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The Pseudoscience of Live Blood Cell Analysis


Thomas Patterson

Skeptical Inquirer Volume 36.6, November/December 2012

Of the many aspects of alternative medicine, one of the most bizarre is live blood cell analysis. This unapproved blood test supposedly identifies nutritional deficiencies and other nebulous conditions.

Take a simple scientific fact or term, build an elaborate fantasy on top of it, promote it, and you have pseudoscience. Live blood cell analysis by darkfield microscopy is an example. It sounds like a legitimate and valuable evidence-based diagnostic procedure; it is not.

Darkfield microscopy is a microscopic technique in which light strikes the observed material from the side rather than from underneath and through the material. The background is dark with the observed material highlighted by the lateral light source. In normal brightfield microscopy, the background is white or very light and the material is usually darkly stained to bring out fine details and colors not normally visible.

In medicine, the most common use of brightfield microscopy is in diagnostic applications. The commonly or­dered complete blood count (CBC) is often partly done with stained smears of the patient’s blood observed under brightfield microscopy. With this technique, the clinical laboratory scientist can observe very fine details about the size and shape of the red blood cells; the shape, size, and relative numbers of the white blood cells; and the presence or absence of platelets, those small cell fragments that cause blood to clot.

Darkfield microscopy is useful in the medical laboratory for identifying living spirochetes collected from an infected patient. These are corkscrew-shaped bacteria that can be seen wiggling and corkscrewing their way through the liquid or material in which they are suspended. However, the use of darkfield microscopy as part of a CBC or analysis of live blood is questionable. Because darkfield is by definition dark, most of the detail that is apparent in brightfield examination is invisible. The use of darkfield techniques in examining live blood for cellular shape and detail is suspect and is not offered by most reputable medical laboratories because it has little diagnostic value.

That fact has not deterred some alternative medicine practitioners from providing live blood cell analysis (darkfield blood analysis) to the unsuspecting public. In a typical scenario, the alternative medicine practitioner will have the darkfield microscope set up at a health fair or in his or her office. A video camera is connected to the microscope and feeds a video monitor so that the enlarged image is visible on the screen. For a fee, the practitioner will offer the test to a patient or attendee at a health fair.

Health Food store live blood analysis sign

The customers may be asked to prick their own fingers with a sterile lancet to obtain blood. It is illegal in some states for an alternative medicine practitioner to perform any invasive procedure on the public. In these states, the customers must perform the invasive procedure by collecting their own blood samples.

After a drop of blood oozes to the surface of the skin, the practitioner will dab it onto a glass cover slip and place the slip on a glass slide for observation under the darkfield microscope. The practitioner will then scan the slide and point out various features of the sample as the customer observes the screen in confused wonderment.

The problem is that most of these practitioners are not trained medical professionals and are not qualified to examine a blood sample. Microscopes and video set-ups are available for purchase by anyone for $3,500 to $6,000. With the purchase of the set-up, a two- or three-day training course is offered. No one can be adequately trained in a couple of days to properly evaluate a blood sample. Laboratory professionals and pathologists must take years of training through accredited educational programs before they can competently perform a microscopic examination of blood cells.

Businesses that provide these microscope/video set-ups are careful in de­scribing the purpose of their product. Most will say that their equipment is to be used for educational purposes only. Customers will supposedly be motivated to improve their lifestyles after seeing their blood on the video screen. The product is not to be used to diagnose, evaluate, or treat any disease or disorder. Undoubtedly, the purpose of this disclaimer is to prevent legal entanglements. Providing an unlicensed, nonvalidated test to diagnose disease or illness is unprofessional if not illegal.

However, in actual practice, most alternative practitioners will come close to a diagnosis as they review the blood sample. While reviewing the sample with the customer the practitioner will often observe “rouleau” formations of the red cells. Rouleaux occur when the red cells stack on top of one another and appear like stacks of coins. True rouleaux can be seen in patients with plasma protein abnormalities like multiple mye­loma, but this is rare. Myeloma is a life threatening condition and requires medical attention.

