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That red blood cells (RBCs) become progressively denser with age has become a universally acknowledged truth. However, as with all universally acknowledged truths, troublesome singularities often arise. We focus here on one particular departure from the rule, the terminal density reversal (TDR) phenomenon, discovered by Bookchin (Bookchin et al., 2000), and documented so far in RBCs from healthy subjects (Bookchin et al., 2000; Lew et al., 2007), from sickle cell anemia patients (SS RBCs) (Bookchin et al., 2000; Franco et al., 2000; Lew et al., 2002; Holtzclaw et al., 2002), from patients with β-thalassemia intermedia (Bookchin et al., 2000), and from diabetic subjects with sustained high levels of glycated hemoglobin, Hb A1c (Bookchin et al., 2009).

The terminal density reversal phenomenon of aging human red blood cells