In G6PD deficiency, haemolysis is triggered by merely smelling fava beans and by eating lentils, as well as by aspirin and antibiotics.
Original statement
بيعمل انيميا البحر المتوسط او انيميا الفول او الفافيزم اللي هو الولد اللي بيكسر كرات الدم الحمراء بتاعته بمجرد تعرضه للاسبرين بمجرد ما يشم الفول بمجرد ما بياكل العدس مجرد ما ياخد حقنه اجمنتين
verbatim according to source. Translation by the project; the Arabic wording is authoritative.
Translation
In G6PD deficiency, haemolysis is triggered by merely smelling fava beans and by eating lentils, as well as by aspirin and antibiotics.
Origin
- Source status
- Video transcript (own words)
- Attribution
- Elawady (machine transcript)
- Video
- Dr.D Clinics - Diaa Al Awady is live!الأنيميا أ اللي بتحصل بتحصل ليه ؟ تبادل الغازات ٣ (Open source)
- Published
- 12 May 2025
- Timestamp
- 0:13:12 (location in the original video’s automatic YouTube caption track; confirms where the words occur, not who speaks)
- Attribution uncertainty
- Archive transcript (YouTube captions or AI-generated); wording may contain transcription errors; no timestamps available.
- Claimed mechanism
Not specified.
- Claimed health effect
Haemolysis.
- Population concerned
G6PD-deficient people
- Geographic restriction by Elawady
none found
Diverging source versions
لو شم ريحه الفول المدمس او مشي في ارض فيها فول زي الدكتور محمد عبدم قال خلايا الدم بتاعته تتكسر
- Source status
- Video transcript (own words)
- Attribution
- Elawady (machine transcript)
- Video
- Dr Diaa Al Awady د ضياء العوضي is live! شريحة في الدماغ (Open source)
- Published
- 1 February 2026
- Timestamp
- 1:32:53 (location in the original video’s automatic YouTube caption track; confirms where the words occur, not who speaks)
- Attribution uncertainty
- Archive transcript (YouTube captions or AI-generated); wording may contain transcription errors; no timestamps available.
هل عدس يعمل تاثير الفول في تكسير كرات الدم الحمراء طبعا اي بقوليات ليها نفس التاثير كتير اي حاجات تعمل استرس في بطنك بتكسر كرات الدمراء بتاعتك
Does lentil have the same effect as fava beans in breaking down red blood cells? Of course; any legumes have the same effect. Many things that cause 'stress' in your abdomen break down your red blood cells.
- Source status
- Video transcript (own words)
- Attribution
- Elawady (machine transcript)
- Video
- Dr Diaa Al Awady د ضياء العوضي is live!لايف الخميس ❤️❤️❤️ (Open source)
- Published
- 30 January 2026
- Timestamp
- 1:29:51 (location in the original video’s automatic YouTube caption track; confirms where the words occur, not who speaks)
- Attribution uncertainty
- Archive transcript (YouTube CC or AI-generated); no timestamps; wording may contain speech-recognition errors; speaker turns are not marked, the excerpt was judged to be Elawady's own speech from context.
Scientific assessment
Mostly false – Essential parts of the statement are not supported by the evidence or are strongly exaggerated.
Certainty of evidence: moderate – Further research may still affect the assessment.
1. What was claimed?
Smelling fava beans or eating lentils triggers haemolysis in G6PD deficiency.
2. What is demonstrably correct?
Eating fava beans is an established trigger of haemolysis in G6PD deficiency, and a short list of specific drugs, including a few antimicrobials such as dapsone and (with caution) nitrofurantoin, should be avoided (I-LEG-107, I-LEG-108). Infections can also trigger haemolysis.
3. What is wrong or exaggerated?
Lentils and other legumes do not contain the fava-bean triggers vicine and convicine (I-LEG-106), and the CPIC guideline could not confirm any food trigger other than fava beans (I-LEG-107). No verified source supports haemolysis from merely smelling fava beans. Aspirin at usual doses (up to 1 g/day) is classed as low-to-no risk (I-LEG-107). Antibiotics as a class are not triggers: penicillins such as amoxicillin(-clavulanate) and quinolones were followed by coded haemolysis in fewer than 0.1% of courses in G6PD-deficient patients (I-LEG-109). In a later live stream (ETrHnHTUqVA, 2026-01-30) Elawady generalises further to all legumes and abdominal 'stress'; no source supports this.
