A 43-year old man came to my Traditional Chinese Medicine clinic for sharp left-sided knee and wrist pains that were aggravated by climbing up and down stairs, and carrying items over 5 pounds. He also had achy upper back and neck muscles. Pulse at his wrists was slightly weak and thin. His tongue was purple-red with red-dotted tip and thin yellow coat at the root.
Typically, 25 – 55 year-old men are not at risk of being iron deficient, but this man’s case proved to be an exception. His pains reduced by 75% after six weeks following treatments of sliding cupping, acupuncture, Chinese herbal medicine, and natural nutritional supplements. Blood tests confirmed he had low serum ferritin, the first marker of iron deficiency. Hemoglobin, on the other hand, is the last marker and diagnoses anemia, a more severe condition of iron deficiency.
So what was the cause of this man’s low iron? There are four major groups of people at risk of iron deficiency. People with:
1. A general need for iron. This includes menstruating women, women planning pregnancy, pregnant or breastfeeding women, and teenagers and children between 1 – 4 years because of rapid growth and often lack of iron in their diet.
2. Decreased ability to absorb iron. This includes elderly because of weakened organ systems; those with low protein intake; and people with digestive problems that result in fast transit time of food causing frequent diarrhea or loose stools which loses necessary nutrients, including iron.
3. Inadequate iron intake. This includes vegetarians, vegans, people on calorie-restricted diets, elderly due to decreased intake of food or bad teeth, and people eating mainly breads, dairy or processed foods.
4. Increased loss of iron. This includes women with heavy monthly periods. Typically women lose on average 75mL of blood each month, but in a heavy period, a woman can lose up to half a cup (125mL) or more. Blood loss during childbirth is included here. Athletes lose iron through bruising, sweating, and overall need more iron to maintain active muscles and joints. Those who had surgery or injury also have increased loss of iron.
Three other groups of people with increased loss of iron that often get missed in western medicine are people who eat spicy foods daily, those with Type A perfectionist personality, and those holding repressed anger.
Spicy foods, sustained high stress, and long-term held anger all lead to excess fire in the body that transforms the natural fire in the body from a warm, comfortable fireplace, to a blazing fire that burns the whole house of the body. Excess internal fire burns the blood and body fluid leading to faster-than-normal loss of iron, which then contributes to a host of conditions including diabetes and arthritis.
In this man’s case, he was a strong Type A perfectionist and pushed himself to work 10 – 12 hour days in order to meet deadlines for multiple projects that he chose to take on simultaneously. This enormous stress led to high amounts of adrenalin to constantly run in the blood, causing excess internal heat to burn the blood, leading to his joint and muscle pains. The clue for excess fire presented in the quality of his tongue.
In cases of excess fire, wet cupping (hijama) can immediately relieve this, but it must be approached with caution. If iron levels are below threshold, then any further loss of blood through wet cupping technique can in fact aggravate joint pains, or iron deficiency symptoms, rather than alleviate them. This is because iron carries oxygen to the muscles and joints, so when it gets too low – from over-exercise, or other forms of blood loss, the resulting lack of oxygen causes sharp joint pains or muscle aches.
Read more on this topic at Iron Deficiency: World’s Most Common Nutritional Disorder.