Iron-deficient often fall through cracks

A 36-year-old man came to my clinic across from Richmond Hospital with sharp pains in his knees when he walked, as well as unexplained fatigue, dizziness, frequent low moods and poor concentration.

He also had a weak pulse and a pale-dark tongue, both markers of iron deficiency in traditional Chinese medicine (TCM).

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Typically, men this age are not at risk of being iron deficient, but there are always exceptions Blood tests also confirmed his iron deficiency, finding his serum ferritin to be below range and hemoglobin at the low end within range. After making specific changes in his diet and lifestyle, along with taking Chinese herbs and nutritional supplements, this man's pains and symptoms improved by 60 per cent within two weeks.

Iron is needed for several functions in the body: it helps with sleep and brain function; carries oxygen to tissues and joints; and produces fuel for the body's cells, known as adenosine triphosphate (ATP).

Exercise demands more oxygen to the muscles and joints than normal, so when iron - the carrier for oxygen - is below threshold in the body, the resulting lack of oxygen can cause sharp joint pains.

And when iron levels are low for a long time, the deficiency will impact the daily functioning of internal organs, causing this man's other symptoms.

Serum ferritin measures the backup stores of iron in the liver and is the first marker of iron deficiency when it is low.

In contrast, hemoglobin is the current use of iron in the blood, and is the last marker to show low iron. Thus, when hemoglobin is below range, the person is already anemic, a more severe form of iron deficiency.

But common blood tests only check hemoglobin. So, unless blood tests show a person has obvious anemia, those with iron deficiency fall through a major crack in the medical system.

According to the World Health Organization (WHO), more than 30 per cent of the global population suffers anemia.

This makes iron deficiency - a pre-anemia condition - the most common and widespread nutritional disorder in the world.

To diagnose iron deficiency and correct it before symptoms become worse or more prolonged, a serum ferritin test should be conducted.

The simplest way to then correct iron deficiency is through using food as medicine. Iron-rich foods include green smoothies, dark green leafy vegetables such as spinach, kale, aragula, gailan, seaweed, as well as raisins, prunes, apricots, lean meats and eggs.

In more deficient cases, there are also options to take western nutritional supplements or Chinese herbal medicine.

Taking Chinese herbs for iron deficiency is more effective than only receiving acupuncture - both of which are important modalities in TCM.

Richmond has many TCM herbal pharmacies to purchase over-thecounter herbs, or get prescriptions through seeing their in-house herbalist.

Either way, if you have iron deficiency and want to address it through natural herbs, visit a TCM doctor or herbalist to ensure it is the best and safest health choice for you.

Dr. Mee Lain Ling is a doctor of Traditional Chinese Medicine with her clinic located in the Richmond Health Sciences Centre across from Richmond Hospital. Visit for more health articles and contact information.

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