Nutrition Diet: What should I eat if my red blood cells are high?

October 4, 2025 •

4 min read

Dehydration can cause a false elevation in your red blood cell count, making adequate fluid intake a critical first step if your red blood cells are high. While a high red blood cell count can have various causes, a targeted nutrition diet can play a supportive role in management.

Quick Summary

A diet for high red blood cell count focuses on staying hydrated, limiting iron-rich foods, and consuming a balanced, heart-healthy plan rich in fruits, vegetables, and lean proteins. Avoid processed foods, excessive sugar, and certain supplements while managing underlying conditions with medical supervision.

Key Points

Prioritize Hydration: Drink plenty of water and avoid diuretics to combat potential dehydration-induced erythrocytosis.
Limit Heme Iron: Reduce or avoid consumption of red meat, organ meats, and shellfish, as they are rich in easily absorbed heme iron.
Moderate Non-Heme Iron: Manage intake of fortified cereals, legumes, and dried fruits, which contain non-heme iron.
Avoid Iron and Certain Vitamin Supplements: Never take iron supplements without a doctor's approval. Be cautious with high-dose vitamin C, B12, and folate supplements.
Adopt a Heart-Healthy Diet: Embrace a Mediterranean or DASH-style diet focusing on fruits, vegetables, whole grains, and lean proteins to mitigate cardiovascular risks.
Quit Smoking: This is a critical lifestyle change, as smoking stimulates excess red blood cell production.
Seek Medical Guidance: Always work with a healthcare provider to address any underlying medical conditions causing the high RBC count.

A high red blood cell (RBC) count, also known as erythrocytosis, can arise from various conditions, ranging from simple dehydration to more serious health issues like polycythemia vera. While a nutritional approach is not a substitute for professional medical treatment, modifying your diet can be a valuable part of a comprehensive management plan. The core principles involve reducing your intake of iron, managing other nutrients that affect blood production, and embracing a heart-healthy lifestyle to prevent complications.

Prioritizing Hydration to Combat Concentration

One of the most immediate and impactful dietary adjustments is to increase your fluid intake. A high RBC count can sometimes be relative, meaning it's a result of reduced blood plasma due to dehydration, which makes the remaining red blood cells more concentrated. By drinking plenty of water, you can restore your blood volume to a healthier level.

Stay hydrated: Aim for at least 8-10 glasses of water daily, especially during and after exercise.
Avoid diuretics: Limit your consumption of coffee, caffeinated drinks, and soda, as these can promote fluid loss.
Monitor urine color: Pale yellow urine is a good indicator of proper hydration.

Limiting Dietary Iron

Iron is a primary building block for red blood cells, so reducing your intake can help manage a high RBC count, especially in conditions like polycythemia vera. It's important to distinguish between heme and non-heme iron, as heme iron is more readily absorbed by the body.

Heme Iron Sources to Limit or Avoid

Red Meat: Beef, lamb, and pork are high in easily absorbed heme iron.
Organ Meats: Liver and other organ meats are particularly iron-dense and should be avoided.
Shellfish: Clams, oysters, and mussels contain high levels of heme iron.

Non-Heme Iron Sources to Manage

While plant-based (non-heme) iron isn't absorbed as efficiently, a high intake should still be managed.

Fortified Cereals: Many breakfast cereals and breads are iron-fortified; check nutrition labels.
Dried Fruits: Raisins, dates, and figs are concentrated sources of iron.
Legumes: Lentils and beans are typically iron-rich and should be consumed in moderation.

Embracing a Heart-Healthy Eating Plan

Adopting a diet similar to the Mediterranean or DASH (Dietary Approaches to Stop Hypertension) diet can help manage complications associated with high RBCs, such as cardiovascular disease and blood clots.

Focus on Fruits and Vegetables: These provide essential nutrients and antioxidants.
Choose Lean Proteins: Opt for poultry, fish (in moderation), and plant-based proteins like legumes, beans, and tofu.
Incorporate Whole Grains: Oats, quinoa, and brown rice provide fiber and energy without excessive iron.
Healthy Fats: Use olive oil, avocados, nuts, and seeds as sources of healthy fats.

