7 Things You Need To Know About ‘Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency’

G6PD what? Not many people know about glucose-6-phosphate dehydrogenase deficiency.  I remember having a medical emergency away from home.  Before the doctor tried to help me I informed him of my condition.  He spent ten minutes reading up about it before administering a steroid injection helping me tackle the anaphylactic shock I was heading into (not good).

This post is to help aid and educate parents, family members and friends of those who know someone with G6PD (or any of you readers willing to learn more about this health issue).

Below are seven things you should know about G6PD:

1. The most important lesson is, “If in any doubt, leave it out”.

Let’s get this clear from the outset; this condition has 5 levels of severity.  Level 5 is the highest, and many don’t live passed 35-40 years of age. I will be focusing on level 2-3, of which a careful diet can help a person with G6PD live a normal long life.

Food is the key factor to staying healthy with G6PD.  People around the world use pulses (beans, legumes) in their cooking. These days it’s difficult to escape the soya bean especially; it seems to be in everything.  The bottom line is this: Pulses are very dangerous if you have G6PD.

Different pulses (legumes, beans) have varying degrees of effect on those with G6PD.  I once asked my doctor, “How do I know which beans are high and low risk?” With a puzzled grin, he recommended that anything grown from a pod should be left out.  The phrase ‘food for thought’ came up into my mind.  Growing up, training myself to avoid pulses (despite the benefits ‘normal people’ gain from them) has become the norm and becomes easier with time.

2. The effects of ‘high’ and ‘low’ risk foods (some of these foods will be mentioned later in the post).

Foods that harm someone with G6PD will have one of two effects; a high or low reaction.

A high reaction would occur if you were to eat a type of food that was severely toxin to those of us with this condition. What could this high reaction lead to? Hemolysis (accelerated damage to red blood cells) leading to severe blood loss. This bleeding could last for hours along with a feverish temperature.  The worst-case scenario even in level 2/3 G6PD people, is death due to excessive blood loss.

It’s good to know that while some pulses may be classed as ‘low risk’, an excessive amount, could build up into a high-risk situation. What about the low-risk reaction?

Low risk foods can cause symptoms like:

  • severe headaches
  • increased tiredness
  • lack of energy
  • yellowing of the skin and eyes
  • nosebleed
  • feelings of sadness

3. The cure for low risk symptoms

There isn’t much that can be done medically for G6PD Deficient people, as many medicinal remedies are harmful.  I found the best cure is to flush your body out with plenty of water and go to sleep.  After 24 hours of rest and lots of fluids you should feel your body attaining some normality.  For others, this period of rest may be shorter or longer, but for me, 24 hours was generally sufficient.

Parents who are worried about how they will care for their children with G6PD Deficiency can be confident that with a little education, your child will be able to live a normal life. My advice to you parents would be, “If your son or daughter feels tired and needs rest then allow them that commodity without making them feel guilty”.

4. What to do when a nosebleed occurs

Mostly due to panicking, many people become confused as to what to do when a nosebleed starts. Some will tell you to raise your head and pinch your nose.  PLEASE DON’T DO THAT! The blood will end up in your stomach and could make you feel worse and even vomit.

Always, pinch your nose tightly whilst holding a tissue, sit up straight with your head bent down and have someone place a cold wet cloth on the back of your neck.

This will allow any excess blood to be absorbed into the tissue and not your stomach. The cold wet cloth/flannel on the back of your neck will tighten up blood vessels leading to your nose, helping the bodies natural clotting process do its job quicker.

5. Some of the food to avoid

The most toxic bean which will cause hemolysis is the fava bean (kidney). Whatever you do, avoid this.  The safest decision is not to eat anything from a kitchen that has even cooked with fava beans.  Always look at the menu in restaurants and if you see a dish like, lets say ‘chilli con carne’, then refrain from ordering.  Although cross contamination won’t be fatal; low risk symptoms will definitely occur (generally within 30 minutes).

