How sick he can get?
The toxic compound in multivitamins overdose is not because of the vitamins but is because of the iron which is one of the so-called bomb medications meaning it is a medications that lack symptoms early after ingestion, but later have profound toxic course. There is a large variety of children multivitamins that contains different amounts of elemental iron per tablet or teaspoon while adult multivitamins may contain up to 60mg elemental iron per tablet. The toxic dose of iron ingestion is at least 20mg per kilogram of elemental iron and a lethal dose of iron is in the range of 60 – 180mg per kilogram of elemental iron.  Because iron can initially cause nausea, vomiting or abdominal pain, a child with a suspected but unknown amount of iron poisoning can be observed and an iron level can be obtained. If you are not sure about ingested tablet an abdominal radiography can also help. A Child who has no complain and has a normal physical exam after 4-6 hours of observation can be safely discharged home especially if serum iron level is less than 500 mcg/ml. If the ingested iron happens to be significant it can cause, shock, coagulation disorder, myocardial depression and cell death.

Dr. Hossein Sardari-Zadeh
Armada Medical Centre