The rouleaux observed by alternative medicine practitioners are almost always artifacts due to the slight drying of the blood sample around the edges of the coverslip or due to clumping in areas of the slide where there is a large concentration of red cells. In micro­scopy, an artifact is something that looks abnormal or odd but is actually insignificant and is ignored by a trained professional. Blood cells will normally start to clot and stack upon coming in contact with glass. Observa­tion of red cell rouleaux on a darkfield microscope from a finger-stick sample obtained from a customer or patient is diagnostic of nothing.

If the slide is observed near the center of the coverslip, rouleaux are rarely seen. The red cells are free floating and are not attached to each other. The practitioner will often identify these red cells as “healthy.” The customer can be misled by the practitioner moving the slide near the edge of the coverslip where false rouleaux are common or showing the field near the center where rouleaux are rarely seen. The practitioner can show the customer whatever he or she wants the customer to see by selecting a specific area of the slide.

According to some alternative practitioners, rouleaux are indicative of acid in the blood. Anyone who has taken a real anatomy and physiology course knows that blood is not acidic unless the person is acutely ill with respiratory or metabolic acidosis, conditions that are life-threatening. The kidneys will normally excrete excess metabolic acid into the urine while the lungs continually rid the body of excess carbon dioxide to keep the blood at the normal level of slight alkalinity; blood is never acidic unless the person is very ill.

Rouleaux are not caused by acidic blood, and people who are actually in severe acidosis would certainly not be well enough to be wandering around an alternative medicine health fair. Curiously, other practitioners will state that rouleaux are actually caused by a sluggish or weak pancreas that is not digesting protein properly.

Alternative medicine practitioners often demonstrate a complete lack of knowledge concerning basic biology—not to mention pathology or medicine. They will comment that the red cells are beginning to bud off bacteria from the edge of the red cell membrane. These small artifacts near the cell membrane are interpreted as bacteria being born. A high school biology student would know that this idea is implausible. One form of life cannot instantly transform into another. It is a biological impossibility for a red blood cell to transform into a bacterium. Each biological organism, from a blue whale to a Vidalia onion to a coliform bacterium, has a completely different genome or set of DNA that makes the organism unique. If the practitioner could actually identify bacteria in the blood, the customer is in danger and should request immediate transfer to the nearest emergency room to be treated for septicemia, a potentially life-threatening infection of the bloodstream.

Some artifacts are mistakenly identified by the practitioner as yeast cells, one of the most common “findings” by alternative practitioners. Yeast cells cannot be seen in the blood of a healthy person for the simple reason that they are not there. An actual fungus (yeast) in the blood is seen in patients who are critically ill with some type of severe immune system deficiency. These individuals also will not be well enough to be wandering about at a health fair.

Often a microscopic shard of glass from the slide will be present in the microscopic field. These tiny shards are present on most slides unless the slide is carefully cleaned before use. The alternative practitioner will usually identify these glass shards as uric acid crystals or cholesterol plaques, which are simply not visible in a blood sample.

Surprisingly, a “parasite” is often found in the blood during live blood cell analysis. Some of these so-called parasites appear to be slightly deformed red cells or microscopic particles of dirt and debris commonly visible on a glass slide. Legitimate medical laboratories never report “parasites” as a laboratory finding. The species of parasite must be identified by carefully observing individual anat­omical features of the parasite’s body or eggs so appropriate treatment can be implemented. The presence of real parasites in the bloodstream indicates a very serious medical condition.

The parasites (actually artifacts) seen by the live blood cell analyst simply cannot be identified because they do not have anatomical features. Addi­tionally, people with real parasitic infections in the bloodstream are ill enough to seek legitimate medical treatment and are treated with antimalarial or antiparasitic drugs, the normal standard of care. Anyone with worms, trypanosomes (sleeping sickness), protozoa (malaria), or other free-living parasites in the bloodstream is in danger and is in need of immediate medical attention, not a nutritional herbal supplement that supposedly rids the body of pesky blood-borne parasites.

