Eating ice iron deficiency

Ask the doctor: What causes a craving for ice?

Published: April, 2011

Q. I recently developed a craving to chew on several ice cubes a day. What causes this? Is it unhealthy?

A. The compulsion to chew ice is a form of pica, a condition characterized by a craving for nonfood substances such as dirt, chalk, glue, cornstarch, or paper. Pica is more common in children but may also occur in adults. In adults, pica for ice — called pagophagia — is most often associated with pregnancy and iron-deficiency anemia, a condition in which the lack of iron in the bloodstream impedes the body’s ability to make normal red blood cells. We don’t know why or how a craving for chewing ice develops. People with iron-deficiency anemia sometimes have inflammation of the tongue, and ice may relieve the discomfort. Occasionally, chewing ice is a sign of emotional distress.

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Chewing on ice is a variant of pica, an eating disorder characterized by craving and eating non-food items as diverse as dirt, glue and hair (and worse). While pica is typically seen in young children, it also occurs in adults.

The specific compulsion to chew ice is called pagophagia and has been associated with pregnancy, iron deficiency anemia and, sometimes, other nutritional problems. We don’t know why it occurs among pregnant women or why individuals with iron deficiency anemia crave and habitually chew ice. One study suggested that the ice may relieve the pain of glossitis, an inflammation of the tongue that can be a sign of iron deficiency. Research also suggests that ice tastes better to people who are iron deficient. However, pica can also be a symptom of stress, emotional upset, obsessive-compulsive disorder and, in children, a developmental disorder.

Don’t start taking iron supplements on the theory that your underlying problem is a deficiency of this mineral. Instead, see your physician for a blood test to determine whether you have it. With the exception of menstruating women and individuals who have had a significant blood loss, no one should take supplemental iron except when advised to by a physician after blood tests reveal iron deficiency anemia. Too much iron is not good for you. Because it is one of the few minerals we cannot eliminate, it can accumulate in the body, and, being a strong oxidizing agent, can increase the risk of cancer and damage the heart and the arteries. Most people get adequate iron from their diets – there’s plenty in red meat, beans, lentils, millet, chickpeas, dark, leafy greens, molasses, dried apricots, dried peaches, pumpkin and sunflower seeds, pistachios, walnuts, almonds, scallops, clams, oysters, soybeans, and many other foods.

If you learn that you are not deficient in iron, you might consider cognitive behavioral therapy, which can help overcome pica.

Andrew Weil, M.D.

Patients suffering from pagophagia compulsively crave and chomp on ice, even scraping buildup off freezer walls for a fix. The disorder appears to be caused by an iron deficiency, and supplements of the mineral tend to ease the cravings. But what is it about ice that makes it so irresistible?

A study proposes that, like a strong cup of coffee, ice may give those with insufficient iron a much-needed mental boost. Fatigue is the most common symptom of iron-deficiency anaemia, which occurs when the body can’t produce enough oxygen-carrying haemoglobinbecause of low iron.

“I had a friend who was suffering from iron-deficiency anaemia who was just crunching through massive amounts of ice a day,” said study author Melissa Hunt, a clinical psychologist at the University of Pennsylvania. “She said: ‘It’s like a cup of coffee. I don’t feel awake until I have a cup of ice in my hand.’”

Hunt and her colleagues had both anaemic and healthy subjects complete a standardised, 22-minute attention test commonly used to diagnose attention deficit hyperactivity disorder. Just before the test, participants were given either a cup of ice or lukewarm water to consume.

Iron-deficient subjects who had sipped on water performed far more slugglishly on the test than controls, as expected. But those who ate ice beforehand did just as well as their healthy counterparts. For healthy subjects, having a cup of ice instead of water appeared to make no difference in test performance.

“It’s not like craving a dessert. It’s more like needing a cup of coffee or that cigarette,” Hunt said.

The study was published in the October issue of the journal Medical Hypotheses.

Pagophagia is one of many types of pica, a disorder that encompasses daily craving and eating of unusual nonfoods such as clay, chalk, paste, cigarette butts or laundry starch. Patients with pica may also ingest atypical foods compulsively, such as lemons, tofu or dried pasta. About 20% of cases are pregnant women, since their iron stores can easily get depleted by their growing foetuses.

For centuries, doctors have taken note of pica in many forms. The first might have been the ancient Greek physician Hippocrates of Kos, who in the fifth century BC wrote about pregnant women’s “desire to eat earth or charcoal”. A Byzantine obstetric textbook from the sixth century AD describes patients craving spicy or salty dishes, but also dirt, eggshells and ashes.

