Chewing Ice (Pagophagia): Is It A Sign Of Anemia?

If you're feeling dry and thirsty on a hot summer day, perhaps you'd think of filling ice cubes in a glass and adding water to it — the water should be cold enough to quench your thirst. But have you ever thought of chewing on ice cubes from the freezer? 

Some people crave ice cubes — and instead of melting them first, they chew them as they are. While it might seem satisfying to some, chewing ice isn't good for your teeth and may even harm your quality of life. 

Often, people who chew ice have an underlying condition (pagophagia) that makes them crave ice. It could also indicate an eating disorder or a nutritional deficiency. 

But is chewing ice a sign of anemia? This post tries to establish the connection between chewing ice and anemia.

Is chewing ice a sign of anemia?

"Pica" is a term doctors use to describe craving and chewing substances lacking nutritional value, like ice, paper, or soil. Although it is common in children, pica may also occur in adults.  

Pagophagia is a term used to describe craving and chewing ice.

In adults, pagophagia is linked to pregnancy and iron deficiency anemia. Iron deficiency anemia is a condition in which blood has inadequate red blood cells.¹

Moreover, some people with iron-deficiency anemia may develop inflammation of the tongue. Therefore, chewing ice may help relieve the discomfort. 

If you experience pagophagia, it's best to seek a medical evaluation to determine if it stems from an underlying condition like anemia.

But why do anemic people crave and eat ice? Many people with anemia crave and eat ice due to iron deficiency, although the exact reason is still unclear. However, that's not the only reason people with anemia chew ice. 

Understanding pagophagia

Pagophagia is an eating disorder characterized by an obsession with consuming ice or frozen foods. This disorder can have severe physical and psychological consequences.²

The exact cause of pagophagia is unclear. But theories suggest it may be linked to iron deficiency anemia, as pagophagia is often seen in people with this condition. It can be considered a coping mechanism for stress, anxiety, and boredom, or it may simply be a craving for sensory stimulation from the coldness of ice or frozen foods.

People with pagophagia often feel compelled to consume ice or frozen foods and may neglect other nutritional needs or activities to fulfill this craving.

Symptoms of pagophagia

How do you know that you have pagophagia? Here are some signs and symptoms to watch out for:

• Excessive consumption of ice or frozen food

• Cravings for cold food when anxious or stressed

• Pale and dry skin

• Depression

• Fatigue

• Headache 

If left untreated, pagophagia can lead to serious health problems, including nutritional deficiencies and depression. 

Treatment typically depends on the cause of pagophagia and might include psychotherapy and medication to help manage cravings and address underlying psychological issues that may be contributing to the disorder.

Also, treatment might involve addressing the underlying cause of pagophagia. Dietary counseling is also essential to ensure the person receives adequate nutrition despite the pagophagia.

If you think you or someone you know may be suffering from pagophagia, it is crucial to seek professional help. With the proper treatment and support, it is possible to effectively manage this disorder and lead a healthy and satisfying life.

Causes of ice craving

Have you ever had an inexplicable craving for ice cubes or crushed ice? You're not alone! 

People worldwide have this unique craving, and researchers have been trying to understand why. Let's explore what scientists have discovered about why people crave ice. 

Nutritional deficiencies 

One of the most common explanations for ice cravings is a nutritional deficiency in iron or other minerals. Studies have shown that people who are anemic are more likely to crave ice than those who aren't. 

It has also been suggested that low calcium levels can lead to ice cravings. Iron and calcium deficiencies can all be symptoms of malnutrition and poor dietary habits.³

So if you find yourself regularly craving ice, it's a good idea to review your diet and ensure that you get enough of these nutrients from natural sources like fruits and vegetables. 

Psychological factors 

It is also possible for psychological factors to contribute to an ice craving. For example, some people with mental health conditions such as depression or anxiety may crunch on ice to cope with their stress or negative emotions.

Others may find comfort in the crunchy sensation when they bite into a frozen cube or feel relaxed by the coolness of the frozen treat. 

Although mental health issues can play a role in cravings for ice, there could also be an underlying physical cause, like nutritional deficiencies. 

