MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

The story about Thomas Rau made me once again look into the plethora of hair-raising nonsense that is being claimed on social media and elsewhere about live-blood analysis (LBA). LBA is a form of ‘dark field microscopy where the sample is illuminated with light that will not be collected by the objective lens and thus will not form part of the image. This generates the appearance of a dark background with bright objects on it. LBA is employed as a diagnostic method used by many practitioners of so-called alternative medicine (SCAM). The procedure is faily simple:

  1. a drop of blood is taken usually by a finger prick,
  2. it is then put on a glass plate without anticoagulation,
  3. the glass plate id placed on a darkfield microscope,
  4. the blood cells (mostly erythrocytes) are oberved,
  5. the SCAM practitioner can make patients watch their own blood cells on a TV screen while they are listening to his/her interpretation of the phenomena on display.

LBA is quick and simple – provided you have a dark field microscope – looks very ‘cutting edge’ to a lay person, and commands impressive fees. For all of these reasons, it is popular in the realm of SCAM.

The claims that are being made for LBA are varied and far-reaching, e.g.:

  • LBA can allegedly find pleomorphic bacteria in the blood of healthy and diseased humans.
  • LBA can allegedly be used to evaluate immune system status.
  • LBA can allegedly diagnose diseases or predispositions to diseases such as allergies and chronic diseases, including cancer, cardiovascular disease, immunity-related disorders and many more.

LBA has a long and colorful history, e.g.:

  • In the early 1900’s, Béchamp claimed that animal body fluids contained subcellular living particles (i.e., microzymas) that transformed into bacteria upon death and decay of the host (Béchamp, A. The Blood and its Third Anatomical Element. (John Ouseley Ltd, 1912)).
  • Enderlein described small entities called endobionts and protits in human blood and believed that these particles underwent a complex life cycle that correlated with disease progression ( Enderlein, G. Bacteria Cyclogeny. (Verlag Walter de Gruyter, 1925)).
  • In the 1950’s, Villequez proposed that human blood was infected by a latent parasite similar to bacterial L-forms.
  • In the 1960/70s, Tedeschi and Pease reported that the blood of healthy and diseased individuals appeared to be continually infected with bacteria.

For a range of reasons, I am confident that LBA is hocuspocus. In the first 10 years of my career as a scientist, I was a researcher of ‘hemorhelology’, i.e. the flow properties of blood. One of the phenomena of interest in this field is that of red cell aggregation (RCA), the tendency of erythrocytes to reversibly aggregate when left still (i.e. in the absence of shear forces normally provided by the flow of blood). In the course of our research we even developed a method to quantify RCA.

Suffice to say that I think I understand the main phenomenon SCAM practitioners see when they look down their dark field microscope. They see red cells aligning in ‘rouleaux’ similar to stacks of coins. So far, so good! Where they go wrong is the interpretation of this phenomenon. It is the normal tendency of red cells to aggregate. It is not indicative of any of the conditions SCAM practitioners think it to be.

While RCA is well researched and understood, it’s re-branding under the banner of LBA has attracted almost no research at all (and this in itself should make us think: valid methods of diagnosis are invariably well-researched). The little research that did emerge fails to show that LBA is a valid diagnostic tool. Judge for yourself, here are the abstracts of the 3 recent papers on LBA that I managed to find:

1st study:

BACKGROUND: Dark field microscopy according to Enderlin claims to be able to detect forthcoming or beginning cancer at an early stage through minute abnormalities in the blood. In Germany and the USA, this method is used by an increasing number of physicians and health practitioners (non-medically qualified complementary practitioners), because this easy test seems to give important information about patients’ health status.

OBJECTIVE: Can dark field microscopy reliably detect cancer?

MATERIALS AND METHODS: In the course of a prospective study on iridology, blood samples were drawn for dark field microscopy in 110 patients. A health practitioner with several years of training in the field carried out the examination without prior information about the patients.

RESULTS: Out of 12 patients with present tumor metastasis as confirmed by radiological methods (CT, MRI or ultra-sound) 3 were correctly identified. Analysis of sensitivity (0.25), specificity (0.64), positive (0.09) and negative (0.85) predictive values revealed unsatisfactory results.

CONCLUSION: Dark field micoroscopy does not seem to reliably detect the presence of cancer. Clinical use of the method can therefore not be recommended until future studies are conducted.

2nd study:

CONTEXT: In 1925, the German zoologist Günther Enderlein, PhD, published a concept of microbial life cycles. His observations of live blood using darkfield microscopy revealed structures and phenomena that had not yet been described. Although very little research has been conducted to explain the phenomena Dr. Enderlein observed, the diagnostic test is still used in complementary and alternative medicine.

OBJECTIVE: To test the interobserver reliability and test-retest reliability of 2 experienced darkfield specialists who had undergone comparable training in Enderlein blood analysis.

SETTING: Inpatient clinic for internal medicine and geriatrics.

METHODS: Both observers assessed 48 capillary blood samples from 24 patients with diabetes. The observers were mutually blind and assessed their findings according to a specific item randomization list that allowed observers to specify whether Enderlein structures were visible or not.

RESULTS: The interobserver reliability for the visibility of various structures was kappa = .35 (95% CI: .27-.43), the test-retest reliability was kappa = .44 (95% CI: .36-.53).

CONCLUSIONS: This pilot study indicates that Enderlein darkfield analysis is very difficult to standardize and that the reliability of the diagnostic test is low.

3rd study

Although human blood is believed to be a sterile environment, recent studies suggest that pleomorphic bacteria exist in the blood of healthy humans. These studies have led to the development of “live-blood analysis,” a technique used by alternative medicine practitioners to diagnose various human conditions, including allergies, cancer, cardiovascular disease and septicemia. We show here that bacteria-like vesicles and refringent particles form in healthy human blood observed under dark-field microscopy. These structures gradually increase in number during incubation and show morphologies reminiscent of cells undergoing division. Based on lipid analysis and Western blotting, we show that the bacteria-like entities consist of membrane vesicles containing serum and exosome proteins, including albumin, fetuin-A, apolipoprotein-A1, alkaline phosphatase, TNFR1 and CD63. In contrast, the refringent particles represent protein aggregates that contain several blood proteins. 16S rDNA PCR analysis reveals the presence of bacterial DNA in incubated blood samples but also in negative controls, indicating that the amplified sequences represent contaminants. These results suggest that the bacteria-like vesicles and refringent particles observed in human blood represent non-living membrane vesicles and protein aggregates derived from blood. The phenomena observed during live-blood analysis are therefore consistent with time-dependent decay of cells and body fluids during incubation ex vivo.

So, what does all of this mean?

It means that LBA is not a valid diagnostic tool. Its use carries the serious danger of making false-positive and false-negative diagnoses. LBA has a poor reproducibility and is prone to all sorts of artefacts (including temperature, time, contaminants, method of obtaining the blood sample, etc.) that influence RCA. RCA is a normal and reversible phenomenon that determines the flow properties of blood in vivo. In itself, it is not a sign of any disease or disposition to fall ill.

In a nutshell:

LBA is an ideal tool for quacks to rip off their gullible clients.

 

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