Light spots seen on the red cells are often identified as “fermentations” by the practitioner. Supposedly these are areas of the red cell undergoing fermentation due to the high sugar content of the blood. This fermentation interpretation demonstrates a lack of understanding of basic chemistry and physiology. Fermentation occurs when yeast produce enzymes that convert sugar to ethyl alcohol and carbon dioxide gas. This causes grape juice to turn into sparkling wine but does not cause red blood cells to develop white spots. Red blood cells do not contain yeast and cannot ferment anything; red cells have also never been observed to be full of alcohol and carbon dioxide gas bubbles. If yeast cells were actually fermenting sugar and forming alcohol in the bloodstream, one could be legitimately charged with driving under the influence after eating a doughnut. The light spots are actually artifacts and are not visible on many of the red cells observed throughout the microscopic field.

Conveniently, most of the serious-sounding conditions discovered by the practitioner can be resolved by waving a special “zero-point energy wand” over the body, eating special alkaline foods, drinking alkalinized water, or by taking a dietary supplement that the practitioner just happens to sell. Although no “diagnoses” are supposedly made, the practitioner will let the customers know that they have one or more of the following: an imbalance in their acids, free radical damage, a weakness in the liver or pancreas, a problem with their alkalophile organs (this mysterious classification of organs cannot be found in any reputable anatomy textbook), blood toxins, stress, poor lymphatic circulation, a tendency toward allergies, yeast in the blood, bacteria in the blood, blood parasites, hormonal imbalances, and a host of other vaguely worded but serious-sounding conditions.

If the customer takes the prescribed supplement or submits to a bizarre zero-point energy wand waving session and returns for a repeat darkfield examination, the original disorder has, more often than not, miraculously disappeared. Or was the practitioner examining the area of the sample near the center of the coverslip where the red cells appear normal, there are no rouleau formations, and few if any artifacts are seen at all?

Live blood cell analysis is not currently recognized by the laboratory profession as a worthwhile laboratory test because it reveals very little diagnostic information. One can only imagine the chaos that would ensue if legitimate laboratory tests had to bear the disclaimer: “This test is for educational purposes only and cannot be used to diagnose, evaluate, or treat any disease or disorder.”

Laboratories that perform evidence-based medical laboratory testing in the United States are regulated by the Clin­ical Laboratory Improvements Amend­ment (CLIA) passed by Con­gress. This legislation requires that all highly complex medical laboratory tests be performed by qualified personnel and that all laboratory tests offered must be continually validated by special programs. Out of ignorance or to avoid these restrictive regulations, live blood cell analysts simply do not register their activity with the federal government and therefore are not inspected. The actual en­forcement of medical laboratory standards in most cases falls under statutes set by each state. Some states have closed down live blood cell analysis when they are aware of such activity. Other states have not investigated the issue or simply allow alternative medicine practitioners to continue their practice.

There are several websites that currently demonstrate live blood cell analysis. These sites have the trappings of real science with the doctor title thrown about as if the procedure is being performed by a medical doctor. Most of these “doctors” have PhDs or medical degrees from schools of nutrition, herbal medicine, natural healing, or naturopathy. They have not published any peer-reviewed research findings in legitimate scholarly journals, have not produced a doctoral-quality dissertation, and have not graduated from any recognized academic university or accredited school of medicine. Many of these sites are interesting to watch. The Internet demonstrations of live blood analysis are sprinkled with quasi-scientific terms that can easily fool an unsuspecting public into thinking there is actual science involved.

The idea that wand waving, dietary supplements, and alkaline diets can cure the host of strange disorders identified during live blood cell analysis is certainly pseudoscience at its worst. The hope is that we are not slowly traveling backward in time toward Sagan’s demon-haunted world through the eyepieces of our darkfield microscopes.

Thomas Patterson

Thomas Patterson is currently a professor in the Clinical Laboratory Science Program at Texas State University where he teaches Clinical Research Methods, Molecular Diagnostics, Immunohematology, Immunology, and Clinical Laboratory Management. E-mail: