Why is diet important when living with multiple myeloma?

It’s important for everyone to have a healthy diet and take on the nutrients they need.1 It is especially important if you are living with cancer.2 Eating healthily can help you physically and mentally. It can help support your energy and strength levels, and help you recover after treatment.3,4

Making diet choices based on signs and symptoms of myeloma 

There are certain signs and symptoms commonly experienced by people with multiple myeloma. These include:5

  • A higher than usual level of calcium in the blood (known as hypercalcaemia)
  • A lower than usual red blood cell count (known as anaemia)
  • Kidney disease
  • Weak bones

Below we’ve shared some diet choices that may be sensible if you’re experiencing any of these signs or symptoms of myeloma.

If you have higher than usual calcium levels in blood (hypercalcaemia)

Calcium is an important nutrient that has a few jobs in the body. These include helping our bones grow strong, keeping our teeth healthy, helping our muscles work, and making sure blood clots normally.6

But a consistently higher-than-normal level of calcium in the blood can have a negative effect on the body. It may cause you to feel tired, weak, extremely thirsty, confused, or drowsy. It can also cause tummy pain, a need to wee often, or constipation.7

For less severe cases of hypercalcaemia, drinking more water may help to balance calcium levels. For more severe cases, your doctor may prescribe medicine to control the blood calcium level.7,8

If you have kidney disease

Myeloma may cause kidney disease because there’s more protein and calcium travelling in the bloodstream. When the blood reaches the kidneys, the extra protein and calcium blocks the small tubes. This may affect the way the kidneys work and can ultimately lead to kidney damage.9

 Kidney damage can be serious and any suspicion of this should always be reported to a doctor. If your doctor is concerned about how well your kidneys are working, they may suggest limiting your intake of some of the foods below:9,10,11

  • Foods high in potassium – including oranges, bananas, spinach, courgettes, apricots, and some fish, dairy products, beans and legumes
  • Foods high in sodium – including processed foods, packaged snacks, salad dressings, sauces, and soups 
If you have anaemia

Being anaemic means having a low number of red blood cells in your blood, which means less oxygen can travel around the body. Having anaemia may make you feel tired or breathless.12

Foods high in the nutrients iron, folate and vitamin B12 may be recommended if you’re experiencing anaemia. Some examples include:13

  • Foods high in iron: Red meat (also poultry and pork), shellfish, liver, fish, eggs, beans and pulses, nuts and seeds, and leafy greens
  • Foods high in folate: Liver, fortified breakfast cereals, brussels sprouts, asparagus, spinach, kale, broccoli, cauliflower, peas, parsnips
  • Foods high in Vitamin B12: Liver, eggs, fish, meat, cheese, milk, as well as fortified breakfast cereals, non-dairy milk and yoghurt, and spreads.
If you have weak bones

With myeloma, the bones may become thinner and weaker. This is because the myeloma cells cluster in the spongy middle of the bones, known as the bone marrow, and can make them weaker over time. For some people, holes may begin to appear in the bone – these are known as lytic lesions.14

Vitamin D is a nutrient that help bones to absorb calcium, which makes them grow strong and healthy. To improve bone strength, your healthcare team may suggest you take a vitamin D supplement or try to eat more foods containing vitamin D.  Foods that are high in Vitamin D include: Oily fish (such as salmon or mackerel), eggs and some mushrooms, as well as fortified bread and yoghurts.15

Making diet choices based on side effects of treatment

If you’re undergoing treatment for myeloma, you may have problems with your digestion. For example, you may be feeling sick (known as nausea), be sick (known as vomiting), or have bowel disturbances such as diarrhoea or constipation.16

These side effects can make it hard to follow a healthy diet and take on the nutrients you need. But making small changes to your diet may help you cope with these symptoms – for example:17,18

  • If you have nausea: Try to eat small, frequent meals, and avoid fatty, spicy or fried foods
  • If the smell of food makes you feel sick: Go for cold food and snacks that don’t smell as much, or ask a loved one if they will cook some food for you
  • If you are constipated: Eat more foods high in fibre and try to drink more fluid to soften the stools 

If you are experiencing any new or worsening symptoms or side effects of treatment, it’s important to speak with your doctor or healthcare team. They will be able to share information and support specific to your situation. 

Making sure you are preparing food in a safe way

Many people living with, or undergoing treatment for, myeloma have a weakened immune system.4,19 Because the immune system is essential to fight infections in our bodies, it is especially important that you prepare food in a safe way to lower your risk of coming into contact with bacteria.19

Here are a few tips to help you safely cook and prepare food. You might hear this called the ‘neutropenic diet’:19

  • Make sure you cook and store food correctly – for example, don’t leave chilled foods out of the fridge
  • Wash all fruits and vegetables thoroughly
  • Avoid undercooked food, such as meat, sushi, and raw or runny eggs
  • Keep things clean – for example, make sure you wash cutlery and plates in hot water and washing up liquid

Before making any changes to your diet, or considering taking supplements such as vitamins or calcium, it is important to speak to your healthcare team first to discuss your individual needs.

References

  1. World Health Organization. Healthy diet. Available from: https://www.who.int/initiatives/behealthy/healthy-diet [Accessed June 2025].
  2. American Cancer Society. Benefits of good nutrition during cancer treatment. Available from: https://www.cancer.org/cancer/survivorship/coping/nutrition/benefits.html [Accessed June 2025].
  3. Medical News Today. What are the benefits of eating healthy? Available from: https://www.medicalnewstoday.com/articles/322268 [Accessed June 2025].
  4. Healthline. Multiple Myeloma Diet: Foods to Eat and Avoid. Available at: https://www.healthline.com/health/cancer/multiple-myeloma-diet [Accessed June 2025]
  5. Healthline. What are the CRAB symptoms of multiple myeloma? Available from: https://www.healthline.com/health/multiple-myeloma/crab-multiple-myeloma [Accessed June 2025].
  6. NHS. Calcium. Available from: https://www.nhs.uk/conditions/vitamins-and-minerals/calcium/ [Accessed June 2025].
  7. MyMyelomaTeam. Understanding hypercalcaemia and multiple myeloma. Available from: https://www.mymyelomateam.com/resources/understanding-hypercalcemia-and-multiple-myeloma [Accessed June 2025].
  8. Cancer Research UK. High calcium levels and cancer. Available from: https://www.cancerresearchuk.org/about-cancer/coping/physically/blood-calcium/high-calcium-people-cancer [Accessed June 2025].
  9. Myeloma UK. Myeloma and the kidney. Available from: https://www.myeloma.org.uk/wp-content/uploads/2025/04/Myeloma-UK-Myeloma-and-the-kidney-Infoguide.pdf [Accessed June 2025].
  10. WebMD. Foods rich in potassium. Available from: https://www.webmd.com/diet/foods-rich-in-potassium [Accessed June 2025].
  11. Healthline. 30 foods high in sodium and what to eat instead. Available from: https://www.healthline.com/nutrition/foods-high-in-sodium [Accessed June 2025].
  12. International Myeloma Foundation. Multiple myeloma and anaemia. Available from: https://www.myeloma.org/multiple-myeloma-anemia [Accessed June 2025].
  13. Patient. Diets suitable for people with anaemia. Available from: https://patient.info/allergies-blood-immune/anaemia-leaflet/diets-suitable-for-people-with-anaemia [Accessed June 2025].
  14. WebMD. Lytic bone lesions from multiple myeloma. Available from: https://www.webmd.com/cancer/multiple-myeloma/bone-lesions-myeloma [Accessed June 2025].
  15. Royal Osteoporosis Society. Vitamin D for bones. Available from: https://theros.org.uk/information-and-support/bone-health/vitamin-d-for-bones/ [Accessed June 2025].
  16. Myeloma UK. Gastrointestinal disturbances. Available from: https://www.myeloma.org.uk/wp-content/uploads/2023/04/Myeloma-UK-Gastrointestinal-disturbances-Infosheet.pdf [Accessed June 2025].
  17. World Cancer Research Fund. Nausea (feeling sick). Available from: https://www.wcrf.org/living-well/living-with-cancer/your-questions-answered/nausea-feeling-sick/ [Accessed June 2025].
  18. Cancer Research UK. Causes of constipation. Available from: https://www.cancerresearchuk.org/about-cancer/coping/physically/bowel-problems/types/constipation/causes [Accessed June 2025].
  19. Myeloma UK. Eating safely with neutropenia. Available from: https://bloodcancer.org.uk/understanding-blood-cancer/treatment/infection-neutropenia-sepsis/neutropenia/eating-safely-neutropenia/ [Accessed June 2025].