Iron overdose
Ferrous sulfate overdose; Ferrous gluconate overdose; Ferrous fumarate overdoseIron 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.
Iron overdose is particularly 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.
This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with has an overdose, call the local emergency number (such as 911), or the local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
Overdose
An overdose is when you take more than the normal or recommended amount of something, often a drug. An overdose may result in serious, harmful sympt...
Read Article Now Book Mark ArticlePoisonous Ingredient
Iron can be harmful in large amounts.
Where Found
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)
Other products may also contain iron.
Symptoms
Below are symptoms of an iron overdose in different parts of the body.
AIRWAYS AND LUNGS
- Buildup of fluids in the lungs
Buildup of fluids in the lungs
Pulmonary edema is an abnormal buildup of fluid in the lungs. This buildup of fluid leads to shortness of breath.
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STOMACH AND INTESTINES
These are the most common symptoms in the first 6 hours after ingestion.
- Black, and possibly bloody stools
Black, and possibly bloody stools
Black or tarry stools with a foul smell are a sign of a problem in the upper digestive tract. It most often indicates that there is bleeding in the ...
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- Liver damage (may occur several days after the ingestion)
- Metallic taste in mouth
- Nausea
Nausea
Nausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up is forcing the contents of the stomach ...
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Vomiting blood
Vomiting blood is regurgitating (throwing up) contents of the stomach that contains blood. Vomited blood may appear bright red, dark red, or look lik...
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HEART AND BLOOD
- Dehydration
Dehydration
Dehydration occurs when your body does not have as much water and fluids as it needs. Dehydration can be mild, moderate, or severe, based on how much...
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- Fast and weak pulse
- Shock (may occur early from blood loss from the stomach or intestines, or later from the toxic effects of iron)
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...
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NERVOUS SYSTEM
- Chills
- Coma (decreased level of consciousness and lack of responsiveness, may occur within 1/2 hour to 1 hour after overdose)
Coma
Decreased alertness is the most severe state of reduced awareness and is a serious condition. A coma is a state of decreased alertness from which a p...
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- Dizziness
- Drowsiness
Drowsiness
Drowsiness refers to feeling more sleepy than normal during the day. People who are drowsy may fall asleep in when they do not want to or at times w...
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- Headache
- Lack of desire to do anything
SKIN
- Bluish-colored lips and fingernails
Bluish-colored lips and fingernails
A bluish color to the skin or mucous membrane is usually due to a lack of oxygen in the blood. The medical term is cyanosis.
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- Pale skin color
Pale skin color
Paleness is an abnormal loss of color from normal skin or mucous membranes.
Read Article Now Book Mark Article - Yellowing of the skin (jaundice)
Note: Symptoms may go away in a few hours, then return again after 1 day or later.
Before Calling Emergency
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
Poison Control
Your local poison control 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 will let you talk to experts in poisoning. They will give you further instructions.
Poison control center
For a POISON EMERGENCY call:1-800-222-1222ANYWHERE IN THE UNITED STATESThis national hotline number will let you talk to experts in poisoning. This ...
Read Article Now Book Mark ArticleThis 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.
What to Expect at the Emergency Room
Take the container to the hospital with you, if possible.
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.
Tests that may done include:
- Blood and urine tests, including tests to check iron levels
- ECG (electrocardiogram, or heart tracing)
- X-ray to detect and track iron tablets in the stomach and intestines
Treatment may include:
- Fluids through a vein (by IV).
- Medicine to help remove iron from the body and treat symptoms. This is called 'chelation.'
- Endoscopy -- camera and tube placed down the throat to view the esophagus and the stomach and to remove pills or stop internal bleeding.
- 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).
- Breathing support, including tube through the mouth into the lungs and connected to a breathing machine (ventilator).
Outlook (Prognosis)
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.
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.
References
Aronson JK. Iron salts. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:323-333.
Bluth MH, Pincus MR, Abraham NZ. Toxicology and therapeutic drug monitoring. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 24.
Theobald JL, Kostic MA. Poisoning. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 77.
Theobald JL, Mycyk MB. Iron and heavy metals. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 151.
Review Date: 11/13/2021
Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.