Iron overdose: MedlinePlus Medical Encyclopedia

P Iron is a mineral found in many over-the-counter supplements. Iron overdose occurs when someone takes more than the normal or recommended amount of this mineral. This can be by accident or on purpose.
P Iron overdose is especially dangerous for children. A severe overdose can happen if a child eats adult multivitamins, such as prenatal vitamins. If the child eats too many pediatric multivitamins, the effect is usually minor.
P This is for information only and not for use in the treatment or management of an actual overdose. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

T Poisonous Ingredient
P Iron can be harmful in large amounts.

T Where Found
P Iron is an ingredient in many mineral and vitamin supplements. Iron supplements are also sold by themselves. Types include:
- Ferrous sulfate (Feosol, Slow Fe)
- Ferrous gluconate (Fergon)
- Ferrous fumarate (Femiron, Feostat)
P Other products may also contain iron.

T Symptoms
P Below are symptoms of an iron overdose in different parts of the body.
P AIRWAYS AND LUNGS
- Buildup of fluids in the lungs
P STOMACH AND INTESTINES
- Black, and possibly bloody stools
- Diarrhea
- Liver damage
- Metallic taste in mouth
- Nausea
- Vomiting blood
P HEART AND BLOOD
- Dehydration
- Low blood pressure
- Fast and weak pulse
- Shock
P NERVOUS SYSTEM
- Chills
- Coma (decreased level of consciousness and lack of responsiveness, may occur within 1/2 hour to 1 hour after overdose)
- Convulsions
- Dizziness
- Drowsiness
- Fever
- Headache
- Lack of desire to do anything
P SKIN
- Bluish-colored lips and fingernails
- Flushing
- Loss of color from the skin (pallor)
P Note: Symptoms may go away in a few hours, then return again after 1 day or later.

T Before Calling Emergency
P Have this information ready:
- Person's age, weight, and condition
- Name of the product (ingredients and strength, if known)
- Time it was swallowed
- Amount swallowed
- If the medicine was prescribed for the person

T Poison Control
P Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.
P This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

T What to Expect at the Emergency Room
P Take the container to the hospital with you, if possible.
P The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated.
P The person may receive:
- Blood and urine tests, including tests to check iron levels
- Breathing support, including tube through the mouth into the lungs, and breathing machine (ventilator)
- Camera and tube down the throat to see the esophagus and the stomach and remove pills or stop internal bleeding
- EKG (electrocardiogram, or heart tracing)
- Fluids through a vein (by IV)
- Medicine to help remove iron from the body and treat symptoms
- Whole bowel irrigation with a special solution to quickly flush the iron through the stomach and intestines (taken by mouth or through a tube through the nose into the stomach)
- X-ray to detect and track iron tablets through the stomach and intestines

T Outlook (Prognosis)
P There is a good chance of recovery if the person's symptoms are gone 48 hours after the iron overdose. But, severe liver damage can occur 2 to 5 days after the overdose. Some people have died up to a week after an iron overdose. The more quickly the person receives treatment, the better the chance for survival.
P Iron overdose can be very severe in children. Children may sometimes eat large amounts of iron pills because they look like candy. Many manufacturers have changed their pills so they no longer look like candy.

T Alternative Names
P Ferrous sulfate overdose; Ferrous gluconate overdose; Ferrous fumarate overdose

T References
P Kulig K. General approach to the poisoned patient. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 147.
P Liebelt EL. Iron. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 72.
P Velez LI, O'Connell EJ. Heavy metals. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 157.

T Review Date 10/13/2015
P Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

