What Should I Avoid If I Have Polycythemia?

January 9, 2026 •

4 min read

Polycythemia vera (PV) is a rare blood disorder affecting approximately 50 out of every 100,000 people in the U.S., causing the bone marrow to produce too many red blood cells. This overproduction can lead to thickened blood and serious complications, making it essential to understand what to avoid to manage the condition successfully.

Quick Summary

This article details the lifestyle and dietary factors individuals with polycythemia should avoid to minimize health risks. It covers the dangers of dehydration, smoking, iron supplements, and certain foods, providing guidance for better disease management.

Key Points

Avoid Iron Supplements: Unsupervised iron supplementation can increase red blood cell production and should be avoided, even if you have an iron deficiency from phlebotomy.
Stay Hydrated: Dehydration thickens the blood, increasing the risk of blood clots, so adequate fluid intake is crucial.
Quit Smoking: Smoking narrows blood vessels and deprives the body of oxygen, both of which increase the risk of dangerous clots.
Limit High Altitudes: Exposure to low-oxygen environments, such as high altitudes, can stimulate additional red blood cell production.
Restrict Certain Foods: Foods high in purines, oxalates, saturated fats, and sodium can exacerbate symptoms and complications like gout, kidney stones, and cardiovascular disease.
Regulate Temperature Exposure: Avoid hot baths, hot tubs, and extreme temperatures, as they can trigger itching and worsen circulation problems.

Understanding the Core Problem of Polycythemia

Polycythemia, and specifically Polycythemia Vera (PV), is a chronic myeloproliferative disorder that causes the overproduction of red blood cells. This results in thicker-than-normal blood, a state known as hyperviscosity. Thicker blood flows more slowly, significantly increasing the risk of potentially fatal blood clots, heart attack, and stroke. To mitigate these risks, managing lifestyle and environmental factors is critical.

The Dangers of Dehydration

Staying adequately hydrated is paramount for those with polycythemia. When you are dehydrated, your blood plasma volume decreases, causing the red blood cell concentration to increase even further and making your blood thicker. This exacerbates the risk of hyperviscosity and blood clots. Avoiding dehydration is a simple yet powerful strategy for managing your condition. High fluid intake is also crucial for preventing uric acid buildup, which can lead to complications like gout and kidney stones.

Things to avoid that promote dehydration:

Excessive alcohol consumption, which acts as a diuretic.
Overindulging in caffeinated beverages, which can also have a diuretic effect.
Ignoring thirst, especially in hot weather or during physical activity.

Why You Must Avoid Smoking and High Altitudes

Both smoking and being at high altitudes deprive the body of oxygen, triggering a compensatory mechanism in the body to produce more red blood cells. For a person with polycythemia, this is counterproductive and extremely dangerous. Smoking causes blood vessels to narrow, compounding the risk of blood clots. Quitting smoking is one of the most impactful decisions you can make to improve your health and reduce serious complications. Similarly, avoiding prolonged stays in high-altitude environments is essential for managing your red blood cell count.

Dietary Restrictions to Consider

While no special diet cures polycythemia, limiting certain foods can help manage symptoms and reduce risk factors for complications like gout, kidney stones, and cardiovascular disease.

Foods to limit or avoid:

High-Purine Foods: These can increase uric acid levels, contributing to gout. Examples include red meat, organ meats, some seafood (anchovies, sardines, shellfish), and high alcohol consumption.
High-Oxalate Foods: These increase the risk of kidney stones. Common examples are spinach, peanuts, rhubarb, beets, sweet potatoes, and soy products.
High-Fat and Processed Foods: Saturated and trans fats can increase inflammation and risk of blood clots. Avoid processed snacks, fried foods, and fatty cuts of meat.
Added Sugars and Sodium: High intake of added sugars and sodium can worsen blood pressure and inflammation. This includes sugary drinks, desserts, and salty convenience foods.

Avoid Unsupervised Supplementation

It may seem logical to take supplements, but certain vitamins and minerals, especially iron, should be strictly avoided unless your hematologist advises otherwise. Iron is the raw material for red blood cell production, and supplementing it can fuel the overproduction characteristic of polycythemia. Even if you experience iron deficiency due to phlebotomy treatments, your doctor must manage this carefully, and unsupervised iron supplements should be avoided. The same goes for certain B vitamins, which aid in red blood cell production. Always consult your healthcare provider before taking any new supplement.

Lifestyle Comparison: Avoid vs. Embrace


Feature	Actions to Avoid	Beneficial Lifestyle Habits
Hydration	Dehydration, excessive alcohol, high caffeine intake	Staying well-hydrated with water and low-sugar fluids
Breathing	Smoking, high-altitude travel, mountain climbing	Regular, gentle exercise to improve circulation
Diet	High-purine, high-oxalate, high-fat, and processed foods	A balanced diet rich in fruits, vegetables, and lean protein
Temperature	Hot tubs, hot showers, extreme heat and cold	Cool baths/showers, protecting hands and feet in cold weather
Supplements	Unsupervised iron and B-vitamin supplements	Following doctor-prescribed treatment and monitoring

The Importance of Medical Guidance

Living with polycythemia requires consistent management under the supervision of a healthcare provider, typically a hematologist. Your doctor's treatment plan, which may include phlebotomy (blood withdrawals) and medication, is the cornerstone of managing your condition and preventing severe complications. Lifestyle modifications are meant to support this treatment, not replace it. For instance, while phlebotomy can cause iron deficiency, it's a deliberate part of treatment to limit red blood cell production. Therefore, avoiding unsupervised supplements is vital for not undermining your medical care.

Conclusion: A Proactive Approach to Health

By understanding what to avoid with polycythemia, patients can play an active role in managing their health. The risks associated with the disease, primarily blood clots, can be minimized by making smart choices. Avoiding dehydration, smoking, and high altitudes directly impacts blood viscosity. Carefully managing your diet and steering clear of unsupervised supplements, particularly those containing iron, prevents fueling the overproduction of red blood cells. Always work closely with your medical team to follow the best possible treatment plan for your specific needs. Taking these proactive steps can significantly improve your quality of life and reduce the risk of serious complications.

Note: For more information on managing polycythemia, consider visiting authoritative sources like the National Institutes of Health. Polycythemia Vera - StatPearls - NCBI Bookshelf

Frequently Asked Questions

Taking iron supplements can stimulate your bone marrow to produce more red blood cells, which is counterproductive to managing polycythemia and can worsen the condition.

Excessive alcohol can contribute to dehydration and is high in purines, increasing your risk for blood clots and gout.

While diet cannot cure polycythemia, limiting high-fat, high-purine, and high-oxalate foods can help manage related risk factors and complications like heart disease, gout, and kidney stones.

High altitudes have lower oxygen levels, which can trigger your body to produce even more red blood cells, worsening your polycythemia.

Red meat is high in iron and purines. While moderate intake may be acceptable, it is best to limit consumption, especially if you struggle with gout, and to focus on lean proteins instead.

For many with polycythemia, hot water exposure can trigger intense itching (aquagenic pruritus). It is recommended to use cooler water and avoid hot tubs.

Avoid contact sports or very strenuous activities that increase your risk of injury or fatigue, especially if your blood counts are unstable. Gentle, regular exercise is generally recommended.