Age of recovery from favism in children When does the child get better

G6PD deficiency (commonly known as “favism”) is a hereditary condition that is widespread among children and often causes significant concern for parents, especially since it is linked to certain foods and everyday items that can trigger complications. A question that frequently comes up is: Can a child outgrow G6PD deficiency over time? Is there a specific age when the problem disappears? you’ll learn about the age at which children with G6PD deficiency may improve, whether the condition truly resolves with age or persists, and the most important tips to protect your child from complications.

What is G6PD deficiency in children?

G6PD deficiency, also known as favism, is a hereditary condition that occurs when the body cannot produce enough of the enzyme responsible for protecting red blood cells from breaking down. The problem becomes more apparent when a child eats fava beans or other foods or takes medications containing oxidative substances, leading to a sudden breakdown of red blood cells and causing acute anemia.

What is the G6PD enzyme?
G6PD is a natural enzyme produced by the body, and its main role is to protect red blood cells from damage or oxidation. Any deficiency in this enzyme makes red blood cells more vulnerable to breaking down, which results in G6PD deficiency.

At what age do children outgrow G6PD deficiency?
The vast majority of children begin to overcome the effects of G6PD deficiency around 10 to 12 years old, as the body starts producing higher amounts of the enzyme.

Can G6PD deficiency be completely cured?
In most cases, yes. Most children show significant improvement during early adolescence and can live normal lives without strict restrictions on food or treatment.

Is G6PD deficiency contagious?
No, G6PD deficiency is not contagious. It is a hereditary condition passed down from the father or mother to the child.

When do symptoms appear?
Symptoms usually appear after the child consumes fava beans, forbidden foods, certain medications, or experiences a strong infection. During these episodes, signs like paleness, yellowing of the skin and eyes (jaundice), or severe fatigue may suddenly appear.

Can a child live a normal life with G6PD deficiency?
Yes, most children can live completely normal lives as long as they avoid trigger foods and medications and have regular follow-ups with their doctor.

Does G6PD deficiency go away over time?
No, G6PD deficiency is a chronic condition that persists throughout life. However, it can be managed easily with proper precautions and regular medical follow-up.

Most serious complications of G6PD deficiency:

Severe hemolysis: rapid breakdown of red blood cells (acute anemia).
Jaundice: yellowing of the skin and eyes due to bilirubin buildup.
Rare severe cases: may lead to kidney failure or enlarged spleen.

Are there special vaccines or medications for children with G6PD deficiency?
Routine childhood vaccines are completely safe for children with G6PD deficiency. However, always inform the doctor before giving any new medication or treatment to ensure it is safe.

What foods are safe for children with G6PD deficiency?
Children with G6PD deficiency can eat most normal foods, but they must avoid:

Fava beans and all their derivatives.
Certain legumes that may cause problems, such as lentils and chickpeas in large amounts.

How can I tell if my child is having a hemolytic crisis?
During a hemolytic episode, you may notice:

Yellowing of the skin and eyes (jaundice).
Dark-colored urine (tea-colored).
Severe fatigue and lethargy.
Noticeable paleness.

Can a girl with G6PD deficiency have a normal pregnancy later?
Yes, it is possible, but she must have careful medical follow-up throughout pregnancy, as some medications are unsafe for expectant mothers with G6PD deficiency.

Types of G6PD deficiency in children

1️⃣ According to enzyme deficiency severity:

Mild G6PD deficiency: Enzyme activity is slightly reduced; most children show no symptoms unless exposed to a strong trigger such as fava beans or certain medications.
Moderate G6PD deficiency: Enzyme activity is lower, and symptoms may appear more easily, even with mild triggers.
Severe G6PD deficiency: Enzyme activity is very low, and hemolysis can occur easily, even without a strong trigger.

2️⃣ According to the type of trigger causing hemolysis:

Classic favism: Occurs after consuming fava beans or other oxidative legumes.
Drug-induced favism: Triggered by medications such as:
- Sulfonamides (Sulfonamides)
- Primaquine
- Certain other antibiotics
Infection-related favism: Hemolysis occurs after a strong viral or bacterial infection, even without consuming fava beans or drugs.

Some children may have a mixed type, where hemolysis can occur from any trigger—food, medication, or infection.

Important Notes
Some children may have a mixed type of G6PD deficiency, meaning hemolysis can occur from any trigger—food, medication, or infection.
Knowing the type and severity of the deficiency is crucial to determine the right prevention and treatment for each child.

Stages of G6PD Deficiency in Children

1️⃣ Silent Stage (Asymptomatic)

The child carries the G6PD deficiency gene.
No symptoms appear as long as they are not exposed to triggers like fava beans or certain medications.
A child can remain symptom-free for years unless a blood test is done.

2️⃣ Trigger Stage (After Exposure)
Occurs hours to a few days after exposure to:

Fava beans or certain legumes.
A forbidden medication.
A strong infection.
During this stage, red blood cells start breaking down rapidly.

3️⃣ Symptomatic Stage
Signs that may appear include:

Yellowing of the skin and eyes (jaundice).
Dark-colored urine (tea-colored).
Severe fatigue and lethargy.
Sometimes dizziness or headache due to low oxygen levels.

