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Iron poisoning is caused by a large excess of iron intake. It has been primarily been associated with young children who consumed large quantities of iron supplement pills, which resemble sweets and are widely used, including by pregnant women. (Approximately 3 grams is lethal for a 2 year old. [1]) 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.[2][3]

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 should only be used as recommended by a primary care provider. Many forms of anemia are treated with, or iron utilization improved with: diet, parasite control,[4] vitamin A, riboflavin (B2),[5] vitamin C (for absorption), folate, vitamin B12 and multivitamin-multimineral supplements,[6] with or without iron; potentially avoiding the use of iron only supplements.[7]

No known cases of iron poisoning have been identified that are associated with iron mining.

Contents

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 brain and the liver, and metabolic acidosis develops. The body goes into shock and death from liver failure.

Treatment

Later stage treatment consists of cleaning the iron from the blood, using a chelating agent such as deferoxamine. If this fails then dialysis is the next step.

Footnotes and references

  1. ^ http://www.ansci.cornell.edu/plants/toxicagents/iron.html
  2. ^ Tenenbein M. "Unit-Dose Packaging of Iron Supplements and Reduction of Iron Poisoning in Young Children", Arch Pediatr Adolesc Med. vol. 159, pp 557-560. June 2005
  3. ^ AAPCC Annual Reports, American Association of Poison Control Centers.
  4. ^ Stoltzfus RJ, Dreyfuss ML. Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anemia. International Nutritional Anemia Consultative Group, International Life Sciences Institute Press, 2000
  5. ^ Allen LH. Supplement: Forging Effective Strategies to Combat Iron Deficiency, Journal of Nutrition,The American Society for Nutritional Sciences, 132:813S-819S, 2002.
  6. ^ Anemia
  7. ^ Hemochromatosis and Anemia Diet. Iron Overload Diseases Association.

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