A Comparison of Heme vs. Non-Heme Iron Sources

Understanding the different types of dietary iron is crucial for managing your intake. Heme iron is derived from animal products and is much more bioavailable, meaning the body absorbs it more easily than non-heme iron from plant sources.


Feature	Heme Iron	Non-Heme Iron
Source	Animal-based foods (red meat, organ meats, shellfish, poultry)	Plant-based foods (beans, nuts, seeds, leafy greens, fortified cereals)
Absorption Rate	High (20-30% absorbed)	Low (3-5% absorbed)
Absorption Factors	Not strongly influenced by other dietary components	Absorption is affected by other foods; enhanced by vitamin C, inhibited by calcium and tannins
Dietary Context	Limiting or avoiding these sources is a key strategy for high RBC management	Intake can be managed, but is less impactful than heme iron; focus on balance

The Role of Supplements and Vitamins

When dealing with a high RBC count, especially polycythemia vera, certain supplements and vitamins should be approached with caution.

Avoid Iron Supplements: This is a key instruction, as adding more iron can further stimulate RBC production. Always check multivitamins for iron content.
Be Mindful of Vitamin C: High doses of supplemental vitamin C can significantly increase the body's absorption of iron. While obtaining vitamin C from whole fruits and vegetables is generally safe, supplements should be discussed with a doctor.
Consult on B Vitamins: In polycythemia vera, vitamin B12 levels are often high, and supplemental intake should be avoided unless specifically directed by a physician.

Lifestyle Adjustments Beyond Diet

Dietary changes are most effective when paired with other healthy habits.

Quit Smoking: Smoking reduces oxygen levels in the blood, prompting the body to produce more RBCs to compensate.
Exercise Moderately: Regular, non-strenuous exercise improves circulation and overall cardiovascular health.
Manage Underlying Conditions: A high RBC count may be a symptom of an underlying condition. Addressing this root cause with your doctor is paramount.

Conclusion

Managing a high red blood cell count involves a careful and informed approach to nutrition. By prioritizing hydration, strategically limiting iron-rich foods (particularly red meat and fortified products), and adopting a heart-healthy diet, you can support your body's health and reduce the risk of complications. Always consult with your healthcare provider or a registered dietitian to create a personalized plan and before making significant changes to your diet or supplement regimen. A balanced, mindful eating plan, combined with other healthy lifestyle choices, can help you manage this condition effectively.

Frequently Asked Questions

Dehydration can cause your red blood cells to appear concentrated in a blood sample, leading to a seemingly high count. Drinking plenty of water helps restore your blood plasma volume, normalizing the ratio of red blood cells to fluid.

Heme iron comes from animal-based foods like meat and poultry and is more easily absorbed by the body. Non-heme iron comes from plant-based foods, and its absorption is less efficient and can be affected by other dietary factors.

You should limit or avoid high-heme iron foods, like red and organ meats. While you don't need to eliminate all non-heme iron sources, managing your intake from things like fortified cereals and legumes is wise. The goal is to moderate, not eliminate, most iron from your diet.

Avoid iron supplements and multivitamins containing iron, as they can worsen the condition. Be cautious with high-dose vitamin C supplements and, if you have polycythemia vera, avoid B12 supplements unless directed by a doctor.

No, diet is only one factor. A high RBC count can be caused by dehydration, living at high altitudes, smoking, lung disease, or other underlying medical conditions, such as polycythemia vera.

Spinach contains non-heme iron, which is not as easily absorbed as heme iron. While excessive intake of non-heme iron can still be a concern, a balanced diet that includes leafy greens is generally safe and provides many other beneficial nutrients.

Yes, therapeutic phlebotomy, which involves removing blood periodically, is a common treatment for high RBC counts. In some cases, blood donation may be an option, but this must be discussed with and recommended by your doctor.

Processed and refined foods often contain high levels of sugar, saturated fats, and sodium. These ingredients can increase inflammation and your risk of blood clots and cardiovascular issues, which are potential complications of a high RBC count.