Key Diet Tips for Managing Polycythemia Vera
Health ConditionsBlood Disorders

4 Diet Rules for People With Polycythemia Vera

Eating certain foods can decrease the risk of certain complications, ease some side effects of treatment, and improve how you feel overall.
4 Diet Rules for People With Polycythemia Vera
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Published on February 14, 2025
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The ongoing treatments for polycythemia vera (PV) can sometimes interfere with appetite. But if you’re getting regular blood withdrawals or undergoing chemotherapy, there’s no understating the importance of eating a healthy diet.

In particular, “Eating a well-balanced, Mediterranean-based diet” can help minimize some of the complications from PV, says Stacy Morig, RD, an oncology dietitian with Dartmouth Cancer Center in Lebanon, New Hampshire. Plus, “Making small changes to their diet can also help people feel better overall.”

Here are four things you can do today to shore up your diet.

1. Follow a Mediterranean Style of Eating

Eating a Mediterranean-style diet — rich in fish, fruits and vegetables, nuts, vegetable oils and whole grains — can help prevent heart disease.

 That makes it a particularly good choice for people with PV, because the cancer causes an overproduction of red blood cells. And that increases the risk of heart attack, stroke, or pulmonary embolism (a blood clot in the lungs).

Even if you don’t follow a Mediterranean diet plan exactly, try eating plenty of fruits and vegetables, olive oil, and whole grains, while limiting added sugar, highly processed foods, and saturated fat, says Morig.

2. Try to Eat a Little Bit, As Often As You Can

Some people with PV will lose weight from the disease, because the spleen has to work overtime to clear out the extra red blood cells, which can cause the organ to grow larger. That can then lead to abdominal pain, bloating, and feelings of fullness, even after you’ve only eaten a little bit.

If you’re struggling with weight loss, try to eat nutritious, high-calorie foods, such as a nutritional supplement or protein-rich snack (think: peanut butter and a banana, full-fat yogurt with fruit and nuts, or cheese and crackers), whenever you’re able. You can also work with a registered dietitian experienced in both nutrition and oncology. Together, you can create a balanced eating plan that gives you the nutrition you need.

3. Pay Attention to Iron Intake

As many as 60 percent of people with PV have an iron deficiency, which can cause fatigue.

But while many people with an iron deficiency can take an iron supplement or a multivitamin containing iron, people with PV can’t.

“We generally try to avoid supplementing with iron, because that will cause you to make more red blood cells and add fuel to the fire,” says Jacqueline S. Garcia, MD, a medical oncologist at Dana-Farber Cancer Institute in Boston.

You can get extra iron from food, such as beans, meat, and spinach. Just be sure not to eat too much of it. For example, Dr. Garcia suggests steering clear of any fad diet that features excessive amounts of red meat. “I don’t restrict the amount someone eats, but I recommend eating a regular amount within the daily requirements,” she says. (Also, be sure to eat plant-based, iron-rich foods along with a food or drink containing vitamin C, such as a glass of orange juice, to help with iron absorption.)

For adults, the Recommended Dietary Allowance for iron is usually 8 milligrams per day, but women ages 19 to 50 need 18 milligrams.

4. Focus on Certain Types of Fiber if You Have Gastrointestinal Side Effects

Treatments such as chemotherapy may cause gastrointestinal side effects, including diarrhea and constipation, says Morig.

To address diarrhea, she recommends prioritizing foods that contain soluble fiber. “Soluble fibers act like a gel and can help absorb water in the intestines, [which adds bulk to the stool]” she says. Foods that contain soluble fiber include applesauce, citrus, pears, cooked carrots, green beans, and sweet potatoes.

If you are dealing with constipation, Morig recommends dried fruit, vegetables, and whole grains, which provide both insoluble and soluble fibers to encourage bowel movements.

If diet alone isn’t helping, talk to your clinician about stool softeners or laxatives to improve regularity, she adds.

The Takeaway

  • A Mediterranean-style diet may help ward off heart complications from polycythemia vera and improve your overall well-being.
  • Include more fruits and vegetables, nuts, olive oil, and whole grains in your diet.
  • Iron-rich foods, such as spinach and meat, can boost your iron intake and help prevent iron deficiency.
  • Work with an oncology dietitian to develop an eating plan for your nutritional needs.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Nutrition for the Person Getting Cancer Treatment [PDF]. American Cancer Society. October 2024.
  2. What Is the Mediterranean Diet? American Heart Association. May 15, 2024.
  3. Disease Complications. Leukemia & Lymphoma Society.
  4. Polycythemia Vera. Cleveland Clinic. April 25, 2022.
  5. Jang A et al. Weight Loss Predicts Inferior Outcome in Polycythemia Vera Patients. Blood. November 5, 2020.
  6. Polycythemia Vera: Diagnosis & treatment. Mayo Clinic. February 11, 2022.
  7. Randrianarisoa RMF et al. Prevalence and Diagnostic Performance of Iron Deficiency in Polycythemia. Hematology. 2023.
  8. Iron. The Vegan Society.
  9. Iron. National Institutes of Health. August 17, 2023.
  10. Eat More Soluble Fibre [PDF]. Alberta Health Services. February 2025.
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Reyna Franco, RDN

Medical Reviewer
Member of American College of Lifestyle Medicine

Reyna Franco, RDN, is a New York City–based dietitian-nutritionist, certified specialist in sports dietetics, and certified personal trainer. She is a diplomate of the American College of Lifestyle Medicine and has a master's degree in nutrition and exercise physiology from Columbia University.

In her private practice, she provides medical nutrition therapy for weight management, sports nutrition, diabetes, cardiac disease, renal disease, gastrointestinal disorders, cancer, food allergies, eating disorders, and childhood nutrition. To serve her diverse patients, she demonstrates cultural sensitivity and knowledge of customary food practices. She applies the tenets of lifestyle medicine to reduce the risk of chronic disease and improve health outcomes for her patients.

Franco is also a corporate wellness consultant who conducts wellness counseling and seminars for organizations of every size. She taught sports nutrition to medical students at the Albert Einstein College of Medicine, taught life cycle nutrition and nutrition counseling to undergraduate students at LaGuardia Community College, and precepts nutrition students and interns. She created the sports nutrition rotation for the New York Distance Dietetic Internship program.

She is the chair of the American College of Lifestyle Medicine's Registered Dietitian-Nutritionist Member Interest Group. She is also the treasurer and secretary of the New York State Academy of Nutrition and Dietetics, having previously served in many other leadership roles for the organization, including as past president, awards committee chair, and grant committee chair, among others. She is active in the local Greater New York Dietetic Association and Long Island Academy of Nutrition and Dietetics, too.

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Jessica Migala is a freelance writer with over 15 years of experience, specializing in health, nutrition, fitness, and beauty. She has written extensively about vision care, diabetes, dermatology, gastrointestinal health, cardiovascular health, cancer, pregnancy, and gynecology. She was previously an assistant editor at Prevention where she wrote monthly science-based beauty news items and feature stories.

She has contributed to more than 40 print and digital publications, including Cosmopolitan, O:The Oprah Magazine, Real Simple, Woman’s Day, Women’s Health, Fitness, Family Circle, Health, Prevention, Self, VICE, and more. Migala lives in the Chicago suburbs with her husband, two young boys, rescue beagle, and 15 fish. When not reporting, she likes running, bike rides, and a glass of wine (in moderation, of course).

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