G6PD Deficiency Explained: Essential Food and Care Guide

Understanding G6PD Deficiency: Food and Care Essentials

Maria Beatriz P. Gepte, MD, MPH

What is G6PD Deficiency?

Glucose 6 Phosphate Dehydrogenase (G6PD) deficiency is the most common enzyme disorder in the world, affecting around 400 million people.¹ Enzymes play an important role in various processes in the body, and a lack of G6PD can lead to fragile red blood cells that are more fragile and prone to damage.  This condition is more common in males as the G6PD gene is found on the X chromosome. It's also more frequent in countries where malaria used to be common, such as those in the Mediterranean, Africa, and Asia.¹

How Common is G6PD Deficiency in the Philippines?

Since 2004, all newborns in the Philippines have been screened for G6PD deficiency under the Newborn Screening Program.¹ Newborn screening for G6PD deficiency was included in the program because it has been reported to be quite frequent in areas where malaria, an illness from mosquito bites, is also found.² From 2004 to 2021, data showed that 1 in every 63 Filipino newborns had G6PD deficiency.³ Thanks to early screening, families can get the right guidance right away. Most children with this condition can lead healthy lives with proper care and by avoiding specific triggers.³

What Happens to Children with G6PD Deficiency?

In general, kids with G6PD deficiency stay well since normally there is enough active enzyme in the body. Problems usually appear only when they eat or come into contact with certain foods, medicines, or chemicals. Newborns may develop jaundice (yellow skin) early on. In more serious cases, their red blood cells can break down suddenly, leading to pale skin, yellowing, or even tea-colored urine—a condition called hemolysis.

Foods and Drinks to Watch Out For

Sometimes, G6PD deficiency is also called 'favism', a name which relates to fava beans or a type of legume. Although legumes include a wide range of plant foods including beans, lentils and peas, fava beans are unique because they can be harmful to individuals with G6PD deficiency due to the presence of natural compounds, vicine and convicine. These substances can cause the destruction of red blood cells in individuals with G6PD deficiency. Luckily, other commonly used legumes like soybeans, mung beans, and chickpeas are safe because they lack these compounds⁴. This is why some parents worry about soy milk, thinking that it may also pose risk. However, scientific evidence does not support that claim. In fact, soy-based food products have not been reported to trigger hemolytic crises in individuals with G6PD deficiency. Other items to avoid include bitter melon (ampalaya), tonic water, dried fruits with sulfites, artificial food dyes, and large amounts of dark berries like blueberries and blackberries³.

What Can Children With G6PD Safely Eat?

A balanced diet is key! Fresh fruits, green leafy vegetables, lean meat, fortified cereals, and whole grains are all good options. These foods help support the immune system and overall health, which can help avoid complications down the line. 

Medicines to Avoid – And What’s Safe

When it comes to medications, some antibiotics and anti-malarial drugs can trigger a crisis in kids with G6PD. It’s best to avoid sulfonamides (like sulfamethoxazole), dapsone, nitrofurans, and quinolones (like ciprofloxacin).⁵,⁶ Safe alternatives include penicillins, cephalosporins, macrolides, and carbapenems. Just remember to always check with your doctor before giving any medication

What to Do When Your Child Gets Sick

Infections can also lead to red blood cell breakdown, even if there aren’t any food or drug triggers involved. If your child gets sick and shows signs like extreme paleness, yellowing skin, or dark urine, it’s important to see a doctor right away. Early treatment can help prevent serious complications.