Definition

What is iron poisoning?

Iron poisoning occurs when a person, usually a child, swallows a large number of iron-containing pills, most often vitamins.

Acute iron poisoning mainly involves children under age 6 who swallow pediatric or adult vitamins containing iron. These children may not be able or willing to tell you what and how much they swallowed.

How common is iron poisoning?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of iron poisoning?

Symptoms of iron poisoning usually become evident within 6 hours after an excessive amount of iron is swallowed. Iron corrodes your intestinal lining and is a direct irritant to the stomach. People with iron poisoning can have the following symptoms:

  • Severe vomiting
  • Diarrhea
  • Abdominal pain
  • Dehydration and lethargy if not treated adequately
  • In a child, bloody vomit or stool

Often, after supportive care, the gastrointestinal symptoms appear to improve within 6 to 24 hours after their onset. If profound poisoning is inadequately treated, shock and death can occur.

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.

When should I see my doctor?

Call your doctor, local poison control center, or go directly to the closest hospital’s emergency department if you suspect your child has swallowed iron-containing vitamins, even if your child shows no symptoms. Bring the container with you.

If you find your child among iron pills or pill containers, or your child tells you he or she swallowed pills, take the child to a hospital’s emergency department.

Causes

What causes iron poisoning?

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.

Risk factors

What increases my risk for iron poisoning?

Please consult your doctor for more information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is iron poisoning diagnosed?

If you can, tell the doctor the type of iron supplement and the number of tablets your child swallowed.

The diagnoses of iron poisoning are usually made by observing your child. A normal physical exam and no symptoms for 6 hours tells the doctor that the child has experienced either little poisoning or did not eat any iron-containing substances.

The doctor may draw blood from your child to determine these levels:

  • Iron
  • White blood cell count
  • Serum glucose (blood sugar)

The doctor may also ask for an X-ray of your child’s abdomen to confirm whether there are iron pills in the gastrointestinal tract, although sometimes the pills can be there and not seen. Laboratory and imaging tests are not usually sensitive enough to detect poisoning. Some tests are also too slow to affect the diagnosis and management of iron poisoning.

How is iron poisoning treated?

If your child is diagnosed with iron poisoning, the doctor will first make sure your child is breathing normally. Then your child will likely have his or her bowel cleaned by drinking a strong laxative.

Severe poisonings will require IV (intravenous) chelation therapy. The patient receives a series of IVs containing deferoxamine mesylate (Desferal), a chemical that binds to iron in a cell and is then excreted in urine. Deferoxamine can be administered by IV or shot, but the IV route is preferred for easier dose adjustment. A change in urine color to a red-orange and low blood pressure are common side effects with deferoxamine treatment. Usually children require no more than 24 hours of therapy.

Orogastric lavage, or pumping of the stomach, may be considered. But generally, it is only helpful if performed within 1 hour of swallowing the pills. Insertion of the tube can cause complications, and many pills may not fit through the ports of a lavage tube if they are not disintegrated.

 

If the doctor suspects your child has also swallowed other medications, he or she may give your child activated charcoal to drink. Activated charcoal does not bind to iron, but it may be useful in absorbing other medications.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage iron poisoning?

The following steps help you prevent iron poisoning:

  • Keep medications where children cannot get to them.
  • Childproof caps are not a guarantee that children are safe.
  • Educate your children that unknown pills are not candy and can be harmful.

If you have any questions, please consult with your doctor to better understand the best solution for you.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: October 27, 2017 | Last Modified: October 27, 2017

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