19/8/2015 Percutaneousexcretionofironandferritin(throughAlhijamah)asanoveltreatmentforironoverloadinbetathalassemiamajor,hemochromatosis

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MedHypotheses.2014Aug83(2):23846.doi:10.1016/j.mehy.2014.04.001.Epub2014Apr8.

Percutaneousexcretionofironandferritin(throughAlhijamah)asa
noveltreatmentforironoverloadinbetathalassemiamajor,
hemochromatosisandsideroblasticanemia.
ElSayedSM1,AbouTalebA2,MahmoudHS3,BaghdadiH4,MariaRA5,AhmedNS6,NaboMM7.

Authorinformation
Abstract
Ironoverloadisabigchallengewhentreatingthalassemia(TM),hemochromatosisand
sideroblasticanemia.ItpersistsevenaftercureofTMwithbonemarrowtransplantation.Iron
overloadresultsfromincreasedironabsorptionandrepeatedbloodtransfusionscausing
increasedironinplasmaandinterstitialfluids.Irondepositionintissuese.g.heart,liver,endocrine
glandsandothersleadstotissuedamageandorgandysfunction.Ironchelationtherapyand
phlebotomyforironoverloadhavetreatmentdifficulties,sideeffectsandcontraindications.As
meanironlevelinskinofTMpatientsincreasesbymorethan200%,percutaneousironexcretion
maybebeneficial.Wetcuppingtherapy(WCT)isasimple,safeandeconomictreatment.WCTis
afamiliartreatmentmodalityinsomeEuropeancountriesandinChinesehospitalsintreating
differentdiseases.WCTwasreportedtoclearbothbloodplasmaandinterstitialspacesfrom
causativepathologicalsubstances(CPS).StandardWCTmethodisAlhijamah(cupping,
puncturingandcupping,CPC)methodofWCTthatwasreportedtoclearbloodandinterstitial
fluidsbetterthanthetraditionalWCT(puncturingandcuppingmethod,PCmethodofWCT).In
otherword,traditionalWCTmaybedescribedasscarificationandsuctionmethod(doubleS
technique),whileAlhijamahmaybedescribedassuction,scarificationandsuctionmethod(triple
Stechnique).Alhijamahisamorecomprehensivetreatmentmodalitythatincludesallstepsand
therapeuticbenefitsoftraditionaldrycuppingtherapyandWCTaltogetheraccordingtothe
evidencebasedTaibahmechanism(Taibahtheory).DuringthefirstcuppingstepofAlhijamah,
afluidmixtureiscollectedinsideskinupliftingduetotheeffectofnegativepressureinside
suckingcups.ThisfluidmixturecontainscollectedinterstitialfluidswithCPS(iron,ferritinand
hemolyzedRBCsinthalassemia),filteredfluids(frombloodcapillaries)withironandhemolyzed
bloodcells(hemolyzedRBCs,WBCsandplatelets).Thatfluidmixturedoesnotcontainintact
bloodcells(havingdiametersinmicrons)thataretoobigtopassthroughporesofskincapillaries
(612nmindiameter)andcannotbefiltered.Puncturingskinupliftingsandapplyingsecond
cuppingstepexcretecollectedfluids.Skinscarifications(shartatmihjaminArabic)shouldbe
small,superficial(0.1mmindepth),short(12mminlength),multiple,evenlydistributedand
confinedtoskinupliftings.Suckingpressureinsidecups(150to420mmHg)appliedtoskinis
transmittedtoaroundskincapillariestobeaddedtocapillaryhydrostaticpressure(33mmHgat
arterialendofcapillariesand13mmHgatvenousendofcapillaries)againstcapillaryosmotic
pressure(+20mmHg).Thiscreatesapressuregradientandatractionforceacrossskinand
capillariesandincreasesfiltrationatarterialendofcapillariesatnetpressureof163to
http://www.ncbi.nlm.nih.gov/pubmed/24857772

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19/8/2015 Percutaneousexcretionofironandferritin(throughAlhijamah)asanoveltreatmentforironoverloadinbetathalassemiamajor,hemochromatosis

433mmHgandatvenousendofcapillariesatnetpressureof143to413mmHgresultingin
clearanceofbloodfromCPS(iron,ferritinandhemolyzedbloodcells).Netfiltrationpressureat
renalglomeruliis10mmHgi.e.Alhijamahexertsamorepressuredependentfiltrationthanrenal
glomeruli.Alhijamahmaybenefitpatientsthroughinducingnegativeironbalance.Interestingly,
Alhijamahwasreportedtodecreaseserumferritinsignificantly(byabout22%)inhealthy
subjectswhileexcessivetraditionalWCTwasreportedtocauseirondeficiencyanemia.Al
hijamahisahighlyrecommendedtreatmentinpropheticmedicine.Inconclusion,Alhijamahmay
beapromisingadjuvanttreatmentforironoverloadinTM,hemochromatosisandsideroblastic
anemia.
Copyright2014ElsevierLtd.Allrightsreserved.
PMID:24857772[PubMedindexedforMEDLINE]

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