Live Blood Analysis Finds Rouleaux

My fiance and I had something called a Live Blood Analyses done yesterday. A small sterile needle used for testing diabetics is used to obtain a drop of blood from your finger. The drop of blood is placed directly on a clean microscope slide and examined under a dark field microscope.

My blood cells have a problem. They stack like pancakes. This is called rouleaux. Mine is quite dramatic.

Her’s are as they should be, mostly single blood cells. I was told that this is due to her good diet and my poor standard American diet. (I actually eat a lot better than that, but according to the Weston A Price followers, my food is unhealthy and lacking nutrient density.)

I was given recommendations for dietary supplements and I’m giving them a try, starting with the liver cleanse Jarrow ToxGuard Liver PF and krill oil.

I did meet someone who had this rouleaux pattern and reversed it with diet.

The examiner thought I would have trouble with circulation in my extremities, fatigue from lack of hemoglobin being able to reach my cells and dizziness. I don’t have any of these, however.

I do have dry eyes, especially at night, a condition that comes and goes but has been there in the background for many years.  Suspecting some auto-immune problem, I’ve had three blood tests in 2005, 2009 and 2010 all of which were negative for abnormal anti-nuclear antibodies (ANA). Tests for Sjogren’s antibodies was also negative, so I don’t have Sjogren’s syndrome.

My blood is very clean and healthy otherwise. Since a healthy blood cell lives 4 months, we are going to return in four months, after diet changes, for a follow up.

I’m still researching what this rouleaux means. Could it be normal, an artifact of the way it was viewed? Some explanations are fairly dark, such as a type of bone cancer that gives me only 3 to 5 years to live.

While researching, I found the following web site. Someone has photos showing that they had stacked blood cells in the first sample, then were able to get their blood cells to appear a few minutes later.

Hmmm….

My educated guess: The osmolarity of the blood sample when you place a drop of blood on a slide is responsible for the rouleaux pattern being seen or not. Osmolarity is the concentration of blood cells to plasma in the sample. Osmolarity is affected by changes in water content, as well as temperature and pressure. Could differences in temperature and pressure during handling of the slide be the culprit?

In both the case of my blood and of the EFT example above, the non-sticky blood was the second sample. The first slide was likely fresh out of the box, and colder than the second slide. The microscope had been completely off when we looked at my blood, so the light from the scope for my sample had not had a chance to warm up the slide. Perhaps the heat of the slide handled by the examiner could, at that scale, make the blood cells unstick? This would be easy to test if someone has a dark-field microscope and was willing to try it.

Plasma osmolarity measures the body’s electrolyte-water balance. … Osmolarity is affected by changes in water content, as well as temperature and pressure. … – wiki

On the other hand, we looked at my blood on the slide for about an hour and it was still stacked the whole time, so heat doesn’t seem like the answer.

When you drop a cover slip onto a microscope slide, it is possible to have the plasma leak off of one side and be evaporated by the heat of the light. This would increase the density of red blood cells in the slide view and I think that could create rouleaux as well. Again, this would be easy to test. When I followed up with the Live Blood Analyst, she was clear that the drops of blood on the slide used in my test were not large enough to reach the edge of the slide and there was no leakage.

A possible reason not to worry about rouleaux in your live blood analysis: (This is from the “Textbook of Anatomy and Physiology for Nurses“)

“Rouleaux Formation

When a freshly drawn drop of blood is observed under microscope the red blood cells are seen adhered to eachother and arranged like a pile of coins. This is called rouleaux formation (Fig. 2.1). Fouleaus formation is influenced chielfly by fibrinogen and globulin. In circulation, the RBCs have negative charges on their surfaces, which repel eacother, thus preventing rouleau formation. “

Another tidbit of information has me even more at ease. One medical image I found had the following caption:

“This is pathologic rouleaux in contrast to normal stacking of red cells in a thick area of a normal blood smear. … Karolinska Institute Medical Images, 2003 “

SO… it seems there is pathologic rouleaux vs normal stacking of red blood cells (RBCs) in “a thick area” of a blood smear. Unfortunately the photo for the above caption was terrible, not at all useful to compare to my RBCs.

My examiner did say that my rouleaux pattern did not look like the one she had seen where someone had multiple myeloma, that it was something she frequently sees due to poor diet.

Will rouleaux appear in normal healthy blood?

Perhaps the area of the slide you are looking at will influence seeing rouleaux or not. I’d think that the edges of the drop would have the most RBCs and thus the most rouleaux.  My Live Blood Analyst, who has done this for years, however, says my RBCs are sticking together because the proteins on them are abnormally sticky.  She says they will stick inside of your body (in vivo) when something called the Zeta Potential drops.

In the body, the blood pressure and fluid motion makes red blood cells have negative charges when in circulation, so they repel each other.

“The concept Zeta potential is important to understand why the cells will maintain a certain distance from each other. Zeta potential refers to the repulsion between the red blood cells.It is due to an electric charge surrounding cells … It is cause by sialic acid groups on the red blood cell membrane which gives the cells a negative charge. “

I need to research this more.

Without further testing I won’t know if a dangerous health problem was responsible for my rouleaux, but I’m not convinced that what we saw under the slide was abnormal or unhealthy. I’ll get tested for abnormal proteins in my blood. According to my doctor, ESR (red blood cell sedimentation rate) is an old test used in the 1940’s (one site says, back to the ancient Greeks) before better tests became available.  People with inflammation have their red blood cells form rouleaux and since groups of cells are heavier they settle in a tube faster and farther than those of healthy people. The ESR can show that disease may be present, but not which disease. Now they can probe for specific proteins (anti-bodies) and find the actual problem.

Meanwhile, I’ll try the krill oil and do some “liver cleaning”.