4. What remains unclear?
Hagag 2018 (Egypt) lists lentils (2.8%) and other legumes as reported precipitants, based on patient history; whether these are true triggers or co-exposures is unclear.
5. Which studies support it?
Hagag 2018 (I-LEG-05; lentils 2.8% of patient-reported precipitants, history-based, unconfirmed); NHS hospital leaflet (I-LEG-110) lists several specific antibiotics to avoid (dapsone, nitrofurantoin, sulphonamides, quinolones, nalidixic acid), but not aspirin, lentils or amoxicillin.
6. Which studies contradict it?
Gammal 2023 CPIC guideline (I-LEG-107); Youngster 2010 (I-LEG-108: solid evidence for only seven drugs); Lavon 2026 (I-LEG-109: haemolysis after 0.050% of penicillin and 0.079% of quinolone courses, aOR 1.29, 0.92-1.77); Beretta 2023 (I-LEG-106: other legumes lack the triggering agents); Luzzatto 2020 (I-LEG-08).
7. What applies to Germany and Europe?
Not specific.
8. What is known about Egypt?
In Egypt, falafel (made from fava beans) is a frequent trigger; mixed dishes may explain attributions to other legumes.
9. What practical conclusion is appropriate?
People with G6PD deficiency should avoid fava beans in all forms (ful, falafel/taameya, fresh beans) and the specific drugs named by their doctor or pharmacist. Lentils, normal-dose aspirin and common antibiotics are not established triggers; needed antibiotics should not be withheld, but every prescriber should be told about the deficiency.
Assessment details
- Rationale for certainty of evidence
Fava bean ingestion is an established trigger (see C-LEG-03), but the claim's extensions are contradicted by moderate-certainty evidence: the 2023 CPIC guideline, based on a systematic review, found no peer-reviewed evidence that foods other than fava beans trigger haemolysis and rates aspirin up to 1 g/day, sulfamethoxazole and ciprofloxacin as low-to-no risk (I-LEG-107); a nationwide cohort found coded haemolysis after fewer than 1 in 1,000 penicillin or quinolone courses in G6PD-deficient patients (I-LEG-109); the vicine/convicine triggers are specific to fava beans (I-LEG-106). Only a few specific antimicrobials (dapsone; nitrofurantoin with caution; some hospital lists add sulphonamides and quinolones, I-LEG-110) are relevant. No verified evidence supports haemolysis from smelling fava beans. Lentil attributions rest on unconfirmed patient histories (I-LEG-05).
- Source quality
Machine transcripts; statements made in passing.
- Regional transferability
Not region-specific.
- Individual exceptions
Some drugs (e.g. primaquine, rasburicase, certain sulfonamides) are established triggers; aspirin at usual doses is a contested trigger (not reviewed here).
- Regional scope of the claim
- not specified
- Last reviewed
- 26 October 2026 provisional
Scientific evidence in detail
Not supported by high-quality evidence – There is no good evidence for the claim; this alone does not prove it wrong.
Research question: In people with G6PD deficiency, do smelling fava beans, eating lentils, taking aspirin, or taking antibiotics (e.g. amoxicillin-clavulanate injections) trigger haemolysis?
Research question in detail (PECO)
- Population
- People (especially children) with G6PD deficiency
- Intervention or exposure
- Fava bean odour/pollen; lentils; aspirin; antibiotics
- Comparison
- No exposure
- Geographic scope
- universal; Mediterranean variant relevant to Egypt
- Outcomes
- Acute haemolytic anaemia
Study results as reported by the authors. Our assessment follows below.
What speaks for the claim?
NHS hospital advice for parents of children with G6PD deficiency
King's College Hospital NHS Foundation Trust. Patient information leaflet 2022 Guideline / position statementfull text checkednewly addedNHS hospital leaflet lists several specific antibiotics to avoid (dapsone, nitrofurantoin, sulphonamides, quinolones, nalidixic acid).
- Actual result
- Named drugs; fava beans the only food that commonly causes attacks.
- Methodological quality
- moderate (clinical guidance, conservative)
- Relevance
- direct for named antibiotics
- Limitations
- Not a national guideline; does not list aspirin, lentils or amoxicillin.
Favism in Egyptian children
Hagag AA et al.. Endocr Metab Immune Disord Drug Targets 2018 · PMID 28982343 · DOI 10.2174/1871530317666171003160350 Case series / case reportabstract checkedEgyptian retrospective series lists lentils and other legumes among patient-reported precipitants.
