The Blood Detective software analyzes blood test results and compares them to healthy ranges to identify nutritional deficiencies and make supplement recommendations. It was developed by Dr. Michael Wald based on years of research. For a patient with severe macrocytes, which can indicate vitamin B12 or folate deficiencies, the software recommended supplements like B12, folate, enzymes, omega-3s, and antioxidants. However, the analysis noted that blood work alone does not provide a full diagnosis, so nutritional recommendations require a comprehensive medical evaluation.

1. Jennifer Eshelman<br />Nutritional assessment<br />Blood Detective Software<br />Purpose of the tool<br />Blood Detective software searches for obvious and subtle clues on blood tests to create food and nutritional supplement recommendations for optimal wellness. Blood Detective system compares the results of comprehensive laboratory tests against \"
clinical ranges,\"
and \"
healthy ranges\"
(a.k.a. functional ranges). Healthy ranges are blood values that are based upon maintaining the proper health, rather than detecting disease (Wald).<br />Explanation to patients<br />Blood Detective takes the blood work results a patient already has from their doctor and compares it to healthy ranges. Blood Detective identifies subtle abnormal blood work results that indicate a possible pre-disease state that could be aided by proper dietary nutrition and supplementation in the prevention of the development of a particular disease process (Wald).<br />History or development of the tool<br />Dr. Michael Wald developed the Blood Detective Logic & Interpretive Systems, which is sophisticated computer software based on years of research and clinical experience. He designed the software for health providers who wish to provide nutritional interpretation of blood work, saliva testing, and urine (Wald). <br />Plausible or Purported Mechanism<br />Since the software covers a large number of tests, one test will be examined. The test results are to be reported as mild, moderate, or severe. An example analysis was performed on Mrs. Sandra Microbe, a 43 year old male who had severe macrocytes. The test was performed on 6/30/09. <br />Dr. Wald’s Findings & Considerations<br />A macrocyte is a red cell that is larger than a normal red cell (> 7 microns).). Increased red blood cell mass is commonly associated with increased blood viscosity. 95% of megaloblastic anemias are caused by either vitamin B12, cobalamin deficiencies, or folic acid deficiencies. All of which are vitamins required as coenzymes for nucleic acid synthesis. B12 deficiency can be the result of decreased or nonfunctional intrinsic factor. Megaloblastic cells from folic acid deficiency are typically due to inadequate dietary intake or malabsorption disorders. Early signs of megaloblastic anemia include dyspeptic symptoms along with weakness, lethargy, and a waxy/yellow pallor. Neurologic symptoms may occur with a B12 deficiency, but not from a folic acid deficiency. Neurologic symptoms may develop prior to macrocytosis and may include the following; numbness, tingling, weakness in the extremities. loss of vibratory and proprioceptive sense in the lower extremity and abnormal gait. Memory disturbances along with irritability and depression may be see and is sometimes called megaloblastic madness; a term describing various severe psychotic manifestations of B12 deficiency. However, most people with moderate to severe anemia may be asymptomatic. Megaloblastic anemia usually occurs along with oval macrocytes as well as Howell-Jolly bodies and hypersegmented neutrophils. Other laboratory findings associated with macrocytic anemias include increased serum iron, indirect bilirubin, and urobilinogen. Elevated LDH-1 and 2 (serum lactic dehydrogenase) is the result of the increased destruction of the megaloblast. Typically, alkaline phosphatase, haptoglobin and uric acid are decreased. Metabolism of glutamic acid and histadine occurs in folic acid deficiency and causes urine excretion of FIGLU (formiminoglutamic acid). Conditions that may be associated with macrocytosis can include alcoholism, liver disease, reticulocytosis, mixed edema, myeloproliferative and myelodysplastic syndromes, respiratory failure, hypoplastic anemia, obstructive jaundice, acquired sideroblastic anemia, post-splenectomy, obstructive jaundice, hypothyroidism, pregnancy, myeloma, physiologic macrocytosis of the newborn, macroglobulinemia, leukocytosis and laboratory artifacts-culled agglutinins, hyperglycemia (Wald).<br />Recommended Nutritional Compounds based on the macrocytes seen<br />· Comprehensive multivitamin and mineral: As directed<br />· EPA/DHA (Liquid High Concentrate): 1500 - 3000 mg/day or the quivalent in capsules.<br />· Folic Acid (5-Formyl Tetrahydrofolate): 400 mcg/day<br />· Pancreatic Enzymes: 100-200,000 USP Units of Amylase, Lipase and Protease, 2-3x/day<br />· Sylimarin (Milk Thistle): 140 - 250 mg/day (Wald)<br />The following is the complete list of Mrs. Sandra Microbe’s test result;<br />Diagnosis:780.71 Chronic Fatigue and 564.00 Constipation<br />Test Name Result<br />ANISOCYTESMild<br />B CELLSModerate<br />BASOPHILSModerate<br />CHOLESTEROLSevere<br />CHYLOUSModerate<br />ECHINOCYTESMild<br />EOSINOPHILMild<br />FUNGAL FORMSModerate<br />HELMIT CELLSModerate<br />HEMOLYSISSevere<br />L-FORM BACTERIAModerate<br />LIVER SPICKLESModerate<br />LYMPHOCYTESModerate<br />MACROCYTESSevere<br />MICROCYTESModerate<br />NEUTROPHIL – NORMALModerate<br />PLAQUEMild<br />POIKILOCYTESMild<br />PROTEIN LINKAGEModerate<br />RED BLOOD CELLSModerate<br />RODSModerate<br />ROULEAU FORMATIONMild<br />SEGMENTED NEUTROPHILSMild<br />T CELLSModerate<br />TARGET CELLSModerate<br />THROMBOCYTESSevere<br />URIC ACID CRYSTALSSevere<br />(Wald)<br />When all of Mrs. Sandra Microbe’s test results are entered into the Blood Detective software, her analysis recommended that she take the following supplements;<br />“RECOMMENDED NUTRITIONAL COMPOUNDS<br />· Aloe Vera Extract (Aloe Barbadensis): 50-100mg/day<br />· Antioxidant Comprehensive Formula: As directed.<br />· Antioxidants (Mixed): 1-2/day<br />· Asian Ginseng Root Extract (Panax Ginseng): 200-400 Mg<br />· B. bifidum: 500 million/day with synergistic bifido and acidophilus species.<br />· B12 (methylcobalamine): 1000 Mcg/day<br />· B6 (pyridoxyl-5-phosphate): 100 Mg, 1-2x/day<br />· Barberry Root (Berberis Vulgaris): 70 -140 mg/day<br />· Betacarotene: 25,000 IU/day<br />· Bioflavanoids: 150-300 mg/day<br />· Bromelain: 100 - 600 mg/day<br />· Buffered Vitamin C Powder: 2 - 6 g/day. How to perform a vitamin C flush: Have the patient remain home near a toilet. The patient is to dissolve 1 level tsp of vitamin C powder in 1-2 ounces of water or juice and repeat this every 30 minutes while not consuming foods or fluids. During this process gas and bloating is to be expected. This process is to continue until the patient experiences a watery-diarrhea. If watery-diarrhea does not occur within 5 hours, then the patient is to stop and expect that later during the day, or the following day, a loose stool may occur. However, if a flush does not occur on the first day of attempt, then this procedure is to be repeated on another day. The patient records the number of level tsp of vitamin C is consumed to produce the watery-diarrhea or flush reaction. The amount of vitamin C the patient is to consume each day is 75% of the amount of vitamin C it took to produce the flush. This smaller amount of vitamin C should not cause diarrhea, but should improve bowel transit time (if too long) as well as many other physiologic functions.<br />· Calcium, Vitamin D and other synergistic bone support: As directed<br />· Choline (as Choline Bitartrate): 300 mg/day<br />· Chromium (as picolinate): 200-1000 mcg/day<br />· Comprehensive multivitamin and mineral: As directed<br />· CoQ10 (coenzyme): 100-400mg day<br />· Cordycepts Mycelium Extract (Paecilomyces Hepialid): 400-800 Mg/day<br />· Curcumin: 500—1000mg/day<br />· ECGC: 100 Mg/day<br />· Echinacea: 200-400mg/day<br />· EPA/DHA (Liquid High Concentrate): 1500 - 3000 mg/day or the quivalent in capsules.<br />· Flavonoids (Mixed): 1-2/day<br />· Folic Acid (5-Formyl Tetrahydrofolate): 400 mcg/day<br />· For Parasitic Infection - Garlic (Allium Sativum): 600-1200 Mg/day<br />· For Parasitic Infection - Horsetail Aerial Parts: 400 mg/day<br />· For Parasitic Infection - Probiotics: 15-30 Billion organisms 1-2/day<br />· For Parasitic Infection - Sweet Wormwood Whole Plant Extract (Artemisia annua): 1500-3000 mg/day<br />· Full spectrum, balanced, high potency B-vitamins, high B12 for methylation and homocysteine metabolism, amino acid chelates:<br />2, 3x/day<br />· Germanium: 200-400 mg/day<br />· Ginko Biloba (120mg) contains: Standardized to 24% ginkgo flavonoglycosides, 6% terpene lactones (by HPLC). 1-2/day<br />· Glucosamine Sulfate or Hydrochloride (for person’s over 50 yrs of age): 1000 mg elemental) derived from 1,250 mg Glucosamine<br />HCI. 3 capsules/day<br />· Glutamine: 500-1500 mg/day<br />· Glycine: 100-200 Mg/day<br />· Grape Seed Extract: 5mg/day<br />· Horse Chestnut Seed Extract: 250mg/day<br />· Immunoglobulins or Supplemental Proteins: 16-32 Grams/day<br />· Iron (Iron Glycinate): 25-300 mg/day<br />· L-Glutamine: 750-1500 Mg/day<br />· Licorice Root Extract (Glycyrrhiza Glabra): 900-1800 Mg/day<br />· Lipoic Acid: 100 Mg, 1x/day<br />· Liver glandular or protomorphogen: 400-1200mg/day<br />· NAC contains: N-acetylcysteine 500 mg 1 tablets 2-3 times daily.<br />· Niacin (inositol hexanicotinate): 1000 mg/day<br />· Ox Bile Extract: Use as directed.<br />· Pancreatic Enzymes: 100-200,000 USP Units of Amylase, Lipase and Protease, 2-3x/day<br />· Pantothenic Acid (as D-Calcium Pantothenate): 500-1000 Mg/day<br />· Raw Thymus Concentrate: 120-240 Mg/day<br />· Resveratrol (Polygonum Cuspidatum): 68-410mg/day<br />· Silymarin (Milk Thistle): 100-500mg/day<br />· Soluble and Insoluble Fibers: Take 1-2 servings per day.