Sheng Tie Luo

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Fe₃O₄ (Ferrosoferric oxide, from Magnetite ore)

Not yet clinically reviewed

Genus: Fe₃O₄ Pinyin: Sheng Tie Luo
Iron filings生铁落

Traditionally used for

  • Cough & breathing
  • Mood & calm
  • Heart & circulation
  • Skin
Moderate evidence · 1 study

☯ TCM Properties

Category: extinguishing wind
Temperature: cool
Taste: pungent
Meridians: heart, liver
Functions:

Calms the Liver and Subdues Yang; Calms the Spirit and Settles Fright; Clears Heat from the Liver and Heart; Resolves Toxicity and Heals Sores

Traditional Chinese Uses

Sheng Tie Luo (raw iron flakes) is a heavy, cool substance used to settle the Liver, calm the Spirit, and clear internal heat. It is indicated for conditions where Liver Fire or Phlegm-Fire have disturbed the mind — producing mania, violent behavior, palpitations, and extreme agitation. Its weight physically anchors rising energy and grounds the Shen. As a metal mineral, it is typically decocted for a long time before other herbs are added.

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Botanical Description

Sheng Tie Luo (“raw iron filings”) is the medicinal substance consisting of the flaky black scales of iron oxide — predominantly ferrosoferric oxide (Fe3O4) with some Fe2O3 — that flake off from the surface of red-hot wrought iron or low-carbon steel when it is hammered or quenched in traditional forges. These hammer-scale flakes are collected from blacksmiths’ anvils, sifted free of slag, and washed; for medicinal use they are further calcined and quenched in vinegar and finely powdered or decocted to yield an iron-rich liquid. In traditional Chinese medicine the prepared substance is acrid, bitter, and cool, with a heavy sinking action attributed to its mineral-metal nature: it settles the spirit and pacifies the Liver to subdue the rising Yang, calming agitation, mania, fright palpitations, and convulsive disorders associated with Liver fire or wind, and is the principal mineral in the classical formula Sheng Tie Luo Yin.

Active Constituents

Wustite (FeO)

Iron(II) oxide; innermost forge-scale phase

Concentration: The dominant phase of scale formed above about 700 C, where it can occupy roughly 95% of the scale layer; much of it converts to iron plus magnetite on slow cooling.

Sheng Tie Luo is the flake that is hammered off wrought or cast iron once the bar has been heated red-hot and its surface has oxidised. Chemically that is forge or mill scale, whose three layers are wustite next to the metal, magnetite in the middle and hematite outside. Wustite is the most acid-soluble of the three, so it is the phase most likely to release ferrous iron in the stomach.

Magnetite (Fe3O4)

Mixed-valence iron(II,III) oxide; spinel-group phase of forge scale

Concentration: Intermediate scale layer; predominant after slow cooling. Total iron in mill scale is typically 68-72% by weight across all three oxide phases.

Magnetite is the phase the drug is usually said to consist of, and that is where the persistent conflation with Ci Shi (Magnetitum) comes from. It is worth being explicit that the pinyin and the formula given for this drug disagree: Sheng Tie Luo is not mined magnetite ore. The Chinese materia medica define it as the iron flakes hammered off pig or wrought iron once the bar has been heated red-hot and its outer layer has oxidised, and they list Ci Shi separately as the spinel-group mineral magnetite. Here magnetite is one of three combustion-formed oxide layers on the surface of worked iron, not the whole substance and not a mined mineral.

Hematite (Fe2O3)

Iron(III) oxide; outermost forge-scale phase

Concentration: Thinnest of the three layers, at the outer surface.

The outermost, most fully oxidised layer. It is the same compound as the whole of Dai Zhe Shi, which is why the two drugs share a heavy sedative character in the classical literature despite coming from entirely different sources.

Metallic iron and entrained steelworking contaminants

Elemental metal and process contaminants

Concentration: Not specified. Scale from modern industrial rolling carries rolling oils, hydraulic fluid and alloying elements from the steel; scale from a traditional charcoal forge does not.

This is the drug's substitution problem rather than a pharmacological constituent, and it is unpoliced: Sheng Tie Luo is not in the 2020 Chinese Pharmacopoeia, so it has no national identity test, no assay and no heavy-metal limit anywhere in the standard. The classical article is scale from a charcoal-fired smith's forge working relatively pure iron; industrial mill scale, the only bulk source now available, is a steelworks waste stream that carries rolling oils, hydraulic fluid residues and whatever alloying metals the steel contained. Nothing distinguishes the two once they are ground.

⚠ Drug Interactions

Levothyroxine

Moderate Evidence: Theoretical

Iron and levothyroxine form a poorly absorbed complex in the gut. The human evidence is the Campbell study of 300 mg ferrous sulfate daily in hypothyroid patients, which showed a rise in TSH and worsening symptom scores. Forge scale is a mixture of insoluble oxides, not a soluble ferrous salt, so the amount of chelating iron it actually liberates is unknown and the ferrous sulfate figures must not be read across as if they described this drug.

