Iron poisoning
Encyclopedia
Iron poisoning is an iron overload caused by a large excess of iron
intake and usually refers to an acute overload rather than a gradual one. The terms has been primarily associated with young children who consumed large quantities of iron supplement pills, which resemble sweets and are widely used, including by pregnant women—see overnutrition
(approximately 3 grams is lethal for a 2 year old). Targeted packaging restrictions in the US for supplement containers with over 250 mg elemental iron have existed since 1978, and recommendations for unit packaging have reduced the several iron poisoning fatalities per year to almost nil since 1998. No known cases of iron poisoning have been identified that are associated with iron mining.
Iron supplements are typically used to treat anemia. Modalities include: diet, parasite control, vitamin A, riboflavin (B2), vitamin C (for absorption), folate, vitamin B12 and multivitamin-multimineral supplements, with or without iron; potentially avoiding the use of iron only supplements.
and the liver
, and metabolic acidosis
develops. The body goes into shock and death from liver failure.
If intake of iron is during a prolonged period of time, symptoms are likely similar to other causes of iron overload.
. If this fails then dialysis
is the next step.
Iron
Iron is a chemical element with the symbol Fe and atomic number 26. It is a metal in the first transition series. It is the most common element forming the planet Earth as a whole, forming much of Earth's outer and inner core. It is the fourth most common element in the Earth's crust...
intake and usually refers to an acute overload rather than a gradual one. The terms has been primarily associated with young children who consumed large quantities of iron supplement pills, which resemble sweets and are widely used, including by pregnant women—see overnutrition
Overnutrition
Overnutrition is a form of malnutrition in which nutrients are oversupplied relative to the amounts required for normal growth, development, and metabolism...
(approximately 3 grams is lethal for a 2 year old). Targeted packaging restrictions in the US for supplement containers with over 250 mg elemental iron have existed since 1978, and recommendations for unit packaging have reduced the several iron poisoning fatalities per year to almost nil since 1998. No known cases of iron poisoning have been identified that are associated with iron mining.
Nature of iron
In nature, iron is usually found in its oxidized form, iron (III) oxide, which is insoluble. Ferrous iron is soluble and its toxicity varies, largely with the integrity of the gastrointestinal lining.Iron supplements are typically used to treat anemia. Modalities include: diet, parasite control, vitamin A, riboflavin (B2), vitamin C (for absorption), folate, vitamin B12 and multivitamin-multimineral supplements, with or without iron; potentially avoiding the use of iron only supplements.
Toxic dosage
The amount of iron ingested may give a clue to potential toxicity. The therapeutic dose for iron deficiency anemia is 3–6 mg/kg/day. Toxic effects begin to occur at doses above 10–20 mg/kg of elemental iron. Ingestions of more than 50 mg/kg of elemental iron are associated with severe toxicity.- A 325-mg tablet of ferrous sulfate has 65 mg (20%) of elemental iron
- A 325-mg tablet of ferrous gluconate has 39 mg (12%) of elemental iron
- A 325-mg tablet of ferrous fumarate has 107.25 mg (33%) of elemental iron
Symptoms
The first indication of iron poisoning by ingestion is a pain in the stomach, as the stomach lining becomes ulcerated. This is accompanied by nausea and vomiting. The pain then abates for 24 hours as the iron passes deeper into the body and damages internal organs, particularly the brainBrain
The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...
and the liver
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...
, and metabolic acidosis
Metabolic acidosis
In medicine, metabolic acidosis is a condition that occurs when the body produces too much acid or when the kidneys are not removing enough acid from the body. If unchecked, metabolic acidosis leads to acidemia, i.e., blood pH is low due to increased production of hydrogen by the body or the...
develops. The body goes into shock and death from liver failure.
If intake of iron is during a prolonged period of time, symptoms are likely similar to other causes of iron overload.
Treatment
Later stage treatment consists of cleaning the iron from the blood, using a chelating agent such as deferoxamineDeferoxamine
Deferoxamine is a bacterial siderophore produced by the actinobacteria Streptomyces pilosus. It has medical applications as a chelating agent used to remove excess iron from the body...
. If this fails then dialysis
Dialysis
In medicine, dialysis is a process for removing waste and excess water from the blood, and is primarily used to provide an artificial replacement for lost kidney function in people with renal failure...
is the next step.