is it possible for an adult to get iron overdose? can chelation therapy help with that?
Yes, an adult can absolutely get an iron overdose, and there is an effective chelating agent that can be used to reverse the overdose if caught early.
Iron overdoses are surprisingly severe illnesses that can lead to death, especially if particularly large amounts of iron are ingested.
Iron overdose happens over the course of about 3-4 days, featuring 4 distinct phases, though long-term health problems, especially problems with the digestive tract, are common for months or years afterwards.
Iron is extremely irritating to the digestive tract. Assuming the ingestion was as a single large dose, within about 6 hours of ingestion, the person typically experiences severe abdominal pain, nausea, vomiting, and diarrhea. The vomit and diarrhea may contain blood. The accompanying loss of blood and fluid can be life threatening if very large doses are consumed. Compared with children, adults tend to have less nausea and vomiting, but still suffer the bleeding and diarrhea.
Then there is a latent period, in which the patient typically feels better. This lasts between 12 and 24 hours. During this time, however, less noticeable symptoms like slowly dropping blood pressure, the blood becoming more acidic, and changes in how the blood clots begin to occur as the liver is unable to make the blood clotting factors as it usually does and other organs begin to take damage.
Once these symptoms become noticeable, the third phase starts. This is where the iron and the body's reaction to it manifest as organ damage. Heart and kidney damage is common, which can cause the blood to become more acidic. The blood vessels also become somewhat leaky, and fluid pools in the tissue around them, worsening the low blood pressure. Changes in consciousness, including coma, can also occur at this point. All of this can last for up to 3 days.
Even after the person begins to recover from the third phase, they usually will continue to have liver damage. This damage continues and worsens the clotting problems and can cause low blood sugar levels. As stated above, even when the patient recovers from this, they can end up with severe scarring in their GI tract that can cause holes and blockages in the stomach and intestines that may require surgeries and hospital stays long into the future.
Fortunately, if caught early, iron overdoses can be significantly lessened in severity. There is an effective chelating agent for iron (also works for aluminum overdoses in conjunction with dialysis) called deferoxamine. Deferoxamine is usually given by IM injection (similar to a vaccine) in 3-6 doses over a period of 24 hours. Additional doses can be given if the first doses aren't effective enough.
Since deferoxamine binds to iron molecules in the blood and tissues and then removes it via the kidneys (in urine), the person will usually need continuous IV fluids to support urinating out the iron and deferoxamine without causing kidney problems. The urine turns a reddish color because of the iron.