But pica largely remains a medical mystery. Certainly its association with low iron is real, although oddly, pica appears in only about half of iron-deficient patients.

“A general hypothesis of pica is that oftentimes, it is an attempt to supplement the diet with basic minerals – think iron or copper,” Hunt said. “That might explain things like dirt consumption, but it absolutely does not explain pagophagia.”

Hunt points to a phenomenon called the mammalian diving reflex as a possible reason the ice-chewing caused better test performance. When submerged in water, most air-breathing vertebrates slow down their heart rate and constrict blood vessels in their arms and legs. This decreases the oxygen supply to the body’s periphery, saving it for vital organs.

“If you think about whales and dolphins diving, the water gets colder and their peripheral blood vessels constrict and shunt all the blood to the internal organs and the brain,” she said. “It is sort of vestigial, but humans do show the dive reflex.”

Crucially, the reflex is triggered by the face having contact with cold water, but not warm water. So perhaps the chill of chewing on ice cubes may lead to an increase of oxygenated blood to the brain, providing the cognitive boost that anemic patients need. For those with enough iron, Hunt speculates, there would be no additional benefit to more blood flow.

Catherine Broome, a haematologist with the Georgetown University School of Medicine, said she often sees pagophagia in her iron-deficient patients. She even uses the intensity of the disorder to help track whether treatment is working.

“As we replace a patient’s iron, the desire to chew ice will lessen, so it’s an easy symptom to follow in patients,” said Broome, who found the study fascinating and the conclusion quite feasible. Although patients will admit to having pica if asked, typically they don’t volunteer the information readily.

“Patients tend to be somewhat secretive about these kinds of behaviours. You have to tease it out,” said Michael Bromberg, a Temple University haematologist. “I had one patient tell me: ‘I love ice. It’s better than sex.’”Bromberg remarked on some issues with the study’s details, such as omitting haemoglobin data for the anaemic patients and equating iron deficiency with anemia. Having an iron deficiency can progress to anaemia, but the two terms aren’t synonymous.

Both haematologists had never heard any of their patients say that ice makes them feel more alert. Instead, eating ice has been described more as an uncontrollable craving than a jolt of energy.

“Patients try not to eat ice,” Broome said. “But like being addicted to a drug, even if you don’t want to do it, you have to.”

This article appeared in Guardian Weekly, which incorporates material from Washington Post

Why Do You Crave Ice?

Do you ever get an urge to crunch on a piece of ice? If you do, you’re not alone.

You might think you’re craving for ice has something to do with the hot weather outside. And while a frozen cube of water can quench your thirst in the middle of summer, there are actually a few medical reasons you may be craving the frozen water in your freezer.

What causes you to crave ice?

You can crave ice for a number of reasons. Here are the common reasons people crave ice:

Pica

If you’re experiencing an insatiable craving to eat ice, you may have a condition called pica. “In medical terms, pica is a disorder defined by a desire to eat substances that lack any nutritional value,” explains Dr. Sarina Pasricha, MD, MSCR.

People with pica often crave nonfood items, like dirt, paint chips, clay, hair, ice, or paper. If ice is the substance you crave, then you may have a type of pica called pagophagia.

While there’s no single cause of pica or pagophagia, they can occur if you have iron deficiency anemia. Malnutrition or a mental health disorder may also be the culprit.

Pica is often seen in children and may have a psychological basis, such as obsessive-compulsive disorder or a pediatric developmental disorder. It’s also commonly related to an underlying nutrient deficiency, typically iron. This then results in anemia.

Iron deficiency anemia

You don’t have to receive a diagnosis of pica to crave ice. Some people with anemia may crave ice as a result of an iron deficiency. One study proposed that this is because ice gives people with anemia a mental boost. Anemia is a medical condition in which your blood doesn’t carry enough oxygen to the rest of your body. This results in less energy.

Other symptoms of anemia include:

  • shortness of breath
  • dizziness
  • weakness

Pregnancy

If you’re pregnant, your doctor may discover that you have anemia. “Pregnant women are often anemic due to the demands on the blood supply and circulation, poor nutritional intake, or from abnormal bleeding,” explains Dr. C. Nicole Swiner, MD. Even if you don’t have a history of anemia, you can become iron deficient during pregnancy.

