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PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Tip from Tweety PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN RIBOFLAVIN B2 PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Major source of Energy in Living organisms Living organisms including humans derive most of their energy from oxidation-reduction reactions. These are processes which involve the transfer of electrons. Flavin coenzymes participate in redox reactions in numerous metabolic pathways . PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Major source of Energy in Living organisms Flavins are critical for the metabolism of carbohydrates, fats, and proteins. Flavins help in releasing energy from carbohydrates. FAD is part of the electron transport (respiratory) chain, which is central to energy production. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN OTHER FUNCTIONS B-2 is important for body growth and RBCs production In treating anemia, adding Vitamin B-2 to iron supplements, increase its effectiveness. Flavins also participate in the metabolism of some vitamins , minerals, drugs and toxins PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN OTHER FUNCTIONS Riboflavin also helps to shore up the immune system by reinforcing antibody reserves, the body's first line of defense against infection. In addition, the body uses extra riboflavin to keep tissue in good repair and speed healing of wounds, burns and other injuries. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN PROTECTION OF NERVOUS SYSTEM Along with vitamins B-1, B-3 and B-6, riboflavin has a role in treating nervous system conditions such as: Numbness and tingling Alzheimer's disease Epilepsy Multiple sclerosis and Even anxiety, stress and fatigue. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Added Benefits of B-2 Carpal tunnel syndrome patients may benefit when B-2 and B-6 combination therapy is given. Epithelial and mucosal tissues require riboflavin for their maintenance . B-2 is also involved in oxidative degradation of short chain fatty acids. It also has a role in transfer of oxygen from plasma to tissues. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Added Benefits of B-2 Riboflavin is helpful for maintaining the skin, nails, eyes, mouths, lips and tongue. It is required for normal vision and prevention of cataracts. Riboflavin is also thought to decrease the duration and frequency of migraine headaches in some people, When used with beta blockers PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Uses in clinical and therapeutic situations. Phototherapy: The light used to irradiate the infant, breaks down not only the toxin causing the jaundice, but also the naturally occurring riboflavin within the infant's blood. For over 30 years, riboflavin supplements have been used as part of the phototherapy treatment of neonatal jaundice. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN SAFE BLOOD TRANSFUSION Development is underway to use riboflavin to improve the safety of transfused blood by reducing pathogens found in collected blood. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Mechanism Riboflavin attaches itself to the nucleic acids (DNA and RNA) in cells, and when light is applied, the nucleic acids are broken, effectively killing those cells. The technology has been shown to be effective for inactivating pathogens in all three major blood components: (platelets, red blood cells, and plasma). It has been shown to inactivate a broad spectrum of pathogens, including known and emerging viruses, bacteria, and parasites. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Riboflavin deficiency Deficiency can result in: Skin lesions Light sensitivity Eye disorders Inflamed mouth or tongue, and Cracks and sores at the mouth's corner. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Low levels of B-2 Arthritis Colon cancer Heart disease Carpal tunnel syndrome Multiple sclerosis Anxiety, stress and fatigue PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Arthritis PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Carpal Tunnel Syndrome PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Multiple sclerosis Peshawar Medical College PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Glossitis PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Why Called Riboflavin ? It is named riboflavin because of its structural similarity to Ribose (Sugar) and its relationship to the flavins. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Chemical structure of Riboflavin PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Flavin Adenine Dinucleotide PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Food Sources The richest sources of riboflavin include organ meats such as liver, kidney and heart. Milk, yeast, cheese, fish, eggs and dark green leafy vegetables are also rich sources. Flour and cereals are enriched with riboflavin. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Absorption and Metabolism Riboflavin is rapidly absorbed form upper part of small intestine and then phosphorylated in intestinal wall to its active form. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Distribution and excretion Riboflavin is found in all cells of the body but maximum concentration is found in liver and kidneys. With an increase in intake above needs, vitamin is excreted by kidneys. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Recommended Dietary Allowances (RDA) Daily intake of 0.6 mg per 1000 calories for persons of all ages is recommended PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN RECOMMNED DAILY INTAKE Age Males mg/day Females mg/day 0—12 months 0.3-0.4 0.3-0.4 Children 1-3 0.5 0.5 Children 4-8 0.6 0.6 Children 9-13 0.9 0.9 Adolescents 14-18 1.3 1.0 19+ 1.3 1.1 Life stage Infants Adults Pregnancy All ages 1.4 Lactation All ages 1.6 PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Response to Physical state Riboflavin is Heat stable but light sensitive. It is easily destroyed by light, and foods stored in clear containers will lose their riboflavin content in a short period of time. It can leach into cooking water PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Deficiency of vitamin B2 Deficiency of riboflavin is one of the most common deficiency disease A shortage of this vitamin may manifest itself as cracks and sores at the corners of the mouth, eye disorders, inflammation of the mouth/ tongue, and skin lesions. Dermatitis, dizziness, hair loss, insomnia, light sensitivity, poor digestion, retarded growth, and slow mental responses have also been reported. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Riboflavin deficiency Burning feet can also be indicative of a shortage. May also result in dull hair, an oily skin, premature wrinkles on the face and arms, and split nails. Riboflavin deficiency also leads to the malfunctioning of the adrenal glands PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN THOSE WHO ARE AT RISK OF DEVELOPING RIBOFLAVIN DEFICIENCY. Riboflavin deficiency occurs in patient of chronic liver diseases, and those who receive total parenteral nutrition (TPN) with inadequate riboflavin. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Conditions that may increase the need for riboflavin. Alcoholism Infection Intestinal diseases Liver disease Burns Cancer Overactive thyroid Diarrhea (continuing) Serious injury Fever (continuing) Stress (continuing) Surgical removal of stomach Illness (continuing) PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Toxic effects There is no known toxicity to riboflavin. As riboflavin is water soluble, excess if taken, is excreted in the urine. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Toxic effects Possible reactions to very high doses may include itching, numbness, burning or prickling sensations, and sensitivity to light. PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN Educate your patients that Excess riboflavin will be excreted in urine. will impart bright yellow color, to urine. which many people notice when they take vitamin supplement containing B-2. It PESHAWAR MEDICAL COLLEGE NWFP PAKISTAN