Pagophagia: Causes, Symptoms, Treatment, Complications

Pagophagia is an eating disorder in which people tend to consume nonfood items and more specifically ice. They have a constant craving for ice that could be related to some nutritional deficiency. Treating these deficiencies could be helpful in treating pagophagia.

There are various hypotheses on what could cause pagophagia.

Iron deficiency could be a cause of pagophagia. It is a condition in which there is a lack of iron in the body that may be required to function correctly.

A study done on 81 people with iron deficiency found that 16% of them had pagophagia.⁽¹⁾ It was also observed that a deficiency of calcium could lead to pagophagia. It was then concluded that pagophagia could be the result of a deficiency of certain nutrients such as iron or calcium that make people develop cravings for non-food items.

Also, chewing ice may be helpful in reducing swelling of the tongue which is a symptom of iron deficiency anemia, making it another cause of the condition.

Calories are free from ice and people with eating disorders may eat it to reduce hunger without increasing the calorie count. This habit may further lead to more compulsive pagophagia.

Pagophagia could also result due to anxiety or stress. A study found a woman who reported developing pagophagia due to stress around the time her son was about to sit for some exams.⁽²⁾ However, the antidepressants cured pagophagia and this indicated that it was due to the stress and anxiety related to her son’s education.

It is also believed that pagophagia could be due to bacterial infection or genetic influence. But, more studies are needed to investigate these theories.

The major risk factor for pagophagia is nutritional deficiency, such as deficiency of iron and calcium. Other risk factors include:

• Depression
• Anxiety disorder
• Pregnancy
• Low self-esteem
• Body dissatisfaction
• Family history of eating disorder
• History of dieting

Craving for and consuming ice is the main feature of pagophagia. The person with this disorder may eat ice cubes or prefer chilled drinks. And these symptoms may progress with time. A study found a female who had just begun consuming a few ice cubes per day and progressed to eating 20-30 per day.⁽²⁾

The known cause of pagophagia is iron and calcium deficiency. This can cause the following symptoms:

• Chest pain
• Brittle nails
• Fatigue
• Dizziness
• Weakness
• Numbness
• Anxiety
• Difficulty in concentration
• Pale skin
• Cramps
• Cold hands and feet
• Swelling of tongue
• Headaches

The treatment of pagophagia depends on its cause. For example, if the cause is iron deficiency anemia, it can be treated by taking iron supplements. As the iron levels start getting better the pagophagia starts disappearing.

Similarly, other nutritional deficiencies can be treated by either taking supplements or increasing their intake in the diet. Such as eating green leafy vegetables or red meat can help in keeping up the iron levels or dairy products and beans can be consumed for calcium levels.

Behavior therapy can be useful if pagophagia is due to a mental health condition. It can help by positive and negative reinforcement to control cravings for ice. Counseling can also prove to be helpful to deal with such cases.

The main risk associated with pagophagia is that it may lead to or worsen nutritional deficiencies. Ice is not at all a good source of nutrition and eating a large amount of it and little of other things may be harmful in several cases. Nutritional deficiencies can further lead to a number of other medical conditions. Iron deficiency can lead to depression, heart problems, infections, development problems in children, and pregnancy complications.

Pagophagia is a type of pica that involves cravings and commonly ice cravings. It may occur alongside nutritional deficiencies or may lead to nutritional deficiencies. Treating Pagophagia is important to avoid severe complications including heart problems.