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Iron Poisoning

By

Gerald F. O’Malley

, DO, Grand Strand Regional Medical Center;


Rika O’Malley

, MD, Grand Strand Medical Center

Last full review/revision Jul 2020| Content last modified Jul 2020
Click here for the Professional Version
GET THE QUICK FACTS
  • Symptoms develop in stages and begin with vomiting, diarrhea, and abdominal pain.

  • Liver failure can develop days later.

  • The diagnosis is based on the person’s history, symptoms, and the amount of iron in the blood.

  • People with iron poisoning need to be hospitalized.

Pills containing iron are commonly used to treat certain kinds of anemia. Iron also is included in many multiple vitamin supplements. People—especially toddlers—who overdose on these pills may develop iron poisoning. Because many households contain adult multiple vitamin supplements that contain iron, iron overdose is common. However, children’s chewable iron-containing vitamins do not contain very much iron, so even a whole bottle does not provide enough iron to cause serious poisoning. Overdose of pure iron supplements, however, may cause serious iron poisoning. Prenatal vitamins contain a lot of iron and may poison a small child.

Iron poisoning is a potential cause of fatal poisoning in children younger than age 5. It first irritates the stomach and digestive tract, sometimes causing bleeding. Within hours, iron poisons the cells, interfering with their internal chemical reactions. Within days, the liver can be damaged. Weeks after recovery, the stomach, digestive tract, and liver can develop scars due to the previous irritation.

Symptoms of Iron Poisoning

Serious iron poisoning usually causes symptoms within 6 hours of the overdose. The symptoms of iron poisoning typically occur in 5 stages:

Diagnosis of Iron Poisoning

  • Iron levels and other blood tests

  • Sometimes x-rays

The diagnosis of iron poisoning is based on the person’s history, symptoms, presence of metabolic acidosis Acidosis Acidosis is caused by an overproduction of acid that builds up in the blood or an excessive loss of bicarbonate from the blood (metabolic acidosis) or by a buildup of carbon dioxide in the blood... read more (acid in the bloodstream released from the poisoned cells), and the amount of iron in the blood. If many pills have been swallowed, they can sometimes be seen on x-rays of the stomach or intestines.

Treatment of Iron Poisoning

  • Whole-bowel irrigation

  • Chelation therapy (for severe cases)

People with significant symptoms or high levels of iron in the blood need hospitalization. A large amount of iron can remain in the stomach even after vomiting. A special solution of polyethylene glycol may be given by mouth or through a stomach tube to wash the contents of the stomach and intestines (whole-bowel irrigation), although its effectiveness is unclear. Deferoxamine, a drug that binds with the iron in the blood (called chelation therapy Chelation Therapy Chelation, a biologically based practice, describes a chemical reaction in which certain molecules bind to metal atoms (such as calcium, copper, iron, or lead). Chelating drugs, such as ethylenediaminetetraacetic... read more ), allowing it to pass into the urine, is given by vein (intravenously) if poisoning is severe.

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