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HelpEpic Code LAB3216 Riboflavin (Vitamin B2), Plasma
Additional Codes
Mayo Code: VITB2
Interface Order Alias: 11566
Epic Code: LAB 3216
Cerner: 8197
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Evaluation of individuals who present the signs of ariboflavinosis
Specimen Type
Plasma HeparinShipping Instructions
Ship specimen in amber vial to protect from light.
Specimen Required
Patient Preparation: Fasting-overnight (12-14 hours) (infants-collect specimen prior to next feeding)
Supplies: Amber Frosted Tube, 5 mL (T915)
Collection Container/Tube:
Preferred: Green top (sodium or lithium heparin)
Acceptable: Light-green top (sodium or lithium heparin plasma gel)
Submission Container/Tube: Amber vial
Specimen Volume: 2 mL
Collection Instructions: Centrifuge within 2 hours of collection and aliquot plasma into amber vial.
Collection Container/Tube: Sodium Heparin Green Top (2 mL or 6 mL)
COLLECTION NOTE: Volumes listed are in serum or plasma, draw approximately 2 1/2 times the requested volume in whole blood.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Plasma Heparin | Refrigerated (preferred) | 28 days | LIGHT PROTECTED |
| Frozen | 28 days | LIGHT PROTECTED | |
| Ambient | 72 hours | LIGHT PROTECTED |
Reject Due To
| Gross hemolysis | OK |
| Gross lipemia | Reject |
| Gross icterus | OK |
Day(s) Performed
Monday, Wednesday, Friday
Reference Values
1-19 mcg/L
Clinical Information
There are 3 principal vitamin B2-active flavins found in nature: riboflavin, riboflavin 5-phosphate (flavin mononucleotide: FMN), and riboflavin-5'-adenosyl-diphosphate (flavin adenosine dinucleotide: FAD). In biological tissues, FMN and FAD serve as prosthetic groups for a large variety of flavoproteins, which are hydrogen carriers in oxidation-reduction processes.
Dietary deficiency of riboflavin (ariboflavinosis) is characterized by sore throat, cheilosis (lesions on the lips), angular stomatitis (lesions on the angles of the mouth), glossitis (fissured and magenta-colored tongue), corneal vascularization, dyssebacia (red, scaly, greasy patches on the nose, eyelids, scrotum, and labia), and normocytic, normochromic anemia. Severe riboflavin deficiency may affect the conversion of vitamin B6 to its coenzyme, as well as conversion of tryptophan to niacin.
There is also evidence that more subtle riboflavin deficiency might have negative health consequences.
Finally, in addition to dietary deficiency, there are rare inborn errors of metabolism, primarily involving loss of function of riboflavin transporters, which result in functional vitamin B2 deficiency. Many of these latter cases present with neurodegenerative features.
Riboflavin has a low level of toxicity and no case of riboflavin toxicity in humans has been reported. The limited absorptivity of riboflavin and its ready excretion in the urine normally preclude a health problem due to increased intake of riboflavin.
Cautions
Testing of nonfasting specimens or the use of dietary vitamin B2 supplementation can result in elevated plasma vitamin B2 concentrations.
Interpretation
Low concentrations in the blood plasma are indicative of nutritional deficiency. Concentrations below 1 mcg/L are considered significantly diminished. Marginally low levels probably represent nutritional deficiency that should be corrected.
Reporting Name
Riboflavin (Vitamin B2), PMethod Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Portions of this test are covered by patents held by Quest Diagnostics
Method Description
Riboflavin (vitamin B2) is extracted from plasma heparin specimens with internal standard and then analyzed by liquid chromatography tandem mass spectrometry.(Unpublished Mayo method)
CPT Code Information
84252
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| VITB2 | Riboflavin (Vitamin B2), P | 2924-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 61637 | Riboflavin (Vitamin B2), P | 2924-9 |
Report Available
2 to 5 daysTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.Clinical Reference
1. McCormick DB. Riboflavin. In: Shils ME, Shike M, Ross AC, et al. Modern Nutrition in Health and Disease. 10th ed. Lippincott Williams and Wilkins; 2006:434-441
2. Hustad S, McKinley MC, McNulty H, et al. Riboflavin, flavin mononucleotide, and flavin adenine dinucleotide in human plasma and erythrocytes at baseline and after low-dose riboflavin supplementation. Clin Chem. 2002;48(9):1571-1577
3. Roberts NB. Taylor A. Sodi R. Vitamins and trace elements. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:639-718
4. Balasubramaniam S, Christodoulou J, Rahman S. Disorders of riboflavin metabolism. J Inherit Metab Dis. 2019;42(4):608–619. doi:10.1002/jimd.12058
5. Suwannasom S, Kao I, PruB A, Georgieva R, Baumler H. Riboflavin: the health benefits of a forgotten natural vitamin. Int J Mol Sci. 2020;21(3):950. doi:10.3390/ijms21030950
6. O'Callaghan B, Bosch AM, Houlden H. An update on the genetics, clinical presentation, and pathomechanisms of human riboflavin transporter deficiency. J Inherit Metab Dis. 2019;42(4):598-607. doi:10.1002/jimd.12053