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G6PD deficiency in detail: what families in India should know | CION Cancer Clinics
G6PD deficiency is an inherited condition where red cells lack a protective enzyme. Most people with it feel completely well. The risk comes from triggers: certain medicines such as primaquine, fava beans, naphthalene balls and serious infections, which can break down red cells suddenly. This page explains the triggers, the tests, the warning signs of an attack, and what it cannot tell you about your own case. At CION Cancer Clinics, our haematologist cares for anaemia, bleeding, clotting and inherited blood disorders, with ArogyaSri, CGHS and cashless insurance accepted.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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The short answer
What is G6PD deficiency?
G6PD deficiency is an inherited condition in which red blood cells lack enough of an enzyme that protects them from damage. Most people with it feel completely well, until a trigger such as certain medicines, fava beans or a bad infection makes their red cells break down suddenly.
What the enzyme does
G6PD stands for glucose-6-phosphate dehydrogenase. It is a working protein that shields red cells from harmful chemicals the body makes when it is under stress. Without enough of it, a trigger can damage many red cells at once. The sudden breakdown, called haemolysis, can cause an anaemia, meaning a low haemoglobin, within a day or two.
Why it matters in India
It is one of the most common inherited blood conditions in the world, and it is found across India. It is more common in some communities, including several tribal groups, and in areas where malaria has long been present. Many people only find out when a newborn is jaundiced or after a malaria medicine causes trouble.
Why boys are affected more often
The gene sits on the X chromosome. Boys have one X, so one changed copy is enough to cause the condition. Girls have two, so they are more often carriers, although some girls and women are affected too.
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Signs of a sudden attack that cannot wait
If someone with G6PD deficiency, or a child being checked for it, develops dark tea- or cola-coloured urine, yellow eyes, sudden paleness, breathlessness, a racing heart or unusual drowsiness, go to the nearest emergency department the same day or call 108. Take the name of any medicine or food taken recently. Do not wait to see if it settles, and do not give a new medicine at home first.
Not sure whether this applies to you?
Ask an oncologistWhat sets it off
What can trigger an attack?
Your haematologist will give you a written list suited to you. These are the groups it usually covers.
Certain medicines
Some antimalarials, antibiotics and pain medicines can cause red cell breakdown. Always tell every doctor, dentist and pharmacist about the condition before any new prescription.
Often on the list
- Primaquine and some other malaria medicines
- Dapsone and some sulfa antibiotics
- Nitrofurantoin, rasburicase and methylene blue
Fava beans
Fava beans, also called broad beans, are a well-known trigger, eaten fresh, dried or cooked. The reaction is called favism. Check packaged snacks and mixtures, since the beans are not always named clearly.
Infections
A serious infection, including hepatitis, typhoid or pneumonia, is one of the most common triggers in practice. Fever with dark urine needs the same urgency as a medicine reaction.
Household chemicals
Naphthalene balls, used to keep insects out of clothes, can trigger an attack, especially in babies wearing stored clothing. Keep them out of the house if a family member has the condition.
Some herbal and home remedies have also been linked to attacks. Ask before using them.Getting tested
How is G6PD deficiency tested?
A screening test
A simple blood test shows whether enzyme activity is normal or low. Some newborn screening programmes and malaria clinics use quick versions of this test.
A measured level
A quantitative test gives an actual enzyme level. It helps when the screening result is borderline, and it is especially useful for girls and women, who can have levels in between.
Timing matters
Straight after an attack, the surviving young red cells hold more enzyme, so the test can look falsely normal. Your doctor may repeat it once the blood has recovered, rather than trusting one early result.
Gene testing, sometimes
Gene testing is not needed for most people. It can help with unclear results in women or with family planning questions, and CION's team arranges it through qualified laboratories where it helps.
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Commonly believed
What do families often get wrong about G6PD deficiency?
"It is a serious blood disease, so our child will always be ill."
Most people with G6PD deficiency live normal, healthy lives and never have a severe attack. The main job is knowing the triggers and avoiding them, not constant treatment.
"Girls cannot have it."
Girls are affected less often, but they can have low enzyme levels and react to triggers. A girl or woman with a family history should be tested with a measured level, not only a quick screen.
"If one medicine was fine last time, all medicines are fine."
Each medicine carries its own risk, and a reaction can depend on the dose, an illness at the same time, and the person's enzyme level. Check every new prescription, including ones bought over the counter.
