What Should I Eat If My RBC Is High?: A Comprehensive Nutrition Guide

October 21, 2025 •

4 min read

High red blood cell (RBC) counts can indicate an underlying condition, such as polycythemia vera, necessitating careful management. Learning what should I eat if my RBC is high? is a crucial part of controlling blood volume, preventing complications like clots, and improving overall wellness.

Quick Summary

This guide provides an overview of dietary strategies and lifestyle changes for managing elevated red blood cell counts. It covers how to control iron intake, prioritize hydration, and choose foods that reduce inflammation and blood thickness.

Key Points

Stay Extremely Hydrated: Drink at least 8-10 glasses of water daily to dilute blood viscosity and improve circulation, avoiding diuretics like excess coffee and alcohol.
Manage Iron Intake Carefully: Limit foods rich in easily absorbed 'heme' iron (like red meat and organ meats) and avoid iron supplements unless directed by a doctor.
Follow a Mediterranean-Style Diet: Focus on anti-inflammatory whole foods, including fruits, vegetables (mindful of oxalate content), whole grains, lean proteins, and healthy fats.
Limit High-Risk Foods: Reduce consumption of high-fat foods, processed foods, excessive sugar, and foods high in purines (to prevent gout) and oxalates (to prevent kidney stones).
Consult a Healthcare Professional: Always work with a doctor or dietitian to create a personalized nutritional and treatment plan for managing a high RBC count.

Understanding a High RBC Count and Its Dietary Implications

An elevated red blood cell (RBC) count, also known as erythrocytosis, can increase blood thickness and the risk of complications such as blood clots, heart attacks, and strokes. In conditions like polycythemia vera (PV), where the body overproduces red blood cells, diet plays a vital supportive role. While nutrition cannot cure these conditions, a tailored dietary approach can help manage symptoms and minimize associated risks.

The Importance of Hydration

The most crucial and immediate step to take when dealing with a high RBC count is to stay properly hydrated. Dehydration reduces the plasma volume in your blood, which concentrates the red blood cells and effectively raises the RBC count. By drinking plenty of water, you help to dilute your blood, improving circulation and reducing its viscosity.

Best hydration practices include:

Aim for 8-10 glasses of water per day, or more if active or in hot weather.
Minimize or avoid diuretic beverages like excessive coffee, soda, and alcohol, as they can contribute to dehydration.
Incorporate fluid-rich foods, such as cucumbers, watermelon, and leafy greens, into your diet.

Strategizing Your Iron Intake

Iron is an essential mineral for producing red blood cells and hemoglobin. Therefore, if your RBC count is high, managing your iron intake is a critical nutritional strategy.

Limit heme iron: Heme iron, found in animal products like red meat and organ meats, is more readily absorbed by the body. Reduce your consumption of these foods to help keep iron levels in check.
Be cautious with fortified foods: Many cereals and breads are fortified with iron. While not as readily absorbed as heme iron, excess consumption should be moderated.
Avoid supplements: Do not take iron supplements unless specifically instructed by a healthcare provider. Taking extra iron can be dangerous for individuals with high RBC counts.
Be aware of paradoxes: Some individuals with polycythemia vera may experience a relative iron deficiency. However, doctors advise against supplementation, as increasing iron would 'fuel the fire' of excess red blood cell production. Regular monitoring and consultation with your physician are essential.

Limiting High-Risk Compounds

Certain compounds found in food can exacerbate symptoms or increase the risk of complications associated with a high RBC count, particularly for those with polycythemia vera.

Foods high in these compounds should be limited:

Oxalates: These can contribute to kidney stones, a known complication of polycythemia vera. High-oxalate foods include spinach, nuts, beets, and sweet potatoes.
Purines: High purine intake can raise uric acid levels and lead to gout, another potential complication. Purine-rich foods include red meat, organ meats, and certain seafood.
Saturated and Trans Fats: These can increase the risk of blood clots and inflammation, posing additional risks for those with high RBC counts. Avoid fried foods, processed foods, and baked goods containing these fats.
Excessive Sugar and Sodium: High sugar intake has been linked to an increased risk of polycythemia vera and inflammation. High sodium intake can also contribute to dehydration. Reduce your consumption of sugary drinks, processed snacks, and fast food.

