Vitamin B2 (Riboflavin) - IBS Freedom Podcast #203

The Role and Importance of Riboflavin (Vitamin B2) in Health and Nutrition

In this episode of the IBS Freedom Podcast, the hosts discuss riboflavin (Vitamin B2), a crucial nutrient that often turns urine bright yellow when consumed in excess. They delve into the origins of its name, its importance in various bodily functions, including energy production, fatty acid oxidation, and neurotransmitter synthesis. They also explore who might be at risk for riboflavin deficiency, such as individuals with thyroid issues, diabetes, or those under stress. The hosts highlight the connection of riboflavin with other nutrients like calcium, vitamin B6, and folate. Practical dietary sources of riboflavin, predominantly found in animal products like liver, dairy, and beef, are discussed. The episode underscores the importance of a nutrient-dense diet, especially for gut health, overall vitality, and addressing conditions like histamine intolerance and migraines.

00:00 Introduction: The Bright Yellow Pee Mystery
00:13 Riboflavin: The Vitamin Behind the Yellow
02:58 Deficiency Symptoms and Signs
06:36 The Importance of Whole Foods and Nutrition
17:27 Riboflavin's Role in Energy and Metabolism
28:14 Finding a Sustainable Diet Balance
29:52 The Role of Riboflavin in Gut Health
32:46 Riboflavin's Impact on Microbiome and Immunity
37:56 Nutrient Interactions and Riboflavin
50:22 Sources of Riboflavin in Food
51:05 The Importance of Dairy and Animal Products
56:58 Concluding Thoughts on Riboflavin

Love this episode?
Be sure to LIKE it and SUBSCRIBE :)

Nikki's Info:
- Youtube Channel: https://www.youtube.com/c/TriangleHolisticGutHealth
- Instagram: @Gut.Microbiome.Queen
- FODMAP Freedom in 90 Days: https://www.fodmapfreedom.com/enroll
- Private Appts: https://infinityholistichealth.com/

Amy's Info:
- Practice: https://sibodiaries.com/
- Instagram: @Amy_Hollenkamp_RD

Transcript

You know when your pee is bright, bright yellow. That's gonna be the opening line of this episode. Amy, can you believe it? Hello? I love it. Welcome. I wouldn't have the other way. And welcome for shenanigans at the IBS Freedom Podcast. Today we are talking about that vitamin that turns your pea, the brightest yellow you've ever seen in your entire life.

And that is. Riboflavin. Woo rib B two rib vitamin B two. As a side note, and I'm sure the dietician in the room knows this already, but as I was revisiting my textbook for all of you so that I would be freshly reminded of riboflavin and its importance, I forgot that the flavin in riboflavin is derived from like a Latin word, meaning yellow or.

something to that effect. Do you want me to read it? I could read it out loud to you. Yeah. Flavus means yellow in Latin, and so riboflavin actually got its name because of that bright, holy crap. What's wrong with me? Yellow color that you get when you pee it out in excess.

Yes. So anyone that's taken like a prenatal or a multi, or a B complex. B complex, yeah. 

Yeah. It's, you know. You're gonna have an experience with that. Yeah. I would personally take that over the asparagus pee smell. Like of all the pee experiences you could 

have. Right. I think rib, since we're opening with this, uh, asparagus question, so I've heard that like some people don't have the pea smell.

I. I heard a genetic component. Is this true? 

I have heard this. Okay. I, for one, definitely get it. My husband gets it. I get it too. So I'm sure our daughter do. I, 

the, I'm in the privileged, p population. 

Is 

that what we're calling ourselves now? I think so. 

Okay. Well now I'm deeply curious to survey our audience.

Comment below on the YouTube video. Do you get asparagus pea smell, or are you one of the blessed few who can eat asparagus with abandoned and never, be reminded of it a few hours later? 

See, but I like the smell because it reminds me that I ate something healthy. I. 

Okay, well, you've rendered me nearly speechless.

I'd like to think I'm a health conscious person, but I would not take it quite that far. So you have outdone me. You would just say like, 

okay, like, oh, I spell that asparagus. I've, I did something really good for my body and that asparagus earlier, you know? Okay. Okay. You know. I appreciate a good reframe as much as 

the next scale.

Yeah. 

I 

mean, Come on. It's like kind of a fun reminder. 

A fun reminder. You heard it here first folks. Yeah. But let's get back to the real conversation at hand, our riboflavin conversation. First off, easy peasy dietician in the room. Would you say riboflavin is like, soup's important? 

Yeah, you could say that.

Let's just leave it at that. Yep. Soup's important. All right, we're done? Yeah, we're done. 

Sorry. Could continue. I was also going to start by saying maybe a good place to start would be to talk about what happens when you become deficient in riboflavin. Acknowledging like if you're deficient in riboflavin, you're probably deficient in other stuff too.

Yeah. So I don't know if you're gonna have just an isolated deficiency and it's a little bit tough to say, like what the signs of deficiency of this one nutrient look like, but what comes to your mind? 

Yeah, I think a lot sometimes skin stuff you know, you can get. Some skin, sometimes you'll get even like, swollen tongue.

I've seen that before. Have you ever seen anyone with a swollen tongue? 

Yes and no. You know, it's interesting 'cause this is where I wonder if TCM. Like western medicine overlap, and I wonder if there's any correlation here, but I know like in herbal medicine and traditional Chinese medicine, they talk about like a swollen red tug.

