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''''Iron poisoning''' is an [[iron overload]] caused by a large excess of [[iron]] intake and usually refers to an acute overload rather than a gradual one. The term has been primarily associated with young children who consumed large quantities of iron supplement pills, which resemble sweets and are widely used, including by pregnant women—see [[overnutrition]] (approximately 3 grams is lethal for a 2 year old).<ref>{{cite web|url=http://www.ansci.cornell.edu/plants/toxicagents/iron.html |title=Plants Poisonous to Livestock - Cornell University Department of Animal Science |publisher=Ansci.cornell.edu |date= |accessdate=2012-04-09}}</ref> Targeted packaging restrictions in the US for supplement containers with over 250&nbsp;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.<ref>{{cite journal |last=Tenenbein |first=M. |year=2005 |month=June |title=Unit-Dose Packaging of Iron Supplements and Reduction of Iron Poisoning in Young Children |journal=Arch Pediatr Adolesc Med. |volume=159 |pages=557–560 |url=http://archpedi.ama-assn.org/cgi/content/full/159/6/557 |accessdate=2011-11-30 }}</ref><ref>[http://www.aapcc.org/annual.htm AAPCC Annual Reports], American Association of Poison Control Centers.</ref> No known cases of iron poisoning have been identified that are associated with [[iron mining]]. ==Nature of iron== {{main|Iron}} 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 are typically used to treat anemia. Modalities include: diet, parasite control,<ref>Stoltzfus RJ, Dreyfuss ML. [http://www.ilsi.org/file/b2_VUHUQ8AK.pdf 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</ref> vitamin A, riboflavin (B₂),<ref>Allen LH. [http://jn.nutrition.org/cgi/content/full/132/4/813S Supplement: Forging Effective Strategies to Combat Iron Deficiency], ''Journal of Nutrition'',The American Society for Nutritional Sciences, 132:813S-819S, 2002.</ref> vitamin C (for absorption), folate, vitamin B₁₂ and multivitamin-multimineral supplements,<ref>{{cite web|url=http://www.nhlbi.nih.gov/health/dci/Diseases/anemia/anemia_all.html |title=Anemia |publisher=Nhlbi.nih.gov |date= |accessdate=2012-04-09}}</ref> with or without iron; potentially avoiding the use of iron only supplements.<ref>[http://www.ironoverload.org/Diet.html Hemochromatosis and Anemia Diet]. Iron Overload Diseases Association.</ref> ==Toxic dosage== The amount of iron ingested may give a clue to potential toxicity. The therapeutic dose for iron deficiency anemia is 3–6&nbsp;mg/kg/day. Toxic effects begin to occur at doses above 10–20&nbsp;mg/kg of elemental iron. Ingestions of more than 50&nbsp;mg/kg of elemental iron are associated with severe toxicity.<ref>{{cite web|url=http://www.webmd.com/a-to-z-guides/iron-poisoning |title=Iron Poisoning |publisher=Webmd.com |date= |accessdate=2012-04-09}}</ref> * A 325-mg tablet of ferrous sulfate has 65&nbsp;mg (20%) of elemental iron * A 325-mg tablet of ferrous gluconate has 39&nbsp;mg (12%) of elemental iron * A 325-mg tablet of ferrous fumarate has 107.25&nbsp;mg (33%) of elemental iron ==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. If intake of iron is during a prolonged period of time, symptoms are likely similar to other causes of [[iron overload]]. ==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. hi ==Footnotes and references== {{reflist}} ==External links== *[http://www.gpnotebook.co.uk/simplepage.cfm?ID=2006581257 General Practice Notebook] *[http://www.webmd.com/a-to-z-guides/iron-poisoning Iron Poisoning on WebMD] *[http://www.merckmanuals.com/home/sec24/ch297/ch297h.html Iron Poisoning on merckmanuals] {{Poisoning and toxicity}} [[Category:Iron|Poisoning]] [[Category:Dietary mineral toxicity]] [[it:Avvelenamento da ferro]] [[sr:Trovanje gvožđem]] [[zh:铁中毒]]'