Eating disorder

Pagophagia is a subtype of pica, an eating disorder in which people compulsively eat non-food items like clay, ice, dirt, or paper. 

So, pagophagia is a form of an eating disorder (pica).

Ice cravings are surprisingly common, but there is still much we don't know about why they occur in certain people and not others. 

Although research has suggested potential causes such as nutritional deficiencies and psychological distress, it's important to remember that everyone is different and what works for one person may not work for another when managing these cravings. 

If you experience frequent cravings for ice, consider talking to your doctor or mental health professional about possible causes so that you can develop a plan to address them in the most effective way possible.

Understanding anemia

Anemia is a condition in which your body doesn't have enough red blood cells, which can lead to various symptoms. While anemia isn't usually severe, it's essential to be aware of the signs and symptoms to seek medical help. 

Let's take a closer look at what you need to know about anemia. 

Causes of anemia 

The most common cause of anemia is an iron deficiency caused by inadequate dietary intake or poor digestive system absorption. 

Other causes include:

• Vitamin B12 deficiency due to poor dietary intake or malabsorption problems such as celiac disease

• Folic acid deficiency due to insufficient nutritional intake

• Chronic diseases such as kidney disease

• Excessive bleeding due to injury or surgery

• Inherited conditions such as sickle cell anemia or thalassemia 

• Heavy menstrual periods

Symptoms of anemia 

The most common symptom of anemia is fatigue. You may feel tired most or all of the time, and even after a good night's sleep, you may still feel exhausted. 

Other symptoms include:

• Shortness of breath

• Dizziness

• Pale skin

• Headaches

• Cold hands and feet

• Chest pain

• Irregular heartbeats (palpitations) 

Anemia can also cause mental confusion and difficulty concentrating. Left untreated for too long, it can lead to depression due to low energy levels. Therefore, patients with anemia should eat iron-rich foods, such as liver or dark green leafy vegetables like spinach or kale.

How is anemia diagnosed?

Getting tested as soon as possible is essential if you suspect you may have anemia. 

Anemia can be diagnosed in various ways, but the most common is a blood test called a complete blood count (CBC). The test measures several components, including:

• Hemoglobin levels

• Hematocrit levels — involves comparing the volume of RBCs with the total blood volume

• RBC count

 Anemia treatment

The treatment for anemia depends on the type and underlying cause. For example, iron deficiency anemia can be treated with iron supplements or dietary changes such as eating more iron-rich foods like lean meats or leafy greens.

In other cases, treatment may involve medications or blood transfusions. 

Also, since some forms of anemia are caused by iron deficiency, treatment usually involves addressing the underlying cause of the iron deficiency and iron replacement. For instance, if it's a heavy menstrual period causing the iron deficiency, you might need medication, hormonal contraceptives, or surgery.

Your doctor will work with you to develop a personalized plan for treating your anemia based on its type and severity.  

Is pagophagia bad?

Pagophagia can damage the enamel on your teeth. The hardness of the ice can cause fractures in the enamel, leading to tooth sensitivity and even decay. It can also lead to cracked or chipped teeth if done too vigorously. 

Ice is a poor source of nutrition, so you shouldn’t replace other foods with it. 

Pagophagia could be particularly harmful in severe cases, especially when you consume the ice in large amounts.

The lowdown

If you always have the urge to chew ice, you could be experiencing pagophagia, a condition characterized by an obsession with consuming ice or frozen foods. The condition affects children and adults and can result from pregnancy, iron deficiency anemia, and mental health issues, among other causes.

While consuming ice may offer relief to anemic patients, it could adversely affect their dental health. Therefore, speak to your doctor whenever you experience an intense craving to chew ice.

Frequently asked questions

What causes people to crave ice?

People crave and eat ice due to iron deficiency, pregnancy, calcium deficiency, developmental and mental health issues, and eating disorders, among other causes. 

Does chewing ice help anemia?

Some studies have indicated that chewing ice might increase alertness in patients with iron deficiency anemia.⁴ However, they have also shown that pagophagia does not help to treat anemia and that it has no effect on the performance of healthy controls.