What foods to eat if you have polycythemia?

October 12, 2025 •

4 min read

As many as 60% of people with polycythemia vera experience iron deficiency, which can cause fatigue. A balanced and mindful diet is essential for managing this chronic blood disorder, which is characterized by the overproduction of red blood cells. By making specific nutritional choices, individuals with the condition can help mitigate complications and improve their overall well-being.

Quick Summary

A proper nutrition plan can help manage polycythemia symptoms and reduce the risk of complications such as blood clots, gout, and high blood pressure. Dietary modifications, including hydration and strategic food choices, are key to supporting treatment and overall health. A Mediterranean-style approach, rich in anti-inflammatory foods and low in excess iron, is often recommended.

Key Points

Embrace a Mediterranean-style diet: Focus on a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats to manage cardiovascular risks and reduce inflammation.
Stay hydrated: Drinking plenty of water is essential to help thin the blood, improve circulation, and minimize the risk of complications like gout and kidney stones.
Manage iron intake carefully: Avoid excessive red meat and fortified cereals high in iron, as this can stimulate red blood cell production. Consult a doctor before taking any iron supplements.
Limit purine-rich foods: Reduce consumption of foods like red meat and organ meats to help prevent the buildup of uric acid, which can cause gout.
Avoid processed and high-fat items: Restrict sugary drinks, fried foods, and trans fats to decrease inflammation and lower the risk of blood clots.
Work with a dietitian: Seek guidance from a registered dietitian specializing in oncology to create a personalized, balanced meal plan tailored to your specific needs.

The Importance of Diet in Polycythemia Management

Polycythemia vera (PV) is a myeloproliferative disorder that causes the bone marrow to produce too many red blood cells. This excess can thicken the blood, slowing its flow and increasing the risk of serious complications like blood clots, strokes, and heart attacks. While diet cannot cure PV, adopting certain eating habits can help manage cardiovascular risk factors, reduce inflammation, and prevent secondary issues like gout and kidney stones.

Embracing a Mediterranean-Style Diet

Many experts recommend a Mediterranean-style diet for people with polycythemia because it emphasizes fruits, vegetables, whole grains, and healthy fats while limiting red meat and processed foods. This eating pattern is known for its anti-inflammatory properties, which can be beneficial in managing PV, as inflammation plays a role in the disorder's progression.

Foods to Emphasize

Fruits and vegetables: A colorful array of fresh, whole fruits and vegetables provides essential vitamins, minerals, and antioxidants. Excellent choices include apples, oranges, bananas, berries, and broccoli. These are also great sources of complex carbohydrates for sustained energy.
Lean protein: Opt for lean protein sources like poultry, eggs, fish, and tofu. Cold-water fish such as salmon and mackerel provide beneficial omega-3 fatty acids, known for their anti-inflammatory effects.
Whole grains: Incorporate whole grains like quinoa, oats, brown rice, and millet, which provide sustained energy and fiber. Fiber is crucial for digestive health, especially for those experiencing gastrointestinal side effects from treatment.
Healthy fats: Use healthy oils like olive oil and consume nuts and seeds in moderation. These provide healthy fats and nutrients to support overall health.
Low-fat dairy: Products like low-fat milk, yogurt, and cheese are good sources of calcium and protein without contributing excessive saturated fat.

Hydration is Key

Staying well-hydrated is one of the most critical dietary practices for someone with polycythemia. Thicker blood is a key feature of the condition, and drinking plenty of water helps to maintain better blood flow and circulation. Adequate hydration is also essential for preventing kidney stones and managing uric acid levels, which can be elevated in PV patients. A good rule of thumb is to drink 8 to 10 glasses of water daily.

Strategic Considerations for Iron Intake

While iron deficiency can be a side effect of regular blood withdrawals (phlebotomy) used to manage PV, it's crucial to approach iron intake carefully. Uncontrolled iron can stimulate further red blood cell production. It is vital to consult a healthcare provider before making any changes to iron consumption.

Navigating Iron-Containing Foods

Moderation is key: Limit the intake of red meat, organ meats, and other foods exceptionally high in iron.
Focus on plant-based iron with inhibitors: Plant-based iron (non-heme) is less readily absorbed than heme iron from animal sources. Combining plant-based iron sources with foods containing calcium, tannins (like coffee and tea), or phytates can further reduce absorption.

