Stuff that occurs to me

All of my 'how to' posts are tagged here. The most popular posts are about blocking and private accounts on Twitter, also the science communication jobs list. None of the science or medical information I might post to this blog should be taken as medical advice (I'm not medically trained).

Think of this blog as a sort of nursery for my half-baked ideas hence 'stuff that occurs to me'.

Contact: @JoBrodie Email: jo DOT brodie AT gmail DOT com

Science in London: The 2017 scientific society talks in London blog post

Sunday, 4 April 2010

Live Blood Analysis and nutritional microscopy - unconvincing so far

Update 12 October 2014: On Friday the subject of this post was fined £4,500 and lost his appeal at Southwark Crown Court. I don't know if the £4.5k is an adjusted figure or an addition to the previous fines. 

Update 20 March 2014: Today the subject of this post was fined £9,000 for nine counts of the Cancer Act of 1939 at Westminster Magistrates Court and handed a total bill (including costs) of over £19,000. He did not attend this final court hearing and did not represent himself.

EDIT: 13 October 2010 - the Advertising Standards Authority have now adjudicated on the leaflet and the complaint was upheld - details of two other upheld adjudications are below.

The shortened link for this page is
http://is.gd/bdoh0

Earlier today I picked up a flyer for a 'nutritional microscopy' service which claims that a drop of blood, viewed under a microscope, can be used to identify the following

* relative level of acidity in the body fluids and the effects they have especially for weight loss!
* blood sugar imbalance
* vitamin deficiency, allergies, cholesterol
* uric acid and mycotoxins
* gastro-intestinal tract dysfunction
* detection of parasites, yeast, fungus and mould
* imbalance associated with degenerative conditions ect (sic)

Flyer page 1 | Flyer page 2

Not surprisingly Quackwatch doesn't have much time for the claims made by this sort of thing:
Live Blood Cell Analysis: Another Gimmick to Sell You Something
http://www.quackwatch.org/01QuackeryRelatedTopics/Tests/livecell.html


This looks like something for the Advertising Standards Authority to investigate as the claims seem... a little unlikely. Before I write a letter of complaint to the ASA I wanted to find out a bit more about some of the claims and also to find out what light microscopy can and can't do in terms of diagnosing things to do with blood. I shall add to this post as I come across things of interest, while trying to trim the text a bit.

Detection of parasites...
Tempting as it is to denounce the entire flyer as unmitigated nonsense it probably pays to be a bit careful as light microscopy of blood can apparently be used in the diagnosis of some infections (malaria, with a bit of staining of the smear) or conditions (sickle cell anaemia). PLos One has a paper on turning a mobile phone into a microscope for global health applications which includes some example pictures:

Mobile Phone Based Clinical Microscopy for Global Health Applications
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0006320


The paper suggests that diagnosing malaria from blood microscopy is fairly uncontroversial, but this does not seem to be the case for Lyme disease - from borrelia spirochaetes. I hadn't realised that Lyme disease has its own subset of woo tests, one of which is inappropriate use of microscopy.

Unorthodox and unvalidated laboratory tests in the diagnosis of Lyme borreliosis and in relation to medically unexplained symptoms
http://www.dh.gov.uk/assetRoot/04/13/89/17/04138917.pdf


Microscopy of whole blood (p5 of 9)
"It has been claimed that chronic Lyme borreliosis can be diagnosed on the basis of
seeing spirochaetes in the blood of patients by high power (on-screen magnification
reported to be X 10,000) ‘live’ microscopy of blood. A drop of blood is placed on a
microscopy slide, covered with a cover slip, and then left to stand for a period of at
least 6 hours and up to 24 hours in a moist chamber. The film is then examined by
dark field and phase contrast microscopy. It is claimed that spirochaete forms can be
seen emerging from red and white cells in these blood films. They have been
described as being ‘intracellular L-forms’ that can be seen emerging from blood cells.
Patients and medical practitioners have been told that this test for Lyme borreliosis is
positive in chronic fatigue syndrome patients, showing that CFS is caused by chronic
B. burgdorferi infection."

"However, these tests are not being performed by medical practitioners or
clinical/biomedical trained or qualified in laboratory medicine specialties such as
microbiology, parasitology or haematology that would include specific training in
light microscopy. They are not performed in laboratories accredited for clinical
pathology testing."

