What is the Best Diet for Someone with Polycythemia Vera?

January 8, 2026 •

4 min read

Polycythemia vera (PV) is a chronic blood disorder that causes an overproduction of red blood cells, increasing the risk of serious complications like blood clots. While no single "best diet for someone with polycythemia vera" can cure the condition, a thoughtful and balanced dietary approach is an important part of a management plan.

Quick Summary

A balanced, heart-healthy diet, such as the Mediterranean style, is recommended for managing polycythemia vera by controlling risk factors like cholesterol, blood pressure, and inflammation. Maintaining proper hydration, limiting certain foods high in purines and oxalates, and consulting a doctor regarding iron intake are crucial considerations for reducing health risks.

Key Points

Stay Hydrated: Drinking plenty of water is essential to help thin the blood, improve circulation, and prevent kidney stones and gout associated with high uric acid levels.
Limit High-Purine Foods: Restrict red meat, organ meats, and certain seafood to reduce uric acid levels and decrease the risk of gout.
Avoid Iron Supplements: Unless explicitly instructed by a hematologist, avoid iron supplements, as excess iron can fuel the overproduction of red blood cells.
Follow a Heart-Healthy Diet: Adopt a Mediterranean or DASH-style diet rich in fruits, vegetables, and whole grains to manage weight, blood pressure, and cholesterol, which are all risk factors for PV complications.
Consume Smaller, Frequent Meals: For those with an enlarged spleen (splenomegaly), eating smaller, nutrient-dense meals more often can help manage bloating and early fullness.
Reduce Processed Foods, Sodium, and Sugar: Limiting processed foods high in sodium and added sugars helps control blood pressure and reduces inflammation.

The Role of Diet in Managing Polycythemia Vera

While medication and regular phlebotomy are the primary treatments for polycythemia vera (PV), diet plays a supporting, but vital, role in managing symptoms and reducing the risk of associated complications. The overproduction of red blood cells in PV can increase blood viscosity and lead to problems like high blood pressure, inflammation, blood clots, and gout. Following a nutrient-dense, heart-healthy eating pattern can help mitigate these risks.

Prioritize Hydration

Staying well-hydrated is one of the simplest yet most effective dietary strategies for managing PV. Sufficient fluid intake helps thin the blood, promoting better circulation and reducing the risk of blood clots. It also helps flush out excess uric acid, which is a byproduct of high cell turnover in PV and can lead to gout and kidney stones. Aim for 6 to 8 glasses of water or other low-fat, low-sugar fluids each day.

Embrace Heart-Healthy Eating

Dietary patterns like the Mediterranean and DASH diets are often recommended for people with PV due to their focus on heart health. These diets emphasize:

Plenty of fruits and vegetables: These are rich in antioxidants and fiber, which help reduce inflammation and improve cardiovascular health.
Whole grains: Opt for complex carbohydrates like quinoa, oats, and brown rice, which provide sustained energy and fiber.
Lean proteins: Choose poultry, fish, eggs, and legumes over red and organ meats to get adequate protein without excessive saturated fat or purines.
Healthy fats: Incorporate sources like olive oil, nuts, seeds, and avocado for their anti-inflammatory properties.
Low-fat dairy: Products like skim milk, yogurt, and low-fat cheese provide calcium and vitamin D for bone health without adding excess saturated fat.

Manage Iron and Other Nutrients

For many with PV, iron levels are low, but iron supplementation is generally avoided as it can stimulate further red blood cell production. Your hematologist will monitor your iron levels closely. If you have low iron (a common side effect of regular phlebotomy), your doctor will provide specific guidance. For patients with a tendency toward high uric acid, avoiding foods high in purines is crucial, and for those with kidney stone concerns, limiting high-oxalate foods is important.

Foods to Incorporate and Foods to Limit

Foods to Enjoy Regularly

Fruits: Berries, apples, oranges, pears, and melons.
Vegetables: Broccoli, bell peppers, carrots, leafy greens in moderation (consider oxalate content), and cruciferous vegetables.
Whole Grains: Brown rice, quinoa, oats, and whole-wheat bread.
Lean Proteins: Chicken, turkey, fish, eggs, tofu, and legumes.
Healthy Fats: Olive oil, avocado, nuts, and seeds.

