Editor’s Note: This article is reproduced with permission from InterAction magazine, the quarterly publication from the UK charity, Action for M.E. To find out more about support services provided by Action for M.E. to sufferers and their carers, please send email to email@example.com or mail a self-addressed stamped envelope to Action for M.E., PO Box 1302,Wells, Somerset BA5 1YE, or telephone 01749 670799.
Action for ME Medical Advisor Dr Andy Wright takes a look at new technology enabling ‘live’ blood analysis and asks ‘Could this help ME patients?
Various workers have developed high magnification video microscopy over the past twenty years, notably Robert Bradford at his research institute in California. There are hundreds of these systems throughout the world, mainly used by practitioners of integrated medical therapies. It is not just a microscope for CFS/ME patients but is used for a multitude of chronic disorders to help in planning treatment protocols. It’s important to note that it is not a diagnostic tool for ME and is not marketed as such.
The unique features of this system are
1) Extremely high magnification- X10 000-18 000,dependent on which model is used (about 10-20 times higher than specimens are usually viewed at in hospital labs)
2) Ease of switching between various means of specimen illumination i.e. from direct viewing to phase contrast and dark field illumination, enabling particular cells and organisms to be easily identified
3) The ability to keep photographic and video records of patients’ blood samples as well as storing them on computer
What can you expect to see?
The difference to other microscope techniques is that instead of heating specimens to fix them on the slide and then staining them to pick out certain features, we look at two different types of blood sample (blood is always taken from the same place to standardize the procedure). The first is a live drop of blood under high magnification. This is not a standard medical technique and not routinely done in hospital settings. At X 8 000 and above magnification you are able to see various features such as abnormalities in the movement of white cells. You are able to see any damaged cell walls in both red and white cells and various microbes you would not normally expect ‘if present’, such as yeast-like forms.
Also evident is microclotting of blood with small clots evident about the size of one to three red cells and larger microplaques. Microclotting is common in many chronic illnesses and occurs because the blood becomes ‘sticky’. This seems to be a combination of inborn genetic predisposition, a response to microbes (bugs in the system) and through oxidative stress. Dr Berg has published independent studies, showing that the blood of CFS (ME) patients is indeed ‘sticky’. He was able to tell with 95% accuracy whether or not blood tested by him was from a CFS / Fibromyalgia patient or a healthy person in a study of 54 patients and 23 controls. He has also found encouraging results using standard blood thinning therapies.
In a study published this year, Professor Roberts has also shown that high free radical activity is present in CFS/ME and the higher the amount the more symptoms people have.
Just what is oxidative stress?
Dr Hyams explains: “Oxidative stress is commonly seen in chronic debilitating illnesses as the result of too much free radical activity in the body, leading to cellular damage (both to the membrane and the nucleus) in any organ. This may initially be caused by the triggering infection but is sustained due to secondary infections or an inability to detoxify as the illness progresses (due to a ‘burnout’ of the body’s enzyme resources which neutralise free radicals).
A free radical is a molecule with an imbalanced number of electrons and the level of damage to the red blood cells is visible on a high powered microscopy. This in itself can explain the functional disorder seen at cellular level in CFS patients on the video microscope. Conventional blood tests of ME patients may appear normal as they are not sensitive enough to measure oxidative cell damage – just tissue damage.
There is a wealth of research to show the role of free radicals causing normal ageing. If you have any chronic illness where the reserve of scavengers which fight free radicals in the body is reduced (as in CFS/ME) and the production of free radicals increases, then cells can age prematurely, leading to the symptoms of fatigue seen in ME.”
In a blood sample showing a sequence of drops of clotted blood, you are looking mainly for high levels of oxidative stress caused by excessive free radical activity. One can see large amounts of soluble fibrin deposited in the clot, appearing as white clots within the larger red clot.
There are other ways of testing for oxidative stress such as getting your doctor to check a blood test called methaemoglobin. If it is high you would benefit from improvements in your nutrition and supplementation with broad spectrum balanced anti-oxidants (see AfME factsheet).
Dr Majid Ali’s theory of CFS
The main expert in interpreting and researching the high magnification findings has been Majid Ali in the USA, Professor of Pathology and also of Integrated Medicine. He is therefore well qualified to comment on which abnormalities seen with any Medical microscope.
The appearances I see do support his theory that excessive free radical activity, coupled with poor oxygen utilization and acidosis could explain at a cellular level the clinical symptoms sufferers describe. He explains that microclots can block up the blood supply to your muscles, brain and internal organs and also block your lymphatic vessels, which drain toxins and waste products away from your tissues. This results in a build up of acids and toxins in tissues and a failure of your waste disposal or detoxification system.
