Why does anemia make people want to crunch on ice?

You may not even realize that you're consuming large quantities of ice. If you're grabbing it by the fistful, that's more than most people.
You may not even realize that you're consuming large quantities of ice. If you're grabbing it by the fistful, you're probably consuming more than the average person.
© Jupiterimages/Pixland/Thinkstock

Chewing on ice will give you more than just the chills; all that crunching, it turns out, is bad for your mouth -- the habit can injure soft tissue (such as your gums) and has been known to break or crack teeth.

And here's something you might now know: It may also be a sign that you're anemic.


Being anemic means your body has an abnormally low number of red blood cells, and it happens for a couple reasons: Either the body isn't making enough -- which it normally does daily, as an individual red blood cell only lives for about 3 months -- or the body is losing or destroying healthy red blood cells at a faster-than-normal rate. Red blood cells carry an iron-rich protein called hemoglobin, which delivers oxygen throughout the body. Without a big enough delivery service in place, your organs and tissues end up with a smaller amount of oxygen. While some people might not have any symptoms or only a few minor complaints, anemia can make you feel tired, dizzy and easily fatigued. People with anemia may also suffer from shortness of breath, an irregular heartbeat, headaches, leg cramps and insomnia, and often complain they have difficulty concentrating.

There are many types of anemia, more than 400 in total, and each specific type has its own cause and its own symptoms that go beyond those most commonly associated with the general condition. Sickle cell anemia, for example, is an inherited blood disorder. Other forms may develop because of a nutritional deficiency, such as the lack of vitamin B12 or iron. Symptoms of vitamin B12 deficient anemia may involve clumsiness, tingling sensations in your hands and feet (like pins and needles when a hand or foot falls asleep) and even depression and hallucinations. And iron isn't just what makes our blood red, rather than blue or green; it's critical to the makeup of a healthy red blood cell. Adults have between 3 and 4 grams of iron circulating throughout the body at all times, or they should; when iron levels drop too low, the red blood cell production line stops, leading to iron-deficiency anemia. This type of anemia, compared to other forms of the condition, is known to cause a red, sore tongue (glossitis) and an inflammation on the inside of your mouth (stomatitis), as well as cracks at the corners of the mouth (angular cheilitis) [source: Johnson-Wimbley]. Iron-deficiency anemia is also the type associated with crunching on ice.


Pagophagia and Iron-deficiency Anemia

Crunching on the ice from your soda isn't a cause for concern, but if you compulsively eat large quantities of ice, it could be a symptom of a medical issue.
Crunching on the ice from your soda isn't a cause for concern, but if you compulsively eat large quantities of ice, it could be a symptom of a medical issue.
© yalcinsonat1/iStock/Thinkstock

Iron-deficiency anemia, which affects about 7 percent of American women and 2 percent of American men, may also cause you to crave some unusual things. A French study found that 44 percent of patients reported regularly eating non-food stuffs, such as clay, ashes or starch, compared to only 9 percent of people without anemia [sources: Gordon, Bowerman]. And you guessed it -- the most common craving was for ice.

Compulsively craving and eating non-food items for a period of at least a month or more is called pica, and when it's ice you crave it's known specifically as pagophagia. This type of ice eating goes beyond crunching a cube or two from your drink on a hot summer day -- pagophagia is the regular consumption of a sizable amount of ice.


It was in the late 1960s when a correlation was made between iron-deficient anemia and abnormal ice cravings, when it was observed patients' ice-eating symptoms resolved when the iron levels in their blood (those are your serum iron levels) rose into the normal range [source: Reynolds]. It was once thought that people with pica were perhaps compensating for a nutritional deficiency in their diet, but today the theory is outdated (plus, since ice doesn't contain any iron, it's a moot point in this instance); currently it's unknown why iron-deficient people may crave ice, or why most cases of pica develop in general. It's been theorized that some ice eaters may like the cooling relief that the ice brings to any mouth inflammation or fissures symptomatic of this form of anemia, although some individuals with the condition report they feel compelled to satisfy their need to chew on crunchy, icy things.

Luckily, iron-deficiency anemia is treatable; increasing how much iron is in your diet as well as daily supplements are enough to resolve and reverse the condition. And when the nutritional deficiency is gone, so is the pagophagia.


Lots More Information

Author's Note: Why does anemia make people want to crunch on ice?

It's pretty cool to see how if you're paying close enough attention, a personal habit (or compulsion) such as crunching on the ice in your drink may be indicative of something deeper -- and important -- going on inside your body.

Related Articles

  • American Society of Hematology. "Anemia." (Feb. 22, 2014) http://www.hematology.org/patients/blood-disorders/anemia/5225.aspx
  • Bowerman, Susan. "Dirt, ice -- those cravings may not be so crazy after all." Los Angeles Times. April. 2, 2007. (Feb. 11, 2014) http://articles.latimes.com/2007/apr/02/health/he-pica2
  • Brynie, Faith. "A Little Known Eating Disorder Is on the Rise." Psychology Today. Sept. 12, 2011. (Feb. 11, 2014) http://www.psychologytoday.com/blog/brain-sense/201109/little-known-eating-disorder-is-the-rise
  • Colgate. "Chew on this: crunching ice can be bad for you." July 19, 2006. (Feb. 11, 2014) http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/ADA/2006/article/ADA-07-Chew-On-This.cvsp
  • Edmundson, Ann. "Understanding Anemia -- Symptoms." WebMD. May 13, 2013. (Feb. 11, 2014) http://www.webmd.com/a-to-z-guides/understanding-anemia-symptoms
  • Edmundson, Ann. "Understanding Anemia -- the Basics." WebMD. May 13, 2013. (Feb. 11, 2014) http://www.webmd.com/a-to-z-guides/understanding-anemia-basics
  • Ellis, Cynthia R. "Pica." Medscape. July 18, 2013. (Feb. 11, 2014) http://emedicine.medscape.com/article/914765-overview
  • Gordon, Serena. "Anemia Rates Down for U.S. Women and Children." ABC News. Dec. 9, 2013. (Feb. 11, 2014) http://abcnews.go.com/Health/Healthday/story?id=6419909
  • Harper, James L. "Iron Deficiency Anemia." Medscape. Dec. 16, 2013. (Feb. 11, 2014) http://emedicine.medscape.com/article/202333-overview
  • Holm, Gretchen. "Serum Iron Test." Healthline. June 1, 2012. (Feb. 11, 2014) http://www.healthline.com/health/serum-iron
  • Johnson-Wimbley, Terri D. "Diagnosis and management of iron deficiency anemia in the 21st century." Therapeutic Advances in Gastroenterology. Vol. 4, no. 3. Pages 177-184. May 2011. (Feb. 22, 2014) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3105608/
  • Khan, Yasir; and Glenn Tismari. "Pica in iron deficiency: a case series." Journal of Medical Case Reports. Vol. 4, no, 86. March 12, 2010. (Feb. 11, 2014) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2850349/
  • Nabili, Siamak T. "Anemia." MedicineNet. March 26, 2012. (Feb. 11. 2014) http://www.medicinenet.com/anemia/article.htm
  • Reynolds, Ralph D.; Binder, Henry J.; Miller, Monte B.; Chang, Walter W. Y.; and Sherman Horan. "Pagophagia and Iron Deficiency Anemia." Annals of Internal Medicine. Vol. 69, no. 3. Pages 435-440. Sept. 1, 1968. (Feb. 11, 2014) http://annals.org/article.aspx?articleid=682625