The article continues with

1. Microscopy of whole blood (p7 of 9)
"The objects purported to be borreliae in the whole blood films are not considered to
be borreliae but to represent artefacts of the method used. If they were spirochaetes
the number demonstrated by light microscopy in such a small sample would indicate a
substantial spirochaetaemia which could readily be confirmed or refuted by electron
microscopy, immunofluorescence or PCR. Some of the structures appear to be
contaminating debris, as would be expected in samples collected by inexperienced
individuals (patients, carers etc) in non-sterile conditions. Other strands appear to be
fibrin produced by the clotting mechanism that would occur in whole blood held for
several hours in this way, collagen fibrils or cell membrane fragments shed from
degenerating red and white blood cells."

.....

"Furthermore, the biological basis for the test is fundamentally wrong. B. burgdorferi
sensu lato is an extracellular bacterium in the bloodstream. It is not an intracellular
bacterium that could be seen ‘emerging from infected blood cells’. Moreover, any
spirochaetes in a thick blood smear, covered by a cover slip, would not remain viable
for long. Blood is not an ‘ideal medium’ for borreliae, the organisms are fragile in
vitro, requiring special media and careful temperature regulation. Spirochaetemia
occurs in the early stages of infection and is intermittent and short lived, with a low
number of organisms."

.....

"Diagnostic tests that require microscopy or culture of samples from patients should be
supervised and the results interpreted by consultant medical microbiologists or
clinical scientists of equivalent standing. Tests should also be done in an accredited
laboratory with quality assurance standards."

The HPA (Health Protection Agency, UK) specifically mentions that microscopy isn't recommended in the diagnosis of Lyme disease.

Diagnosis and Treatment of Lyme borreliosis Clinical signs of Lyme borreliosis (LB)
http://www.hpa.nhs.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1204031510081


Unorthodox Clinical and Laboratory Practices Related to Lyme borreliosis (overview)
http://www.hpa.nhs.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1204013002855


I'm not convinced that it's possible to tell anything about 'blood sugar imbalances' from looking at blood cells. There are easier enzymatic methods used to test blood glucose concentrations from a small drop of blood, and laboratory (eg chromatographic) methods for assessing how much haemoglobin in the blood has had glucose added to it ('glycated' - the test for this is called the HbA1c test). I have to assume that some sort of chemical testing is being implied by this claim.

Discussion on Twitter with @medtek suggested that other information can be gleaned from blood smears, including a limited assessment of vitamin deficiency in the case of B vitamins leading to different types of anaemia - but even this would be confirmed by a test for serum levels of the vitamin/metabolites.

Flyers are generally a little more circumspect regarding health claims but the website to which this flyer leads has information implying that iridology can help too (nonsense) and there's even an opportunity to have an online iridology consultation
http://www.livebloodtest.com/membershealthclub.php?gid=1


This mp3 is quite illuminating (a phone in to an LBC radio show)
http://www.livebloodtest.com/images/march2010.mp3

More to follow... at some point...

EDIT: 13 October 2010 - the complaint was upheld

----------- EDIT 5 April 2010 ------------

Lab Tests Online is a very useful resource for finding out about different blood tests - this is a page on the UK version (there's are little flag icons on every page providing information for other countries too) about taking a pinprick of blood, smearing it on a slide and peering at it microscopically: Blood Film: At a Glance
http://www.labtestsonline.org.uk/understanding/analytes/blood_film/glance.html - this is the overview page, note the other tabs on the page for more detailed information on what this type of test can be used for.

Further reading
Fellow blogger Josephine Jones has also been writing on Live Blood Analysis, for example see these two posts:
A new era of scientific discovery? (12 July 2005) by Edzard Ernst, in The Guardian.
"Intrigued by the spectacular claims made for Live Blood Analysis? Don't be. It doesn't work"The three Advertising Standards Authorities adjudications which were upheld are as follows:
Also known as live blood test, see my cells, nutritional microscopy




13 comments:

  1. Most routine whole blood analysis nowadays is done by machines- very precise machines that size and count the cells and platelets. These machines generate histograms and indices which can be interpreted by properly trained persons. These machines can perform counts and sizing much more accurately and on a much larger sample than can be done by human eyes.

    In the event that the machine sees an abnormality, a smear may be read. Creating a good smear requires some skill, as the blood must feather out to a single layer, but the cells must not be damaged. The smear is fixed with alcohol and then stained using Wright-Giemsa stain.

