What G6PD-deficient individuals should really avoid

Some of the foods commonly eaten around the world can cause people with G6PD Deficiency to hemolyze. Some of these foods can be deadly (like fava beans). Some others can cause low level hemolysis, which means that red blood cells die, but not enough to cause the person to go to the hospital. Low level hemolysis over time can cause other problems, such as memory dysfunction, over worked spleen, liver and heart, and iron overload. Even though a G6PD Deficient person may not have a crises when consuming these foods, they should be avoided.

Fava beans and other legumes

This list contains every legumes we could find, but there may be other names for them that we do not know about. Low level hemolysis is very hard to detect and can cause other problems, so we recommend the avoidance of all legumes.

Sulfites

And foods containing them. Sulfites are used in a wide variety of foods, so be sure to check labels carefully.

Menthol

And foods containing it. This can be difficult to avoid as toothpaste, candy, breath mints, mouth wash and many other products have menthol added to them. Mint from natural mint oils is alright to consume.

Artificial blue food coloring

Other artificial food color can also cause hemolysis. Natural food color such as found in foods like turmeric or grapes is okay.

Ascorbic acid

Artificial ascorbic acid commonly put in food and vitamins can cause hemolysis in large doses and should be avoided. It is put into so many foods that you can be getting a lot of Ascorbic Acid without realizing it. See Ascorbic acid for more information about iron absorption and ascorbic acid.

Vitamin K

This is from drugbank: “Menadione (Vitamin K3), which is not used as a nutritional supplemental form of vitamin K for humans, has been reported to cause adverse reactions, including hemolytic anemia. Large doses have also been reported to cause brain damage. Vitamin K administered to newborns with G6PD Deficiency has been known to cause adverse outcomes including hemolytic anemia, neonatal brain or liver damage, or neonatal death in some cases.

Tonic water

(contains quinine, a contraindicated drug which causes hemolysis in G6PDD people)

Bitter Gourd and Garden Egg

Bitter Gourd is also known as Bitter Mellon. These are common foods in some parts of Africa and Asia.

Some Chinese Herbs
Particularly Rhizoma Coptidis (huang lien), Calculus Bovis (neu huang), Flos Chimonanthi Praecocis (leh mei hua), Flos Lonicerae (kam ngan fa) and Margarita or anything containing them.

List of Legumes for Those With Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency and Favism

Fava beans are contraindicated for people with G6PD Deficiency, however, many people also react to varying degrees to many or all legumes. Many times the reaction is not a full blown hemolysis where hospitalization is required, but does cause hemolysis of a lesser degree. Over time, these smaller hemolysis events can lead to other more serious complications or related disorders. See Why We Recommend Avoiding Legumes for more information. The list is provided as an aid to those wishing to abstain from all legumes. If you would like more information about legumes and g6pd deficiency, Plants Of Life, Plants of Death has in interesting discussion.

Why We Recommend Avoiding Legumes

There is a lot of controversy about legumes causing hemolysis in G6PD Deficient patients. In order to address this issue, I will first address the issue of varying degrees of hemolysis

Low level hemolysis

Most doctors and other medical professionals see hemolysis in G6PDD patients as an all or nothing problem. If you don’t hemolyze badly enough to send you to the hospital, you’re fine. I strongly disagree with this for the following reasons:

• If that were true, all hemolytic events would end in death, and this is not correct. The vast majority of hemolytic events are mild enough for the body to compensate for without intervention. Following this reasoning, it is only logical that hemolysis can happen from very mild to very severe, depending on circumstances such as health, stress, trigger, age, etc.

• Many people go for years experiencing hemolysis without knowing it. They can have other health issues that eventually lead to the discovery that they have G6PDD, or they eventually have a hemolytic crises. I have received countless emails from people in this category. Their health issues run from liver, heart, blindness, renal spleen and chronic yellow color to skin, to death in some cases. These problems can occur from early in life to later in life. Many families discover G6PDD runs in their family only after the needless death or serious illness, cause by G6PDD complications, of a family member.

Hemolysis

Now that we know that hemolysis varies in intensity, let’s discuss the cause of hemolysis. When a red blood cell comes into contact with an oxidative substance, an RBC with sufficient G6PD to reduce glutathione will neutralize the oxidative substance rendering it harmless. Those with G6PDD cannot reduce enough glutathione to protect RBCs from damage so, the oxidative substance destroys the RBC. It is my opinion that his happens to everyone with G6PDD, regardless of which variant they have. What is more important than variant is the degree of G6PDD the person has. One person may have more G6PD than another so that person is able to produce more reduced glutathione to protect RBCs than a person with less G6PD. For the purpose of this discussion both less G6PD and less effective G6PD are considered the same.

Legumes and Hemolysis

Now I will discuss legumes. In every contraindicated list I have ever seen, fava beans, or broad beans, are considered contraindicated for all variants of G6PDD, yet some insist that all variants of G6PDD do not exhibit favism. The definition of favism is a condition that causes hemolysis from exposure to fava beans. As of now I have never seen a research paper or other proof as to the exact chemical, or chemicals, in fava beans that cause hemolysis.

Over the past few years, some people using hemoglobin meters have shown that many other legumes also cause hemolysis to varying degrees. Again, it is my opinion that all people react to these substances, but to varying degrees depending on severity of G6PDD, health, etc, as described above.

Because low level hemolysis (or mild hemolysis) is very hard to detect, it is logical that many people believe that they are not reacting to legumes or other substances that cause low level hemolysis. But, low level hemolysis can be very dangerous over time. Our bodies must generate more RBCs to compensate for the ones that are destroyed and the destroyed RBCs must be cleaned up. This process takes resources needed for healthy bodies, consequently we are more susceptible to other diseases and they can be more severe than when we are not undergoing low level hemolysis.

Medical research is far behind when it comes to legumes and G6PDD. Because I have had so much success in stopping hemolysis by avoiding all legumes and products containing them, I recommend that

they be avoided. Hopefully, someday maybe medical research will provide us with more information concerning the exact chemicals they contain that causes hemolysis.