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G6PD Deficiency Lifestyle Guide
An effort has been made to ensure that the information provided by the g6pd Deficiency Foundation (g6pdDF) is accurate and up-to-date, but this information is not intended to cover all possible uses, precautions, or other considerations relating to the therapies covered.
The g6pd lifestyle guide does not advocate or endorse the use of any drug or other therapy and does not diagnose patients. Healthcare professionals should use their professional judgment in using this information, and this information should not be considered a substitute for the care and professional judgment provided by a licensed healthcare practitioner.
Where to start…
Hello,
Living with G6PD deficiency (G6PDd) can be very frustrating as there are no signs and symptoms that are necessarily specific to this condition. Every G6PD-deficient individual has limits and triggers that can be very
unpredictable.
Nutrition and wellness are ways to protect ourselves from products and medications that include known G6PDd triggers. I hope that this guide helps you to feel more confident living with G6PDd and knowing what you can do to feel your best and manage the condition.
Sincerely,
Brianne Brathwaite MS RDN CDN
Fellow individual with G6PD deficiency
What is G6PDd?
Glucose-6-Phosphate Dehydrogenase deficiency (G6PDd) is a lifelong inherited enzyme deficiency caused by a mutation in the G6PD gene located on the X chromosome. Males, with one X chromosome, are hemizygous and usually exhibit severe symptoms, while females can be heterozygous or homozygous, leading to variable symptoms. Family screening is vital for identifying affected individuals and assessing the risk of inheritance. G6PD deficiency is not acquired but passed down through generations.
Oxidative Stress
Hemolytic anemia occurs when red blood cells are destroyed at a faster rate than they can be produced, resulting in an insufficient number of healthy cells for oxygen transport. Symptoms include malaise, fatigue, abdominal or back pain, followed by jaundice, brain fog, dark urine, and anemia within a day or so.
Oxidative stress can harm health, especially in individuals with G6PD deficiency, potentially leading to acute hemolytic anemia. There are established lists of drugs, chemicals, foods, and herbs that may trigger oxidative stress. The risk of hemolysis varies based on the type of G6PD deficiency. It’s important to consult a healthcare provider to review these triggers.
Further research is needed, and the G6PD Deficiency Foundation is developing an “avoid” list.
Medication Awareness Guide for G6PD Deficiency
This guide serves as a reference for potential trigger medications for those with g6pd. Prior to taking any medications, consult your doctor.
Antibiotics
- Sulphonamides
- Co-trimoxazole (Bactrim, Septrin)
- Dapsone
- Chloramphenicol
- Nitrofurantoin
- Nalidixic Acid
Antimalarials
- Chloroquine
- Hydroxychloroquine
- Primaquine
- Quinine
- Mepacrine
- Tafenoquine
Sulfa Drugs
- Sulfonamides & Sulfones (Dapsone)
- Acne Medication ( Aczone)
Urinary Infection Drugs
- Bardium (Phenazopyridine)
- Macrobid (Nitrofurnatoin)
- Maldixic Acid
- Sulfamethoxazole
Aspirin-Based Over-TheCounter (OTC)
- Aspirin (acetylsalicylic acid)
- Anacin
- Excedrin
- Pepto Bismol
Chemicals
- Moth Balls (Naphthalene)
- Methylene Blue
- Henna dyes
- Mentholated products
- Naphtylhydroxylamine (household drain, oven & bathroom cleaners)
Other Chemicals
- Detoxifying agents for chemotherapy treatment (Elitek-rasburicase)
- Beta-Naphthol or 2- Naphthol (Sudan Dyes)
- Large doses of Vitamin C (ascorbic acid)
Disclaimer: This list serves as a guide to bring awareness to potential trigger medications, as dosages may affect individuals differently. Please consult your doctor for your medical questions. The list is subject to change due to ongoing research.
The Core 4
Alcohol consumption can affect individuals very differently. Individuals with G6PD deficiency have to be careful to prevent hemolytic anemia, which is caused by oxidative stress. Excessive alcohol consumption can lead to oxidative stress. Even CDC recommendations for drinks (a maximum of 2 drinks for men and 1 drink for women daily) should be reconsidered if you feel run-down or are sick.
Smoking tobacco products may enhance oxidative stress as it encourages the production of reactive oxygen radicals and weakens the immune system. Smokers with G6PD deficiency are at a higher risk of triggering a hemolytic attack and developing complications from smoking. It is recommended to abstain from smoking.
Individuals with G6PDd are not put at risk if they participate in moderate exercise, as it can actually positively affect the body without triggering hemolytic attacks. Over-exercising, however, can lead to oxidative damage in skeletal muscle fibers and increase oxidative stress within the body.
Getting the right amount of sleep is vital and aids in reducing reactive oxygen radicals. G6PDd individuals should take this into account. Getting in hours of sleep will help aid in overall immune health and prevent brain fogginess. The National Sleep Foundation recommends that adults get anywhere between 7 to 9 hours of sleep per night.
Grocery Shopping Guide
Food guide on potential foods that can trigger g6pdd reactions.
Steer Clear
- Fava beans (fava bean, also known as broad bean, windsor bean, horse bean, bell bean, English dwarf bean, fever bean, haba bean, tick bean, pigeon bean, silkworm bean)
- Bitter gourd melon
- Chinese herbs: Click for more
Caution
- Highly processed foods- (salad dressing, canned soups, snacks fried in soybean oil, hot dogs, sausages, deli meats, and pre-made
Sauces). - Supplements
- Beans/legumes
- Blueberries (possible artificial blue dyes and contain salicylic acid)
- Soy
- High concentration of vitamin c (absorbic acid)
- Plant-based protein foods (pea protein blends)
Safe
- Dark leafy greens
- Fruits/vegetables
- Lean meat and poultry
- Eggs
- Fish
- Whole grains
Examining The Threshold Theory
G6PD deficiency can vary significantly among individuals, even though we share the same genetic predisposition. The extent to which our enzyme levels are affected by this deficiency differs from person to person. Consequently, our reactions to triggers may appear quite diverse. This variability has led to the formulation of the threshold theory, which posits that not just one trigger can have life-threatening consequences. Instead, the cumulative effect of multiple triggers, even if acting independently, could lead to hemolytic anemia.