Foods to Limit or Avoid

Excessive Iron: Avoid supplements and heavily iron-fortified cereals unless directed by your doctor.
High-Purine Foods: Limit red and organ meats, shellfish, sardines, and anchovies to help prevent gout.
High-Oxalate Foods: Consume foods like spinach, peanuts, almonds, beets, and sweet potatoes in moderation to reduce the risk of kidney stones.
High-Fat and Processed Foods: Reduce saturated and trans fats found in red meat, fried foods, and packaged snacks to maintain cardiovascular health.
Added Sugars and Sodium: Limit sugary drinks, desserts, and high-sodium processed foods, as they contribute to inflammation and high blood pressure.
Alcohol: Excessive alcohol consumption can worsen PV symptoms and should be limited.

A Comparative Look: Mediterranean vs. DASH Diet for PV


Feature	Mediterranean Diet	DASH Diet	PV-Related Benefits
Primary Focus	Whole foods, heart health, anti-inflammatory	Lowering blood pressure, reducing sodium	Both control risk factors like hypertension, obesity, and cholesterol, which can lead to PV complications.
Key Foods	Fruits, vegetables, whole grains, legumes, fish, olive oil.	Fruits, vegetables, whole grains, lean meats, low-fat dairy.	Emphasis on fruits, vegetables, and whole grains reduces inflammation and provides antioxidants.
Limitations	Limited red meat, saturated fat, processed foods.	Limited sodium, saturated fat, and added sugar.	Both restrict processed and high-fat foods, which can worsen inflammation and blood clot risk.
Specific Considerations for PV	Naturally low in high-purine and high-iron animal products.	Sodium restriction helps manage high blood pressure, a common PV issue.	Both are generally beneficial, but dietary choices should be personalized based on a patient's specific risks (e.g., gout, kidney stones).

Conclusion: Your Personalized Approach

Creating the best diet for someone with polycythemia vera is not about finding a single solution, but about adopting a healthy eating pattern that supports overall health and helps mitigate specific risks associated with the disease. Focus on hydration, heart-healthy whole foods, and limiting inflammatory, high-fat, and processed items. Because PV can present with various symptoms and complications—such as splenomegaly, gout, or iron deficiency—a personalized plan is essential. Always consult with your healthcare provider or a registered dietitian to develop a strategy that is tailored to your individual needs and treatment regimen. Your diet is a powerful tool to support your journey with polycythemia vera.

Learn more about managing your condition by visiting the MPN Voice website, a valuable resource for those with myeloproliferative neoplasms.

Frequently Asked Questions

No, dietary changes will not cure polycythemia vera, but they can play a crucial role in managing symptoms and reducing the risk of serious complications like blood clots, heart disease, and gout.

Staying well-hydrated helps improve blood flow by preventing the blood from becoming too thick. It also helps prevent the buildup of excess uric acid, which reduces the risk of painful gout and kidney stones.

While iron supplements are generally avoided because they can increase red blood cell production, you do not necessarily need to avoid all iron-rich foods. Many plant-based iron sources have lower absorption rates, and your doctor will advise you based on your specific iron levels. Never take iron supplements without a doctor's guidance.

To help prevent gout, limit foods that are high in purines. This includes red meat, organ meats (liver, kidneys), and certain types of seafood like shellfish, anchovies, and sardines.

The DASH (Dietary Approaches to Stop Hypertension) diet is highly recommended. It focuses on reducing sodium intake and emphasizes fruits, vegetables, whole grains, and lean proteins, which helps control blood pressure and supports overall heart health.

To combat fatigue, focus on consuming balanced meals throughout the day that combine complex carbohydrates (like whole grains) with lean protein and healthy fats for sustained energy. Avoid relying on simple sugars, which can cause energy spikes and crashes.

If an enlarged spleen causes you to feel full after only a few bites, try eating smaller, more frequent meals throughout the day. Focus on nutrient-dense foods to ensure you are getting enough calories and nutrition in smaller portions.