From an energetic kind of perspective, but yes, from a nutritional like western medicine perspective, we could definitely think of riboflavin deficiency. So I think I've seen various shades of that, But not like what you would see in a nutrition textbook necessarily. 

Yeah I would say like, I've seen it only a couple times.

It's not something I see super frequently. I think typically, again I've seen more like sometimes cracked or cracks at the corner of the lips, like where the lips meet or like kind of, chapped lips, angular, yeah. Or something or other. I always can't wait, look at my book pronounce that one.

But yeah, like the cracked kind of corners of the lips seems to be a one I've seen Angular, 

stomatitis. 

Yeah. 

And the outside of the lips is the, kelos. We're digging up knowledge from many years ago going through school. I know this is the kind of stuff that would be outta Scantron in school and you to Scantron have to commit it to memory. 

Yeah. So like, those are some of the stuff I think you can see more visibly. from my standpoint, some of the earlier bees too, like they're all involved in metabolism, so it's like sometimes too, like hard to even understand the impact, completely of some of these nutrients just because like they do affect energy metabolism in a lot of different ways.

it could be very broad sweeping. That's why it's just important to get it in, even if you're not having these symptoms, 

they're all important. And like, if you think about, for those of you who have any sort of health background, this is going to elicit some PTSD, but just run with me here.

You know how they draw out the Kreb cycle and it's like one step and then the next and then the next. Yeah. And it's always drawn in a circle and it goes round and it's spitting off A-T-P-A-K-A energy currency the whole way through Will. All of those steps require some sort of nutrient, basically like vitamin B one, B two, B three, B five.

And yeah if you get one single monkey wrench in that wheel, the wheel will not turn. So it's almost a little bit silly to think of nutrition in this context. This is how we learn it in the West. This is like the academic way to talk about nutrition. But in truth, getting back to. Whole foods and you know, laying that foundation with nutritious foods and then having a little bit of quality of life foods for fuzzies.

But you know, making sure that you're getting all of your vitamins and minerals regardless of how much you deem them to be important. Like that's actually where it's at. 

With riboflavin, know, when we're talking about, you know, oh, you could get like swollen tongue or some cha nest in the corner of your lip or chapped lips, or you know, some skin stuff like these could be stuff.

These symptoms could be things more specific to riboflavin, but generally you could just feel like low energy and not super well in a riboflavin deficient, broadly fatigue cog, right? that's the thing that's challenging when you start building up multiple deficiencies.

It's like you're just generally not gonna feel well across the board if you can't make a TP and can't, run your metabolism effectively because you're low on resources. Well, 

and it kind of paints this picture of. The chronically unwell patient, and frankly, the kind of person who would wind up in a functional medicine or a naturopathic office is somebody who feels kind of broadly like crap, but then they go to their doctor and everything looks good and perfect and you're normal.

But if all of your metabolic energy producing machinery is running. At 50% or your immune system is crapping out on you, you're gonna feel broadly crappy, but maybe you don't have an overt pathology or an overt infection that Western medicine is gonna recognize. So it really makes you think of people who present with numerous nutritional deficiencies and they just broadly feel like crap.

But there's nothing super egregious on their blood work. Right. And, you know, it's like how much of that could be fixed with nutrition? 

Yeah. And I will say the blood work too, the ranges are so broad. I'm sure you see this all the time where you're talking to someone and you're actually going like a little bit more line by line of like, Ooh, is this in the optimal range?

'cause how often, I mean, I was just talking to a guy earlier today. A patient and you know, his blood glucose is consistently fasted between like 95 and a hundred. And I'm like, oh, your doctor wouldn't say anything about that. Typically they'd just be like, oh, whatever. You're good. But that's definitely not optimal.

And it's sort of, he has some, a lot of signs of having like. Probably some stress chemistry driving up that, glucose a little bit. So it kind of confirms what we're suspecting that there's like some sort of stress chemistry component of this, person's case. But it's just a good example of, ooh, like this is a really broad range a lot of the times the blood work can be deceptive 'cause it's like.

Ooh, this is a huge broad range. You're falling kind of towards this end or that end, and that still might be something to pay attention to, but you're right, it's not gonna be this egregious you know, your blood sugar is 150 fasted. We need to like, do something right now. It's typically not like that from the nutritional side.

The subtleties are often missed. Right. And the things that. Have more than one variable mixed in with them. Often get mixed. Again, like if you have a single tumor that's gonna get identified, right. If you have a single infection, that's gonna get identified reasonably well. But if it's, again, like you have.

10 kind of subclinical nutrient insufficiencies and two nutrient deficiencies. And you're also a bit stressed and your sleep kind of sucks. And you know, it's like the more of these things pile up that could make a person feel like bonafide crap, but it's not gonna be caught typically. 'cause it's not.

It's not just like a one and done. Right. You know, I think that there are plenty of people who are probably undershooting riboflavin. And actually the reason I had my husband deliver my nut Vore book is so I could cite this. One of the charts that she gives towards the beginning of the book is a reference to a study where they talk about the prevalence of nutritional deficiencies and.

Riboflavin, it doesn't sound as impressive as like potassium clocking in at 97.8% of the population eating less than they should. Look forward to the potassium episode people, but about 9.6%. In 2011, 9.6% of the US population was undershooting riboflavin. And keep in mind, that's the broad population.

