Category Archives: Pyrrole Page

Are you being treated properly for pyrrole?

by Sue Kira, Naturopath

Over the past decade I have seen many clients who were who were previously prescribed high doses of nutrients for pyrrole by practitioners, including doctors, only to find their symptoms did not improve, and sometimes even deteriorated.

Admittedly, I’ve also seen many positive changes from this type of treatment, so it’s not necessarily incorrect. But what I have observed frequently are four factors:

  1. The pyrrole reading was inaccurate, thus clients’ treatments were incompatible
  2. Often the true cause of the elevated pyrrole reading wasn’t investigated
  3. Insufficient monitoring of nutritional levels
  4. Incorrect dosing

1. Inaccurate pyrrole reading
I recently wrote an article – Do you really have Pyrrole, or were your results distorted? – where I present how certain metabolites in urine such as Urobilinogen can cause a false elevated result. It appears that some labs are not testing correctly or not adjusting the score to compensate for these extra metabolites.

Why is that important? Well if you had a score of say 45-60 ug/dL HPL and were told you had an elevated reading, your practitioner may decide that you have pyrrole disorder and need to be treated with B6, zinc etc.

But in reality, your score may have been falsely elevated by urobilinogen, which means you should be being treated for elevated urobilinogen, not pyrrole.

Elevated urobilinogen can be caused by various factors that I refer to in my article, including leaky gut, kidney or liver conditions.

However, a truly elevated level of HPL (pyrrole) can also be elevated by these conditions, hence point No 2…

2. What is the true cause of pyroluria?
What came first, the chicken or the egg? And what does that have to do with pyrrole?

You see, elevated pyrrole levels don’t suddenly arrive without a reason, even if symptoms onset rapidly as a result of acute stress or illness. There’s a cause – a reason – why someone develops pyrrole.

Without that cause, elevated pyrrole would not exist.

Some that say pyrrole is a disorder or a disease and that it is genetic. The truth is, while some genetically defective genes may contribute to elevated pyrrole levels, it’s really the result of some type of oxidative process in the body. In other words, something has created it and when you resolve the cause, it can be cleared from your body. There are no known gene SNPs directly linked to pyrrole.

SNPs also called ‘snips’ or technically, ‘single nucleotide polymorphisms’, are considered as defective genes, however new theories are emerging to suggest that SNPs are adapting to evolutionary changes which can be protective in other ways. For example, it has been shown statistically that those with schizophrenia have adapted to a lower risk of cancer.

Some of the potential genetic variants that can contribute to a genetic influence include genes such as MTHFR, COMT, CBS, GAD1, OXTR, CYP1A2 and more, but with all gene SNPs, there’s always an epigenetic factor involved.

In a broad sense, epigenetics is about our lifestyle and environment. Although we may have defective genes, they must be ‘switched on’ to be effective. If not switched on, they remain dormant. This means that chemicals, stress, poor food choices, alcohol, drugs and so on can break the homeostatic balance – the ‘straw that broke the camel’s back’ – that then ‘upsets the apple cart’ and creates elevated levels of toxic pyrrole in the body.

The reverse applies. A clean healthy lifestyle can turn off negative gene expression.

We all make a small amount of HPL (pyrrole) as part of normal metabolic processes related to haemoglobin synthesis (making blood), but we get an excess of this toxic substance floating around our body if it’s not cleared properly.

It used to be thought that the body would bind B6 and zinc to any excess pyrrole and by doing so, the excess pyrrole was eliminated from the body. This would be fine, until our bodies ran out of B6 and zinc, and then the pyrrole levels would rebuild. So it was thought that giving the body high doses of B6 and zinc would balance everything and ‘hey presto’, we’re back to normal. See more on this below in the talk about B6 and Brett from AAL.

Fortunately, we now understand that there’s a lot more to just taking B6, zinc and a few other bits and bobs.

Causes of elevated pyrrole levels (HPL) include leaky gut, dysbiosis, heavy metal toxicity and other various stressors on the body. I expand on how to address these causes in my article Pyroluria is not for life and can be treated and eliminated

If it is purely stress and nothing else that has caused the elevation of pyrrole, and this stress hasn’t made other things too dysfunctional, then pyrrole can be resolved quickly by dealing with the stress and re-establishing the lost nutrients.

It is rare to see this situation, but many years ago one of my clients who tested for pyrrole had this situation. He’d been wrongly accused of something and the police arrested him, and he was facing possible jail. Fortunately, the truth was established, and his massive stress was gone but left him feeling quite frazzled to say the least.

When I tested him for pyrrole, his score was in the hundreds. I treated him with a typical pyrrole nutrients protocol. As a result, his pyrrole levels returned to normal and he felt so much better within a couple of weeks.

