Q. I've heard that if you have a craving to chew ice cubes, you might need iron. Could such a thing possibly be true?

A. Yes — believe it or not, severe iron deficiency can cause anemia that leads to some pretty odd cravings, including the urge to chew ice, eat pure starch, or ingest dirt.

One of my patients, after months of unusually heavy menstrual bleeding, had been obsessed with chewing ice. Her compulsion was so intense that she had created a map of every location in town where she could buy cups of ice to go. After her menstrual condition was resolved and her iron level was restored, her cravings disappeared.

When someone has anemia caused by iron deficiency, a host of other symptoms usually occur before such strange cravings appear. If there is insufficient iron, the body is unable to carry adequate oxygen to the tissues. This can result in symptoms of fatigue, pale skin, cold hands and feet, shortness of breath, lightheadedness, headaches, brittle nails, poor appetite, and an inflamed and sore tongue. Another condition associated with iron deficiency anemia is "restless leg syndrome" — a crawling sensation that makes you want to move your legs after you get in bed at night, often resulting in difficulty getting to sleep.

Iron deficiency anemia occurs in approximately 20 percent of women, 50 percent of pregnant women, and 3 percent of men. Its causes are numerous; the most common include blood loss (from menstruation, a gastric ulcer, a tumor, or hemorrhoids), a lack of iron in the diet, poor iron absorption, and increased blood volume in pregnancy. In children, iron deficiency anemia can be due to lead poisoning.

If it is suspected that you have iron-deficiency anemia, your doctor will order blood tests.

To correct a low-iron status, eat iron-rich foods such as raisins, fish, poultry, beef, eggs, peas, beans and whole-grain bread. You can also take iron supplements. For best absorption, avoid taking them with calcium supplements or calcium-rich foods such as milk, and take them on an empty stomach with vitamin C. The recommended daily allowance of iron is 18 milligrams for women (27 milligrams if pregnant), 8 milligrams for men, and 7 to 11 milligrams for children, depending on their age.

Laurie Steelsmith is a naturopathic physician and licensed acupuncturist in Honolulu, as well as author of "Natural Choices for Women's Health" (Random House). Reach her at www.drlauriesteelsmith.com.