In addition to anemia, Pasricha says there are other reasons you may crave ice during pregnancy:

  • Pregnancy can cause nausea and vomiting, which can lead to dehydration. In this case, eating ice allows you to stay hydrated without worsening the nausea symptoms.
  • Since ice has no odor or taste, many women crave ice during pregnancy.
  • Pregnancy increases a woman’s metabolic rate and causes vasodilation (swelling of the blood vessels). Both of these can lead women to feel increasingly hot and therefore crave cold items such as ice.

Should you see a doctor about your ice cravings?

Pasricha recommends seeing your doctor if your desire to eat or chew ice continues to increase for at least one month. Your doctor will likely perform basic lab work to test for iron deficiency anemia, which needs to be evaluated and treated.

It’s also a good idea to have your teeth evaluated. Chewing ice over time can ruin enamel. Ask your doctor to look at your teeth. They can tell you if a visit to the dentist is necessary.

How can you stop your ice cravings?

Once you visit your doctor, the next step is to come up with a plan to stop, or at least decrease, your ice cravings.

If anemia is the cause of your cravings, your doctor may start you on iron supplements and replacement therapy. After your iron stores are replaced, the ice craving usually resolves.

If anemia isn’t the underlying cause, your doctor may look at psychological reasons for the craving. “Some people may have craved ice due to psychological stressors, in which case, cognitive behavioral therapy has been shown to be helpful,” says Pasricha.

The bottom line

Compulsive ice chewing for a period of longer than one month is a sign of a more significant medical or psychological issue that needs to be checked out.

If you’re craving and chewing on ice for reasons other than thirst, make an appointment to see your healthcare provider.

Why does anemia make people want to crunch on ice?

Chewing on ice will give you more than just the chills; all that crunching, it turns out, is bad for your mouth — the habit can injure soft tissue (such as your gums) and has been known to break or crack teeth.

And here’s something you might now know: It may also be a sign that you’re anemic.

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Being anemic means your body has an abnormally low number of red blood cells, and it happens for a couple reasons: Either the body isn’t making enough — which it normally does daily, as an individual red blood cell only lives for about 3 months — or the body is losing or destroying healthy red blood cells at a faster-than-normal rate. Red blood cells carry an iron-rich protein called hemoglobin, which delivers oxygen throughout the body. Without a big enough delivery service in place, your organs and tissues end up with a smaller amount of oxygen. While some people might not have any symptoms or only a few minor complaints, anemia can make you feel tired, dizzy and easily fatigued. People with anemia may also suffer from shortness of breath, an irregular heartbeat, headaches, leg cramps and insomnia, and often complain they have difficulty concentrating.

There are many types of anemia, more than 400 in total, and each specific type has its own cause and its own symptoms that go beyond those most commonly associated with the general condition. Sickle cell anemia, for example, is an inherited blood disorder. Other forms may develop because of a nutritional deficiency, such as the lack of vitamin B12 or iron. Symptoms of vitamin B12 deficient anemia may involve clumsiness, tingling sensations in your hands and feet (like pins and needles when a hand or foot falls asleep) and even depression and hallucinations. And iron isn’t just what makes our blood red, rather than blue or green; it’s critical to the makeup of a healthy red blood cell. Adults have between 3 and 4 grams of iron circulating throughout the body at all times, or they should; when iron levels drop too low, the red blood cell production line stops, leading to iron-deficiency anemia. This type of anemia, compared to other forms of the condition, is known to cause a red, sore tongue (glossitis) and an inflammation on the inside of your mouth (stomatitis), as well as cracks at the corners of the mouth (angular cheilitis) . Iron-deficiency anemia is also the type associated with crunching on ice.

Is Chewing Ice Bad For You?

Is Chewing Ice Bad For You?

Chances are that you’ve crunched your way happily through an ice cube or two on occasion. Those little melted chips of frozen delight that lurk at the bottom of a tall glass of your favorite beverage can be hard to resist.

And for some of us, eating ice covered with a flavored syrup (Shave Ice in Hawaii, Italian Ice in New York City, Water Ice in Philly, Raspa in Texas, Granita to the Sicilians among us, Slushies, Snow Cones and Snowballs to everyone else), is an unmissable summer tradition. Summer without a damp white paper cup of lemon ice is just a lost season of sweaty sadness.

But if you were addicted to ice, you’d be chomping your way through a few bags of ice daily, year round.

Addicted to chewing ice?