<br />· Spleen Glandular: 100 - 200 mg/day.<br />· Sylimarin (Milk Thistle): 140 - 250 mg/day<br />· Taurine: 100 Mg, 1-2x/day<br />· Thymus Glandular (Defatted Product): 400-800mg/day<br />· Vitamin A (Retinyl Palmitate): 5000IU/day<br />· Vitamin E: 400-800 IUs/day.<br />· Zinc (as zinc gluconate): 10-30mg”<br />(Wald)<br />Safety of Use<br />“It is not possible to provide a comprehensive diagnosis for a patient based upon microscopic findings alone. Nutritional considerations must be based upon a comprehensive medical workup including detailed blood, urine, imaging and/or other appropriate diagnostic and supportive investigations. Suspected diagnoses and tests, considered in context with microscopic finding, helps provide many of the essential components required to formulate a therapeutic healing plan.” (Wald)<br />Due to the fact that the blood work does not provide a complete overview of what is truly going on with the patient, such as what medications the patient is taking or if they have a genetic disorder that presents with macrocytosis such as hereditary elliptocytosis, the nutritional recommendations should be a consideration and not a prescription (An, & Mohandas, 2008).<br />“Health-care practitioners should caution patients against co-administration of silymarin and pharmaceutical drugs.”<br />(Wu, Lin, & Tsai, 2009)<br />Case studies, Testimonials and Methods of Marketing the Tool<br />No literature, testimonials, or case studies were available with regards to the Blood Detective software. The Blood Detective software is primarily advertised via a website with doctors and their patients as the target sale population. <br />An appropriated experiment to assess the validity of the Blood Detective software would start with a patient population of 20-30 year old subjects. The subjects would consist of individuals with adrenal fatigue. This diagnosis would be based on an initial questionnaire and followed by a diagnosis from a licensed medical practitioner. Exclusion criteria include co morbidities such as diabetes, autoimmune disease, pre-existing conditions, and persons currently taking prescription medications or supplementation. No pregnant females would be included in the study. The cohort would be formed from a target population living in the same geographical area and same socioeconomic status. The test subjects would be instructed to stay consistent with their current exercises habits and undergo no significant changes in their activities of daily living. The cohort would include 1,000 subjects. Those healthy subjects would be randomly divided into four groups. All of the groups would keep an accurate food diary for 3 months during the experiment. The first test group in addition to keeping an accurate food diary would not be given any type of food guidance nor would they be allowed to utilize any form of nutritional supplements. The second group of individuals in the study would keep a dietary journal (same as the first) and they would be given supplementation based on their dietary journal. The third group of individuals would keep a dietary journal and would receive dietary supplementation based on their Blood Detective software analysis. The fourth group of individuals would be given supplementation based on the Standard Process Symptom Survey. All individuals in this experiment would be given supplements from the same company and the same lot numbers. Prior to the beginning of the experiment, all subjects would be given a physical exam, standard blood work, and consultation with the same doctor. Once a week for 3 weeks, the subjects would undergo blood work and be given a subjective symptomology survey. At the end of the 3 month period, the data would then be analyzed to see if a significant difference exists between the tested methods.<br />Conclusion<br />Lack of research in the Blood Detective software can neither confirm nor deny the effectiveness of this nutritional assessment and dietary modification/supplementation method. A possible flaw in the Blood Detective software method may conceivably be seen in the fact that the analysis does not allow for a “normal” test result. The Blood Detective software is also based on supplementation and does not take into account the possibility of dietary intake modifications in the form of whole foods to address nutritional deficiencies.<br />References<br />An, X., & Mohandas, N. (2008). Disorders of red cell membrane. British <br /> Journal of Haematology, 141(3), 367-375. <br />Wald, M.B. (n.d.). Between health & disease there's blood detective. <br />Retrieved from http://www.blooddetective.com/about.aspx <br />Wu, J.W., Lin, L.C., & Tsai, T.H. (2009). Drug–drug interactions of silymarin <br />on the perspective of pharmacokinetics . Journal of <br />Ethnopharmacology, 121(2), 185-193.<br />