These situations are rare because normally with elevated pyrrole levels, there’s a lot more going on than stress alone. Yet this shows that simply treating pyrrole with ‘Walsh protocol’ nutrients can be beneficial. But typically, there’s more going on that requires further investigation so that treatment is specific for an individual’s needs.

3. Nutritional levels not monitored
When nutritional levels are not monitored (measured), serious toxicity issues can occur.

Nutritional levels and other health biomarkers can be monitored with hair mineral and heavy metal analysis and/or tests using urine, blood, stool and saliva – depending on what needs to be checked.

It can be a good idea to test levels more than one way. For example, hair analysis of minerals and heavy metals is very useful to monitor the excretion of these elements, but at the same time checking the blood for mineral and vitamins levels is also important.

It’s particularly important to check copper, zinc (and the ratios), B6 and B12 with blood tests. Hair testing is best for checking calcium and magnesium. Saliva is best for hormones. Urine best to check pyrrole levels as well as neurotransmitters, amino acids and organic acids. Stool or faecal testing is best to check digestive markers, microbiome status, parasites and leaky gut, although you can also check some of these with urine and even breath testing.

The frequency of monitoring depends on the dosage levels of nutrients you are working with and if you have any adverse effects but can’t work out why. I suggest annually is, on average, a good time frame to retest nutrient levels and health parameters.

4. Incorrect dosing
Now we look at important nutrients related to pyrrole treatment to understand their benefits and the potential pitfalls of incorrect dosing.

VITAMIN B6
We are told that when you have elevated HPL (Pyrrole) then you need to take B6. B6 is an awesome vitamin and in its two different forms can be extremely useful to support hormone balance, neurotransmitter balance and help the digestive system function better.

The forms of B6 are Pyridoxine Hydrochloride and Pyridoxyl 5 Phosphate (P5P). Pyridoxine hydrochloride has more longevity in the body. Whereas P5P is the more active form, which means it is made into a more useable form for the body. For those who don’t absorb Pyridoxine Hydrochloride well (which applies to many, particularly those with elevated pyrrole levels) P5P is the better option. However, some people respond better to a combination of both.

B6 in either form is the most overprescribed nutrient for pyrrole disorder.

Why? Because many have not been tested for B6 levels prior and even if their level is high, they are told that they are not absorbing the B6, so take more. If you are not absorbing B6, then the P5P form is generally a better option for you, but the question is, “Do you really need B6?”

More importantly than how much, or the type of B6, is the fallacy we are told that pyrrole binds to B6 making us deficient because most of it is eliminated in our urine and flushed down the toilet along with pyrrole.

In Brett Lambert’s article citing the latest research he has done in his pyrrole testing lab (AAL), he debunked the myth that pyrrole binds to B6. Treatment for pyrrole can include B6, but not because it has been bound and lost via urinary excretion. It was previously recommended to stop taking B6 prior to taking a pyrrole test. Brett has proven that taking or not taking B6 prior to testing makes no difference to the levels.

The main point is to always check levels of B6 before taking any, as you may not need it.

But really, the more important nutrients are zinc and magnesium, with other nutrients as needed by the individual.

Vitamin B6 toxicity
In February 2019 I asked my Pyrrole Australia Facebook Group with more than 7,500 followers if anyone had any issues with vitamin B6 toxicity or side effects.

Some commented that their wellbeing depended on taking their supplements, including B6. While the majority commented about side effects of increased anxiety and agitation (which also happened to me). Some people had serious toxicity symptoms such as peripheral neuropathy (tingling and numbness of fingers and toes, and sometimes lips).

Most vitamins and minerals are water soluble, including B6, and any excess is normally flushed down the toilet. But some nutrients, including B6 can build up to toxic levels. Other nutrients such as zinc, if taken for too long or in very high doses, can unbalance copper levels and cause issues with hormones, connective tissue and the immune system.

Don’t get me wrong, sometimes very high doses are needed to resolve a health imbalance. The main point is that nutrient levels need to be monitored so you are on the right treatment regime to suit your specific health situation.

Another issue to consider, which I discovered with some of my new clients who were having problems, is that they had been taking a B6 supplement, which on face value should not have affected their well-being. But other supplements they were taking also contained B6 which they were unaware of, which meant the accumulative level of B6 was too high, leading to B6 toxicity.

Dreams and cycling/pulsing of B6
While B6 levels need to be monitored, you can feel if you need more, or need a break for a while. Sometimes ‘pulsing’ B6 is beneficial. ‘Pulsing’ or ‘cycling’ is where supplements are taken for a period, then stopped for a while, then taken again.

For me and many of my clients, B6 cannot be tolerated for long periods of time without toxicity symptoms occurring, or at the very least, an overload that the body cannot process, so it needs a short break to catch up.