4️⃣ Acute Anemia Stage (Severe Cases)

Significant drop in hemoglobin levels.
Symptoms become more serious:
- Shortness of breath.
- Rapid heartbeat.
- Severe paleness.
In severe cases, the child may require a blood transfusion.

5️⃣ Recovery Stage

After stopping exposure to the trigger and providing proper treatment.
The body begins producing new red blood cells.
Symptoms gradually improve over a few days.

Causes of G6PD Deficiency in Children

1️⃣ Genetic Cause

G6PD deficiency is hereditary, usually linked to the G6PD gene on the X chromosome.
Boys are more likely to be affected because they have only one X chromosome.
Girls can be carriers without showing symptoms.
Children with the gene have red blood cells sensitive to certain substances, which can lead to hemolysis.

2️⃣ Dietary Triggers

The most common trigger is fava beans, which is why the condition is called “favism.”
Some other legumes or unusual foods may have the same effect in sensitive children.

3️⃣ Medications
Certain drugs can trigger red blood cell breakdown, such as:

Some antibiotics (e.g., sulfonamides).
Antimalarial medications (e.g., primaquine).
Occasionally, high doses of painkillers like paracetamol or other drugs.

Always consult a doctor before giving any medication to a child with G6PD deficiency.

4️⃣ Infections and Illnesses

Any strong viral or bacterial infection can trigger hemolysis in affected children.
Severe fever or infections may cause sudden anemia symptoms.

Symptoms of G6PD Deficiency in Children

1️⃣ Jaundice (Yellowing of Skin and Eyes)

The most common sign after exposure to a trigger (fava beans or certain medications).
Can appear gradually or suddenly depending on the severity of hemolysis.

2️⃣ Severe Fatigue and Lethargy

The child may feel very weak, sleepy, or unable to play.
Caused by low hemoglobin levels due to red blood cell breakdown.

3️⃣ Dark Urine

Urine may turn tea-colored or brown.
Due to hemoglobin or breakdown products of red blood cells in the urine.

4️⃣ Rapid Heartbeat or Shortness of Breath

Due to low oxygen-carrying capacity in the blood.
The child may breathe faster or feel tired even with mild exertion.

5️⃣ Enlarged Spleen

In chronic or recurrent cases, the spleen may enlarge as it works to remove damaged blood cells.

Important Notes
Some children may remain asymptomatic until they are exposed to a trigger.
Symptoms often appear suddenly, usually within hours or days after exposure to fava beans or a triggering medication.

Foods to Avoid for Children with G6PD Deficiency

1️⃣ Fava Beans and Their Derivatives

Fresh, dried, or canned fava beans.
Any legumes that contain fava beans mixed in.

2️⃣ Certain Other Legumes (Use Caution)

Lentils (especially in large amounts).
Chickpeas.
Peas.

Not all children react to all types of legumes, but it is recommended to avoid them or introduce cautiously under medical advice.

3️⃣ Processed Foods and Chemical Additives

Foods containing artificial colors or strong preservatives.
Some processed juices or colored candies.

4️⃣ Unfamiliar or New Foods

Any food the child has not tried before, especially if it contains additives or dyes.

Medications to Avoid for Children with G6PD Deficiency

1️⃣ Certain Antibiotics

Sulfonamides (e.g., sulfamethoxazole, TMP-SMX).
Nitrofurantoin: sometimes used to treat urinary tract infections.
Other antibiotics may also be unsafe—always follow the doctor’s prescription.

2️⃣ Antimalarial Medications

Primaquine: one of the main triggers for hemolysis in children with G6PD deficiency.
Other antimalarials may need to be used with caution or under strict medical supervision.

3️⃣ Some Painkillers and Other Medications

Aspirin (Salicylates): may cause problems in some children.
Other painkillers or fever reducers not deemed safe—consult your doctor first.

How to Diagnose G6PD Deficiency in Children

1️⃣ Medical History and Clinical Examination

Family history: since G6PD deficiency is hereditary, having affected relatives increases the likelihood.
Observation of symptoms: jaundice, fatigue, dark urine, rapid heartbeat, or shortness of breath.

2️⃣ Basic Laboratory Tests

G6PD Test: measures the activity of the G6PD enzyme in the blood. Low results confirm the deficiency.
Complete Blood Count (CBC): detects anemia and hemolysis, showing low hemoglobin or abnormal red blood cells.
Peripheral Blood Smear: shows red blood cell shapes and signs of hemolysis.
Urine Test: detects hemoglobin or breakdown products from red blood cells.

3️⃣ Genetic Testing (Optional)

Identifies mutations in the G6PD gene.
Useful for confirming the diagnosis in children without symptoms or in families at risk.

Important Notes

Diagnosis is usually made after symptoms appear or after exposure to a trigger such as fava beans or a certain drug.
Early detection is crucial to prevent serious complications like severe anemia or jaundice.

Complications of G6PD Deficiency in Children

1️⃣ Acute Anemia

Rapid breakdown of red blood cells can cause a severe drop in hemoglobin.
The child may feel extremely tired, pale, and may require a blood transfusion in severe cases.