It's probably worse in a subset of the population that doesn't feel good, right? So it would be interesting to look at this in like, people with IBS or people with tummy problems. But yeah, I mean, I think that this is an important nutrient and it touches a lot of systems that are very important to our readers or our listeners rather.

And so I'm excited to take a little bit more of a dive into it. can I start us off with something that I found a little bit? On the juicy side, by the way. Yeah, for sure. Okay, so I busted out one of my nutrition textbooks and brushed it up on the riboflavin section. And I had to chuckle this because this book is not particularly integrative.

It's just like a decent nutrition textbook, but I don't think it was written by like integrative medicine people. it's Gropper or Gropper, you know, 

I believe that is the book that we had for my micronutrient class in college. Okay. So for my RD school. Yeah. So it's right.

Don't think I have it anymore, but yeah, I don't think I bought it. I was like, notoriously for not buying textbooks. I think it's 'cause they were so exp like they were fairly expensive and I'm just like, shit, I'm not gonna buy it. it was like me putting my foot down, but I could find it online.

Like I had it online somehow, so I just read it. Online, but I am like 95% sure that's the book that we used. Yeah. 

It's a good book. Yeah. I am old school and I personally like to highlight, so for topics that I'm gonna reference back potentially, like, I like to have a hard copy of something. Yeah.

But anyway, this was funny because again, this is not coming from the integrative medicine world, the naturopathic world. This is again, like a pretty right standard nutrition textbook that they use in dietetic school, even apparently, and they said. The riboflavin founded foods is attached to proteins and must be digested or freed from the protein prior to absorption.

This process is accomplished by the action of hydrochloric acids secreted in the stomach and by gastric and intestinal enzyme hydrolysis of the protein. Yet another reason why stomach acid matters, and I'm gonna, I'm gonna make this really like, is meta the right word? Like inception. I don't know what I'm doing yet.

Oh gosh. Okay. So you need stomach acid to properly absorb and break down riboflavin, right? Well, remember the episode we did with Thomas Ley, where we were talking about, I know where you're going. Baking stomach acid is a very A TP. Intensive process and you need your energy production to be like top notch and your mitochondrial health to be top notch.

To shove hydrogen od into the stomach and actually make stomach acid. If your energy metabolism sucks because you're not getting enough riboflavin, it's gonna be hard to make stomach acid. And now we have this nice little catch 22 loopy lu going Yes. Where it's almost like, which came first, the chicken or the egg?

So yeah. Very important for digestion, even starting right at the top of the chain with the stomach. 

Yeah, no, totally. I think that's a really fun inception moment. Take it full circle. And I feel like that there's so many cases like that in the body and with nutrition and it's like, oh, so many systems kind of start to break down and then those.

The systems that you need to actually break down the food and then it just becomes this whole runaway train, so to speak to. And I think it really does. you might need some support stomach acid wise to help get the riboflavin and digest food properly for at least a period of time, maybe to help kind of get things back on track.

But yeah, I love that. And. Props to the old school rd textbook for that little tidbit. That's 

right. 

Maybe I should have bought the hard copy, so now I'd have it now to refer to, 

I'm sure you can find one on eBay or something. Yeah. You know, there's bound to be somebody getting rid of one.

The things that would annoy me is like, they would make one change and then the old book would be like, 20 bucks. I did this a lot in college Right. By like the old book that was $20 and would have like. You know, one less chapter or something in it than the old. Than the new book, but they always played games with the textbook companies.

Oh, it was a cash grab for sure. It was a racket. How old? But yeah, it was a racket for, what was our, the saying last week? Uh oh. The brass tacks. Brass tacks that you didn't know. 

I'm not even joking, guys. I have never heard this saying in my entire life. Not even once. And then Amy busted out and then, what was it like three or four days later, my husband says it and I'm texting Amy and I'm like, you're never gonna believe this.

You guys are in cahoots. Clearly. can't believe it. Yes. We're just, we're learning so much here on the podcast. can I take it back to riboflavin though? 

Yes. I was about to take it back to riboflavin as well. Oh, 

good. Going back to the idea of.

You need this vitamin and a lot of B vitamins in general to make A-T-P-A-K-A energy. You could think about it from the perspective of every single cell and every single tissue in the body needs energy to do its stuff. Mm-hmm. But you could especially think of. Kind of like energy hogs of the body and the nervous system is right at the tip top of that list, right?

Your nervous system uses up, I forget what it is. It's like 20% of the oxygen in your entire body. This little, you know, two pounds of jello that you have in your head uses up like 20% of your oxygen and probably a similar amount of your a TP and. Neurologic function is very energy intensive.

And that, again, we talk about people having brain fog and fatigue, and they're demonizing histamine and they're demonizing candida, and they're saying that the SIBO is giving a brain fog, and it's like, but is it? Or is it just that you're not making energy and therefore this energy hog of an organ is not able to do its job?

But then it also makes me think of. Vagal tone. Yeah. And how the gut brain axis tells the gut what to do. The gut brainin axis tells your gut to do the motility migrating motor complex stuff. Right. It tells your gut to make stomach acid at enzymes and bile, and it's like if your nervous system doesn't have enough a TP, all hats are off.

Yeah. No, totally. I think that I like how you brought up how the blame game that happens with our patients where it's, ooh, I'm blaming the sexy topic for this issue. And I think it's really important to go back to the fundamentals and make sure you are getting enough nutrition, whether that's rib, not just riboflavin, but everything.