An indication you need more B6 is the absence of dream recall. I don’t mean remembering the details of a dream. Waking and thinking, ‘I’ve had a dream, can’t remember it, but I know I’ve had one’ is enough to say you recall a dream state.

Restorative, healing sleep occurs in stage three and stage four (REM) sleep. But dreaming happens in stage four REM (rapid eye movement) sleep. It is possible to get to stage three and not get to stage four, where dreaming occurs. But it is definitely better for our emotional, hormonal and physical wellbeing if we do get to stage four deep sleep and dream.

Without sufficient B6, we simply won’t have this level of restorative sleep and our neurotransmitter and hormonal balance will pay for it, and consequently we suffer from it.

If I take B6 (and I only take 25mg) for more than three days in a row, I start to have weird crazy often violent dreams, even if I haven’t watched anything nasty on the TV before going to bed. And I can also feel ‘racier’ and more agitated in general.

Many of my clients have reported the same happens to them, so I suggest to stop taking B6 until the dreams or raciness settles, and then take their supplements for two days and have 1-2 days off again. This seems to work a charm…and it certainly does for me.

It’s quite apparent that there’s a level of B6 that the body can assimilate and then clear, and an overload causes a ‘back up’ in the liver and liver distress, So a break by ‘pulsing’ can work well and then the B6 seems to be even more effective.

This is more important for those who are particularly sensitive to B6 (and other nutrients like zinc) and can only take small doses. However, I do have many clients who can only function with 200mg of B6 (as a combination of both types) daily but they still find it beneficial to have one or two days off per week – like having the weekend off.

I like to have the weekend off all supplements, or at least Sundays, unless I have a higher need, like when fighting an infection. This ‘trick’ has helped lots of my clients, so hopefully it will help you if you feel that your body feels overwhelmed with supplements at times.

Please note, this does not apply to prescribed medications, but if you feel overloaded with any medications, then talk to your doctor and get your liver enzymes checked.

It’s all about listening to your body.

When should you take B6?
This varies from person to person. Some find B6 at night helps them to sleep, whereas most find B6 is better in the morning as it can be stimulating and help to give you more energy throughout the day.

Some find that taking anything in the morning makes them feel sick. Eating a breakfast or lunch with plenty of protein seems to help – even a few nuts can be beneficial.

It’s very common for those with pyrrole to not feel like breakfast, in fact they commonly feel nauseous in the mornings, and for them, taking nutrient pills at lunch serves them better. Some of my clients who decided to eat breakfast even though they feel nausea, say that the nausea clears quicker for them by doing so.

It can be a bit like pregnancy morning sickness, whereby the liver is not coping well with the extra surge of hormones, but eating (if possible) foods that slow the liver such as fats, proteins, salty foods and starches can help morning sickness symptoms abate.

In both of my pregnancies I had morning sickness. With my first child, my son, nothing worked, but with my daughter it was much less. I found that if I had toast with vegemite (that I don’t normally like) before I got out of bed (courtesy of hubby) then my morning sickness wasn’t too bad. If it came back, munching on a few potato chips worked a charm. Note, the rest of the time I ate healthy food, but these tricks helped settle the nausea.

I’m not saying to do this, but it shows how certain foods slow down the liver’s detoxification process and this can be a good quick fix. But it also shows there’s something going on that needs addressing. Interestingly, vegemite is rich in B vitamins (and full of salt).

ZINC and COPPER
We are told that zinc is needed for pyrrole because many with pyrrole have low zinc and an excess of copper. This is very true for many with pyrrole disorder, but only if you have been tested to confirm this status.

More of a problem is the balance or ratio between the copper and zinc, but some practitioners are simply looking at the reference range. All within range, then all good…but is it? Often not.

I love zinc and find it such a useful mineral. Along with magnesium, zinc is so helpful for all sorts of conditions from healing the gut, supporting our immune systems and balancing our neurotransmitters, plus it’s an awesome antioxidant. The biggest problems I have seen with zinc is ‘copper dumping’, and levels apparently not responding to consumption.

The type of zinc is also important. This can vary from person to person, but some of the favourite types include zinc picolinate, zinc citrate, zinc glycinate and there’s also zinc carnosine.

How do you know the best form of zinc to take for pyrrole?
Some find one type may make them feel sick while others don’t. But I must mention here that if you feel sick or nauseous with zinc it is sometimes because you need to take it with a meal containing protein.

Some find that their levels respond better with one type over another. Zinc Picolinate is said to be the preferred type for pyrrole disorder because it is considered gentler and allows better absorption. I use zinc pic a lot, but I also love zinc carnosine for gut healing support.

When to take zinc
Zinc is best absorbed if taken at night, but it’s hard to take high doses in one go, so it may be better to spread it across the day. Talk to your practitioner about what minerals and vitamins can be safely taken together as some compete with each other for absorption. There are too many variables to list here.