Embracing a Balanced, Anti-Inflammatory Diet

Shifting towards a balanced, anti-inflammatory diet is a cornerstone of managing a high RBC count. A Mediterranean-style eating plan is often recommended due to its focus on fruits, vegetables, whole grains, and healthy fats.

Key components include:

Lean Protein Sources: Choose poultry, fish, and plant-based proteins like legumes, tofu, and beans instead of red meat. Shellfish is high in heme iron and should be limited.
Healthy Fats: Incorporate sources like olive oil, nuts, and seeds to support cardiovascular health and reduce inflammation.
Whole Grains: Opt for brown rice, quinoa, and whole wheat bread for sustained energy and fiber, which helps with digestion.
Fruits and Vegetables: Consume a wide variety of colorful fruits and vegetables (excluding high-oxalate ones) for essential vitamins, minerals, and antioxidants.
Soluble Fiber: For those experiencing gastrointestinal side effects from treatment, soluble fiber from sources like applesauce, pears, and carrots can be helpful.

What to Eat vs. What to Limit for High RBC Count


Category	What to Eat	What to Limit or Avoid
Hydration	Water, herbal teas, fluid-rich fruits and veggies like watermelon and cucumber	Excessive coffee, tea, alcohol, sugary sodas
Protein	Lean poultry (chicken, turkey), cold-water fish (in moderation), tofu, legumes, lentils	Red meat (beef, lamb), organ meats (liver), large amounts of high-purine seafood
Grains	Whole grains like oats, brown rice, quinoa, whole wheat bread	Refined grains, excessive fortified cereals, high-sugar baked goods
Fats	Healthy fats from olive oil, nuts, seeds, and avocado	High-saturated and trans fats found in deep-fried foods and processed items
Fruits & Veggies	A variety of colorful fruits (especially citrus, berries) and vegetables (broccoli, peppers)	High-oxalate vegetables like spinach, beets, and sweet potatoes
Dairy	Low-fat dairy products	Excessive high-fat dairy, as it contains saturated fat

Conclusion

While a high red blood cell count requires medical supervision, dietary changes play a pivotal role in managing the condition and its associated risks. Prioritizing hydration by drinking plenty of water, carefully managing your iron intake, and embracing a balanced, anti-inflammatory diet rich in whole foods are the cornerstones of nutritional management. Simultaneously, limiting foods high in saturated fats, purines, oxalates, and processed ingredients helps mitigate complications. As each case is unique, consulting with your doctor or a registered dietitian is essential to create a personalized plan. For more information on your specific condition, always refer to your healthcare provider.

A Note on Medical Consultation

Dietary management is one part of a comprehensive treatment plan for a high RBC count. Your doctor may recommend therapeutic phlebotomy (blood withdrawals) or medication to control your condition. It is crucial to follow their instructions and not rely on diet alone for treatment. For additional reliable information on polycythemia vera, consider sources like the National Heart, Lung, and Blood Institute.

Frequently Asked Questions

Staying hydrated by drinking plenty of water helps dilute the concentration of red blood cells in your blood, which lowers its viscosity and improves circulation. Dehydration has the opposite effect, making blood thicker.

Some leafy greens, like spinach, are high in oxalates, which can increase the risk of kidney stones in people with polycythemia vera. While many leafy greens are healthy, it's best to limit high-oxalate types and discuss your intake with a healthcare provider.

Red meat contains heme iron, which the body absorbs very efficiently. It's recommended to limit red meat intake, but you don't necessarily have to eliminate it entirely. Focus on moderation and prioritizing lean protein alternatives like poultry, fish, and legumes.

Yes, a Mediterranean-style diet is often recommended because it focuses on whole, anti-inflammatory foods like fruits, vegetables, whole grains, and healthy fats, which can help manage blood health and reduce the risk of complications.

You can include cold-water fish in moderation, which provides lean protein and omega-3 fatty acids that support heart health. However, be mindful of high-purine seafood like shellfish if you are at risk for gout.

Yes, it is best to avoid excessive alcohol, coffee, and tea, as they can cause dehydration and interfere with iron absorption. Sugary sodas should also be avoided due to their link with inflammation.

No, you should not take iron supplements if your RBC count is high, as this could stimulate more red blood cell production. Only take supplements if your doctor has diagnosed an iron deficiency and has specifically prescribed them.