Funnily enough, fruit with high acidity can cause harm.  I have noticed this with me, but, it may or may not cause problems with you.  Keep a close watch on your well-being after eating anything which may cause low risk symptoms.  For myself, eating grapefruit leaves me with a headache and a generally unwell.

Chickpeas, lentils and any form of bean should be avoided.  Remember point one; “If in doubt, leave it out!”

As a youngster, I was obsessed with peanut butter.  I would go through jars of its thick and sticky sweetness. In my adolescent years I suffered a lot with nosebleed.  I would be sitting watching TV, reading a book at school or on an outing with my family, and my nose would just start gushing out with blood.  I felt more embarrassed than anything.  At times, I would feel so weak after a nosebleed I could barely walk.

My schooling suffered and one bad year I recall a 66% attendance.  It was so frustrating sitting at exams not knowing answers to many of the questions simply due to being absent from illness.

As I grew, learning about my body, it suddenly dawned on me that peanuts come from a pod, the same as beans.  I thought, ‘could peanuts be one food I cannot have?’.  The moment I decided not to eat peanut butter or peanuts was the moment I stopped having nosebleeds. Since that decision, I have not had a severe nosebleed.  It just goes to show, everyone will have to monitor themselves closely to the point they eventually, and unknowingly stop harming their bodies.

6. You want to help with the BBQ? Think again!

It’s a sunny day and everyone wants to get their BBQ started.  There is nothing quite like a sizzling piece of well marinated chicken cooked over a BBQ.  There is only one problem with those having G6PD; ‘naphthalene’, a chemical released from burning organic matter like coal is dangerous.  To be fair, the smoke is not good for anyone, but, especially G6PD people.

I would always have a pounding headache accompanied by extreme tiredness after cooking over a BBQ.  I never associated it with the smoke rising from the burning coals. Again, we live and learn!  I only hope this little tip helps you before learning the hard way.

Naphthalene is in other products too i.e. mothballs (let grandma know), vehicle exhaust emissions, tobacco and some plasticisers and insecticides.

7. Some harmful medicines – a very brief list!

Medicine has come so far in helping cure many infections and diseases.  I have a huge list of high and low risk drugs printed on an A4 piece of paper which I fold neatly into my wallet for reference when I’m out and about or in case of an emergency.

A whole list of drugs that can be harmful to G6PD Deficient people

Here is a very small sample of just some of these high-risk drugs:

Aspirin – pain reliever / blood thinner

Chloramphenicol – antibiotic

Dapsone – antibacterial to help fight leprosy (Hansen’s disease)

Doxorubicin – drug used in chemotherapy to fight cancer

Gadopentetate Dimeglumine – aids image scanning of blood vessels including the brain barrier (usually injected)

Isobutyl Nitrite – antidote to cyanide poisoning

Lamotrigine – treats epilepsy and bi-polar disorder

Menthol – synthetic compound from mint/peppermint (check your favourite sweets)

Urate Oxidase – found in legumes (soya bean)

P-Amino Salicylic Acid – antibiotic to treat tuberculosis; also found in face cleansers

Primaquine – used to treat malaria

Sulfacetamide – used to treat acne

Tamsulosin – used to treat enlarged prostate

Be careful with paracetamol and ibuprofen as excess amounts of these pain relievers can cause harm too.

The emotional side of living with G6PD can at times be difficult.  One bad culinary decision could lead to grave consequences.  Eating in restaurants and visiting friends’ homes for a meal can at times be embarrassing.  You hear the odd laugh when you tell the waitress, “I can’t eat beans. Can I have an extra …….. instead?”

A red face and a little nervous perspiration is far better than an anaphylactic attack!

This post is a very basic introduction to the complex deficiency of G6PD, but I hope it gives food for thought and hopefully, a little more confidence to those of you dealing with the same problem.

Stay Well.  Eat safe!


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