Because again, like if your brain gut access doesn't have the resources. It needs to function optimally, like good luck, right? We can't rule that out as a factor in something like brain fog or gut function. And I think that's like why? Simplifying stuff is so helpful because I think when you're all out in the like, oh, it could be his me, it could be that.

Like there's so many things it could be, but if you don't rule out, which again, most of the time people do start feeling better, It more often than not isn't just this like crazy out of control histamine situation. It's deeper than that. It's that your body doesn't have the resources it needs.

Or maybe again, there's stress chemistry driving up a histamine. I think again, like in the rare case, there could be a genetic predisposition to higher histamine, but like, you know, you have to really look at the fundamentals before going down to these sexy topics or else you could kind of. lose sight of these really key things that are important to fuel the gut brain access.

And I'll take this to a different angle if I may. 'cause maybe this will be more convincing. I think no matter how many times we say it on this podcast and on our respective channels there's always gonna be people who are resistant to the idea. That something as unglamorous as. A nutrient could help them, right?

And they're gonna be completely convinced that they have candida or the histamine thing. Here's the thing though. The treatment of the sexy thing might hinge on the unsexy thing more than you realize. And by might, I mean it totally does. So for example let's just take histamine intolerance.

Well, you need riboflavin. To Methylate, first of all, and methylation just broadly is important for histamine clearance. But also you need riboflavin to make the enzyme Dao diamine oxidase, which is one of your enzymes that clears fricking histamine from the body. Yeah. So if you wanna treat histamine intolerance, you need the fricking nutrients to do it, and you need other, you know, copper and I forget what else.

Yeah. For Dow function, but yeah. These topics will come back to haunt you even if you do choose to focus on the sexy stuff. Right? And that's part of why we harp on this so much and we really preach. I. Efficiency in the treatment plan. Like maybe you don't need the expensive $80 a bottle DAO supplements.

Maybe you just need fricking riboflavin and then you're gonna make your own dao. Wouldn't it be nice if you could save $80 a bottle on a DAO supplement and treat things more efficiently and more holistically? That's appealing to me at least. Yeah, and I'll, and have more 

energy. All of these things have all these other, yeah, but I think the hard part of the cell is that.

You're not gonna get necessarily like quick feedback with all this stuff. If you start adding riboflavin into your diet or something, 'cause it's low your intake's low, you're not necessarily going to eat riboflavin one time and be like, I have all the energy. My gut brain access is perfect. And that's the hard cell and everybody when they're establishing habits has that, valley of disappointment where they've started a habit and they're like a week or two in and saying like, oh, well, nothing's happening yet. And that's the hard part with some of these nutritional related strategies is that you oftentimes don't get that feedback. well, it's not instant, right?

You don't get that instant feed feedback and acute feedback to say like, oh, this is definitely helping. And I think there's a lot of things that you don't get that feedback that are still gonna be really valuable. Uh, but that's adaptogens Yes. Is a good 

example of that. You know, you're not gonna, you're not gonna totally normalize all of your stress chemistry and your relationship with your spouse and your relationship with stress and your trauma and your bag of bullshit overnight just because you took two pills of ashwagandha.

Right. If only it were that easy, right? But if you give a tool like that time, it can help you. it can help you have a better relationship with your stress, so to speak. And your stress chemistry. But Yeah, it, you know, I think also I was trying to find the reference here in the book, but I don't, I didn't highlight it, so I'm having a hard time finding it, but, oh no.

So it says that it is estimated that the body stores enough riboflavin to meet the body's needs for about two to six weeks. So, yeah, this is a water soluble. Vitamin, it's not stored nearly to the degree that a fat soluble vitamin would be. So things like vitamin D, vitamin A, you could store those. But with riboflavin, if you slack off on your intake for.

Two to six weeks, somewhere in that range. Like you're gonna burn through anything that you had stored up. And that's where you can start getting deficiency. But it also kind of paints this image of it might take that long to fully replete your storage again and get all of these enzymes working. and it might even take a supplement for a short period of time just to give you a boost.

So that you have time to either learn the foods that have riboflavin and introduce them to your diet or maybe work on your ability to tolerate those foods and then introduce them into your diet. And those things can take time, right? Like if you've been avoiding riboflavin rich foods like dairy, because your gut is a mess.

It can take a little bit of time and like boosting stomach acid and working on motility and working on your microbiome to build up tolerance so that you could even get those foods back in. So a supplement could be a reasonable bridge to get you there just for the sake of correcting a deficiency.

But I don't think that's, I don't think that's the end goal. Would you agree with me? Oh, dietician of mine? 

Yeah, for sure. For sure. I think. You know, the goal is that you make a diet and lifestyle change that creates sustained, Sustained relief from the symptoms. And that again, helps you thrive in general.

It's not just necessarily about reducing symptoms. I think you're gonna feel, better and can do more things and have more energy, once you, achieve optimal nutrition. But yeah, I think, the more I work in the gut health space, the more I view it as like a practice. you have to keep getting better at different little habits.

And it's not like you achieve, you know, this destination of like IBS freedoms a destination. Like I'm doing all these things and once I get there, I'm gonna stop all the things I'm doing. It's like, no, it is sort of like you have to build a diet and lifestyle for optimal. health. 

Well, it kind of, it reminds me of people who sometimes will say, I want my life back.

