What Is Pagophagia? Causes, Treatment, and More

Medically reviewed by Natalie Butler, RD, LD on February 24, 2017Written by Ashley Marcin

Overview

Can’t get enough ice? You may have pagophagia.

You’ve probably heard the term “pica” used to describe craving nonfood items like dirt, chalk, or paper. What these substances have in common is that they don’t have nutritional value. If you have the type of pica called pagophagia, you crave and chew ice. It’s usually not serious, but it may be an indication that you have a medical condition that needs attention.

Symptoms of pagophagia

Craving or chewing ice or drinking iced beverages is the most common symptom of pagophagia. In the short term, wanting to chew or eat lots of ice may not mean you have an issue. If your cravings last longer than a month, though, you may be diagnosed with pica.

Pagophagia is related to iron deficiency anemia. As a result, you may experience other symptoms of deficiency, including:

  • fatigue and weakness
  • pallor, which means skin that is paler than usual
  • chest pain, fast heartbeat, or shortness of breath
  • dizziness or lightheadedness
  • swollen or sore tongue
  • cold hands or feet
  • poor appetite

Causes of pagophagia

Pica cravings most often occur in children, but adults can develop pagophagia as well. For example, pagophagia is sometimes associated with pregnancy due to pregnancy-related anemia.

In one study, researchers asked 81 people with iron deficiency anemia to share their eating habits. Of the participants, 13 showed signs of pagophagia. Some of these people took oral iron supplements, which ended up stopping their cravings for ice.

Another study suggests that chewing ice may increase alertness in people who have iron deficiency. In other words, there’s a clear link between anemia and pagophagia.

Chewing ice may also be a sign of an emotional issue. Some people may have symptoms of pagophagia if they are under a lot of stress. Others may have obsessive-compulsive disorder (OCD) or another developmental disorder. In these cases, chewing ice may be soothing in some way.

Diagnosis for pagophagia

If you’ve been craving and chewing large amounts of ice for longer than a month, you may want to see your doctor. Before you head to your appointment, try writing down anything about your cravings and habits you think your doctor may find helpful in diagnosis, such as:

  • how much ice you eat per day
  • how many weeks or months you’ve been chewing ice
  • other nonfood items you crave
  • any other symptoms you’ve been experiencing

Your doctor will likely ask for your medical history, and what medications and supplements you’re currently taking. They’ll also give you a physical exam. If your doctor suspects iron deficiency anemia or another deficiency, you may need a blood test or other lab work to confirm.

Treatment to relieve pagophagia

If you have iron deficiency anemia, treating the deficiency may relieve pica symptoms without the need for any other intervention. However, you shouldn’t just start taking iron supplements without speaking with your doctor first. That’s because using iron supplements when you don’t need them can cause your body to build up too much iron. The human body can’t get rid of excess iron. A buildup of iron may lead to cancer and damage your arteries and heart. Iron supplements can also cause constipation.

Cognitive behavioral therapy (CBT) may help in cases where pagophagia is caused by stress, OCD, or another mental health issue. The therapy may involve either positive and negative reinforcements or counseling.

Complications of pagophagia

Eating large quantities of ice may harm your teeth by damaging enamel and cracking or chipping a tooth. When your enamel is damaged, your teeth may become more sensitive or prone to cavities. Older dental work, like fillings, may fall out if you crunch too much ice as well.

If your pagophagia is caused by iron deficiency anemia, you may be at risk for several health issues. Mild anemia usually isn’t serious. However, anemia can get worse without treatment, and may lead to:

  • Heart issues, like rapid or irregular heartbeat. When you have anemia, your heart has to pump more blood to make up for the lack of oxygen in your bloodstream. Your heart may enlarge, or you may even experience heart failure.
  • Issues during pregnancy, like premature birth or low birth weight.
  • Growth issues in children, as well as increased risk for infections.

Outlook

Treating underlying iron deficiency anemia through supplementation and other methods can help tremendously. When treated, symptoms of pagophagia usually resolve without additional medical intervention. Women who experience this type of pica during pregnancy usually find their cravings go away after birth.

Learn more: 3 ways to prevent anemia in pregnancy »

CBT can help people manage pica. Speak with your doctor about getting a referral to a specialist who can help you manage stress, emotional issues, or compulsive behaviors.

Preventing anemia

Eating a balanced diet may help prevent iron deficiency anemia. You’ll want to include a good mix of iron-rich foods and others high in vitamin C. Vitamin C helps your body absorb plant iron.

Foods that contain a good dose of iron include:

  • red meat
  • beans and lentils
  • millet
  • dark, leafy greens
  • molasses
  • dried apricots and peaches
  • pumpkin
  • sunflower seeds, pistachios, walnuts, and almonds
  • scallops, clams, and oysters
  • soybeans

Good sources of vitamin C include:

  • broccoli
  • leafy greens
  • grapefruit, oranges, tangerines, and other citrus fruits
  • kiwi
  • melons
  • peppers
  • tomatoes
  • strawberries

Speak with your doctor if you’re at high risk of anemia due to other factors, like taking certain medications, having intestinal disorders, experiencing blood loss, or being pregnant. There may be additional measures you can take to protect yourself.

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