Riboflavin (Vitamin B2) Deficiency in Pregnancy

Riboflavin, also known as vitamin B2, is a water-soluble vitamin essential for energy production, cellular function, and the metabolism of fats, proteins, and carbohydrates. It serves as a building block for two important coenzymes, FAD and FMN, which are involved in hundreds of metabolic reactions throughout the body. During pregnancy, the demand for riboflavin increases to support the rapid growth and development of the baby.

Riboflavin deficiency, known medically as ariboflavinosis, occurs when dietary intake is consistently below the body's needs. Because riboflavin is water-soluble, the body cannot store large amounts of it, making regular dietary intake essential. Studies conducted in India have found that riboflavin deficiency is relatively common among pregnant women, particularly in communities where dairy consumption is limited.

The primary cause of riboflavin deficiency in pregnancy is insufficient dietary intake of riboflavin-rich foods. Dairy products such as milk, curd, and paneer are among the best sources, and women who avoid dairy due to lactose intolerance or personal preference may be at higher risk. Diets that are low in eggs, lean meats, and green vegetables can also contribute to inadequate riboflavin levels.

Riboflavin is sensitive to light, and foods stored in transparent containers or exposed to sunlight for extended periods can lose significant amounts of this vitamin. The way food is prepared also matters; boiling vegetables in large amounts of water and discarding the water can lead to substantial riboflavin loss. These cooking practices are common in many Indian households.

Certain medical conditions, including thyroid disorders and chronic stress, can increase the body's requirement for riboflavin. Women carrying multiple babies or those with closely spaced pregnancies may also have higher needs that are not met by a standard diet alone.

One of the earliest signs of riboflavin deficiency is the development of cracks or sores at the corners of the mouth, a condition known as angular cheilitis. A swollen, magenta-colored tongue (glossitis) and inflammation of the lips (cheilosis) are also characteristic symptoms. These oral symptoms can be uncomfortable and may interfere with eating, further worsening nutritional status.

Other symptoms include dry, flaky skin, particularly around the nose and forehead, and eyes that are sensitive to light or feel gritty and irritated. Some women may experience a sore throat that does not seem to be related to infection. Persistent fatigue and a general sense of low energy, beyond what is typical during pregnancy, may also suggest riboflavin deficiency.

For the mother, riboflavin deficiency can impair energy metabolism, leading to increased fatigue and reduced ability to cope with the physical demands of pregnancy. It can also affect iron metabolism, as riboflavin is needed for the proper absorption and utilization of iron. This means that riboflavin deficiency can indirectly contribute to or worsen iron-deficiency anemia, a common concern for pregnant women in India.

Research has suggested that severe riboflavin deficiency during pregnancy may be associated with an increased risk of pre-eclampsia, a serious condition characterized by high blood pressure and protein in the urine. Some studies have also linked low riboflavin levels to a higher risk of certain birth defects, including heart defects, though more research is needed to fully understand this relationship.

Riboflavin also plays a role in the metabolism of other B vitamins, including folate and vitamin B6. A deficiency in riboflavin can therefore have a cascading effect, reducing the effectiveness of these related nutrients and potentially increasing the risk of complications associated with their deficiency.

Dairy products are the richest and most readily available sources of riboflavin in the Indian diet. A glass of milk, a bowl of curd, or a serving of paneer can provide a significant portion of the daily requirement. Women who are lactose intolerant can often tolerate curd and paneer, as the fermentation process reduces the lactose content. Fortified plant milks are another option for those who avoid dairy entirely.

Other good sources include eggs, almonds, mushrooms, and green leafy vegetables such as spinach and amaranth leaves. Whole grains and millets like ragi and jowar also contain modest amounts of riboflavin. Including a variety of these foods in daily meals can help ensure adequate intake throughout pregnancy.

To preserve riboflavin in food, store milk and dairy products away from direct sunlight and avoid overcooking vegetables. Steaming or sauteing vegetables rather than boiling them in excess water helps retain more of this vitamin. Most prenatal multivitamins available in Visakhapatnam include riboflavin, which can serve as a helpful safety net alongside a balanced diet.

If you notice persistent cracks at the corners of your mouth, unusual tongue soreness, or skin changes around your nose and face, mention these symptoms to your obstetrician. While these signs can have multiple causes, they may indicate riboflavin deficiency, especially if your diet is low in dairy and other B2-rich foods. Your doctor can assess your symptoms and may recommend a B-complex supplement.

Women with thyroid conditions, those carrying twins or triplets, or those who have had closely spaced pregnancies should discuss their riboflavin needs with their healthcare provider. At prenatal clinics in Visakhapatnam, including Heamac Healthcare, your doctor can help tailor your diet and supplementation plan to address any B-vitamin gaps and support a healthy pregnancy.