Clinical note: Separate by four hours and check TSH if the mineral is continued beyond a few weeks in a patient on replacement.

Tetracycline and fluoroquinolone antibiotics

Moderate Evidence: Theoretical

Both antibiotic classes chelate iron cations and lose oral bioavailability when given with it. The controlled human data are entirely from ferrous sulfate: Neuvonen showed serious impairment of four tetracyclines, and Lehto showed significant AUC reductions for norfloxacin, ciprofloxacin and ofloxacin with 100 mg elemental iron. No study has given either antibiotic class with iron oxide scale, so this is a chemical inference, not a measured interaction.

Clinical note: Give the antibiotic at least two hours before the decoction, or suspend the mineral for the course.

Olanzapine and other antipsychotics

Minor Evidence: Possible

The drug's main modern use is inside Sheng Tie Luo Yin given alongside antipsychotic medication for agitation in schizophrenia, and at least one randomised Chinese trial has used exactly that combination with olanzapine. The trials report the combination as tolerated and do not identify a pharmacokinetic interaction, but they are small, unblinded and test a multi-herb decoction, so they cannot exclude additive sedation from the other constituent herbs.

Clinical note: Reasonable to combine under psychiatric supervision, but do not treat the Chinese trial data as evidence that the mineral itself is inert alongside an antipsychotic.

Evidence Tier

Moderate evidence · 1 study

Recorded studies by study design, strongest design at the top. This is a study-design tier only, not a GRADE rating: it does not weigh risk of bias, consistency or precision.

Systematic review / meta-analysis

0

Randomized controlled trial

1

0 verified · 1 unverified

Show the study

Other clinical trial

0

Observational / case report

0

In vitro / animal

0

Other / unclassified

0

Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description

Clinical Studies

生铁落饮合并奥氮平治疗精神分裂症激越行为49例

Liao Tao, Liu Lu, Xie Jing, Xie Ying, Xi Jiaolong (2020) 药品评价 (Drug Evaluation) RCT

Ninety-eight inpatients with schizophrenia and agitated behaviour at Ganzhou Third People's Hospital were randomised to olanzapine alone or olanzapine plus a modified Sheng Tie Luo Yin decoction, 49 per arm, with PANSS and TESS scored at two and four weeks. Note what this does and does not test: Sheng Tie Luo Yin is a multi-herb formula and the trial gives no separate account of the mineral, so it is evidence about the decoction, not about iron scale. It is also small, single-centre, unblinded and reported only in Chinese without a DOI.

Historical Texts

Huang Di Nei Jing Su Wen, chapter Bing Neng Lun (On the Capacities of Disease)

Warring States to Western Han, compiled by the 1st century BCE
The earliest and most famous use: a decoction of Sheng Tie Luo alone, Sheng Tie Luo Yin, prescribed for nu kuang, mania with rage, on the reasoning that the drug drives qi downward. The Su Wen prescription is single-ingredient; the multi-herb Sheng Tie Luo Yin used in modern psychiatry is a much later formula from Cheng Guopeng's Yi Xue Xin Wu of 1732 and should not be confused with it.

Shen Nong Ben Cao Jing (Divine Husbandman's Classic of the Materia Medica)

Han dynasty, compiled by the 2nd century CE
Entry point for the drug in the materia medica tradition. Later texts record a proliferation of names for iron by-products that are not the same substance: tie ye in the Ming Yi Bie Lu, tie shi in the Qian Jin Fang, tie xie in the Tang Ben Cao, tie hua in the Ben Cao Tu Jing, tie e in the Ben Cao Gang Mu.

Ben Cao Gang Mu (Compendium of Materia Medica)

Ming dynasty, 1596
Li Shizhen states the drug levels the Liver and disperses timidity, and treats a tendency to anger and outbreaks of mania. He also sets out the definition still used: the iron flakes knocked off pig iron that has been heated red-hot and whose outer layer has oxidised.

References

  1. XU Shan, XU Liu, XIANG Tang-yong, ZHU Ling, GU Yi, CAI Bao-chang, CHEN Zhi-peng. Research Progress on Metallic Mineral Chinese Medicines . Journal of Nanjing University of Traditional Chinese Medicine (2021)
  2. Neuvonen P. J., Gothoni G., Hackman R., af Bjorksten K.. Interference of Iron with the Absorption of Tetracylines in Man . BMJ (1970) [DOI]
  3. Lehto P, Kivisto KT, Neuvonen PJ. The effect of ferrous sulphate on the absorption of norfloxacin, ciprofloxacin and ofloxacin. . British Journal of Clinical Pharmacology (1994) [DOI]
  4. Campbell Norman R. C., Hasinoff Brian B., Stalts Helga, Rao Babu, Wong Norman C. W.. Ferrous Sulfate Reduces Thyroxine Efficacy in Patients with Hypothyroidism . Annals of Internal Medicine (1992) [DOI]
  5. Chinese Pharmacopoeia Commission. Pharmacopoeia of the People's Republic of China, 2020 Edition, Volume I: contents list of medicinal materials and decoction pieces . China Medical Science Press (2020)

This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.

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