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Why Do Anemic People Eat Ice (Pagophagia)?

In this article, we will take a close look at anemia, a medical condition characterized by a decrease in the number of circulating red blood cells or the amount of hemoglobin. We will also explore the phenomenon of pagophagia, an intense desire to consume ice often associated with anemia. The causes, diagnosis, and treatment of anemia will also be discussed.

Jakub Gwiazdecki

Author - Jakub Gwiazdecki

Fifth year medical student at the Medical Faculty of Comenius University in Bratislava.

Jakub used MediSearch to find sources for this blog.
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Why do anemic people eat ice?

Anemic people can develop a condition called pica, which is an odd craving for non-nutritive substances. One form of pica is the craving for ice or pagophagia [1, 2].

The cause of pagophagia is not entirely known. One theory says that chewing on the ice increases the cerebral blood flow, increasing the alertness and mental abilities. This could be helpful in anemic patients, as they experience chronic fatigue due to lowered brain oxygen levels [3].

However, not all patients with anemia get pica and pagophagia. Thus, some people with anemia will not eat ice [3, 4].

Is chewing ice bad for your teeth?

Eating ice does not directly impact anemia and internal organs as long as the water is clean. However, there are other hazards linked to teeth.

Eating large amounts of ice can potentially damage teeth. The hard structure of the ice can affect the enamel of the teeth and result in chips and cracks. It can also increase tooth sensitivity, increase the risk of cavities, and damage dental fillings [5].

What is anemia?

Anemia is a condition arising from a decrease in red blood cells or the amount of hemoglobin in them [6, 7]. The reduction in hemoglobin or red blood cells decreases the oxygen-transporting capacity of the blood. Thus, anemia results in lower oxygen delivery to all tissues in the body [8, 9].

According to the World Health Organization, anemia occurs when the hemoglobin level falls below 13 g/dL in men and 12 g/dL in women [6].

What are the causes of anemia?

The three main reasons for anemia are:

  • blood loss,
  • lack of red blood cell production,
  • increased red blood cell destruction [10, 11].

Iron deficiency is one of the most common causes of anemia. It results from insufficient iron absorption, iron intake, or blood loss. Blood losses and subsequent anemia occur, for example, in conditions like colon cancer, ulcers, or heavy menstruation [12, 13].

Another leading cause of anemia is deficiency of vitamin B12 and folate (B9). These nutrients are needed for the production of red blood cells, so a lack of them leads to a decline in the number of erythrocytes (red blood cells). Low intake or problems with their absorption can cause low levels of B12 or B9 vitamins [12, 13].

Anemia can also be caused by some diseases, especially those of a chronic nature. Conditions like kidney disease, HIV, autoimmune disease, and bone marrow disease like leukemia lead to anemia [12, 13, 14].

Also, specific genetic disorders of the blood can cause anemias. For example, sickle cell disease or thalassemia are hereditary connections that shorten life and restrict the function of the red blood cells. Both conditions lead to anemia.

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Sometimes, pregnancy can cause anemia. During the baby's growth, the body needs more iron and folic acid to share with the fetus. When the demand is not met, the levels in the blood fall with time, leading to anemia [12, 13].

Other causes of anemia include chronic inflammation and reactions to toxic chemicals. Anemia can, for instance, be present with cancer [14, 15].

What are the diagnosis and treatment of anemia?

The diagnosis of anemia is made based on the blood laboratory results.

To diagnose anemia, laboratory tests such as:

  • complete blood count,
  • iron panel
  • iron serum levels [16].

are performed.

To find and later treat the cause of anemia, a doctor can also test for vitamin B12 and folic acid levels, perform a blood smear, or perform a Comb test [16].

The complete blood count and iron panel give insight into the red blood cells, hemoglobin, and iron levels in the blood. These parameters are crucial for diagnosing anemia.

What is the treatment for anemia?

The treatment of anemia depends on the cause of anemia, and different causes require different treatments.

However, commonly used methods include eating an iron-rich diet or taking iron supplements and taking vitamin B12 and folate [17, 18].

In specific cases, doctors can prescribe red blood cells to stimulate erythropoietin injection [18].

If the cause of anemia is chemotherapy, the oncologist can prescribe drugs that work as natural stimulants. Examples of such drugs are Epogen and Aranesp [19].

In severe anemia, the physician may proceed with blood transfusions. It can happen mainly when the anemia is caused by blood loss or a disease like thalassemia [17, 20].

When red blood cell production is affected by a genetic disorder linked to the bone marrow, a transplant may be the solution [17, 20].

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