    Using the stain allows for many determinations.

    Red cells- The amount of haemoglobin in the cells, as well as their size and shape can be estimated. Also, cells that have been kicked out of the bone marrow too early can be identified. Malaria can be diagnosed here. Finally, a variety of hamoglobinopathies can be identified (such as sickle cell).

    White cells- Although machine counts can differentiate the types of white cells very accurately, there are times when a pair of human eye is needed. Abnormal leukocytes need to be looked at by trained eyes. Young cells in particular need to be verified, and often this will lead to a bone marrow examination as well. White blood cells can also have inclusions which will take up the stain. These can be seen in cases of severe infection and suggest other analyses to be done. I personally have also seen a rare case of histoplasmosis presenting in the peripheral blood, unfortunately the gentleman died the next day. It's so rare in many areas that I still remember the patient's name 25 years hence.

    Platelets- Although they're not cells, a lot can be determined about platelets. Their size, shape, and number can be determined, and young platelet source cells can be identified (platelets are cell fragments). I'd think that in a whole blood suspension the platelets would quickly clump.

    I really don't see how you can get any of this this from an unstained whole blood suspension. Certainly if it were useful we would have developed such a thing at NASA instead of spending our time developing a blood counter and cell staining system.

    This is nothing more than a parlour trick designed to cure overly worried people of their heavy wallets. Diagnostics like this are best paired with Reiki and Homeopathy, as they are certainly intended and effective only for the severely gullible.

    ReplyDelete
  2. By looking at your picture you look like you could benefit from the service.

    ReplyDelete
  3. Heh, thanks for that ;)

    Actually, *no-one* can benefit from this. It's a waste of money.

    Jo

    ReplyDelete
  4. Jo Brodie Just another Drug Company Prostitute. A big fat Pharmaceutical Whore.

    ReplyDelete
  5. If *no-one* can benefit from this test how comes there are thousands of people saying they have? Are these thousands of people just hypochondriacs or is there something more sinister going on here??? Perhaps someone is getting paid by big pharmaceuticals to debunk a perfectly natural therapy that does not involve the sale of chemicals with side effects. From all the testimonials that I have read on that website most of the people are saying that they have been taking pills for years and have suffered side effects. I even found a woman who had suffered kidney damage through taking pharmaceutical drugs for high blood pressure. The blood pressure was not cured until she visited the guy but you fail to mention this. why? There is definitely bias on your part. read the article for yourself here: http://www.livebloodtest.com/testimonial.php?tid=20

    ReplyDelete
  6. Dear Anonymous

    I am not paid by the pharmaceutical industry so you are mistaken - thanks also for the personal comments ;)

    Dear other Anonymous

    There have been three Advertising Standards Authority adjudications against misleading claims made by Errol Denton's (aka Fitalifestyle Ltd) two websites, one from me and two from someone else. The entire premise of nutritional microscopy is nonsense.

    I don't doubt in the slightest that people feel better when talking to Errol - he seems a pleasant chap from his TV and radio work. However, he also sells supplements and chemicals... for example liquid chlorophyll (there was an adjudication published against claims made there too), so I'm not really sure what your point is.

    To address your first question - have a look on Google for "regression toward the mean".

    To reiterate, I've not been paid a bean* by the pharmaceutical industry nor do I have shares in them; the sale of their drugs (or not) has no impact on my income. Is anyone paying you to write these comments, or might you otherwise benefit from them?

    Jo
    *I took part in a focus group once a couple of years ago for a pharma company - they paid me £30 for commenting on the readability of a patient information leaflet. Hope you won't hold that against me.

    ReplyDelete
  7. I too have made complaints to the ASA about live blood analysis (I am the 'someone else' Jo refers to).

    I too have been called a drugs whore. Like Jo, I have to point out that I'm acting purely on a voluntary basis and receive no money from any pharmaceutical company for my efforts. I am motivated solely by a desire to protect vulnerable members of the public from being misled and to prevent the misrepresentation of science in advertising and the media.

    Live Blood Analysis is based on a 'theory' that would be laughable were it not for the sad fact that people are taken in by it (with some potentially serious consequences).

    I have heard of worried people being told they may have cancer by practitioners who have no conventional medical training. I have seen cases of websites illegally advertising that they help cancer... I have seen sites run by people with no conventional medical training advertising that they can treat almost any condition you care to name.