- Actual result
- Lentil 2.8%, chickpea 10.8% of precipitants (history-based).
- Methodological quality
- low (retrospective, unconfirmed attribution)
- Relevance
- direct but weak
- Limitations
- Possible co-exposure to fava in mixed dishes.
What speaks against the claim?
Which medicines are risky in G6PD deficiency (CPIC guideline)
Gammal RS et al.. Clin Pharmacol Ther 2023 · PMID 36049896 · DOI 10.1002/cpt.2735 Guideline / position statementabstract checkednewly addedCPIC guideline: no confirmed food trigger other than fava beans; aspirin <=1 g/day and most antibiotics low-to-no risk.
- Actual result
- Low-to-no risk: aspirin <=1 g/day, sulfamethoxazole, ciprofloxacin, chloramphenicol; high risk: dapsone etc.; nitrofurantoin medium.
- Methodological quality
- high (systematic evidence review)
- Relevance
- direct
- Limitations
- Evidence base mostly case reports.
Antibiotics and haemolysis in G6PD deficiency
Lavon O et al.. J Antimicrob Chemother 2026 · PMID 42522747 · DOI 10.1093/jac/dkag265 Cohort studyabstract checkednewly addedNationwide cohort: haemolysis after <0.1% of penicillin or quinolone courses in G6PD-deficient patients.
- Actual result
- 0.050% after penicillins; quinolones aOR 1.29 (0.92-1.77).
- Methodological quality
- moderate
- Relevance
- direct (includes penicillins such as amoxicillin)
- Limitations
- Coded outcomes.
Favism at different ages
Beretta A et al.. Nutrients 2023 · PMID 36678214 · DOI 10.3390/nu15020343 Narrative reviewfull text checkednewly addedOther legumes lack the triggering compounds vicine/convicine.
- Actual result
- Statement in review; no evidence for smelling found.
- Methodological quality
- low-moderate
- Relevance
- direct
- Limitations
- Narrative.
What does the overall evidence say?
Editorial assessment based on the studies above – not itself a study result.
Which position is better supported?
Fava bean ingestion and a short list of specific drugs (including a few antimicrobials such as dapsone and nitrofurantoin) are established triggers; lentils, smelling fava beans, normal-dose aspirin and antibiotics in general (e.g. amoxicillin-clavulanate) are not established triggers.
Why some studies weigh more
A systematic-review-based guideline and a large cohort outweigh history-based attributions.
Is a causal relationship established? Not established No mechanism or confirmed cases for lentils or odour; aspirin and penicillins low risk at usual doses.
Remaining uncertainty
Rare reactions in severe variants or infants; historical reports of reactions to pollen were not verified.
Justified conclusion
Most of the claim's extensions beyond fava beans are not supported; the safety-relevant message is to avoid fava beans and named drugs and not to withhold needed antibiotics.
Why do studies seem to disagree?
Hospital leaflets are more conservative than CPIC (e.g. sulphonamides, quinolones). This reflects precaution vs evidence grading, not contradictory data; neither lists lentils, smelling, normal-dose aspirin or amoxicillin.
Does this depend on the country?
- General biological effects
- Universal.
- Eating habits
- Falafel and ful contain fava beans; mixed dishes may explain attributions to other legumes.
- Origin of the food
- Not relevant.
- Contaminants
- Not applicable.
- National production conditions
- Not applicable.
- Legal rules
- Drug labels in some countries carry broader G6PD warnings than CPIC.
- Actual monitoring data
- Not applicable.
A regional difference that changes the conclusion is not supported by robust data.
Statistical re-check
- Crude risks, RR, risk difference, NNH; CI log-symmetry – 0.079% vs 0.050%, crude RR 1.59, RD 0.029 points, crude NNH ~3,400; aOR CI approximately log-symmetric; <=18 y crude RR 0.99. recalculated
Certainty of the overall evidence (GRADE, simplified)
- Main outcome
- Haemolysis after lentils, odour, normal-dose aspirin or common antibiotics in G6PD deficiency
- Starting level
- low (observational studies)
- Reasons for downgrading
- imprecision for rare events
- Reasons for upgrading
- consistent null findings across a guideline review and a large cohort
- Result
- moderate
Simplified assessment by a single reviewer, following the GRADE approach; not a formal GRADE panel. GRADE rates the body of evidence for one outcome, not individual studies.
