What is the mechanism of pica in iron deficiency?

Martin A. Samuels Schapira: Neurology and Clinical Neuroscience, 1st ed. Copyright © 2008 Mosby, An Imprint of Elsevier

Iron deficiency is associated with obsessive-compulsive behaviors that belong to two categories: compulsive eating (pica) and compulsive moving of the limbs, usually the legs (restless legs). Common pica behaviors include the eating of starch (amylophagia), paint chips, earth and clay (geophagia), and ice (pagophagia). The precise relationship between the iron deficiency and pica is unknown, but it is clear that pica does not represent replacement of iron, inasmuch as ice eating, the most common pica behavior, usually does nothing in this regard and many clays contain substances that actually chelate iron, thereby worsening the problem. It seems more likely that pica represents some form of compulsive behavior akin to a tic.

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