What to know about pagophagia

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The main feature of pagophagia is craving and consuming ice. A person may drink iced drinks or eat ice cubes or freezer frost. This symptom may worsen over time. A case study of a 42-year-old woman states that she began by consuming just a few ice cubes per day but progressed to eating 20–30 per day.

In some cases, pagophagia may cause or be due to iron and calcium deficiencies. These deficiencies can lead to further symptoms, including:

• fatigue
• pale skin
• brittle nails
• swelling of the tongue
• chest pain
• difficulty concentrating
• dizziness
• weakness
• headaches
• cold hands and feet
• numbness
• cramps
• anxiety

The causes of pagophagia are unclear, but researchers have various hypotheses. Possible causes include those below:

Micronutrient deficiencies

One possible cause of pagophagia is iron deficiency anemia. In people with this condition, the body lacks the required iron to function correctly.

In one study, researchers interviewed 81 people with iron deficiency anemia about their eating habits. They found that 16% of this cohort also had pagophagia. Deficiencies in other micronutrients, such as calcium, can also lead to pagophagia or other forms of pica.

This finding supports the micronutrient deficiency hypothesis, which suggests that people may develop cravings for nonfood items when they have deficiencies in certain micronutrients, such as iron or calcium. However, it is unclear whether this theory could explain pagophagia because ice contains very few micronutrients.

Another explanation might be that chewing ice is a way to reduce swelling of the tongue, which is another symptom of iron deficiency anemia.

Eating disorders

There are no calories in ice, but some people with eating disorders other than pagophagia may eat ice as a way of reducing hunger without increasing calorie intake. It is possible that this habit could develop into the more compulsive pagophagia over time.

Other mental health conditions

In the case study that we referred to above, the woman reported that her pagophagia had started around the time her son, whom she was tutoring, was about to sit some very important exams. Antidepressants cured her pagophagia, which indicates that it was the stress and anxiety relating to her son’s education that had caused it.

Other factors

Some researchers believe that pagophagia is the result of a bacterial infection or genetic influence, but there is a need for more studies to investigate these theories. As the condition is rare, there are few studies on the topic. More research will be necessary to determine the causes of pica and pagophagia.

The main risk factor for pagophagia is a nutrient deficiency, such as insufficient iron or calcium. Other risk factors could include:

• body dissatisfaction
• anxiety disorders
• depression
• experiencing bullying or trauma
• family history of eating disorders, particularly pica
• low self-esteem
• pregnancy
• history of dieting, particularly extreme or fad diets

The treatment for pagophagia will vary depending on whether doctors can find a diagnosable cause. If the cause is iron deficiency anemia, treatment may involve taking iron supplements. As iron levels start to increase, the symptoms of pagophagia should disappear.

It is possible that treating other nutrient deficiencies will also help ease the symptoms of pagophagia. For example, calcium supplements can treat deficiencies in calcium carbonate or calcium phosphate.

Changes to the diet can also help with these deficiencies. Eating more leafy green vegetables or red meat can increase iron levels. Dairy products and beans are good sources of calcium.

Other ways to treat pagophagia could include behavioral therapy if mental health issues have played a role in its development. This therapy could involve positive or negative reinforcement to control cravings for ice. Counseling can also help a person understand why the behavior occurs in the first place and how to deal with it.

The main risk of pagophagia is that it will cause or worsen nutrient deficiencies. Ice is a poor source of nutrition and should not replace other foods. For this reason, pagophagia could be particularly harmful in more severe cases, where people might be eating large amounts of ice and little else.

Without treatment, nutrient deficiencies can lead to a number of severe medical conditions.

For example, iron deficiency anemia could result in:

• depression
• heart problems
• infections
• developmental problems in children
• pregnancy complications, such as preterm birth

Pagophagia is a form of pica, which is an eating disorder. Other eating disorders include:

• anorexia nervosa
• bulimia nervosa
• binge eating disorders
• avoidant or restrictive food intake disorders
• rumination disorders

You can read more about other eating disorders here.

Pagophagia is a form of pica that involves craving and compulsively consuming ice.

Pagophagia can occur alongside nutrient deficiencies, such as iron deficiency anemia, although it is still unclear what exactly causes it. Nutrient deficiencies are one explanation, but it may involve other factors, such as genetics, an infection, or mental health issues.

The type of treatment for pagophagia will depend on the underlying cause, but it could include changes to the diet or behavioral therapy.

Treating pagophagia is important to prevent it from leading to more severe complications that can include heart problems, among others.