Dedicated ice chewers crave ice like a smoker needs a cigarette. They have favorite places to buy ice (Sonic ice seems to be the Internet’s ice-chewing population’s #1 choice). They have websites devoted to documenting their frosty obsession. The truly hardcore may even purchase snow-cone machines for home use, or find themselves “scraping buildup off freezer walls for a fix.”

But, OK, to each their own, right? And chewing ice seems like it would be a pretty harmless activity, apart from annoying others with the incessant crunching. But the sad truth is that gnawing on cubes can be an indicator of serious health condition, and can ruin your teeth and hurt your gums.

Read on to find out how you can break the habit and save your smile from the frigid embrace of your icy little overlords.

Why Chew Ice?

“Pica” is the medical term for craving and chewing on items that have little or no nutritional value – such as ice, dirt, clay, chalk, paper, paint, sand and rocks. Medical experts have documented the condition over thousands of years. Ancient Greek physician Hippocrates of Kos wrote about pregnant women’s “desire to eat earth or charcoal” back in the 5th century B.C. A 6th century A.D. medical textbook describes patients craving overly spicy or salty foods, as well as dirt, eggshells and ashes.

Chewing on ice is the most common form of pica and is called pagophagia. Compulsive ice chewing is increasingly considered to be a symptom of anemia, particularly iron deficiency anemia (there are more than 400 types of anemia).

Medical science has not yet 100% sure why people with anemia seem compelled to chew ice but suspect the coolness of the crunchy cubes may soothe the oral inflammations often caused by iron deficiencies.

A recent study indicates that, for those with insufficient iron, eating ice acts like a cup of strong coffee. Anemics often report feeling fatigued and foggy-brained due to their bodies inability to produce enough oxygen-carrying hemoglobin.

Our bodies have a hardwired response to being submerged in cold water. Our heart rates slow, the blood vessels in our legs and arms constrict. The idea is to keep the brain fed with oxygen, along with protecting the body’s other core functions. Researchers think that the cold jolt provided by chewing ide might push better-oxygenated blood to the brain, which would help people with anemia feel awake and focused. Sipping on ice water does not produce the exact same perky feeling.

Other reasons to chew ice include relief for a dry mouth, quitting cigarettes, stress relief, boredom or an attempt to cut back on food consumption in order to lose weight.

Dangers of Chewing Ice

Ice munching won’t destroy your health like other addictions will. But the dental damage that comes from chewing on ice often include cracked and chipped teeth, damage to tooth enamel, problems with existing dental work such as fillings and crowns, and sore jaw muscles.

You may also find your teeth become extremely sensitive to hot and cold drinks and foods, and are more prone to cavities.

Quitting The Ice Chewing Habit

Get a physical check up to see if you have anemia or another issue that is causing you to crave ice. Virtually every ice-addicted anemic reports that their craving to chew cubes is gone when they get proper treatment for their medical condition.

If you’ve opted to chew on ice due to dry mouth problems or kicking the tobacco habit, try switching to cold drinks and/or popsicles ahead. To avoid weight gain and cavities, look for unsweetened popsicles … you can even make your own with a tiny bit of fruit juice for taste and frozen water.

If all else fails, or you don’t want to quit your frosty fun habit, you might consider switching to slush. If you must chew ice, you’re likely to cause the least damage by sticking with finely shaved or semi-melted slivers of ice rather than cubes or chunks.

Dental care is essential to reduce and repair the damage that can be caused by chewing ice. If you’ve been putting off seeing a dentist due to cost, you’ll be happy to know that their affordable alternative to paying out of pocket and pricey dental insurance: a dental savings plan from DentalPlans.com. Members save 10-60% on dental procedures – from emergency care to check-ups, root canals and crowns, fixes for chipped teeth and cavities, even orthodontia.

Kay Suzanne is a 45-year-old stay-at-home mom of two kids who developed a serious addiction to eating ice. She speaks about the compulsion and how she finally overcame it.

After I gave birth to my daughter at the age of 34, I developed iron deficiency anemia. Even with iron pills and diet tweaks, the anemia never really resolved, and became more and more of a health issue in my life. When my daughter was in first grade, I discovered that I craved ice and it was then that I began chewing ice throughout the day.

At the height of my addiction, I was buying large bags of ice at the store. Eventually I bought an ice-making machine, which I kept running all day. I was always freezing. Anybody around me knew I had an ice-chewing problem. I always had a large cup of ice nearby. I always apologized as well, since the sound of somebody chewing ice is understandably annoying.

