What to Eat When You Have Polycythemia Vera

Dietary Recommendations for Better Management

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Polycythemia vera is a chronic blood disorder in which the body makes too many red blood cells. This condition can cause a number of symptoms and complications. The disease is not caused by dietary factors, and it cannot be reversed or managed with any specific diet.

However, if you have polycythemia vera, it is important that you understand that many serious complications can be exacerbated by certain foods. You need to consider dietary issues to make sure that you eat in a way that helps minimize your risk of polycythemia vera complications. 

Best Diet Practices for Polycythemia Vera

Verywell / Jessica Olah


If you have polycythemia vera, you are prone to having excess red blood cells circulating in your body throughout your life. This can cause low energy, tiredness, stomach ulcers, gout, and kidney stones.

Sometimes life-threatening blood clots occur, leading to a pulmonary embolism (a blood clot that develops in a blood vessel in the body), heart attack, and stroke. Over time, polycythemia vera may progress to blood cancer. The associated bone marrow damage can also predispose you to bone fractures.

The complications of polycythemia vera can cause disability and death. Fortunately, medical treatment for polycythemia vera is highly effective for prolonging a healthy survival. 

Certain dietary habits can increase the risk of fatigue, ulcers, kidney stones, blood clots, and cancer. So, you can benefit a great deal by adopting a diet that does not increase the risk of these problems. 

Dietary Modifications

It’s important for you to know that the dietary modifications you need to follow with polycythemia vera are safe and are not extremely difficult to manage. You will only have to reduce your intake of a few types of foods.

While the recommendations aren’t highly restrictive, the dietary habits you need to follow when you have polycythemia vera require planning and attention. Over time, you will learn to adjust to these modifications, and they can become healthy habits for you. 

How It Works 

With polycythemia vera, you need to adopt a lifelong approach to certain eating strategies. It is a good idea to meet with a nutritionist or a dietitian to be sure you are getting an adequate amount of calories, vitamins, and minerals when you eliminate certain foods from your diet. 

You should learn the optimal calorie intake for your height, body size, and level of activity. A nutritionist or dietitian can create a few sample menus that you can easily prepare. Also, look at the menus of restaurants that you like so you can quickly figure out what is best to order or avoid if you like to eat out.


You need to maintain a consistent approach to your diet. The food habits that work best for polycythemia are safe and don't cause side effects. So it's healthy to maintain this dietary approach whether your polycythemia vera is severe, moderate, or mild.

If you develop problems such as an ulcer or a kidney stone, your doctor may also prescribe a strict dietary modification for you to follow until the issue stabilizes or resolves.

What to Eat 

Low energy can be a problem with polycythemia vera. So, you can’t skimp on calories. The best way to maintain your energy is by avoiding simple sugars and by eating foods that contain complex carbohydrates (like vegetables and whole grains) and lean proteins. These will provide you with lasting energy throughout the day.

Compliant Foods
  • Calcium-rich foods: Dairy, broccoli, bananas

  • Water throughout the day

  • Lean protein

  • Fruits

  • Vegetables

  • Nuts

Noncompliant Foods
  • Excess oxalate: Beans, berries, leafy greens

  • Excess purine: Alcohol, meat, seafood

  • Excess sugar

  • High-fat foods

  • Processed foods

  • Deep-fried foods

With polycythemia vera, you need to get enough of certain nutrients while avoiding some components in food that can cause problems, such as:

  • Water: Polycythemia vera causes excess red blood cells to circulate in your blood vessels and increases the risk of kidney stones and gout. Drinking enough water is vital to address these issues. Getting ample amounts of water won’t completely solve these problems, but it can help reduce their severity and risk.
  • Calcium: Polycythemia vera is associated with bone marrow damage, which can increase your risk of bone fractures, making it important to get enough calcium in your diet. This mineral helps build and maintain bone strength.
  • Oxalate: You can also develop kidney stones, a condition that causes flank pain (pain in the lower back on one side), and possibly blood in the urine. In general, it’s recommended to avoid foods that are high in oxalate (such as beans, berries, and leafy greens), a component of kidney stones.
  • Purines: You can develop gout as a complication of polycythemia vera. This is a painful type of joint swelling. In general, it’s recommended that you avoid foods that are high in purines (such as red meat, organ meat, cold-water fish) if you have gout because they can increase your level of uric acid—a major culprit in gout.
  • Fat: With polycythemia vera, it is important that you avoid consuming too much high-fat foods because they can increase your risk of blood clots and inflammation. These include red meat with fat, chicken with skin on it, and deep-fried foods or dessert made with heavy creams or large amounts of butter.
  • Processed food: It is important to eat fresh food and to minimize your intake of highly processed foods and foods that contain preservatives, which can increase the risk of inflammation and cancer.
  • Foods that irritate a peptic ulcer: Ulcers are another potential complication of polycythemia vera. It may help to avoid alcohol, caffeinated beverages, fatty foods, chocolate, and spicy foods while healing.

