Iron toxicity how often do you see?

[Blackheartednurse]

I have several patients that have been started on Iron-I know it takes some time for the iron to build up in the body but I also know that it can be poisonous.One of my patient has been ordered to take one iron pill (325 mg ferrous sulfate) three times a day for 3 months (of course labs will be drawn monthy) another twice a day.It sounds like literally half of my patients are on Iron or need to be on iron (cbs,hemoglobin out of whack) I know that upset painful stomach can be one of the early signs of iron toxicity.I was just wondering have you even run into patient who has been taking an iron for long time and ended up with iron toxicity?

[AgentBeast, BSN, RN]

Unless you are dealing with children, or an incredibly small adult iron toxicity really shouldn't be an issue unless they are really screwed up or take the entire bottle all at once.

The generally accepted threshold for GI toxicity is 20mg/kg death may occur at doses above 60mg/kg.

Toxicity, Iron: eMedicine Emergency Medicine

[klone, MSN, RN]

Iron supplements quite often cause stomach upset. Doesn't always equal toxicity.

[VivaRN]

Toxicity is more of an issue with IV iron administration. This is not something you will likely see or need to worry about. Stomach upset is common as is constipation.

[BrnEyedGirl, BSN, MSN, RN, APRN]

I work ER,..the only time I've been aware of iron toxicity is in children who have gotten into a bottle of vitamins with iron and eaten them like candy. Actually, I usually see these kids immediately after ingestion and treat them as an accidental OD, give them some charcoal so the don't ever become toxic.

I do remember a confused elderly lady who we suspected of being iron toxic. She came in as a GI bleed,..liver enzymes out of whack,..when family arrived they mentioned that Grandma was getting more an more confused and would sometimes take her meds over and over during the day because she couldn't remember if she had taken them. The family took all of her RX meds out of the house and left a weekly pill container clearly marked for her. The did however leave all the OTC "vitamins and herbs she likes to take, because we figured they couldn't hurt her".

[himilayaneyes]

I personally haven't seen it. However, I have heard from a icu clinical educator/np about a patient with iron toxicity. Everyone just assumed he was an anemic and an alcoholic. He said he was told by multiple doctors to just take iron pills everyday...so he did. She decided to do some blood work and the man was in iron toxicity...his blood had to be let (they bled him)...so apparently it happens...but I think it's a rare occurrence. I had so many patients on iron pills on the tele floor. And IV iron...I don't like it...I've seen to many patients develop chest pain with it...that's just my personal opinion. But I guess with so many patients taking iron pills these days that we should all brush up on the signs of iron toxicity.