Understanding the Disease Caused by Deficiency of Vitamin B2

According to the National Institutes of Health, riboflavin deficiency, also known as ariboflavinosis, is rare in developed countries but can occur in certain populations, leading to a variety of nonspecific but painful symptoms. Understanding which disease is caused due to deficiency of vitamin B2 is crucial for maintaining overall health and preventing related complications.

Quick Summary

Ariboflavinosis is the medical term for the disease caused by a deficiency of vitamin B2 (riboflavin). It manifests with symptoms such as painful oral and throat lesions, skin rashes, and eye problems. In severe cases, it can lead to anemia and cataracts.

Key Points

• Ariboflavinosis is the deficiency disease: The condition resulting from a lack of vitamin B2 is medically known as ariboflavinosis.

• Symptoms affect mouth, skin, and eyes: Common signs include angular cheilitis (cracks at the corners of the mouth), glossitis (magenta tongue), seborrheic dermatitis, and photophobia (light sensitivity).

• Deficiency can be primary or secondary: It can be caused by a poor diet (primary) or impaired absorption due to other health conditions like alcoholism or celiac disease (secondary).

• Risk factors include diet and health status: Vegans, individuals with chronic illness, and those with a history of alcohol use are at increased risk.

• Treatment is often simple and effective: Mild cases can be managed with dietary changes, while more severe deficiencies may require oral supplements under medical supervision.

• Prevention is key: A diet rich in dairy, lean meats, eggs, fortified cereals, and leafy green vegetables can prevent ariboflavinosis.

• Deficiency can impact other nutrients: Riboflavin is crucial for the metabolism of other B vitamins like B6 and folate, so its deficiency can create wider nutritional imbalances.

What is ariboflavinosis?

Vitamin B2, or riboflavin, is an essential water-soluble vitamin that plays a vital role in energy production and the metabolism of carbohydrates, proteins, and fats. The disease caused by deficiency of vitamin B2 is medically known as ariboflavinosis. This condition is uncommon in regions where fortified foods and dairy are widely consumed, but it can affect specific at-risk groups and those with poor nutritional intake.

Ariboflavinosis does not typically occur in isolation; it often accompanies deficiencies of other B-complex vitamins. Since the body only stores small amounts of riboflavin and continuously excretes it, a consistent dietary intake is necessary to prevent a deficiency.

Signs and symptoms of riboflavin deficiency

The symptoms of ariboflavinosis often begin subtly and may be mistaken for other conditions. They primarily affect the mouth, skin, and eyes.

Oral and throat symptoms:

• Angular cheilitis: Painful, macerated, and fissured lesions or cracks that develop at the corners of the mouth.
• Cheilosis: Swelling, chapping, and fissuring of the lips.
• Stomatitis: Inflammation of the mucous membrane lining the mouth.
• Glossitis: An inflamed, sore tongue that often appears magenta or purplish in color.
• Sore throat: Swelling and pain in the throat.

Skin conditions:

• Seborrheic dermatitis: Red, scaly, and greasy patches of skin that typically appear around the nose, on the ears and eyelids, and in the genital area.
• General skin rashes: Itching and overall skin irritation.

Eye problems:

• Corneal vascularization: The growth of new blood vessels in the cornea, which can cause vision problems.
• Photophobia: Increased sensitivity to light.
• Conjunctivitis: Itchy, red, and watery eyes.
• Cataracts: In severe and prolonged cases, riboflavin deficiency can contribute to the development of cataracts.

Other systemic effects:

• Anemia: A mild, normochromic-normocytic anemia may develop due to impaired iron absorption and metabolism.
• Fatigue and weakness: Reduced energy production can lead to feelings of extreme tiredness.
• Depression: Psychological effects, including depression, have been associated with riboflavin deficiency.

Causes and risk factors

Riboflavin deficiency can be categorized into primary and secondary causes.

• Primary deficiency: This is a result of inadequate dietary intake of riboflavin, often seen in populations with limited access to dairy, meat, and fortified grains.
• Secondary deficiency: This occurs when a person's body cannot properly absorb or utilize riboflavin, even with adequate intake. Common factors include:
  • Chronic alcohol use disorder: Alcohol can impair the absorption and utilization of riboflavin.
  • Malabsorption syndromes: Conditions like celiac disease and other intestinal disorders interfere with nutrient absorption.
  • Liver disease: A malfunctioning liver can prevent the proper metabolism of riboflavin.
  • Dialysis: Patients undergoing hemodialysis or peritoneal dialysis may experience nutrient loss, including riboflavin.
  • Vegan diet: Individuals following a strict vegan diet without proper supplementation are at a higher risk.
  • Certain diseases and medications: Endocrine abnormalities like thyroid insufficiency and long-term use of barbiturates can contribute to deficiency.

