Know someone who eats paint?
Ever watch someone sitting next to you eat paint or chew on ice for hours? We quickly accuse people of being strange (if I had a dime for every time someone called me that); however, what if there were a medical reason for these seemingly odd behaviors? Imagine how badly you would feel if you started avoiding your ice-craved best friend only to later learn that s/he was iron-deficient all along? Seemingly strange symptoms may actually be genuinely treatable ones.
Symptom: Eating Paint, Clay or Other Non-foods
Pica is a condition when one craves and eats nonfood items such as paint, clay, or ice for at least one month (two days during the summer chewing ice doesn't qualify). The word pica is from the Latin word for magpie, a bird that apparently eats almost anything. Although a small number of people with psychological illnesses such as anorexia nervosa, obsessive-compulsive disorder, and schizophrenia may engage in these behaviors, pica occurs more commonly in children and pregnant women and can also occur in people with medical conditions such as iron-deficiency anemia and celiac disease. In fact, it is thought that in some people these cravings may be the body's attempt to replenish a vitamin or mineral deficiency, such as iron or zinc. Chewing ice, also known as pagophagia, is a form of pica and has been seen in people who are iron-deficient. Although this relationship is unclear, possible explanations are that the ice relieves an inflamed tongue (which can be a symptom of iron deficiency) and, as one study found, that chewing ice increases one's alertness, possibly combatting the fatigue caused by being anemic. You should unabashedly seek medical attention if you are craving and eating non-food items, as potential complications include causing tears and blockages in your digestive tract, ingesting toxic substances such as lead, and actually creating nutritional deficiencies by substituting these non-food items for real nutrition. Conceivably, if you are found to have a specific vitamin or mineral deficiency, starting the proper supplement may abate your craving.
Symptom: Smells Like Fish
Condition: Fish Odor Syndrome
Have you ever sat next to someone and wondered if s/he worked at a fish store? There is actually a condition called Fish Odor Syndrome in which the person effuses an odor that smells like fish. This is a rare disorder, usually inherited from both of your parents even though neither of them may have symptoms (you need to get one gene from each), that causes a defect in an enzyme needed to break down a compound derived from foods rich in choline and carnitine (I won't bore you with the enzymatic details). This compound then builds up and produces this fish smell that then gets excreted in the affected person's sweat, urine and breath. Treatment consists of avoiding foods rich in choline, such as egg yolks, red meat, beans, and fish (surprisingly), as well as low dose antibiotic therapy and washing with a slightly acidic soap. A simple urine test measuring this compound can establish the diagnosis.
Symptom: Perceiving Things as Larger or Smaller Than They Are
Condition: Alice in Wonderland Syndrome
A possible example of art imitating life may be seen in the book Alice's Adventures in Wonderland as author Lewis Carroll may have literally suffered from a disease which is now called Alice in Wonderland Syndrome (AWLS), a rare disorder (usually affecting children and young adults) in which a person can experience momentary episodes of distorted perception, whether it be visual or of time. During an episode, objects (including oneself) can seem larger or smaller, as well as closer or farther, than they truly are. Possible causes of this syndrome include Epstein-Bar virus infection, head trauma, seizure disorder, tumor and migraine. In fact, in people with migraines, it is believed that these distorted visual perceptions may be the aura (warning symptoms usually before the migraine) that occur right before the migraine headache (interestingly, some people have migraines without actual headaches). Of note, since we only truly know that Lewis Carroll suffered from migraines and it is just speculative that he may have had this syndrome, perhaps I should have refrained from perpetuating this defamatory rumor (sorry).
Symptom: Severe Vomiting Relieved by a Hot Shower
Condition: Cannabinoid Hyperemesis Syndrome
Fun fact: for those of you habitual marijuana uses who, unfortunately, suffer from severe bouts of vomiting, a syndrome called Cannabinoid Hyperemesis Syndrome, there is actually a strange way to improve your symptoms (if you are not inclined toward the best and what should seem obvious treatment option: abstinence from marijuana). Although it is unclear why, many people during an episode of severe nausea and vomiting report relief while taking a hot bath or shower. In fact, some people divulge spending hours a day in a hot bath (may be easier to just quit). Of note, if you are suffering from a bout of vomiting that does not resolve or are feeling lightheaded, please get to an emergency room quickly as you may be severely dehydrated and need emergent intravenous hydration.
Of course, not all strange symptoms can be explained by an obscure medical condition. Perhaps your friend who first heads straight to your freezer to chew on your ice and then rushes to your bathroom to take a hot shower is merely just peculiar and not both iron-deficient and suffering from cannabinoid hyperemesis syndrome. However, let's give most strange symptoms the benefit of the doubt and not rush to judge the sufferer.
By Dr. Marc Eisenberg
Dr. Marc Sabin Eisenberg, M.D., F.A.C.C. is an associate professor of medicine at Columbia University Medical Center. He is co-author of the book "Am I Dying?!: A Complete Guide to Your Symptoms and What to Do Next" and co-host of the "Am I Dying?!" podcast, which provides light-hearted advice for the hypochondriac in all of us. He writes the "Rounds With Dr. E" column for DoctorOz.com.