Clinical guidelines and official statements checked
- CPIC: Expanded CPIC Guideline for Medication Use in the Context of G6PD Genotype (I-LEG-107) (2023) · Original publication
High-risk drugs to avoid (e.g. dapsone, primaquine at standard doses, rasburicase, methylene blue); nitrofurantoin medium risk; aspirin <=1 g/day, sulfamethoxazole and ciprofloxacin low-to-no risk; no peer-reviewed evidence confirmed for foods other than fava beans; favism can be fatal, mostly in children. - NHS (King's College Hospital NHS Foundation Trust): G6PD deficiency: information for parents, PL296.2 (I-LEG-110) (2022) · Original publication
Fava/broad beans are the only food that commonly causes attacks; runner beans and baked beans are safe; named drugs to avoid include dapsone, nitrofurantoin, sulphonamides, quinolones, nalidixic acid, primaquine, rasburicase, methylene blue; seek GP/A&E care for pallor, jaundice, dark urine. Hospital leaflet, not a national guideline; review date August 2025 has passed. - WHO: Glucose-6-phosphate dehydrogenase deficiency. WHO Working Group (Bull World Health Organ 1989, PMID 2633878) (1989) · Original publication
G6PD deficiency is the commonest enzyme disorder; it can cause life-threatening haemolytic crises by interaction with specific drugs and fava beans; complications are largely preventable by education and information. (Abstract only.)
Search strategy
Documented literature searches for this review (search strings in the original database syntax).
| Database | Date | Search | Looking for | Hits | Included |
|---|---|---|---|---|---|
| Europe PMC | 26 October 2026 | favism AND (pollen OR inhalation OR smell OR inhaled) | supporting evidence | 154 | |
| Europe PMC | 26 October 2026 | TITLE(favism) AND (pollen OR inhal* OR breast OR "breast milk") | supporting evidence | 117 | |
| PubMed | 26 October 2026 | favism[tiab] AND (pollen[tiab] OR inhal*[tiab] OR breast milk[tiab]) | supporting evidence | 8 | |
| Europe PMC | 26 October 2026 | (G6PD OR favism) AND (lentil OR chickpea OR legumes OR "Lens culinaris" OR "Cicer arietinum") | supporting evidence | 349 | |
| PubMed | 26 October 2026 | (G6PD[tiab] OR favism[tiab] OR glucose-6-phosphate dehydrogenase[tiab]) AND (lentil*[tiab] OR chickpea*[tiab] OR peas[tiab] OR soy*[tiab] OR legume*[tiab]) AND (hemoly*[tiab] OR haemoly*[tiab]) | supporting evidence | 7 | |
| Europe PMC | 26 October 2026 | (vicine OR convicine OR divicine) AND ("Vicia faba" OR "faba bean" OR "fava bean") | contradicting evidence | 337 | |
| Europe PMC | 26 October 2026 | TITLE(favism) | both directions | 378 | |
| Europe PMC | 26 October 2026 | "G6PD deficiency" AND (drugs OR medications) AND ("evidence-based" OR "systematic review") AND (hemolysis OR haemolysis) | contradicting evidence | 531 | |
| Europe PMC | 26 October 2026 | "G6PD deficiency" AND (drugs OR medications) AND ("evidence-based" OR "systematic review") AND (hemolysis OR haemolysis) | contradicting evidence | 531 | |
| PubMed | 26 October 2026 | glucosephosphate dehydrogenase deficiency[MeSH] AND (drug safety[tiab] OR medications[ti] OR drugs[ti]) AND (review[pt] OR systematic review[pt]) | contradicting evidence | 15 | |
| Europe PMC | 26 October 2026 | (G6PD OR "glucose-6-phosphate dehydrogenase") AND (aspirin OR "acetylsalicylic acid") AND (hemolysis OR haemolysis OR safety) | contradicting evidence | 952 | |
| Europe PMC | 26 October 2026 | (G6PD OR "glucose-6-phosphate dehydrogenase") AND (antibiotic* OR nitrofurantoin OR sulfonamide OR "amoxicillin" OR quinolone) AND (hemolysis OR haemolysis) AND (review OR cohort) | contradicting evidence | 1360 | |
| PubMed | 26 October 2026 | (G6PD[ti] OR glucose-6-phosphate dehydrogenase[ti]) AND (guideline[ti] OR practice guideline[pt]) AND (medication*[ti] OR drug*[ti] OR genotype[ti]) | guidelines | 2 | |
| Web (WebSearch/WebFetch) | 26 October 2026 | NHS G6PD deficiency broad beans medicines to avoid page | guidelines |
Open questions
Historical pollen-inhalation reports (not verified); dose thresholds for aspirin in severe variants.
How deeply was this checked?
8 linked studies: 2 checked in full text (0 of them with a structured risk-of-bias assessment), 6 on the basis of the abstract, 0 bibliographically only. No formal assessment with two independent reviewers and no independent human expert review has taken place yet.
Last scientific review: 26 October 2026
History of the verdict
- 25 October 2026 · Phase 1 · Initial assessment: Potentially false (low)
- 26 October 2026 · Phase 4 (systematic evidence review) · Verdict changed: Potentially false (low) → Mostly false (moderate)
Changed: the 2023 CPIC guideline (systematic review) explicitly found no peer-reviewed evidence for food triggers other than fava beans and classes aspirin <=1 g/day and most antibiotics as low-to-no risk; a 2026 nationwide cohort shows haemolysis after <0.1% of penicillin or quinolone courses; a favism review confirms that other legumes lack vicine/convicine. This moves the evidence base from 'weak contradiction' to consistent, moderate-certainty contradiction of the extensions in the claim. The fava-bean core remains correct (see C-LEG-03).
New sources: I-LEG-106 I-LEG-107 I-LEG-108 I-LEG-109 I-LEG-110
In plain language
Elawady said that people with G6PD deficiency can break down their red blood cells just by smelling fava beans, by eating lentils, or by taking aspirin or antibiotics. Eating fava beans really is dangerous for these people. But a major international guideline found no confirmed evidence that any other food, including lentils, causes this, and found no evidence for the smelling claim. Aspirin in normal doses and most antibiotics are considered low risk; only a few specific medicines must be avoided. A needed antibiotic should not be withheld, but the doctor should know about the deficiency.
Studies on this claim
Studies supporting the claim (0)
No studies in this group.
Studies contradicting or limiting the claim (6)
-
G6PD deficiency review (Blood 2020)
Luzzatto L et al.. Blood 2020 · PMID 32702756 · DOI 10.1182/blood.2019000944Narrative reviewindependent cross-checkabstract checked★ key studyAbout 500 million people carry G6PD deficiency; fava beans, some drugs and infections trigger haemolysis.
Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Review G6PD
- How was the study done?
Narrative review
- How many people, animals or samples were studied?
Not applicable
- What was actually found?
Fava ingestion trigger
- How large was the observed effect?
Not applicable
- What do the results mean in everyday life?
Targeted fava avoidance.
- What are the study's limitations?
Narrative
- What does it say about Elawady's specific claim?
Supports favism; names fava specifically
- Do the results apply to Germany and Europe?
High
- What can explicitly not be concluded from this study?
Cannot support avoidance for non-deficient people.
-
Lancet review on G6PD deficiency
Cappellini MD, Fiorelli G. Lancet 2008 · PMID 18177777 · DOI 10.1016/S0140-6736(08)60073-2Narrative reviewcited by the Tayebat archiveabstract checked★ key studyG6PD deficiency affects over 400 million people; haemolysis is triggered by external agents and is prevented by avoiding them.
Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Summarise G6PD deficiency
- How was the study done?
Narrative review
- How many people, animals or samples were studied?
Not applicable
- What was actually found?
400+ million affected; haemolysis triggered by exogenous agents
- How large was the observed effect?
Not applicable
- What do the results mean in everyday life?
People with the deficiency must avoid triggers such as fava beans.
- What are the study's limitations?
Not systematic
- What does it say about Elawady's specific claim?
Supports favism, not avoidance of legumes by everyone
- Do the results apply to Germany and Europe?
High
- What can explicitly not be concluded from this study?
Cannot show risk for people with normal G6PD.
-
Favism at different ages
Beretta A et al.. Nutrients 2023 · PMID 36678214 · DOI 10.3390/nu15020343Narrative reviewindependent cross-checkfull text checked★ key studyFava beans trigger haemolysis through vicine and convicine, which other legumes do not contain; infants and young children are most at risk.
Other legumes lack vicine/convicine; no evidence for smelling.
Does the study support the specific claim? Partly · Methodological quality: low · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Describe favism by age.
- How was the study done?
Narrative review of case reports.
