Signs of iron poisoning and how to handle it

Iron poisoning occurs when a person takes a large amount of iron-containing drugs or vitamins. Iron poisoning if not treated promptly can cause serious health complications and can lead to death.

Iron poisoning was once the leading cause of drug overdose death in children under 6 years of age in the United States. This rate is currently decreasing. However, it remains a serious potential health risk for children.
The problem is that the child does not have too much iron in the diet. Instead, the culprits of iron poisoning tend to be iron supplements or multivitamins that look like candy. They look very attractive to young children.
Consuming an adequate amount of iron is important for brain, muscle and red blood cell function. But with excess iron, they can start to irritate the lining of the digestive tract. From there, some serious complications can occur.
The amount of iron that will cause poisoning depends on the size of the child. An 8-year-old child may have no symptoms from an amount that can cause severe symptoms in a 3-year-old.

The first signs of iron poisoning are usually nausea and abdominal pain. Vomiting blood may also occur. Iron poisoning can also lead to diarrhea and dehydration. Sometimes, too much iron causes stools to turn black and bloody. These symptoms usually develop within six hours. After that, symptoms may improve in a day or so.
After the initial symptoms, other serious complications can develop within 48 hours of an iron overdose, such as:
Dizziness Low blood pressure and a fast or weak pulse Headache Fever Difficulty breathing and fluid in the lungs Gray or bluish skin Jaundice (yellowing of the skin caused by liver damage) Convulsions

If you suspect your child has iron poisoning or any kind of drug or supplement poisoning from an overdose, call 911. As this could be a life-threatening emergency. When you call 911, try to have information like:
The child's age, weight and symptoms, as well as other health conditions. The name of the iron product, including ingredients and effects, and how much and for how long the child has taken the iron. Treatment of iron poisoning usually involves a procedure called a total bowel lavage. With a tube inserted through the nose and down the stomach to push excess iron out of the body.
In very severe cases, chelation may be necessary. This is a procedure in which a chemical that helps bind iron and other metals in the body is given through an intravenous (IV) line. Iron can then be removed from the body in the urine.
Other treatments include rehydration, especially if a lot of water has been lost due to vomiting and diarrhea. If breathing is difficult, a breathing tube and ventilator may be needed to return breathing to normal.
If a child is diagnosed with iron poisoning, the doctor will first make sure the child is breathing normally. After that, the child will probably have a bowel cleanse by drinking a special liquid. Severe toxicity will require IV (intravenous) chelation therapy. The patient received an IV series containing deferoxamine mesylate (Desferal), a chemical that binds to iron in the blood and is then excreted in the urine. Change in urine color to red-orange and low blood pressure are common side effects of deferoxamine treatment. Usually children need no more than 24 hours of therapy.
Gastric lavage, or gastric emptying, may be considered. But in general, it is only helpful if taken within 1 hour of taking the iron pill. Intubation can cause complications, and many pills may not fit through the ports of the washout tube if they haven't disintegrated. If the doctor suspects that a child has swallowed other medicines, they may be given activated charcoal. Activated charcoal does not bind to iron, but it can be helpful in absorbing other medications.

Iron supplementation higher than 35 milligrams per kilogram of body weight (mg/kg) resulted in the deaths of 43 American children between 1983 and 2000. In healthy adults, symptoms can begin with if a person takes at least 20 mg/kg of elemental iron at once. Very severe iron poisoning occurs at consumption levels of about 60 mg/kg and higher.
Elemental iron is the actual amount of iron in a supplement. A supplement will contain other ingredients, so it's important to read the label to know exactly how much elemental iron is in each pill.
Most causes of iron poisoning occur when a person takes too much iron or vitamin supplements. Pregnant women often take iron supplements during pregnancy. If children have access to these drugs, there is a very high risk of iron poisoning for children. But any iron supplement or multivitamin can be dangerous for children. If you take iron supplements as directed by your doctor, follow your doctor's advice. If there are children in the house, keep iron supplements out of the reach of children.

If you suspect your child has accidentally swallowed an iron tablet, call your doctor or medical facility immediately. Do not try to induce vomiting, either by hand or with ipecac syrup. This will make it more difficult to assess whether a child is really iron toxic or not.
Contact the nearest medical facility if you suspect your child has swallowed a vitamin containing iron, even if there are no symptoms. If possible, tell the doctor what type of iron supplement and how many tablets your child is taking.
Diagnosis of iron poisoning is usually made by observing the child. The child will have a normal physical exam and follow up if no symptoms for 6 hours indicate that the child has experienced a bit of poisoning or has not eaten any iron-containing substances. The doctor may also draw a child's blood to determine iron, blood cell count, and blood chemistry
The doctor may also order an X-ray of the child's abdomen to confirm if there is iron in the digestive tract, although although sometimes the medicine can be there and not seen.
Imaging tests are often not sensitive enough to detect poisoning. Some tests are also too slow to diagnose and treat iron poisoning.
Full recovery from iron poisoning is possible for children and adults with early intervention, before symptoms of poisoning appear. People with symptoms may be sick and need more aggressive treatment.

Liver failure can develop within a few days if iron poisoning is not treated. Bleeding or blood clot problems can also develop during this time. If liver failure is not present and iron poisoning is not treated effectively, scarring of the stomach and intestines can occur. This can cause major digestive problems. Permanent scarring of the liver, known as cirrhosis, can also follow iron poisoning. The most common causes of death from iron poisoning are liver failure and circulatory shock.
If treated promptly, iron poisoning is less likely to cause permanent harm. If treatment is started soon after an overdose occurs, symptoms and other complications may resolve within 48 hours.
But because the risk of liver failure and other serious health problems is so great, it's important that anyone, child or adult, who may have consumed too much iron is monitored. Blood and urine tests can quickly check iron levels in the body.
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Articles refer to sources: webmd.com, healthline.com