Treatment and prevention

The good news is that ariboflavinosis is often easily treatable and preventable with proper nutritional adjustments.

Treatment options:

• Dietary modification: The primary approach is to incorporate more riboflavin-rich foods into the diet. This is often sufficient for mild deficiencies.
• Supplementation: For moderate to severe cases, a healthcare provider may recommend oral riboflavin supplements. Supplements are also used as a preventative measure for at-risk individuals.
• Address underlying causes: If the deficiency is secondary to a medical condition, managing that underlying issue is crucial for long-term recovery.

Prevention strategies:

• Balanced diet: A diet rich in dairy products, lean meats, eggs, fortified cereals, and green vegetables is the best defense against ariboflavinosis.
• Proper food storage: Riboflavin is sensitive to light. Storing riboflavin-rich foods, such as milk, in opaque containers helps preserve its nutritional value.

Comparison of primary vs. secondary riboflavin deficiency

Feature	Primary Riboflavin Deficiency	Secondary Riboflavin Deficiency
Cause	Inadequate intake of riboflavin-rich foods.	Impaired absorption or metabolism of riboflavin due to other medical conditions or treatments.
Associated Factors	Often linked to low consumption of dairy, meat, and fortified cereals in a diet.	Associated with chronic alcohol use, malabsorption syndromes (e.g., celiac disease), liver disorders, and long-term dialysis.
Prevalence	More common in developing countries with poor dietary diversity.	Can occur globally, particularly in individuals with specific health issues or lifestyle factors.
Diagnosis	Clinical diagnosis based on symptoms and dietary history; may include biochemical tests.	Requires evaluation of underlying medical conditions in addition to symptoms.
Treatment Focus	Primarily dietary changes and supplements.	Addressing the underlying medical cause is essential, alongside dietary changes and supplementation.

Ariboflavinosis and other health concerns

Ariboflavinosis can affect the metabolism of other B vitamins, including B6 and folate, as riboflavin is an essential cofactor in their activation. This can lead to a cascade of related nutritional issues. In addition, severe and long-term deficiency has been linked to potential issues like neurological damage and liver degeneration. For pregnant women, inadequate riboflavin levels have been associated with a higher risk of preeclampsia and developmental abnormalities in the fetus.

In rare cases, a genetic disorder known as riboflavin transporter deficiency (formerly Brown-Vialetto-Van Laere syndrome) can cause severe riboflavin deficiency by impairing its absorption and transport. For these individuals, high-dose riboflavin supplementation is a critical, life-saving treatment.

Conclusion

To conclude, the disease caused due to deficiency of vitamin B2 is ariboflavinosis. While often mild and treatable, it can lead to uncomfortable and potentially serious health complications if left unaddressed. Early recognition of symptoms, such as cracks around the mouth, sore throat, or skin rashes, is key. Ensuring an adequate intake of riboflavin through a balanced diet or supplements, especially for those at higher risk, is the most effective strategy for prevention. Always consult a healthcare provider for a proper diagnosis and treatment plan if you suspect a nutritional deficiency.

Recommended reading

• NIH Fact Sheet on Riboflavin: https://ods.od.nih.gov/factsheets/Riboflavin-HealthProfessional/

Frequently Asked Questions

What is the medical name for vitamin B2 deficiency?

The medical name for vitamin B2 deficiency is ariboflavinosis.

What are the first signs of ariboflavinosis?

Early signs often appear around the mouth, including painful cracks at the corners (angular cheilitis), chapped lips (cheilosis), and a sore tongue that may appear magenta.

Which foods are rich in vitamin B2?

Good sources of riboflavin include dairy products (milk, yogurt, cheese), eggs, lean meat, organ meats, fortified cereals, almonds, and leafy green vegetables like spinach and broccoli.

Is vitamin B2 deficiency common?

In countries with widespread food fortification, severe riboflavin deficiency is rare. However, it can still occur in at-risk groups, such as those with chronic alcoholism, malabsorption disorders, or those following a restricted vegan diet without supplementation.

Can vitamin B2 deficiency cause permanent damage?

While the symptoms are often reversible with treatment, severe and prolonged deficiency can lead to more serious, and potentially permanent, health issues like cataracts and neurological damage.

How is ariboflavinosis diagnosed?

Diagnosis is typically based on a patient's symptoms and dietary history. A healthcare provider might also conduct a urine test or measure the activity of the enzyme erythrocyte glutathione reductase to confirm a deficiency.

Is riboflavin supplementation safe?

Riboflavin is a water-soluble vitamin and is generally considered safe. Excess amounts are simply excreted in the urine, leading to a harmless yellow discoloration. However, it's always best to consult a healthcare provider before beginning any supplementation.