Right? It's 

like that is perfectly reasonable, right? I'm not knocking it. But you do have to have like a little asterisk next to that statement in your mind, right? And you need to acknowledge that. the goal needs to be a slightly different and healthier version of getting your life back.

add to, this is gonna come off horribly insensitive, but it is what it is. It's the best analogy that I think people will understand. It's like if you are obese and that you work out really hard. Because you want to achieve this thing skinness, and then once you get to skinny, you get your old life back and you go back to eating garbage and not moving your body and having higher cortisol levels and not sleeping.

Do you know? Drinking alcohol, whatever it was that made you overweight in the first place. If you get to your goal weight and then you immediately start pounding the Doritos and the wine again. Side note, that sounds like a nauseating combination. Can we think of something better? Cheesecake and white.

That sounds so much better. But you know, like if you immediately revert back to your old life, that's where we get into yo-yo dieting and people putting the weight back on. But if you can have the goal of. yeah, you could get off of the strict diet. You don't need to do keto forever and ever, or you don't need to do, you know, the intense diet that you used for weight loss for the rest of your life, but maybe like.

Some halfway in between, right, where you're focusing on nutritional density, you're being mindful of portion sizes, but not like over the top anal. You're having SubT treat foods, but not nearly as many as you used to before. You're working out, maybe not as intensely as you were during the weight loss phase.

You know, it's like. Finding some happy, healthy middle that feels sustainable and realistic for you, but also is healthier than your formative life. Right? And I feel like that sometimes will come up in the gut space. Like people want their life back, but it's like, ooh, but it was your life that put you here in the first place.

Right? So some of that's gotta change, man. Yeah. 

Yeah, I think it's like the, there's maybe a therapeutic period where you might need extra TLC, and then it's like, okay, once you move through that period of time, then you need to find whatever the maintenance level of good enough that you need to do to sort of maintain.

But yeah, I think it's still a practice over time. Yeah. I think like you can't just. have symptoms get better and then be like, well, I'm not gonna sleep anymore. I'm good now. Like, you know, I can go back to my old ways. But it's important to kind of make those changes. I have something else riboflavin wise, like when I was doing some of my book research that I found really interesting.

One thing, like with riboflavin. Is, it's really important for glutathione recycling. So almost like an indirect antioxidant in the gut. I was gonna say in the butt, in the gut. Maybe the butt too. There go. But yeah, don't discriminate. The, there could be any accidents on the butt.

Who knows why not? But yeah, it's, it tends to, like, in some of the research, have this very indirect antioxidant effect on the gut because of its role in glutathione recycling. So it does really seem to help reduce oxygen in the gut, which is what you want. You don't want tons of oxygen in the gut.

It can kind of some inflammation in different things. So it helps reduce oxygen in the gut and creates a much better environment for your good microbes and sort of helps to crowd out microbes you don't want in excess. So in some of the studies with. Riboflavin, especially when they've done like more intensive supplementation for two week chunks of time.

It does seem to increase vial bacterium, Prezi, which is a super important butyrate producer. And it seems to sustain. So they'll do two weeks of supplementation. I forget when the check-in point was. But when they checked in again, oh, there was sustained even after the supplementation ended, increases in fecal bacteria and pregnancy.

It also increases roseburia and it seems to reduce e coli which e coli tends to be kind of more linked to IBS related conditions and be a little bit more inflammatory in excess. 

And that's one of the microbes that Pimentel and his team are implicating in the overgrowth in sibo, correct? Right.

Like when they suck out the juice of the SIBO gut, they're seeing e coli and Klebsiella. So pretty rad if you could suppress that with a humble vitamin. Yeah, with a very excellent safety profile and it's reasonably cheap and easy to get through food. 

Yeah. And I, there's other nutrients too we can talk about that have like this similar effect where they almost reduce oxygen in the gut because they're antioxidants.

I believe vitamin Cs like that's kind of where they see the benefit. When they've done supplementation studies with vitamin C is like, oh, there's this big antioxidant. Effect where it reduces oxygenation in the gut and that environmental shift causes this shift in microbes. So yeah, it's super fascinating.

Or at least in part that's what it's doing. 

Yeah. Well, if I can add another layer onto the microbiome specific conversation too. There was a study that, I've referenced in some of my FODMAP freedom slides, and I'll pull up part of it right now and it says. In addition to energy generation, vitamin B two is associated with reactive oxygen species, generation in immune cells.

Reactive oxygen species are important, effector and signaling molecules in inflammation and immunity. So basically we hear reactive oxygen species and we think, oh, that's a bad thing. That's inflammation, but. That's how your immune system works. that's why we have the ability to create something like inflammation is largely because it's your immune cells using inflammation as a weapon to go after bacteria and yeast and viruses, and.

You need riboflavin to make those reactive oxygen species and make that inflammation that is necessary for engulfing and breaking down and killing pathogens. So if you want healthy immune function in the gut or elsewhere, riboflavin is pretty important and that they actually went on to say too all bacteria, including those that are unable to synthesize vitamin B two themselves require.

The Flavoprotein, FAD and FMN for their growth and survival. So every single microbe in the gut needs riboflavin just as much as you do. But if you think about it, what is a recurring theme with dysbiosis and like antibiotic use? The good bacteria are the wissy ones. Yeah. And they get killed off pretty easily.

They're delicate little flowers. And then the bad ones tend to be the ones that. Are a bit scrappier and they survive better. And maybe they can make do with a little bit less riboflavin, but poor little delicate fal bacteria presi is like, oh, I can't survive in this ecosystem no more. And it just perishes.