Sickest patients have most abnormal findings
This abnormal chemistry of the blood (the low amount of oxygen present, coupled with high levels of oxidative stress), then allows proliferation of what Professor Ali calls ‘Primordial Life Forms’ such as yeast, which clump with the microclots and worsen the problems outlined above.
In my experience, there is a correlation between the amounts of these anaerobic bugs seen and the severity of the illness.
Certainly my sickest patients have the most abnormal blood appearances on the video microscope. However these appearances are not only seen in CFS (ME) and Fibromyalgia (FM), but in many chronic illnesses. This is because at a cellular level the oxygen problems also exist in these illnesses. What I feel is important though is that the clots and yeast are a very important co-factor.
Is there any evidence that the microbes seen are indeed yeasts/candida type organisms?
Majid Ali has done work correlating the severity of appearance under the microscope with increased urinary excretion of organic acids produced by yeasts, providing some evidence that these are a real phenomena. One of these, Tartic acid has also been shown to show decreasing levels when patients are treated with anti-fungals.
Professor Ali has published his findings in the Journal of Integrative Medicine. He has also done studies showing that treatment with anti-fungals decreases the amount of yeast-like forms and improves symptoms:
Dr Charles Shepherd, Medical Director of the ME Association, has serious reservations about the video microscope. He comments:
‘I don’t think you’ll find any reputable NHS (National Health Service – UK health system) haematologist (blood specialist) who believes that this type of technology can provide reliable diagnostic information on the presence of vitamin deficiencies, heavy metal intoxication, opportunist bacterial and fungal infections, undigested food particles or oxidative cellular damage as the manufacturers claim. I therefore think it is wrong to aim expensive and unproven diagnostic techniques such as this at very vulnerable patients.
‘The only way that sceptics like myself are going to change our minds about the value of video microscopy is to subject the technique to an independently assessed clinical trial.’
Dr Shepherd suggests that a useful study would involve taking several blood samples at approximately six times throughout one week from a number of people: perhaps one with AIDS and secondary candida infection, one with a bacterial infection, one with ME and some healthy controls. If the blood samples could then be ‘matched’ with any accuracy to the illness of the person whose blood was being analysed, ‘then it would definitely be worthy of further assessment.’
Professor Anthony Pinching, CFS Specialist at St Barts’ Hospital, adds:
‘I’m not aware of anything in the peer-reviewed scientific literature that shows the validity of the video microscope for the detection of disease. …but I have to say that some of the suggestions seem inherently implausible to me.’ He supports Dr Shepherd’s wish to see a ‘clear demonstration in an objective fashion that the claims being made can be demonstrated and justified.’
Dr Michael Jenkins, CFS specialist at the Royal London Homeopathic Hospital comments: ‘I saw a fascinating demonstration of the video microscope after the Fatigue 2000 conference. Of course, there’s going to be a lot of junk going about in the blood anyway so what wasn’t clear to me was how you interpret what you see. In any case, I can’t see the NHS funding it – it would mean not only buying the expensive technology but training doctors to use it and interpret the results. No chance.’
Dr Julian Kenyon, integrated medicine practitioner, has the final word:
‘I became involved in Dark Field Microscopy over 20 years ago in America. I found the pictures produced fascinating but was unsure of their meaning. Claims were made by the Dark Field Microscopists that fungi and bacteria could be seen in the bloodstream, which my bacterial colleagues all said was nonsense. However, some years later I was looking at Dark Field Microscopy on a range of cancer patients whose blood showed large amorphous bodies, which were claimed to be plemorphic bacteria (ie with no cell wall). I remained sceptical until I came across many cancer patients who had been significantly helped with a vaccine made from this bacterium. This gave me some more reality for the strange forms often seen on Dark Field Microscopy.
‘I remain fascinated at how conventional haematology looks at things when they are dead. It strikes me that when they are in a living state they are potentially more informative. Dark Field Microscopy looks at the qualities of the various bloods cells seen and the way they interact. In my clinical experience this has been very useful and helpful to patients with chronic illnesses.
However, even looking at healthy people who have a proper diet and take reasonable exercise, only a small percentage of them have entirely ‘clean’ blood with no bacteria, plaque or candida (yeast spores) or evidence of free radical damage – so this is certainly not a diagnostic tool for any one condition.’
Editor’s Note: If you live in the UK you can email firstname.lastname@example.org for a selection of practitioners using video microscopes for ME/CFS.