Brain Effects of Iron Deficiency-Related Pagophagia

Pagophagia, defined as compulsive ice eating or ice chewing, is a common form of an eating anomaly (pica) caused by iron deficiency and is treated with iron replacement therapy. The physiological characteristics of pagophagia are reviewed. In one study, iron-deficient subjects were deficient in a test of attention, and ice consumption improved the subjects' response time relative to those drinking tepid water, an effect attributed to increased blood perfusion to the brain and heart. Several studies show that cold stimuli applied to the mouth increase blood flow velocity in the middle cerebral artery, increase peripheral blood pressure, and cause bradycardia. It is possible that pagophagia facilitates attention by elevating cerebral blood flow or by providing more oxygen to the brain. More research effort should be paid to the neurobehavioral impact of cold stimuli ingestion in humans and animals.