Craving ice on a hot day is both normal and common. But if your craving is persistent, and seems unrelated to heat or thirst, it may be due to a nutritional deficiency. “Doctors use the term ‘pica’ to describe craving and chewing substances that have no nutritional value—such as ice, clay, soil, or paper,” explains Rajiv K. Pruthi, M.B.B.S., on behalf of the Mayo Clinic. “Craving and chewing ice (pagophagia) is often associated with iron deficiency, with or without anemia,” he adds.

Iron deficiency is the most common nutritional disorder worldwide, notes a 2013 study in the journal American Family Physician.

Pruthi says that while the exact cause for ice cravings is unclear, researchers have begun to examine their connection to iron deficiency. “At least one study indicates that ice chewing might increase alertness in people with iron deficiency anaemia,” he writes.

Here’s what’s happening inside an iron-deficient body.

In patients with iron deficiency anaemia, the blood lacks adequate amounts of healthy red blood cells. This impacts the haemoglobin—the molecules in the blood which are tasked with carrying oxygen to the body’s tissues. As a result, the tissues can become weakened and less able to function normally.

Iron deficiency can affect anyone, but tends to affect women more frequently than men. You may be at high risk of iron deficiency if you have heavy menstrual periods, are pregnant, breast-feeding or have recently given birth, have a low-iron diet, have certain gastrointestinal conditions, or have undergone certain surgical procedures. Your doctor can help you assess whether you are at high risk for iron deficiency anaemia.

Look out for these other symptoms of iron deficiency anaemia.

Individuals with iron deficiency anemia often feel tired, weak, or short of breath. If you develop the condition, you may also experience chest pain, rapid heartbeat, poor appetite, headache, dizziness, or lightheadedness as a result of anaemia. Some people with anaemia may develop pale skin, hair loss, cold hands and feet, tongue inflammation, restless legs, or brittle nails.

Because these symptoms are not unique to anaemia and could suggest a range of conditions, it’s important to bring them to your doctor’s attention if you notice them.

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