For instance, while contracting the flu may not directly trigger hemolytic anemia in a person with G6PD deficiency, it can significantly increase oxidative stress and deplete glutathione. Under such circumstances, exposure to another trigger when immunity is low and the G6PD pathway is overwhelmed, could push an individual with G6PD deficiency into a hemolytic anemia episode. This underscores the importance of maintaining a robust immune system. This is not a complete science, and more research is needed in this area. This theory serves as a safety precaution.
Mind Body Connection
It’s crucial for individuals with G6PD deficiency to develop a strong bond with their bodies and learn to listen to their signals effectively. Reframing symptoms like brain fog and fatigue as indicators of the need to decrease oxidative stress is vital. However, this can be challenging, given that we’re often conditioned to follow rules and structures in our lives. Because each person’s experience is unique, it’s essential to seek out a healthcare provider who not only understands G6PDd but also embraces the concept of mindfulness.
Things You Can Do Now!
Take a Deep Breath
This news can be overwhelming; just like oxidative stress, our emotional well-being can influence how our bodies function. It’s important to prioritize self-care and find gentle mindfulness practices that can help regulate your nervous system during this period.
Get Tested
There are two main types of tests: qualitative and quantitative. A qualitative test confirms the presence of G6PD deficiency, while a quantitative test provides detailed information about the levels of the enzyme in your body. Additionally, it’s advisable to undergo blood work, focusing on parameters like iron levels and red blood cell count, to establish a baseline for further assessment.
Remove The Triggers
As mentioned in earlier sections of this wellness journal, not all triggers will impact you in the same way. However, it’s crucial to eliminate all triggers initially and then collaborate with a dietitian regarding food-related triggers. Together, you can navigate the process of reintegrating these items into your diet while relearning to tune into your body’s signals.
Prioritize Antioxidants
Because our bodies are adept at managing oxidative stress, it’s essential to recognize the need for regular intake of antioxidants, especially for individuals with G6PD deficiency. Opting for antioxidant-rich foods is preferred over supplements, as certain sources of vitamin C (ascorbic acid) in supplement form can potentially trigger hemolytic anemia.
Practice Gratitude
Discovering that you have G6PD deficiency can be seen as a blessing. Without this knowledge, one may experience numerous adverse effects throughout their lifetime. Understanding your condition empowers you to embark on a new journey, taking control over your well-being and how you feel.
You are the Expert on Your Own Existence
Given the scarcity of healthcare providers specializing in G6PD deficiency, it can be challenging to connect with the right professionals. It’s advisable to be prepared with specific questions and, if necessary, inquire about alternative resources. In some instances, you might be the first individual they’ve encountered with G6PD deficiency.
Checklist
- Genetic testing will determine if you have the G6PDd gene that can cause G6PD deficiency
- Quantitative testing to determine the amount of G6PD enzyme activity actually present.
- Eliminate triggers.
- Alerting the family, as this deficiency is genetic.
- Connecting with a G6PD community and signing up for the G6PDd Foundation resources is a great start!
- Finding a G6PDd healthcare professional.
Frequently Asked Questions
How Do I know I Have It?
You can know if you have G6PD deficiency through a simple blood test that measures your G6PD enzyme levels. If you’ve experienced symptoms like fatigue, jaundice, or reactions to certain foods or medications, consult your healthcare provider for testing. Testing is especially recommended for those with a family history or from regions where it is more common.
Who Are The Experts?
G6PD deficiency experts include hematologists, geneticists, and specialized healthcare providers familiar with metabolic and enzyme disorders. Researchers focused on genetic conditions, pediatricians, and dietitians with experience in managing G6PD-related dietary considerations. The G6PD Deficiency Foundation collaborates with specialists to provide up-to-date resources and guidelines.
What Are The Signs And Symptoms?
Symptoms of G6PD deficiency-related hemolysis include pale skin, jaundice (yellowing skin and eyes), and dark-colored urine (deep yellow to tea-colored). Individuals may also experience extreme fatigue, dizziness, shortness of breath, rapid breathing, and a fast heart rate. An enlarged spleen (splenomegaly) may occur, along with possible fever, abdominal or back pain, and digestive issues like diarrhea and nausea.
Red Flags
Red flags around misinformation regarding G6PD deficiency include claims that it can be cured (it’s a lifelong genetic condition), suggesting that all individuals with G6PD deficiency will experience severe symptoms (severity varies), and misleading advice about the safety of foods or medications. that are safe. It’s also important to be cautious of any sources that do not cite reputable medical research or guidelines. Always rely on information from trusted healthcare professionals or organizations like the g6pd Deficiency Foundation.
Pregnant with g6pd Deficiency
This video was created for parents & family members when their baby/newborn is diagnosed with G6PD deficiency (G6PDd).
Over 400 million worldwide have this condition, yet too many have never heard of it. Knowing you are G6PD deficient is a lifetime gift of staying healthy!
Be mindful to avoid G6PDd triggers when pregnant or breastfeeding.
The g6pd Deficiency Foundation, Inc.’s purpose is to provide a website that has effective and enriching G6PD Deficiency information based on valid research and reported cases. Through the implementation and provision of educational seminars & literature to the general public and medical community, we hope to encourage G6PD-deficient individuals to live healthy lives.
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