Foods to Limit or Avoid

Certain foods can exacerbate polycythemia symptoms and increase the risk of complications. Limiting or avoiding these can be a proactive step in managing the condition.

High-purine foods: High purine levels can lead to gout, a potential complication of PV. Red meat, organ meats, and certain seafood like anchovies and sardines should be limited.
High-oxalate foods: To reduce the risk of kidney stones, which can also occur with PV, high-oxalate foods should be consumed in moderation. This includes items like spinach, rhubarb, beets, and sweet potatoes.
Processed and high-fat foods: These can increase inflammation and raise the risk of blood clots and cardiovascular issues. Limit sugary drinks, highly processed snacks, fried foods, and foods with trans fats.
Alcohol and caffeine: Both can contribute to dehydration and may worsen certain symptoms.

Comparison Table: Food Categories for Polycythemia


Food Category	Recommended Foods	Foods to Limit/Avoid	Reason
Protein	Lean poultry, fish, eggs, tofu, beans	Red meat, organ meats, some seafood (anchovies, sardines)	Heme iron in red meat is highly absorbable and can overstimulate red blood cell production.
Fruits & Vegetables	Apples, oranges, broccoli, carrots, pears, cucumber	Excessive amounts of high-oxalate vegetables like spinach and beets	Promotes overall health; can help prevent gout and kidney stones.
Grains	Quinoa, oats, brown rice, whole wheat bread	Enriched or fortified cereals/breads, refined grains	Fiber supports digestion, whole grains provide sustained energy. Avoidance of fortified iron.
Fats	Olive oil, nuts, seeds, fish oil	High saturated fats (butter, heavy cream), trans fats	Promotes heart health and provides anti-inflammatory benefits.
Fluids	Water, fruit juices, low-fat milk	Alcohol, sugary drinks, excessive caffeine	Maintains hydration and good blood flow, reduces kidney stone risk.

Seeking Professional Nutritional Advice

Creating a personalized diet plan is the most effective approach for managing polycythemia. A registered dietitian with experience in oncology can help develop a balanced eating strategy that meets specific nutritional needs while accounting for potential side effects from treatments, such as chemotherapy. They can help interpret blood test results to tailor recommendations regarding iron and other dietary factors.

Conclusion

For individuals navigating polycythemia, adopting a thoughtful and strategic diet can significantly contribute to better symptom management and a reduced risk of complications. A diet rich in fruits, vegetables, lean proteins, and whole grains—similar to a Mediterranean-style plan—provides the nutritional foundation needed to support overall health. Strategic hydration and a careful approach to iron intake are also cornerstones of this nutritional strategy. While dietary changes cannot replace medical treatment, they are a powerful, complementary tool for promoting well-being and managing the challenges of this chronic condition. Always consult with a healthcare professional to create a plan that is right for you. For more information, the Leukemia Research Foundation offers valuable resources on diet and blood cancer management.

Frequently Asked Questions

The Mediterranean-style diet is often recommended, as it is rich in anti-inflammatory foods like fruits, vegetables, and whole grains, and is low in saturated fats and red meat.

No, you don't need to avoid all iron, but you should manage your intake carefully and avoid excessive amounts. It's crucial not to take iron supplements without a doctor's guidance, as too much iron can cause your body to produce more red blood cells.

You should limit or consume in moderation vegetables high in oxalates, such as spinach, beets, and sweet potatoes, to help prevent kidney stones.

Staying hydrated with plenty of water helps to thin the blood, which can improve circulation and reduce the risk of blood clots. It also helps manage uric acid levels and prevent kidney stones.

Focus on a wide variety of fresh fruits like apples, oranges, bananas, and berries. These are excellent sources of complex carbohydrates, vitamins, and antioxidants.

Focus on lean protein sources like poultry, eggs, fish, and tofu. These options provide essential protein without the high iron load found in red and organ meats.

Incorporate healthy fats from sources like olive oil, nuts, seeds, and cold-water fish. These fats can help reduce inflammation and support overall cardiovascular health.