So I wonder if replenishing a nutrient like riboflavin could be selectively prebiotic for good bacteria. Yeah, even though I just said all bacteria need riboflavin and maybe that's just me being a little bit crunchy, biased and naive to hope that, but It stands to reason. 

And I definitely think, uh, especially in someone that's low in riboflavin, just again, not even specific to how it manipulates the environment or the need by the.

By the microbes. It's like, oh, every cell in the body back to what we were talking about before, needs riboflavin. So there could be all these other mechanisms that we can't even really put together. Of why riboflavin is gonna be helpful to manipulate the microbiome. Even the HCL like you were talking about before, like if you have plenty of HCL, that's gonna create a better environment, and better absorption of riboflavin.

Like all these things it's, so, that's why it's so hard to tabulate the importance, but like the more you think about it, the more important it becomes. 

I kind of feel like, you know, the meme or the gif with what is it? Is it Charlie from, it's always Sunny in Philadelphia. Oh, yeah. And he looks like a bonafide, crazy person.

Yeah. And he has like the board with all of the red strings that he's, yeah. Like I feel like that's almost what we feel like in these episodes, right? Where we're like, it's all connected guys. Like, and it's all important. It's all this big thing. and again, like we are approaching these episodes in a very classically academic way, which.

This is gonna jive with some people, but not other people. I acknowledge that. But really the end goal for nutrition, I think should be to take a more like cere Ballad Ravo approach, or even like a Michael Pollen esque kind of approach of eat food. Not too much. Mostly plants try to get, 80, 90% of your calories from.

Healthy stuff, like minimally processed whole foods and then have some quality of life foods just because you like, we live in a world that where Oreos exist and life is short and weird and you might as well have a little bit of a treat here and there. But you know, it's funny 'cause I think this is almost the antithesis of what Michael Pollen preaches, for example.

And I think that his. His viewpoint on nutrition is much more practical. But we have to convince people to give a crap about nutrition and get off of their restricted diets and give them the motivation and the dopamine to do it. And that's where this like nerdy academic series comes in. So. Right. Can I share something else about riboflavin?

Yes, please. I don't know why I was surprised. 'cause I think instinctively I knew this on some level, but Riboflavin has a lot of connections with other nutrients. 

Yes, for sure. In particular, 

like more direct connections than you might realize.

Even. So again, ed, I'm not talking about indirect connections like, oh. Riboflavin deficiency might decrease a TP and that might decrease your stomach acid. And then you're not gonna absorb much of anything Well, without stuffing, like that's an indirect link. But I'm talking there are direct links like in research and in textbooks with other nutrients that I found very interesting.

So, for example the book pointed out that some riboflavin carriers in some tissues, such as the liver, appear to be regulated by calcium. Hubble Calcium, the flavoprotein are involved in vitamin B six metabolism and the enzyme that makes the active form of B six. Yeah. A P five P is dependent on a riboflavin based flavoprotein.

So that's kind of important. 

That kind of brings up the histamine situation too, like, yeah. You're gonna be in a rough place if you're riboflavin deficient and you don't have B two onboard or B six. 

Well, and I actually have a PubMed study pulled up too to mention. I know that we largely focus on IBS SIBO in our podcast.

However, there's PubMed, ID 3 2 7 6 1 8 7 8. Has shown that about 30% of patients with inflammatory bowel disease show evidence of vitamin B six deficiency. 

Oh, interesting. 

I get like, this is overt deficiency. Yeah. This is not like, eh, you're on the low end of normal. This is like, Ooh, you don't have any.

Yeah. So, it stands to reason that B six could be deficient in a fair number of people with IBS too. 

Yeah. Well, and I think too, like, IBS again there, there's oftentimes a little bit more histamine released at the gut, in the gut at least. Typically, and it's like you wonder if the B six connection could be in part histamine related.

Might not be the whole story. You know, B six is needed to make serotonin, which affects motility and all this other stuff. So 

you need riboflavin to make dopamine too. Yeah. So now we have two neurotransmitters that are directly implicated with this vitamin. Yeah. Here's another handful though, just to kind of rapid fire, go through 'em and then we could chew on them together.

In. Fatty acid beta oxidation acetyl co. A dehydrogenases require FAD 

So all of the people on the high fat diets that are ch literally chugging olive oil and chugging, you know, MCT oil, well hopefully your fatty acid oxidation is running smoothly. Oh, this one's huge. I have to do a shout out for Chris, master John on this.

However, Chris Master John has a delightfully clickbaity named video on YouTube titled your M-T-H-F-R is just a rival flavored deficiency and it cracks my ass up, but he's right. If you want your M-T-H-F-R gene to work better because you have one of the dreaded SNPs. That is a riboflavin dependent enzyme.

Mm-hmm. And there's some evidence that he talks about in that video that simply supplementing with riboflavin or getting adequate dietary riboflavin is enough to keep the enzyme working perfectly fine, even in people with the snip. So you don't need your methylfolate, you don't need your fancy schmancy, you know, Ben Lynch products just.

For God's sake, get enough rib fla in people. Yeah. And I say that as a double carrier of M-D-H-F-R snips. I'm a compound heterozygous carrier myself. So you mean you're not doomed? I'm not doomed. I'm choosing to believe that I'm not doomed. Right. Because I smart about my nutrition, uh, continuing, however, so the full weight thing.

