Dear Alice,

My sister has been told by one doctor that eating ice is effective for an iron deficiency. Another doctor says that this is balderdash and not effective.

What is the deal? Which opinion is correct? Why is there no consensus on the feedback physicians give for this subject?

I also would like pointers to more information for this topic.

Thanks.

Dear Reader,

Getting a second opinion is usually helpful, but hearing conflicting medical advice can certainly make your head spin! Luckily, your sister has a trusty sibling who looks out for her health. To add a little clarity to your dilemma, one of the health care providers seems to be on the mark: there doesn’t seem to be any definitive evidence that suggests eating ice treats iron deficiency. Water (in the solid, liquid, or gaseous state) neither contains iron nor corrects iron deficiency. However, there are ways to up iron intake if necessary, such as through dietary sources or supplements. While one of the medical professionals was correct to dispute the other, there seems to be an interesting relationship between iron deficiency and eating ice — some researchers think that iron deficiency may be associated with an urge to eat ice. Again, this doesn’t mean eating ice boosts iron intake, but may be correlated to iron levels in the body.

For some folks, iron deficiency may be the result of not eating enough iron-rich foods, while others may find that their body is unable to absorb the iron they ingest. Outside of food-related causes, iron deficiency can also be caused by blood loss from an underlying medical condition or pregnancy. In order to determine appropriate treatment options, seeking medical attention to properly diagnose and determine a possible underlying cause for the condition. If a lack of iron in a person’s diet is the culprit, over-the-counter iron tablets (in a specific dosage) may be recommended and specific instructions will be provided on taking them to maximize absorption of the supplements. For more information about iron supplements and how they interact with food, check out Iron, calcium, and constipation, oh my! in the Go Ask Alice! Nutrition and Physical Activity archives.

While iron supplements are a quick and easy way to get adequate iron intake, it’s preferable to get essential nutrients from food rather than supplements. In fact, the body can better digest and absorb nutrients in the amount and form in which it naturally occurs. The good news is that there are sources of iron to suit any dietary preference, from meat-lovers (e.g., oysters, beef liver, sardines) to vegetarians (e.g., white beans, dark chocolate, lentils, tofu). To better understand specific dietary needs and how they might overlap with food preferences, talking with a registered dietitian can be helpful. Not sure where to look for one? Check out the Academy of Nutrition and Dietetics website or ask a medical professional for a referral.

Lastly, though there isn’t evidence to show that eating ice treats iron deficiency, there may be a potential link between iron deficiency and the urge to eat ice. Craving non-nutritive, non-food items is considered pica behavior; specifically, there’s a form of pica behavior called pagophagia, or ice pica, which involves compulsive ice chewing. Some research suggests that chewing ice seems to increase alertness and response time in people with iron deficiency, and in some cases ice cravings were resolved when they were given iron supplements. However, it’s worth noting that there isn’t enough research to give the connection a solid thumbs up.

If your sister is still struggling to learn more about these issues, encouraging her to seek out a third or even fourth medical opinion need not be out of the question. Sometimes, a little extra digging and questioning is called for to get to the bottom of a health-related concern. Hopefully though, this information helped turn your investigation of eating ice and iron deficiency into a cold case.

Alice!

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