Recommended Timing

It's best to approach your diet with an attitude of moderation. Eat and drink a balanced diet throughout the day, rather than being too hard on yourself and then craving the foods that you have been missing.

Cooking Tips 

Avoid deep-frying your food, which can increase the cholesterol, fat, and harmful trans fats that you consume. Also, avoid adding sugar or salt to the food you cook, as these can be dehydrating, and they don’t provide needed nutrients.


If you develop an ulcer, gout, or a kidney stone, you can expect these issues to resolve with a combination of medical treatment and dietary modifications. Your doctor may advise you to make some temporary changes as you recover from these complications.

You may need modifications if you have:

  • A kidney stone: Avoid foods high in oxalate.
  • A gastrointestinal ulcer: Avoid foods and drinks that irritate the ulcer.
  • Gout: Avoid foods high in purine.


You may need periodic blood tests to monitor your condition, and you doctor may recommend different dietary modifications based on the results of your blood tests.

Overall, the eating habits that you need to follow with polycythemia vera are very similar to the standard diet that's recommended by the U.S. Department of Agriculture (USDA). The main difference is that you should avoid excess consumption of oxalate-rich foods and purine-rich foods.

When you reduce your intake of certain foods—like beans and meat—it's important that you maintain a varied diet that includes an ample supply of the nutrients in those foods. For example, beans and meat are high in protein, but you can get this nutrient from chicken, tofu, eggs, and dairy, as well.

Additionally, keep your energy up by eating foods that contain carbohydrates—like brown rice and bananas—throughout the day, and make sure you drink plenty of water.

Other Polycythemia Vera Diets 

Among the ideas that have been proposed for managing polycythemia vera is to avoid iron. That’s because iron is a component of hemoglobin, a protein in red blood cells. However, iron intake has not been shown to have an effect on polycythemia vera or its symptoms and complications.

A Word From Verywell

Polycythemia vera can affect many aspects of your health as it progresses. While there is no specific polycythemia vera diet, it is important that you approach your eating habits with consideration of your condition.

The more you understand the implications of your diet on your health, the more likely you are to develop eating habits that work—along with your medical treatment—to help you achieve the best quality of life with polycythemia vera.

Smoking is not a dietary factor, but this habit can have a detrimental effect on polycythemia vera. If you smoke, it is highly recommended that you quit. Talk to your doctor about a smoking cessation program because it is very hard to quit on your own.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Podoltsev NA, Wang X, Wang R, Hofmann JN, Liao LM, Zeidan AM, Mesa RA, Ma X. Diet and risk of myeloproliferative neoplasms in older individuals from the NIH-AARP cohort. Cancer Epidemiol Biomarkers Prev. 2020 Nov;29(11):2343-2350. doi:10.1158/1055-9965.EPI-20-0592

  2. Ramanathan G, Hoover BM, Fleischman AG. Impact of host, lifestyle and environmental factors in the pathogenesis of MPN. Cancers (Basel). 2020 Jul 24;12(8):2038. doi:10.3390/cancers12082038

  3. Siener R. Nutrition and kidney stone disease. Nutrients. 2021 Jun 3;13(6):1917. doi:10.3390/nu13061917

  4. Cleveland Clinic. Gout.

  5. MedlinePlus. Peptic ulcer disease—discharge.

  6. US Department of Agriculture. Dietary guidelines for Americans.

  7. Hasselbalch HC. Smoking as a contributing factor for development of polycythemia vera and related neoplasms. Leuk Res. 2015 Sep 9:S0145-2126(15)30373-8. doi:10.1016/j.leukres.2015.09.002

By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.