Iron supplements are widely used to treat iron deficiency and anemia. In large amounts, iron is toxic and damages multiple organ systems of the body. Iron in vitamin supplements is the leading cause of fatal poisoning in children under 5 years of age. If you suspect a person has taken an excessive amount of iron, seek immediate emergency medical care.
Causes
Many people taking iron supplements are unaware of the dangers of iron toxicity poisoning. Iron in supplements may be in the chemical forms of ferrous sulfate, ferrous gluconate or ferrous fumarate. Supplements may contain iron alone or in combination with other vitamins in multivitamin supplements. Chewable vitamins may also contain iron as an ingredient. Prenatal vitamins are usually very high in iron, and the U.S. Consumer Safety Commission has advised obstetricians to educate patients about the hazards of iron overdose.
Symptoms
Symptoms of overdose usually appear within six hours. Early signs may include vomiting, vomiting blood, diarrhea, abdominal pain, irritability, drowsiness, unconsciousness, and seizures. In severe cases, these initial symptoms may also include rapid breathing, a rapid heart rate, coma, and low blood pressure. In the second stage of poisoning, six to 48 hours after the overdose, these symptoms may improve. However, over subsequent days this may be followed by signs of shock, very low blood pressure, fever, bleeding, jaundice and seizures. The patient may develop life-threatening liver failure, coma and bleeding. Prompt medical attention and hospitalization are critical for treating serious iron poisoning.
Treatment
Iron toxicity can worsen quickly, so do not delay in seeking medical treatment. If possible, it is helpful to bring with you information about the patient's age and weight, the amount and type of iron that was consumed and the time at which the overdose occurred. Doctors will order blood tests to determine the amount of iron in the blood. Gastric lavage may be used to empty the stomach contents. An x-ray of the stomach may show how many pills were swallowed. Injections of deferoxamine may be given to bind the iron in the blood.
Prevention
Store all vitamins in containers with child-resistant closures and out of the reach of children. When you are finished with the supplements, discard any extra by flushing them down the toilet. Do not leave them in a wastebasket where children might discover them. Keep a careful eye on children when you enter an unfamiliar home, since you don't know whether the home has been "childproofed."
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