Arsenic Poisoning Symptoms and Signs of Toxicity, Exposure

Arsenic poisoning may be accidental or intentional and depending on the source, method and degree of poisoning, the severity and range of signs and symptoms may vary. Arsenic is known for its toxicity but death due to arsenic poisoning is not immediate in most cases.

Usually arsenic poisoning, whether accidental or intentional, occurs over a long period of time. Small doses of arsenic in contaminated drinking water (accidental) or intentionally added to daily meals (food and drink) leads to chronic arsenic poisoning. The signs and symptoms of arsenic poisoning in these cases develop over a period of time and are often mistaken for other conditions – gastrointestinal, neurological or immune related.

When arsenic is consumed in large quantities (suicide or murder), the signs and symptoms are very acute and death within a short time is possible.

Arsenic Poisoning Symptoms

The symptoms may be experienced almost immediately after consuming drink or food containing arsenic or it may only be present 30 to 60 minutes after consumption. This depends on the quantity of arsenic within the food or drink and the type of food ingested. It terms of gas inhalation, the symptoms are obvious much sooner than with ingestion.

  • Burning pain in the gastrointestinal tract – chest (esophagus), lower chest/upper abdomen (stomach) and abdomen as a whole (small and large intestines).
  • Difficulty swallowing (dysphagia).
  • Throat irritation – varying from the feeling of throat constriction to a lump in the throat.
  • Nausea.
  • Metallic taste in the mouth
  • Disturbances in movement, muscle strength and coordination (motor), or numbness, tingling and pain (sensory).
  • Generalized muscle aches and body pains.
  • Pain may cause anxiety and fear with shortness of breath (dyspnea), insomnia and even nightmares have been reported.
  • Lack of appetite which may lead to weight loss (further aggravated by vomiting and diarrhea).
  • Headaches with dizziness.

Arsenic Poisoning Signs

The signs of arsenic poisoning may mimic many diseases and apart from the above symptoms that the patient will report, other signs are evident to the physician or concerned associates. A conclusive diagnosis of arsenic poisoning will involve positive blood tests, although bone, hair and nails may be tested post mortem. Excluding other conditions that may cause these signs and symptoms should not lead to a final diagnosis unless there is evidence of arsenic poisoning and positive test results.

  • Vomiting.
  • Diarrhea – with severe gastrointestinal bleeding, black diarrhea may be evident.
  • Hypersalivation – increased saliva production.
  • Muscle wasting and twitching, particularly in the limbs.
  • Difficulty coordinating voluntary movements and unsteady gait (ataxia).
  • Peripheral neuropathy – diminished sensory perception which can be confirmed during a neurological examination.
  • Seizures.
  • Low grade fever.
  • Hair loss.
  • Conjunctivitis (‘pink eye’) or even red, bloodshot eyes.
  • Corneal tissue death (necrosis) and/or ulcers.
  • Skin discoloration – darkening (hyperpigmentation), pale (pallor), yellow (jaundice), blue (cyanosis).
  • Mee’s lines – white lines on fingernails and/or toenails.
  • Thickening of the skin on the palms (palmar keratosis) or soles of the feet (plantar keratosis).
  • Vasospasm (constriction of blood vessel due to muscle contraction in the vessel wall)  resulting in a reduced oxygen supply to tissues leading to ischemia, necrosis and/or gangrene.
  • Enlarged liver (hepatomegaly) and/or spleen (splenomegaly).
  • Aplastic anemia when the bone marrow fails to produce new cells.
  • Kidney failure.
  • Impaired immune functioning.
  • Increased risk of cancer – liver, bladder, larynx and lymphoid system.