Iron Poisoning

Medically reviewed by Judith Marcin, MD on August 7, 2017Written by Stephanie Watson

What is iron poisoning?

Iron poisoning was once the leading cause of death from medication overdose among children under age 6 in the United States. Iron poisoning is now on the decline. However, it remains a serious health risk for children.

The problem isn’t usually too much iron in the diet. Instead, the culprits tend to be iron supplements or multivitamins that look like candy. They can be very tempting to small children.

A healthy amount of iron consumption is critical to the function of the brain, muscles, and red blood cells. But the body can’t metabolize high doses of iron. Excess iron can start to irritate the lining of your gastrointestinal tract. From there, some serious complications will follow.

Symptoms of iron poisoning

Among the initial signs of iron poisoning are nausea and abdominal pain. Vomiting blood can also occur. Iron poisoning can also lead to diarrhea and dehydration. Sometimes, too much iron causes stools to turn black and bloody. These symptoms usually develop within six hours. After that, symptoms may appear to improve for a day or so.

After those early symptoms, other serious complications can develop within 48 hours after the iron overdose, such as:

  • dizziness
  • low blood pressure and a fast or weak pulse
  • headache
  • fever
  • shortness of breath and fluid in the lungs
  • a grayish or bluish color in the skin
  • jaundice (yellowing of the skin due to liver damage)
  • seizures

Treatment of iron poisoning

If you suspect your child has iron poisoning or any type of poisoning from a medication or supplement overdose, call 911. This can be a life-threatening emergency. Iron poisoning always requires emergency room evaluation.

When you call 911, try to have the following information available:

  • your child’s age, weight, and symptoms, as well as other health conditions
  • name of the iron product, including other ingredients and strength
  • amount that was swallowed
  • time it was swallowed

That same information is important for adults who may have iron poisoning. The condition is less common in adults than in children. But if it happens, a fast response is also necessary.

Treating iron poisoning often involves a procedure called whole bowel irrigation. A special solution is swallowed or given through a tube that is passed through the nose and down into the stomach. The solution helps flush the body of the excess iron.

In very serious cases, chelation may be necessary. This is a procedure in which a chemical that helps bind iron and other metals in the body is given through an intravenous (IV) line. The iron then can be passed out of the body through the urine.

Other treatments include rehydration, especially if there has been a great loss of fluids through vomiting and diarrhea. If breathing is difficult, a breathing tube and a ventilation machine may be needed to get respiration back to normal.

Causes of iron poisoning

According to the Office of Dietary Supplements, ingestion of doses of iron higher than 35 milligrams per kilogram of body weight (mg/kg) resulted in the death of 43 U.S. children between 1983 and 2000. In healthy adults, symptoms can begin by consuming as little as 20 mg/kg of elemental iron at one time. Very serious iron poisoning occurs at around 60 mg/kg and higher for children and adults.

Elemental iron is the amount of iron actually in a supplement. A supplement will contain other ingredients, so it’s important to read the label to know exactly how much elemental iron is in each pill.

Most causes of iron poisoning occur when a person, usually a child, simply swallows too many iron supplements or vitamins. An expectant mother often takes iron supplements during pregnancy. If these are left around the house, they can become targets of curious children.

But iron supplements or multivitamins of any kind can be dangerous to children. With the popularity of gummy and chewable vitamins for adults, the risk of accidental poisoning is even higher. In response, vitamin manufacturers have started making prenatal iron supplements and similar vitamins in tablets that look less like candy than they did years ago.

If you take iron supplements because your doctor recommends them, be sure you know what to do if you miss a dose. Never take more than you’re advised to by your doctor. If there are children in your house, keep iron supplements in child-proof containers and away from any youngsters.

Complications and risks of iron poisoning

Liver failure can develop within a few days if iron poisoning isn’t treated. Bleeding or blood clot problems may also develop during this time.

If liver failure doesn’t occur and the iron poisoning isn’t effectively treated, scarring of the stomach and intestines may result. This can cause major digestive problems.

Permanent scarring of the liver, known as cirrhosis, can also follow iron poisoning.

The most common causes of death resulting from iron poisoning are liver failure and shock to the circulatory system.

Outlook for iron poisoning

If treated promptly, iron poisoning is less likely to cause permanent damage. If treatment begins soon after the overdose, symptoms and other complications may be gone within 48 hours.

But because the risk of liver failure and other serious health problems is so great, it’s important that anyone — child or adult — who may have consumed too much iron be evaluated. Blood and urine tests can quickly check iron levels in the body. Other blood work may also be needed to fully assess the impact of iron levels on the body.

If you ever have questions about a possible overdose, call the Poison Help line at 800-222-1222. Medical experts are available 24 hours a day, seven days a week. There doesn’t need to be an emergency to call. You can get information to help prevent an overdose too. Their interactive online resource, PoisonHelp.org, can also be useful.

CMS Id: 129754