In choline, catabolism, several enzymes such as choline, dehydrogenase require FAD. Choline is needed for brain health. For methylation to make acetylcholine, which is the neurotransmitter of the vagus nerve. Choline is pretty important. Make bile for stuff. Bile. Yeah. Bile. Thank you. Huge. Yeah. Sub neurotransmitters such as dopamine and other amines, like tyro mean and histamine require FAD dependent.

MAO for metabolism. They bring up the glutathione thing and then they also bring up that arol and sulf hydro oxidase are FAD dependent and help for diss sulfide bonds involved in the structure or folding of selected secretory proteins. So makes me start thinking about mucus and how important the mucus barrier is for preventing leaky gut and protecting you from microbes at.

All of your mucosal surfaces, but certainly the gut. So this is a big deal. The next point that I had highlighted that I wanna make is who might be, especially at risk for deficiency, but do you have anything that you wanna say at this point or should we kind of pivot over to that?

We need to make sure it's not a two hour episode, riboflavin. And I do feel like that would be a little excessive. 

Let's pivot. yeah, let's pivot. Okay. I'm totally pro that. 

Okay. Excellent. So, as. Hopefully should be intuitive by this point. People who don't eat enough riboflavin are at risk for deficiency.

That should be a no brainer at this point. If you don't put it in your mouth, it, you're not gonna have it in your body. That's, yeah. Yeah. Shy of you go to Hogwarts and learning sub magic spell. But they have another point here. So, excess alcohol intake is gonna be a risk of numerous b vitamin deficiencies, not just riboflavin.

But also they make a point, and I th this was actually new news to me to review this. They said, because riboflavin metabolism is altered with thyroid disease and riboflavin excretion is enhanced with diabetes mellitus, trauma and stress. People with these conditions are at risk for deficiency. they also mentioned that tricyclic antidepressants.

Inhibit riboflavin, absorption. 

Interesting. So those are not uncommon things, right? Like how many people with hypothyroidism, how many people with diabetes, or if not overt diabetes, insulin resistance, trauma, and stress. I find it very interesting that they mentioned those both here too. And then tricyclic antidepressants.

Those are not terribly uncommon. Prescriptions. So it makes you really wonder. And then I'll mention too, I don't think this is a risk of deficiency per se, but just maybe another indicator light. There's sub research that high dose riboflavin supplements. I'm talking like. 400 milligrams, something bonkers.

Yeah, 

that's pretty high. Can 

help with migraine. And I have worked with people who either have migraine or I've worked with several people where they have like this squirrely stuff that's really severe GI wise and nobody could quite diagnose it. And it strikes me as abdominal migraine esque or like abdominal migraine adjacent.

And I have used. Higher dose riboflavin supplements in that group of people with a great deal of success. 

So cool. I think if you are a migraine sufferer, that's another consideration that riboflavin might be worth looking at specifically. At possibly at much higher doses way above and beyond what you would get through food.

that's a potential consideration that I find interesting. 

if you're not getting enough to eat, you have a higher propensity for riboflavin deficiency. So like, if you're undereating, I would say that's generally who I would typically see with a riboflavin deficiency.

Or if your diet's very restrictive which again is not uncommon in our patient population. So that's probably gonna be the. Biggest risk factor that I see clinically. So just make sure you're getting enough to eat and that you're building some variety back in. It's probably the, well, your best bet.

If you think of like nutrients per calorie and you think, Ooh, if you're just not eating a lot of calories, you know, if you have somebody who's on. 1500, or heaven forbid, 1200 calories a day. It, you basically just have to eat nothing but liver and spinach at that point to get everything you need.

Like everything has to be so ridiculously nutrient dense. 

Right. With 

that kind of calorie count versus like, I remember we talked about this when you were, breastfeeding Cece as you were pumping the calories like a crazy person. And eating like 3000 calories a day. And I remember you even remarked, wow, it's way easier to get all of my vitamins and minerals when I have this huge Kind of number of calories to work with. it's easier to paint the painting and make it beautiful if you have a lot of paint to work with. 

Right. I don't 

know if that works as well as I hoped it would, but we're gonna run with it anyway. just. Getting adequate calories should still be the number one goal.

I will say too, and I think I shared this in the last episode maybe, but I had a little bit of a come to Jesus moment with myself last year regarding nutrition, and I noticed like I have a bunch of holes when I've done chronometer tracking and. It. It was a bit overwhelming and daunting to look at initially because it was effectively like all of the B vitamins and protein, and I think there might have been one other thing, but I decided to practice what I preach and I went after the protein thing first, and I didn't touch a single vitamin or mineral otherwise, and I was really happy when I reassessed my nutrition about six months later that just focusing on protein and nothing else.

Increased almost all of my B vitamins, and now I went from, Ooh, I think I need to work on every single B vitamin, and oh my God, that's gonna be overwhelming. I went from that to, oh, okay, I'm good now I just need to focus on folate. So much easier. Yeah, to focus on a single nutrient, but it's because I went in the order that we preach, focus on getting enough calories first and foremost.

Once you get that. Accomplished. Then you can move on to something like carbs, protein, and fat. and, and fiber. I would layer fiber at that stage of the game possibly too. Then you could start thinking about individual vitamins and minerals and get into like the nitty gritty specific stuff.

it would've been dizzying if I had, 15 different lists of where I could get all these nutrients and making sure I'm checking the check boxes on all of those frigging lists every day. Like that would be exhausting. 

Right. 

So go in the order we preach people, please.

