Pica refers to the compulsive craving and persistent consumption of substances not fit as food such as ice (pagophagia) and soil (geophagia). Several reports have implicated iron deficiency as a cause of pica, with resolution of symptoms following treatment of iron deficiency (1).

In a recent study involving blood donors , pica (particularly pagophagia) was nearly 3 times as likely among donors with iron deficiency  compared to iron-replete donors (11%  vs 4%, respectively, P<0.0001).  In the same study, donors with pica reported a marked reduction in their pica by day 5-8 of iron therapy. 

It has been suggested that cerebral tissue function may be adversely impacted by a deficiency in Fe-containing enzymes (e.g. cytochrome c reductase) resulting in behavioral disorders, such as hyperactivity and pica (2).  

Of interest, cats can be induced to swallow inedible objects when certain points in the hypothalamic area high in iron content are stimulated (3).

Liked this post? Download the app on your smart phone and sign up below to catch future pearls right into your inbox, all for free!

References

 

1. Bryant BJ, Yau YY, Arceo SM, et al. Ascertainment of iron deficiency and depletion in blood donors through screening questions for pica and restless legs syndrome. Transfusion 2013;53:1637-1644. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691288
2. Osman YM, Wali YA, Osman OM. Craving for ice and iron-deficiency anemia: a case series from Oman. Pediatric Hematol Oncol 2005; 22:127-131. https://www.ncbi.nlm.nih.gov/pubmed/15804997
3. Von Bonsdorff B. Pica: a hypothesis.. British J Haematol 1977;35:476-477.  https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2141.1977.tb00611.x

Disclosures: The listed questions and answers are solely the responsibility of the author and do not necessarily represent the official views of Massachusetts General Hospital, Harvard Catalyst, Harvard University, its affiliate academic healthcare centers, or its contributors. Although every effort has been made to provide accurate information, the author is far from being perfect. The reader is urged to verify the content of the material with other sources as deemed appropriate and exercise clinical judgment in the interpretation and application of the information provided herein. No responsibility for an adverse outcome or guarantees for a favorable clinical result is assumed by the author. Thank you!

Contributed by S.J. Lee,  Medical Student, Harvard Medical School, Boston, MA