Toxic effects of iron pills

The New Straits Times, May 8,1995

Q: Recently, my neighbour's three-year-old son was taken to hospital when he complained of stomach pain and vomited blood after ingesting his mother's iron pills. What are the toxic effects of iron pills?

A: Accidental ingestion of iron involving children  is a common occurrence. Being an essential element in our body, it is taken by children, adults and pregnant mothers in the home not only in the form of iron pills (either as ferrous fumarate, ferrous sulphate or ferrous gluconate) but also, more commonly, as part of multivitamins.

Iron, however, may also be harmful, especially when as appreciable amount is ingested as in the case of accidental poisoning. It is corrosive in nature, and may cause injury to the stomach and the small intestine, with a good possibility of bleeding and scarring.

When too much iron is absorbed, a lot will be circulating in the blood and this can affect the heart, liver and brain. The effects, however, depend very much on the number of tablets consumed and the amount of elemental iron found in the tablets.

In a sever poisoning case, the effects on the victim can be divided into several stages:

Stage one (as early as 30 minutes to six hours after ingestion): The victim may develop nausea, vomiting, diarrhoea (usually with the presence of blood) stomach pain and cramps.

Stage two (as early as three to four hours after ingestion and may last up to 48 hours): The condition of the victim may seen to be stable with signs of improvement. This sometimes gives us a false sense of security. Close observation is therefore warranted at this stage.

Stage three (between 12 and 48 hours after ingestion): The patient's condition may worsen. Bleeding from the gut continues and victims look very tired or become unconscious and appear to be in shock. Yellowing of the skin and the sclera of the yes (jaundice) may be observed.

Stage four (more than 48 hours): Liver damage can occur. Otherwise, the patient's condition may start to improve.

In cases where victims do not show any sign or symptom within the first six hours following ingestion, toxicity is very unlikely. However, in cases of accidental iron poisoning, patients should be brought to hospital immediately for assessment and treatment.