I have one more thing that we could maybe wrap up the episode with. Yeah. I love it. Where does one acquire riboflavin in food? Assuming that we got the point across that riboflavin is important and that maybe folks are doing some chronometer or MyFitnessPal and they've had a little come to Jesus moment with themselves and they realize, Ooh, I actually don't get enough riboflavin.

And assuming that they're not immediately just gonna jump to a B complex or a riboflavin supplement, and they actually wanna do this through food primarily. What might one eat to acquire this? 

Yeah, nutrient. It's a good question. I mean, I think, uh, this is another, shout out for liver, which again, I am not a huge fan of, but liver's very high in riboflavin.

I think the other big one that a lot of people aren't eating in this space is dairy. 


And dairy again. Is one of the best ways to get calcium. So I think if you can tolerate dairy, please eat dairy. I think it gets very much demonized and I think there's some people that truly can't tolerate it, so I'm not saying those people.

But I think if you really can get to a point that you can tolerate dairy, it's amazing because you're not only getting calcium, but you're also gonna get riboflavin. But I think that's a big one that people can typically eat. Pretty, like they, they want to eat more of it versus liver. Like it's a more popular item to add into the diet.

You know, some yogurt, some cheese, some milk. And I think meat's pretty high in it. You know, something like beef is gonna be high in it. Comparatively it's definitely 

more of a animal based vitamin. Yeah. You can get it in some. Plant and fungi like mushrooms, but the heavy hitters are pretty much gonna be meat, seafood, and dairy.

Right. Yeah, ed, you're right. So for example, I had that the NIH page pulled up for riboflavin and one three ounce serving of beef liver is, 223% of your daily value of riboflavin, right? That just, it blows everything else outta the water, right? The next couple on the list that they give at least, are fortified breakfast cereals and fortified oats.

You're like, eh, I mean it's fine. It's maybe not ideal. But then the next couple in line after beef liver, if we're doing like whole unprocessed foods and non fortified foods, it would go beef liver at 223%. One cup of yogurt for 46% of your daily value. That's not too shabby. Yogurt, a cup of milk, 38% of your daily value.

Likewise. That's pretty damn good. And then we get into beef clams almonds, cheese, chicken, egg, et cetera. Right. And you know, the numbers kind of fall the further down the list you get. But definitely a recurring theme with the B vitamins all basically, except for Folated baby kind of thiam, is that they are much more abundant in plant, or I'm sorry, in animal foods.

So possibly risky business for vegan, uh, vegans definitely, but vegetarians, maybe somewhat if they're not big dairy and egg eaters. 

Yeah. I wonder too I haven't researched this extensively, but there's a lot of nutrients where I. The meat versions are much more bioavailable as well. You see that with like, some of the minerals more so like zinc. Yeah. Iron or iron, yep. Yeah. So I don't know if that would be the same for like plant and animal. Based options for riboflavin. But that's an interesting question too. 

Yeah. I didn't see it in the textbook when I was reading up on this.

And I do know that for the chapters for Iron and Zinc, they do specifically mention that, so right. Probably less of a big deal if they're not mentioned. Yeah. Or maybe it's just a little bit less established, like Yeah. Research wise. You know, if you think about it, overt riboflavin deficiency is more rare than like zig deficiency or iron deficiency.

Sure. So maybe it just doesn't get quite the research funding that those two might. But yeah I think again, recurring theme is that if you get enough, whole food protein sources. You also might find that your B vitamins are on the up and up. that is what I discovered for myself.

So certainly embrace the healthy protein sources. Embrace the dairy, if you can. Even lactose-free dairy. You know, if you are lactose intolerant, we're not insensitive, meaning pie. Yeah. We're not gonna tell you to eat a big bowl of regular ice cream and make yourself bloated and. In pain and have diarrhea, but maybe you could do some lactose-free cheese or some lactose-free yogurt Yeah.

Or something and get your riboflavin that way For sure. I think quite a lot of people who are currently avoiding dairy could probably do that. Yeah. And again, I say that as somebody who actively avoided all dairy for 10 years. But I wish I had added a little bit in sooner. 

Well, I think it dairy's a hard one.

I think food fear wise just 'cause I, it gets a lot of bad press. But it is a very nutrient dense food. And a lot of the studies I. Whether you take it in different forms like fat, like without fat, with fat, it does seem like dairy generally helps, like it improves mortality and like seems to help health and in studies broadly.

So this idea that it's like inflammatory and you know, all this stuff. And yes, there could be people where that's true. It's like this gray area, but majority of the people that I work with can add some dairy back in and there's a minority that might still struggle with it ongoing, so I just wouldn't rule it out.

It's gonna take experimentation to figure out if you can eat it, but I think the overall goal should be, if you can eat dairy, definitely do it because it, it does supply really rich sources of certain nutrients that might be harder to get from other sources. Riboflavin, but definitely calcium too.

Yeah. 

Here, Here again, somebody who avoided it for 10 years. 

Here. 

Yeah. You know, I think that was a pretty well-rounded conversation about our friend Vitamin B two. Don't forget, comment down below on the YouTube video. Let us know. Do you get asparagus, p odor or are you one of the blessed few?

Well, it depends on your perspective. I would call you one of the blessed few. Amy would be very sad for you that you don't get. The experience of the aroma of, uh, the asparagus reminder aroma. So deeply curious about that. Comment down below and we will be back before you know it with another rip roaring episode, either with a guest or about another nutrient here on the IBS Freedom Podcast.

Yay. Until then 

to.