    It is not advisable for a person with no medical training to advise somebody to stop taking blood pressure medication. This could, for example, result in the unfortunate person suffering a stroke. If someone has kidney damage because of the drugs they are on then that person ought to be talking to a real doctor - not a quack who thinks the body's own cells are turning into yeast.

    It is not possible for anyone to benefit from this test - except for the obvious financial benefit to the practitioner.

    ReplyDelete
    Replies
    1. the medical industry is sensitive to these sorts of things because they are trying to protect their high paying jobs. can't blame them for that but the rape needs to end and good health needs to begin. Labs test dead blood these guys show living blood in a living state, something an MD would never do. I have seen this work and it does help much more than some computerized lab report.

      Delete
    2. I have had this done and its right on the money and I only paid 25 dollars and could see my living blood right before my eyes. I could see the cells clumped together and I could see the progress I was making with each visit and most of all I opened my eyes to the quackery that is modern medicine and the quacks that go around calling others quacks merely to protect their high incomes. The AMA, the FDA and the drug industry form the largest organized crime syndicate ever to plague mankind.

      Delete
    3. While medicine isn't perfect and nor is any regulatory body this doesn't diminish the fact that live blood analysis is a made up technique that doesn't and cannot do what it claims.

      Far too much emphasis is given to what appears to be mostly artefact and it relies on a misunderstanding of physiology and nutrition.

      Live blood analysis is a scam practised by people who genuinely don't seem to know that it's a scam and who honestly want to help people - commendable, but ultimately unfortunate. While I am critical of the claims made by people who sell this service I do not think they are fraudulent, they are just as mistaken as the people who waste money on it.

      Anecdotes still unreliable.. not really sure why people keep bothering to send them in.

      Delete
    4. Hi Jo,
      I have a BA in Medical Technology and am a licensed Med Tech. I also have my license in MRI and my Masters in Alternative Medicine. Currently I am working on my Doctorate in Alternative Medicine so I do have an avid interest and belief in the value of Alt Med and its benefits. While I do believe there are many aspects of holistic medicine which are sound and extremely beneficial, I have also discovered that there are some modalities such as Nutritional Cellular Microscopy which can be misleading in its claims. While it is true one can determine sickle cell and even some parasites such as elephantiasis (provided the blood sample was taken at night) and to a certain degree malaria, the incidence of error and misdiagnosis is high. Anemia's besides sickle cell can be visually "assumed" by looking at whole blood wet preps (micro or macrocytic anemias)it once again is a judgement call and not very reliable. The fact is that many of us are nutritionally poor, whether by poor diet, unhealthy lifestyles or medications. So most suggestions given by this modality can help an individual because they involve methods we all could use to improve our health. Suggestions generally include a healthier diet, vitamin or herbal supplements, exercise and some form of mind/body therapy (meditation, visualization, biofeedback or de-stressing techniques) which can benefit a person.

      So my overall opinion is that this modality is basically not beneficial and if one is seeking to improve their health through non-traditional means there are many viable options out there for one to consider. Ayurvedic medicine, naturopathy, homeopathy, nutritional therapy and traditional Chinese medicine are just a few areas that have proven to be very helpful in maintaining and improving health.

      Delete
    5. why are we arguing we should all be finding a solution for good health

      Delete
    6. Yes, and live blood testing isn't a solution, no argument about that. I recently came across this article which explains extremely well why live blood analysis is such pseudoscience http://www.csicop.org/si/show/the_pseudoscience_of_live_blood_cell_analysis/

      It also seems that the rather regrettable behaviour of one live blood analyst has now brought this particular use of microscopy under far greater scrutiny than it might have had in previous years. Three different analysts are now listed on the Advertising Standards Authority's non-compliant online advertisers page and there have been numerous other adjudications and informally resolved adjudications.

      Delete

Comment policy: I enthusiastically welcome corrections and I entertain polite disagreement ;) Because of the nature of this blog it attracts a LOT - 5 a day at the moment - of spam comments (I write about spam practices,misleading marketing and unevidenced quackery) and so I'm more likely to post a pasted version of your comment, removing any hyperlinks.

Comments written in ALL CAPS LOCK will be deleted and I won't publish any pro-homeopathy comments, that ship has sailed I'm afraid (it's nonsense).