Live Blood Analysis: New Diagnostic Method or Quackery?

CLINICAL VIGNETTE

Live Blood Analysis: New Diagnostic Method or Quackery?

Case report and Review of the Literature

Zachary A. Rubin, M.D.

UCLA Department of Medicine

Case Report

A 45-year-old woman presented for evaluation to an infectious diseases specialist with chief complaint of "blood parasites." She stated that she had recently gone with a friend to a consultation with an alternative medicine practitioner who performed live blood analysis with a dark-field microscope. After expressing some skepticism, the patient allowed the practitioner to draw a drop of blood from her finger, place it onto a slide and then use a dark-field microscope to provide a detailed analysis. The practitioner identified multiple structures which she identified as red blood cells. She also identified other structures which she stated were parasites, though she could not identify the species. Because the "parasites" were moving during the microscopy session, the practitioner felt that this was clear evidence of active infection. The practitioner recommended a course of treatment which included multiple herbal supplements. After the visit, the patient became anxious about her diagnosis of "blood parasites" and sought a second opinion.

The patient denied any past medical history. Her only hospital stays had followed vaginal delivery of 2 children after normal pregnancies. She felt well except for some mild fatigue and denied fevers, rigors, headache, nausea, vomiting, or diarrhea. She had visited her primary physician for a routine checkup within the last 3 months. Her only medication was daily multivitamins. Physical examination was unremarkable.

Discussion

A recent survey found that 38% of adults in the United States admit to using alternative medical treatments¹. While there is little evidence to support the use of most of these alternative therapies, every year Americans spend billions of dollars on them². Many therapies, such as Ayurvedic medicine and traditional Chinese medicine have been imported into the United States and may be attractive to Americans due to their long history, many loyal adherents in their native cultures, and their basis on exotic philosophy. Many other therapies have been invented recently within the United States and use pseudoscientific claims and internet marketing to further their appeal. Live Blood Analysis (LBA) is an alternative diagnostic modality that uses the scientific instruments of medicine, in this case, a dark-field microscope, to diagnose many systemic diseases and vitamin deficiencies. While there is little literature pertaining to the practice prior to the 1980's, there are many current web sites that tout its professed benefits despite a Department of Health and Human Services (DHS) warning³.

Though a PubMed search yields no matches for LBA⁴, there are over 2.5 million hits on Google⁵. Web sites offer correspondence training in multiple microscopy techniques for as little as $499⁶ and sell microscopes and other equipment. Though most practitioners of LBA seem to have little formal medical training, many trained physicians and chiropractors appear to use the technique also.

The general treatment approach is to obtain a drop of the patient's blood and place it on a microscope slide. The slide is then projected onto a television screen for both practitioner and patient to examine. There are a number of online tutorials which give examples of abnormal findings including parasites attacking corpuscles, rouleaux formation and other purportedly significant findings⁷. After an extensive evaluation which may last up to 2 hours, the practitioner recommends therapy which often appears to include chelation therapy or nutritional supplements.

While it is unclear where LBA originated, a number of physicians going back to the 1920's claimed to have been able to detect cancer and infectious diseases using dark-field and other types of microscopy long before symptoms of the disease may be identified by more conventional methods^8,9. LBA methods were tested by two groups of German investigators^9,10. Both studies used independent microscopists trained and experience in LBA to evaluate blood samples for presence of disease. In one study, a practitioner reviewed 110 total patient slides, 12 of which had known metastatic cancer, with dark-field microscopy. The sensitivity and specificity of the microscopy was 25% and 64%, respectively¹⁰. In the other study, 2 separate experienced and trained LBA practitioners reviewed 48 blood samples from 24 patients and their conclusions were then compared. The researchers found very low agreement between practitioners⁹, with a kappa of 0.35.

While LBA offers the appeal of a scientific approach to diagnosis and treatment, there is no reliable scientific evidence to substantiate the claims made on the internet and elsewhere. While some alternative therapies may alleviate somatic symptoms not well-addressed by many mainstream physicians through placebo effect or other mechanisms, LBA appears to be a pseudoscientific sales pitch to get patients to buy equally unsubstantiated alternative treatments. While DHS and local law enforcement departments have tried to eliminate the practice of LBA¹¹, a simple review of the internet seems to demonstrate an active and thriving industry.

REFERENCES

1. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report. 2009 Dec 10;(12):1-23.
2. Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, Kessler RC. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA. 1998 Nov 11;280(18):1569-75.
3. Department of Health and Human Services. Office of Inspector General Report: CLIA Regulation of Unestablished Laboratory Tests. July, 2001. Accessed through internet on http://www.quackwatch.org/01QuackeryRelatedTopics/Tests/clial ivecell.pdf. June, 19, 2009.
4. PubMed search June 19, 2009. Search terms "live blood analysis, dark-field microscopy."
5. Google search June 19, 2009. Search terms "live blood analysis."
6. http://naturesgift.netfirms.com/the_integrated_blood_morphology_ program.htm, accessed June 19, 2009.
7. http://www.betterblood.net/gallery.htm, accessed June 19, 2009.
8. Bird, Christopher. The Persecution and Trial of Gaston Naessens: The True Story of the Efforts to Suppress an Alternative Treatment for Cancer, AIDS, and Other Immunologically Based Diseases. HJ Kramer, Inc. Tiburon, California 1991.
9. Teut M, Lüdtke R, Warning A. Reliability of Enderlein's darkfield analysis of live blood. Altern Ther Health Med. 2006 JulAug;12(4):36-41.
10. El-Safadi S, Tinneberg HR, von Georgi R, Münstedt K, Brück F. [Does dark field microscopy according to Enderlein allow for cancer diagnosis? A prospective study]. Forsch Komplementarmed Klass Naturheilkd. 2005 Jun;12(3):148-51. German.
11. Barrett S. Live Blood Analysis: Another Gimmick to Sell You Something. http://www.quackwatch.com/01QuackeryRelatedTopics/ Tests/livecell.html, accessed June 19, 2009.

Last Revised: Fri, 18-Dec-2009