One of the most common questions Sickle Cell Warriors ask is:
"What can I do to make my eyes white?"
And I get it.
Yellow eyes are one of the most visible signs of sickle cell. People notice. People ask questions. And sometimes… people judge.
So naturally, you want to fix it.
But to understand if you can fix it…
You first need to understand why it happens.
In Sickle Cell, your red blood cells break down faster than normal.
When they break down, they release a yellow pigment called bilirubin into your blood stream.
Normally, your body clears this.
But when breakdown is happening really quickly, bilirubin builds up in the blood…
And that’s what causes the yellow colour in your eyes (and sometimes skin).
Here’s the key point most people miss:
Not everyone with sickle cell breaks down red blood cells at the same speed.
Some people have lower levels of haemolysis (red blood cell breakdown)
Their bilirubin stays low enough that their eyes look white most of the time.
Others have a higher baseline level of breakdown.
Their bilirubin stays higher…
So their eyes appear yellow more often, even when they feel well.
This is why advice around "clearing your eyes" can feel confusing.
You might hear things like:
"Just drink more water and your eyes will clear"
And yes, hydration can help in some cases.
It can slightly dilute the bilirubin in your blood.
So if your levels are borderline, that might be enough to make a visible difference.
But if your bilirubin levels are already higher at baseline…
Hydration alone won’t fix it.
In those cases, the only real way to reduce yellowing is to reduce the rate of red blood cell breakdown.
This comes down to:
1) Medical Treatment
-Hydroxyurea, Exchange transfusions, or Newer therapies can help.
2) Good Nutrition
-Anti-oxidants found in many fruits and vegetables help protect your red cells from damage.
3) Trigger Avoidance
-Avoiding triggers like infection, dehydration, and stress also plays a role.
Another idea I want to introduce for further explanation in its own newsletter is the effect that Sickle Cell can have on the liver.
Because if you have liver damage then you won't be able to clear bilirubin effectively.
Therefore even if red cell breakdown reduces, the bilirubin and the yellow eyes may stay.
The key takeaway here is that:
If your eyes are still yellow despite doing 'all the right things'…
It doesn’t mean you’re doing anything wrong.
It just means your body has a different baseline.
And thats something that you can't control.
Instead of trying to fit other peoples standards, create your own.
Stay Healthy,
Lewis