"Iron tonics will help the weakness after an attack."
The anaemia after an attack comes from red cells breaking down, not from a lack of iron. The body usually rebuilds on its own. Ask your doctor before giving any iron or tonic.
Two situations that matter
What about newborns and malaria treatment?
Newborns and people being treated for malaria are the two groups where G6PD deficiency most often causes real harm in India. Both are largely preventable once the condition is known.
Newborn jaundice
Babies with the condition are more likely to develop deep jaundice, a yellow colour of the skin and eyes, in the first days of life. Very high bilirubin can harm a baby's brain, so doctors watch these babies closely and start light treatment early. If your baby looks more yellow, feeds poorly or is unusually sleepy, see a doctor that day.
Malaria medicines
Primaquine is used in India to clear the hidden liver stage of vivax malaria. It can cause serious red cell breakdown in people with G6PD deficiency. Current national guidance supports testing before it is given where testing is available. If you know you have the condition, tell the doctor treating the malaria. Do not stop a malaria medicine on your own; the team will decide on a safe plan.
Reference ranges for enzyme tests differ between laboratories, and a single result is read alongside symptoms and repeat tests.Being straight with you
What can this page not tell you?
This page cannot tell you which medicines are safe for you, or how badly you might react. Enzyme levels and the type of gene change vary, so the list of medicines to avoid is personal. Your haematologist gives you that list.
When to see a haematologist
Ask for a referral if the result is borderline, if you are a woman with a family history, if you have had an attack, or if your red cells seem to break down even without a clear trigger. That last pattern is rarer and needs a closer look. At CION, a haematologist reviews your reports and discusses the case with a wider team.
What to keep with you
Keep a copy of the test report on your phone and in your wallet. Carry the list of medicines to avoid when you travel, and share it with your child's school and paediatrician.
Questions we are asked
Common questions about G6PD deficiency
Is G6PD deficiency a type of blood cancer?
No. It is an inherited enzyme condition of the red cells, not a cancer, and it does not turn into leukaemia or any other cancer. Haematologists look after both cancerous and non-cancerous blood conditions, so being seen at a cancer centre for it does not mean cancer is suspected.
Can my child take paracetamol?
Paracetamol at the normal dose your doctor advises is generally considered usable in G6PD deficiency. Some other pain and fever medicines are less certain. Because every child is different, check with your child's doctor, and never give a new medicine at home without telling them about the condition.
Does G6PD deficiency go away as my child grows?
No. It is lifelong, because it comes from the genes. What changes is how you manage it. Older children and adults learn their triggers, and most go through life with few or no attacks. The newborn period is usually the riskiest time.
Can we eat normal Indian food?
Almost all everyday food is fine. The main food to avoid is fava beans, also called broad beans. Ordinary dals and pulses are not the problem. If you are unsure about a particular bean or packaged snack, ask your haematologist rather than cutting out whole food groups.
Does the whole family need testing?
It often helps. Brothers of an affected boy may also have it, and his mother is likely to be a carrier. Sisters may be carriers or mildly affected. Knowing in advance makes it easier to avoid triggers and to warn doctors before surgery or a new medicine.
Can I donate blood?
Rules differ between blood banks. Some do not accept blood from people with G6PD deficiency, because donated red cells may break down in a sick person receiving them. Tell the blood bank about the condition and follow their guidance.
What happens in hospital during an attack?
The team stops the likely trigger, checks the haemoglobin and kidneys, and gives fluids. A blood transfusion is given if the haemoglobin falls too far or the person is struggling. Most people recover once the trigger is removed, but a severe attack needs hospital care, not home treatment.
Are tests and treatment covered by Aarogyasri or insurance?
Emergency admissions and transfusions are often covered by Aarogyasri, CGHS, ECHS, EHS, PM-JAY or cashless insurance. Cover for enzyme or gene tests varies. Scheme rules change, so call the helpline with your card details and we will check the current position.
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Sources
- MedlinePlus Genetics (US National Library of Medicine) — Glucose-6-phosphate dehydrogenase deficiency
- MedlinePlus (US National Library of Medicine) — Glucose-6-phosphate dehydrogenase deficiency
- NHLBI — Hemolytic Anemia
- National Center for Vector Borne Diseases Control, Government of India — Malaria programme and treatment guidelines
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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Send it to us or call the helpline. A CION haematologist will read it with you and help you understand what to avoid. One helpline serves every CION centre.