# Nutrition and diets in myelofibrosis
Nutrition plays a role in how people with myelofibrosis feel and how well their body can resist the disease and treatment. In recent years, more research has been conducted into which nutritional choices may be beneficial. This tab describes what is known about this.
Protein-rich nutrition
ResearchediPositive results in clinical studies, not yet standard treatment
Protein-rich nutrition means eating a lot of foods high in protein: meat, fish, eggs, dairy products, legumes and nuts. In myelofibrosis, it may be important to get enough protein, because research shows that albumin (a protein in the blood) plays a role in how well someone can resist the disease.
Studies have shown that patients with better albumin levels have better outcomes and live longer. This suggests that adequate protein intake contributes to the maintenance of muscle mass and overall health. Research from 2024 and 2025 shows that albumin can be used to monitor how someone responds to treatment. A dietitian can help ensure that you get enough protein in ways that work for you.
Risks are minimal, but in severe kidney dysfunction (which sometimes occurs in myelofibrosis) protein intake may have limitations. This is something to discuss with your doctor or dietitian.
Iron avoidance and iron restriction
ResearchediPositive results in clinical studies, not yet standard treatment
Iron is an important mineral, but in myelofibrosis the body may have difficulty regulating iron levels. Some patients receive regular blood transfusions and accumulate iron (iron overload). Other research suggests that iron can worsen the symptoms of the JAK2 mutation (a major cause of myelofibrosis).
A diet with less iron or avoiding certain iron-rich foods is something that may come up in some treatment plans. This would be especially relevant when iron storage has been measured. Recent research (2023) shows that iron is a 'modifier' of how myelofibrosis behaves – it can affect the severity of symptoms.
This is a very personal matter and depends on your blood values and transfusion schedule. A dietitian with knowledge of blood disorders can help you determine what applies to you. Making your diet completely iron-free is not advisable; the goal is to find the right balance.
Vitamin B12 and folic acid
ResearchediPositive results in clinical studies, not yet standard treatment
B vitamins, especially B12 and folic acid (folate), are important for the production of red blood cells. In myelofibrosis, where the bone marrow is not working properly, these vitamins may be lacking.
Research from 2024 shows that B12 deficiency is rare but can be serious and can occur with symptoms similar to myelofibrosis itself. Research known from 2019 showed that B6 deficiency occurs in many patients with primary and secondary myelofibrosis. This suggests that B vitamin monitoring and possible supplementation may be worthwhile.
A diet richer in B12 (mainly found in animal products) and folic acid (leafy greens, legumes, certain grains) can be supportive. If you have a deficiency, your care provider will likely suggest supplementation. This is safe and can help improve your energy levels and reduce cytopenias (too few blood cells).
Nutrition to support liver function
ResearchediPositive results in clinical studies, not yet standard treatment
Myelofibrosis can damage the liver in the long term. The disease can lead to abnormalities in the blood vessels of the liver (portal hypertension), which sometimes causes nutritional problems.
Research from 2022 showed that a diet with certain characteristics can help with liver complications. A nutritional pattern that supports the liver – low in salt, low in certain types of fats, with adequate vitamins – can contribute to better wellbeing. A dietitian can help you develop an eating pattern that supports hepatic health without feeling strict or restrictive.
This is especially relevant if you have developed symptoms of liver inflammation (hepatitis) or liver fibrosis, which occurs in some patients.
Mediterranean dietary pattern
ResearchediPositive results in clinical studies, not yet standard treatment
The Mediterranean dietary pattern – lots of vegetables, fruit, nuts, olive oil, fish and limited red meat – is investigated in many studies on chronic diseases. This pattern contains many antioxidants and anti-inflammatory substances.
A 2020 study on lifestyle factors and myeloproliferative neoplasms showed that certain dietary patterns are associated with a lower risk of these diseases. Although this research focused on prevention, it suggests that this pattern may also be supportive for someone who already has myelofibrosis.
An advantage is that this pattern is flexible, tasty and sustainable. There are no risks, although with certain other conditions (for example kidney problems) you should discuss the composition with a dietitian.
Periodic fasting or intermittent fasting
UnproveniNo scientific evidence that it works
Periodic fasting (eating within a certain time window per day) is popular for general health. However, in myelofibrosis there is no direct research showing that it helps.
Because myelofibrosis already demands energy and nutrients from the body, and many patients struggle with fatigue and weakness, the risk that fasting leads to malnutrition is not small. Without specific research, it is prudent not to encourage this pattern.
If you want to try this, caution is required and you must discuss it with your doctor and dietitian. It must not lead to weight loss or reduced nutrition.
Ketogenic diet
UnproveniNo scientific evidence that it works
A ketogenic diet is low in carbohydrates and high in fats. This diet has been studied in cancer and neurological conditions, but not specifically in myelofibrosis.
There are no studies showing that a ketogenic diet helps in myelofibrosis. Moreover, this diet can be strict and carry risks (for example kidney stones, disturbed electrolytes) that can be particularly concerning in myelofibrosis. This pattern is not recommended without very strong individual reasons and close monitoring.
Complementary food and herbal supplements
Investigated (but caution needed)
Many patients with myelofibrosis try complementary and alternative medicines (CAM), including herbs and nutritional supplements. A 2026 study on patient experiences showed that many people try this.
The problem is that many of these substances can interfere with JAK inhibitors (the common treatment) and other medicines. Some herbs affect how the body breaks down medicines. This can make your treatment less effective or make side effects worse.
Anything you take as a supplement – herbs, vitamins above normal levels, powder – must be discussed with your doctor or hospital pharmacist beforehand. They can check whether it is safe alongside your medicines.
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**In conclusion:** Dietary choices in myelofibrosis are tailored. They belong in your overall treatment plan and should be matched to your blood values, symptoms, side effects of medicines and any other conditions. Many hospitals now have dietitians or nutritionists with experience in blood cancers and myeloproliferative diseases. A recent study (2026) showed that telehealth guidance by dietitians in these conditions is feasible and useful. Always discuss your dietary choices with your own healthcare provider or a specialist dietitian.
_This information never replaces a doctor's judgment. Always discuss your situation with your own healthcare provider._