2️⃣ Jaundice (Yellowing of Skin and Eyes)

Increased bilirubin in the blood due to red blood cell breakdown.
High bilirubin, especially in infants, can lead to brain complications (kernicterus) if untreated.

Complications of G6PD Deficiency in Children

3️⃣ Enlarged Spleen

The spleen works harder to remove damaged red blood cells.
Over time, it may enlarge and cause additional health problems.

4️⃣ Delayed Growth and Persistent Fatigue

Caused by reduced oxygen delivery to the body’s organs.
The child may always feel tired, have poor concentration, or experience slower physical growth compared to peers.

5️⃣ Complications of Hemolytic Crises

Rapid hemolysis can lead to severe circulatory collapse.
Liver and kidney problems may occur due to the accumulation of red blood cell breakdown products.

6️⃣ Psychological and Social Impact

Children with G6PD deficiency need a specific diet and medications.
This may make them feel different from other children and affect their mental well-being, especially if parents do not explain and reassure them.

G6PD Test for Children

1️⃣ Test Name

The main test is called the G6PD Enzyme Test.
Purpose: measures the activity of the G6PD enzyme in red blood cells.

2️⃣ How the Test Is Done

A small blood sample is taken, usually from a vein or finger prick in young children.
The sample is sent to the lab to measure enzyme activity.
Results indicate:
- Normal: enzyme level is normal.
- Partially deficient: the child may be a carrier or sensitive.
- Severely deficient: high risk of hemolysis when exposed to triggers.

3️⃣ Additional Tests That May Be Done

Complete Blood Count (CBC): checks for anemia.
Peripheral Blood Smear: shows red blood cell shapes and signs of hemolysis.
Urine Test: detects hemoglobin from red blood cell breakdown.

4️⃣ Tips Before Testing

Inform the doctor about recent medications or illnesses, as some can affect results.
In some cases, testing may need to be repeated after recovery from a hemolytic episode for accuracy.

Safe Medications for Children with G6PD Deficiency

1️⃣ Safe Painkillers and Fever Reducers

Paracetamol (Acetaminophen): safe for most children.
Ibuprofen: safe for most cases if used in proper doses and under medical supervision.

2️⃣ Safe Antibiotics

Benzylpenicillin and its variants.
Amoxicillin: generally safe.
Cephalosporins (e.g., Cephalexin).

Always confirm with the doctor before giving any antibiotic.

3️⃣ Safe Alternative Antimalarials

Some antimalarial drugs can be used after consulting a doctor, while primaquine must be strictly avoided.

Normal G6PD Test Levels for Children

1️⃣ Test Overview

Measures G6PD enzyme activity in red blood cells.

2️⃣ Typical Ranges

Condition	Enzyme Activity (U/g Hb)
Normal	6 – 10 or 7 – 20 (depending on the lab)
Partial Deficiency	2 – 5 (depends on age and sex)
Severe Deficiency	< 2

Important Notes

Values may vary slightly between labs; always check the reference range on the report.
Newborns may naturally have temporarily higher enzyme activity shortly after birth.

When to Repeat the Test

If the child is in a hemolytic crisis, results may appear falsely low or normal.
It is best to repeat the test after recovery for accurate results.

Treatment of G6PD Deficiency with Medications

Treatment Principle

There is no definitive cure for G6PD deficiency as it is hereditary.
Medication is used to manage symptoms during hemolytic episodes, not to treat the underlying cause.

Treatment Goals

Stop hemolysis.
Replace lost blood.
Prevent complications.

1️⃣ Remove the Trigger

Stop the causative food or medication immediately.
Treat any infection safely in children with G6PD deficiency.

2️⃣ Symptomatic Treatment

Antioxidants: sometimes vitamin C or E may be prescribed to support cells (not always).
Folic Acid: helps the body produce new red blood cells faster.
Safe antibiotics: for bacterial infections, as directed by a doctor.
Safe fever reducers: e.g., paracetamol.

3️⃣ In Severe Cases

Blood transfusion: for very severe anemia.
IV fluids: to replace fluids and reduce hemolysis effects.
Hospital monitoring may be required for severe symptoms like:
- Severe jaundice
- Shortness of breath

Supportive Foods and Herbs for Children with G6PD Deficiency

1️⃣ Spinach and Leafy Greens

Rich in iron and folic acid, which help produce new red blood cells.

2️⃣ Beetroot

Known to increase hemoglobin and improve blood circulation.

3️⃣ Blackstrap Molasses

High in iron and essential minerals for blood strengthening.

4️⃣ Fenugreek

Supports blood production; can be consumed as a mild infusion in child-appropriate amounts.

5️⃣ Hibiscus (Cold Infusion)

Helps improve circulation and iron absorption.

⚠️ Important Warnings

Herbs and recipes must be safe and tested for children, used in small amounts.
Never replace medical treatment or blood transfusions with herbs in severe cases.
Always consult a doctor before giving any herbal remedy, as some may contain oxidizing substances that affect the child.