain and body activity, inducing feelings of calmness or sleepiness. Prolonged use of the anticonvulsant phenobarbital can enhance riboflavin breakdown by liver enzymes, potentially raising the risk of deficiency.
• Probenecid: Probenecid, used to treat gout, may decrease the digestive tract’s absorption of riboflavin while increasing riboflavin excretion, thus potentially leading to lower levels.
• Methotrexate: This drug, used for cancer treatment and autoimmune diseases, may interfere with the body’s use of riboflavin. Thus, riboflavin supplementation might be necessary for some patients on long-term methotrexate therapy.
• Oral contraceptives: Research suggests that oral contraceptives may lower riboflavin levels.
• Doxorubicin: This chemotherapy drug may interact with riboflavin metabolism, potentially depleting riboflavin.
• Penicillin derivatives: Penicillin derivatives may lower riboflavin levels in some individuals.
• Tetracycline: Riboflavin may interfere with the absorption of the antibiotic tetracycline. It’s recommended to separate the intake of riboflavin and tetracycline by several hours.
• Quinolone antibiotics: Similar to tetracyclines, riboflavin may interfere with the absorption of quinolone antibiotics such as ciprofloxacin, gatifloxacin, and ofloxacin. Quinolones may also deplete riboflavin from the body.
• Thiamine: High doses of thiamine may compete with riboflavin for absorption.
• Photosensitizing drugs: Riboflavin can increase light sensitivity. This could potentially enhance the effects of drugs that cause photosensitivity, such as certain antibiotics or acne medications.
• Propantheline: This anticholinergic drug may delay riboflavin absorption but later cause more amounts to be absorbed.
• Phenytoin: Phenytoin, prescribed for managing seizures, can influence riboflavin levels within the body.
• Diuretics (water pills): Thiazide diuretics such as hydrochlorothiazide can increase the loss of riboflavin through urine.