- How many people, animals or samples were studied?
Published cases worldwide.
- What was actually found?
Severity highest in infants; raw beans most risky.
- How large was the observed effect?
Only ~25% of deficient adults react.
- What do the results mean in everyday life?
People with G6PD deficiency should avoid fava beans; other legumes are not known triggers.
- What are the study's limitations?
Case-based, no systematic search.
- What does it say about Elawady's specific claim?
Limits the lentil claim and the universal ban.
- Do the results apply to Germany and Europe?
Universal biology.
- What can explicitly not be concluded from this study?
It cannot rule out rare reactions to other pulses.
-
Which medicines are risky in G6PD deficiency (CPIC guideline)
Gammal RS et al.. Clin Pharmacol Ther 2023 · PMID 36049896 · DOI 10.1002/cpt.2735Guideline / position statementindependent cross-checkabstract checked★ key studyOnly a short list of medicines is high risk; aspirin at normal doses and most antibiotics are low risk, and no food other than fava beans is confirmed as a trigger.
Only fava beans confirmed as food trigger; aspirin <=1 g/day and most antibiotics low risk.
Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Classify drugs by haemolysis risk.
- How was the study done?
Systematic review and expert grading.
- How many people, animals or samples were studied?
Published evidence on implicated drugs.
- What was actually found?
High risk: e.g. dapsone, rasburicase, primaquine; nitrofurantoin medium.
- How large was the observed effect?
Not applicable.
- What do the results mean in everyday life?
Most common medicines, including normal-dose aspirin, can be used; a few must be avoided.
- What are the study's limitations?
Evidence mainly case reports.
- What does it say about Elawady's specific claim?
Contradicts the claim that lentils, aspirin and antibiotics in general trigger haemolysis.
- Do the results apply to Germany and Europe?
Universal.
- What can explicitly not be concluded from this study?
It does not prove that rare reactions to other foods never occur.
-
Medicines and G6PD deficiency: what is the evidence?
Youngster I et al.. Drug Saf 2010 · PMID 20701405 · DOI 10.2165/11536520-000000000-00000Systematic reviewindependent cross-checkabstract checkedOnly seven medicines had solid evidence of causing haemolysis; many others were blamed wrongly.
Only seven drugs with solid evidence; not antibiotics or aspirin in general.
Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Review drug safety in G6PD deficiency.
- How was the study done?
Literature review.
- How many people, animals or samples were studied?
Published reports to 2009.
- What was actually found?
Seven drugs clearly to avoid.
- How large was the observed effect?
Not applicable.
- What do the results mean in everyday life?
Most medicines are safe in normal doses, but a few must be avoided.
- What are the study's limitations?
Abstract only; older.
- What does it say about Elawady's specific claim?
Limits the aspirin/antibiotic part of C-LEG-05.
- Do the results apply to Germany and Europe?
Universal.
- What can explicitly not be concluded from this study?
It does not cover foods other than drugs.
-
Antibiotics and haemolysis in G6PD deficiency
Lavon O et al.. J Antimicrob Chemother 2026 · PMID 42522747 · DOI 10.1093/jac/dkag265Cohort studyindependent cross-checkabstract checked★ key studyIn 465,083 antibiotic courses, coded haemolysis occurred after fewer than 1 in 1,000 courses, with no clear excess for quinolones.
Haemolysis after <0.1% of penicillin or quinolone courses.
Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Test whether quinolones cause haemolysis in G6PD deficiency.
- How was the study done?
National database cohort vs penicillins.
- How many people, animals or samples were studied?
64,861 patients.
- What was actually found?
No clear increase.
- How large was the observed effect?
aOR 1.29 (0.92-1.77).
- What do the results mean in everyday life?
Ordinary antibiotics rarely cause haemolysis in G6PD deficiency.
- What are the study's limitations?
Coded data; abstract only.
- What does it say about Elawady's specific claim?
Contradicts the class-wide antibiotic claim.
- Do the results apply to Germany and Europe?
Applicable.
- What can explicitly not be concluded from this study?
It cannot exclude rare reactions in severe variants.
No study in this group is marked as key.
Studies with mixed or unclear results (2)
-
Favism in Egyptian children
Hagag AA et al.. Endocr Metab Immune Disord Drug Targets 2018 · PMID 28982343 · DOI 10.2174/1871530317666171003160350Case series / case reportindependent cross-checkabstract checked★ key studyIn 1,000 Egyptian children with G6PD deficiency, haemolysis was most often triggered by fava beans and falafel.