Ice chewing was a serious addiction. I knew the ice-chewing was a problem, and discussed it with both my doctor and dentist. I believe my doctors knew we needed to get the anemia under control and I did get lectures on what it was doing to my teeth. They both believed the craving was related to my anemia but no real solutions other than to just stop chewing ice. That is a lot easier said than done. I’m a former smoker and I compare the ice chewing to smoking. I’d try not to chew ice but the urge would become overwhelming. I didn’t know how to quit chewing ice.

My anemia was getting worse and I finally ended up in a hematologist’s office. They said I was severely anemic and wanted to start me on IV iron infusions the next day. I suffered from pagophagia for about two years before I had my first iron infusion. On the way to my infusion at the cancer center, I had a huge cup of ice. That was the last ice I ever chewed. After my infusion, I no longer craved ice in any way.

Thankfully I didn’t have any side effects from the ice chewing, other than I wore my teeth down a bit. My marriage is great and my kids took the ice chewing in stride.

I think people don’t realize that ice chewing is often a sign of a more serious problem. I was once in Starbucks. The guy behind the counter was chewing ice. I told him my story. The next time he saw me, he thanked me. He had gotten checked and found out he was anemic as well. Although I still struggle with anemia, they monitor me and when my levels start to drop, I get an infusion. For that reason, my levels have not been that low since I started my treatments. I’d imagine that if I stopped treatments, the ice craving would come back at some point.

I absolutely believe this affects many people. I’ve met a lot of ice chewers. I continue to share my story. I’ve also shared my story online and have had others tell me that when they had their first infusion, the craving immediately left as well. I haven’t chewed ice in three years. Also, akin to smoking, I find it a bit repulsive now and I’ve never been tempted to relapse in the least.

Follow Lane on Twitter.

Lane Moore Sex & Relationships Editor I’m Lane Moore, sex & relationships editor at Cosmopolitan.com.

Is it bad to eat ice?

The following conditions can make people want to eat or chew on ice:

Pagophagia

Share on PinterestIce cravings may be caused by nutritional deficiencies or emotional issues.

Pagophagia is the term for someone who frequently craves ice.

The cravings can be persistent and often last for more than a month.

Pagophagia is a rare form of an eating disorder called pica. Pica often accompanies other mental disorders such as autism and schizophrenia and gives people compulsive cravings for foods that have no real nutritional value.

While children are generally more likely to develop pica cravings, pagophagia can affect both adults and children.

Some researchers believe there is a link between iron deficiency anemia and craving ice, but the reason remains unclear.

People with anemia have an insufficient number of healthy red blood cells, which are essential for carrying oxygen around the body. In iron deficiency anemia, a lack of iron is the cause.

Typical symptoms of anemia include:

  • fatigue or lack of energy
  • pale skin (pallor)
  • feeling dizzy or lightheaded
  • heart palpitations
  • breathlessness
  • chest pain
  • a swollen tongue
  • cold hands or feet

A study on people with iron deficiency anemia found that 13 of the 81 participants had symptoms of pagophagia. For some of these individuals, taking iron supplements eliminated their ice cravings.

Additional research suggests that iron supplementation may also provide relief from other pica symptoms.

One theory is that chewing ice makes people with anemia feel more alert. Researchers believe that it triggers an effect that sends more blood up to the brain, which in turn supplies the brain with more oxygen. In addition to improved alertness, this can lead to greater clarity of thinking.

Emotional issues

Some emotional issues can also make people want to chew on ice cubes. For example, a person with stress may find chewing on ice soothing.

Obsessive-compulsive disorder (OCD) could also be a cause. OCD is a mental health condition that leads to compulsive behaviors or obsessive thoughts.

Nutritional problems

People who constantly crave ice may have underlying dietary issues that exacerbate the cravings.

It is common to add flavored syrups to shaved ice, so cravings for this may, in fact, be sugar cravings. People should limit their consumption of this type of ice as the sugar content is high.

Dehydration

Mild dehydration can also make a person crave ice cubes. Ice cubes are cooling and can soothe a dry mouth and lips in addition to quenching thirst. They can also help to lower body temperature on a warm day.

The symptoms of mild dehydration are thirst and darker-colored urine. Anyone who is experiencing more severe dehydration symptoms, such as a seizure or feeling dizzy, confused, or disorientated will require urgent treatment.

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