All You Need To Know About Iron Toxicity: Who Is At Risk?

While iron deficiency anemia is one of the most commonly talked about nutritional deficiencies in the world, the adverse effects of excess iron go largely undiscussed. But if statistics are to be believed, iron toxicity is a leading cause of poisoning-related deaths in children younger than 6 years. Adults can also experience iron overload if they overdose on supplements or have disorders like hemochromatosis.¹

When the iron absorbed by your body reaches toxic levels, it can affect your health in a major way. Here’s everything you need to know about iron toxicity, its causes and symptoms, and ways to reverse it.

An Iron Supplement Overdose Can Cause Acute Iron Poisoning

Iron toxicity is often the result of consuming iron supplements in excess. Usually, iron supplements in the form of multivitamins do not contain enough iron to cause an overdose in adults and children’s multivitamins have very low doses of iron. However, it’s possible to get an acute iron poisoning from pure iron pills.² More common in children than adults, an accidental overdose of iron syrups could cause the iron in the body to increase to toxic levels.

Minor symptoms of an acute iron poisoning include fast but weak pulse, dizziness, pale skin, stomach pain, nausea, diarrhea, black stool, and a metallic taste in the mouth. These symptoms last for about 6 hours but may recur after 12 to 48 hours. If the patient does not receive immediate treatment, the toxicity might lead to shock, multiple organ failures, and even death.³

[pullquote]The tolerable upper limit for iron intake is 40 mg per day for infants and 45 mg for adults.⁴[/pullquote]

To avoid an overdose, make sure that you keep your iron supplements away from kids. Also, avoid giving unprescribed iron supplements to children. In addition, don’t take extra doses at the same time, even if you’re trying to make up for a missed dose.

Iron Toxicity Could Be Due To Hemochromatosis

Hemochromatosis is a condition where your body absorbs more iron than required, resulting in a toxic accumulation of iron. Without treatment, this condition can lead to problems like liver cancer, liver cirrhosis, and heart disease.

[pullquote]The African iron overload is a rare condition caused due to the consumption of a traditional African beer, which contains dissolved iron from the metal drums in which it is brewed. This may cause excess iron to be deposited in your immune cells, thus reducing their ability to fight infections.⁵[/pullquote]

Although hemochromatosis is largely genetic, you may acquire the condition if you have hereditary anemia (like sideroblastic anemia, hemolytic anemia, pyruvate kinase deficiency, thalassemia intermedia, and thalassemia major) as your intestine absorbs excess iron to meet the body’s growing need to form new RBCs. And since the excess iron cannot be excreted by the body, it leads to iron toxicity.

Symptoms of hemochromatosis include a change in skin color, joint pain, digestive issues, heart problems, and underactive pituitary and thyroid glands.⁶ But sometimes hemochromatosis can also cause some severe side effects and complications like

• Fibrosis
• Cirrhosis of the liver
• Diabetes
• Prolonged jaundice
• Cardiac failure
• Reproductive organ failure
• Brain damage
• Increased risk of cancer

Avoid Iron Toxicity By Controlling Your Diet

Iron toxicity or poisoning needs immediate medical intervention. But there are a few things you can do to avoid an overload, especially if the toxicity is due to a hereditary condition. If you’re experiencing toxicity, avoid iron-rich foods like red meat and cut back on alcohol and sugary food, which enhance iron absorption. However, certain foods can actually reduce the absorption of iron by your body.

• Consume calcium-rich foods like milk, kale, and soybeans as calcium hinders iron absorption.
• Drink black tea, herbal teas, coffee, and cocoa with your meal as they are believed to be potent inhibitors of iron absorption.^{7 8}
• Eat fresh fruits and vegetables, including spinach and kale. While these contain iron, these also contain fiber and antioxidants. While fiber reduces the absorption of iron, antioxidants fight free radicals which excess iron triggers. These also contain oxalate which reduces iron absorption.
• Eat nuts, grains, and beans since these are high in fiber beside other nutrients.⁹

Avoid Toxicity By Preventing Drug Interaction

If you need to take iron supplements and are on medication for other conditions, consult your doctor to find out whether iron supplements are safe for you. For example, gout medication tends to increase iron storage in the liver. So, before going on supplements, identify and avoid any possible drug interaction.¹⁰

To Detect Iron Toxicity, Check Your Serum Ferritin Levels

Your body stores iron in the form of ferritin, a structural protein. An increased ferritin level can mean that you have toxic levels of iron in your body. So a test for ferritin levels is suggested to diagnose iron overload. However, be warned that diagnosing iron toxicity by examining ferritin levels may not be accurate if the iron overload is the result of an alcoholic liver disease.¹¹ Which is why you may also be asked to get a liver function test. A serum transferrin saturation test is also advised where the amount of iron bound to the protein transferrin in blood is measured. A high transferrin saturation value indicates excess iron in the body.

Getting an early diagnosis and the correct medication and making a few dietary changes will help you overcome the toxic effects of raised iron levels in the blood.