Does the study support the specific claim? Partly · Methodological quality: low · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Describe Egyptian G6PD patients
- How was the study done?
Retrospective series
- How many people, animals or samples were studied?
1,000 children
- What was actually found?
Diet main trigger, especially fava
- How large was the observed effect?
32.6% fava, 19.4% falafel
- What do the results mean in everyday life?
Fava avoidance matters for G6PD-deficient children in Egypt.
- What are the study's limitations?
History-based
- What does it say about Elawady's specific claim?
Supports favism; weak for lentils
- Do the results apply to Germany and Europe?
High (Egypt)
- What can explicitly not be concluded from this study?
Cannot show legumes harm G6PD-normal people.
-
NHS hospital advice for parents of children with G6PD deficiency
King's College Hospital NHS Foundation Trust. Patient information leaflet 2022Guideline / position statementindependent cross-checkfull text checkedFava beans are the only food that commonly causes attacks; a list of specific medicines, including some antibiotics, should be avoided.
Names specific antibiotics; fava beans only food trigger; other beans safe.
Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Advise parents.
- How was the study done?
Patient leaflet.
- How many people, animals or samples were studied?
Not applicable.
- What was actually found?
Fava beans, mothballs and named drugs are triggers.
- How large was the observed effect?
Not applicable.
- What do the results mean in everyday life?
Tell doctors and pharmacists about the deficiency; other beans are fine.
- What are the study's limitations?
Local leaflet, conservative list.
- What does it say about Elawady's specific claim?
Partly supports, partly contradicts C-LEG-05.
- Do the results apply to Germany and Europe?
UK.
- What can explicitly not be concluded from this study?
It does not provide evidence grades.
No study in this group is marked as key.
Regional context
Germany / EU
Not specific.
Egypt
In Egypt, falafel (made from fava beans) is a frequent trigger; mixed dishes may explain attributions to other legumes.
What applies in my country?
General scientific assessment
Mostly false This claim is mostly false: eating fava beans and a few specific drugs are real triggers, but smelling fava beans, eating lentils, normal-dose aspirin and antibiotics in general are not established triggers.
The following areas of food safety are relevant to this statement:
- Pesticides and pesticide residues
- Contaminants (heavy metals, PFAS, PCBs, dioxins, nitrate)
- Mycotoxins (mould toxins)
Legumes and nuts
Choose a country to see the checked information for it.
Limits: legal rules describe what is allowed, not what every single food contains. Measurement data come from samples and are meaningful only together with their method details.
Country of residence or purchase Compare with another country
References
- Glucose-6-phosphate dehydrogenase deficiency.. Luzzatto L et al.. Blood 2020 · PMID 32702756 · DOI 10.1182/blood.2019000944
- Glucose-6-phosphate dehydrogenase deficiency.. Cappellini MD, Fiorelli G. Lancet 2008 · PMID 18177777 · DOI 10.1016/S0140-6736(08)60073-2
- Favism: Clinical Features at Different Ages.. Beretta A et al.. Nutrients 2023 · PMID 36678214 · DOI 10.3390/nu15020343
- Expanded Clinical Pharmacogenetics Implementation Consortium Guideline for Medication Use in the Context of G6PD Genotype.. Gammal RS et al.. Clin Pharmacol Ther 2023 · PMID 36049896 · DOI 10.1002/cpt.2735
- Medications and glucose-6-phosphate dehydrogenase deficiency: an evidence-based review.. Youngster I et al.. Drug Saf 2010 · PMID 20701405 · DOI 10.2165/11536520-000000000-00000
- Quinolones and risk of haemolysis in patients with glucose-6-phosphate dehydrogenase deficiency: a nationwide retrospective active-comparator cohort study.. Lavon O et al.. J Antimicrob Chemother 2026 · PMID 42522747 · DOI 10.1093/jac/dkag265
- Study of Glucose-6-Phosphate Dehydrogenase Deficiency: 5 Years Retrospective Egyptian Study.. Hagag AA et al.. Endocr Metab Immune Disord Drug Targets 2018 · PMID 28982343 · DOI 10.2174/1871530317666171003160350
- Glucose-6-phosphate dehydrogenase deficiency (favism or G6PD deficiency): Information for parents (leaflet PL296.2). King's College Hospital NHS Foundation Trust. Patient information leaflet 2022