What is Copper Dumping?
The term copper dumping came from the side effects often seen when people first start a zinc treatment, but often this is because the zinc dosage is too high (at least initially), or the type of zinc doesn’t suit that person.

What are the signs and symptoms of copper dumping?
In most cases it is actually an exacerbation of the very symptoms you are trying to get rid of.

Symptoms may include an increase in depression, anxiety, mood swings, rage, impulsiveness and sometimes complete mania or psychosis if allowed to become unchecked. In children we see a worsening of behavioural issues.

Why do we get copper dumping?
To get copper dumping you first must have elevated copper in relationship to the amount of zinc.

But if copper is safely bound to caeruloplasmin it is less of a problem. For more information see my article on Copper, Zinc and Caeruloplasmin.

The other reason for the dumping is because the dose of zinc is too high for you, so the first thing to do is stop taking it, have a break until things settle, then start again at a super low dose and build very slowly, monitoring your symptoms as you go.

On a physiological level the reason we get this surge in our symptoms is because high copper levels can alter the neurotransmitters in the brain (in a bad way). The reason this happens is because zinc, being a copper antagonist, pushes out the excess copper. This is like we are dumping heaps of extra copper into the body, but in reality, the copper has been released from our somewhat safe storage sites within the body.

How to avoid copper dumping
If you are sensitive, the dose of zinc needs to start around 10mg and slowly build up to your prescribed level, which could be as high as 100mg spread throughout the day.

The level of milligrams of zinc referred to here is the ‘elemental’ value. When a mineral is bound to an amino acid (protein fraction), part of what we see in mg’s is the amino, and part is the mineral. For example, sometimes we see on a bottle:

 125mg of zinc amino acid chelate (zinc glycinate), equivalent to elemental zinc 25mg.

In this case the dose has 25mg of zinc, the rest is the glycine, which by the way is a calming amino, which can also be a good choice.

If a bottle just says 25mg then most likely it is just that. Products bought from America usually just say the amount of zinc, whereas in Australia, products from a manufacturer always shows the bound amount as well as the elemental amount (which is the one to take notice of).

However, with nutrients compounded by a pharmacist, sometimes they only show the bound amount, but the prescription from your practitioner should show the elemental quantity.

Generally, most minerals, but not vitamins, are bound in this way to an amino, so we get better absorption via the intestines. The body recognises aminos easily but may refuse entry (from gut to blood stream) of a straight mineral.

Are compounded nutrients the best way to go?
Many people are prescribed a compound (mixed blend of nutrients made up by a compounding chemist) of their prescribed protocol of nutrients. This is very handy and can sometimes be cost effective.

I say sometimes, because often three months of a prescription is made up in one go by the pharmacist, which is cheaper than lots of small batches. BUT the big problem occurs if there’s one or more ingredient that either doesn’t suit the individual, or the dosage of one or more ingredient isn’t quite right.

With compounding, it usually requires several capsules to get all the nutrients needed for one dose, and then split into morning and evening doses, so overall you are still taking quite a lot of capsules.

I initially encourage my clients to take their nutrients individually at small doses of each and incrementally build to a level that suits them.

The slow build allows the body to adjust to physiological changes such as detoxification and hormone pathways. Dosing this way allows for a more controlled environment you can adjust as needed.

At premenstrual times, women need a little more B6 and magnesium, and kids need more zinc when sick to support their immune system (which means some zinc is utilised for behaviour and some zinc to fight infections).

After a while, if you find you have regular set doses of nutrients to support your body, then that’s a good time to consider compounding. Compounding of certain ingredients can be helpful at times where certain nutrients are otherwise not available over the counter, such as melatonin (sleep) and DHEA (adrenal) where that extra support is needed.

Following are two case studies which provide further insight into the issues presented in this article. Both names have been changed. The point of sharing these client’s stories is to point out that simply addressing an elevated pyrrole reading with nutrients may not resolve symptoms and that further investigation is often necessary.

Case Study 1
Bruce came to me after being treated with the ‘Walsh Protocol’ by his integrative doctor for the previous 12 months. He had a set plan of certain nutrients compounded for him to take in the morning and evening along with a few extras for his ‘Under Methylation status’ such as SAMe, Methionine and TMG.

His symptoms included anxiety, depression, insomnia, heartburn and reflux, loose stools and poor ability to concentrate. After 12 months on high doses of B6 as both Pyridoxine hydrochloride and Pyridoxyl 5 phosphate, along with zinc pic, vitamin C, biotin, theanine and magnesium, there were no symptomatic improvements.

His digestive symptoms were worse, his anxiety had increased with more constant feelings of agitation and the addition of occasional panic attacks, his toes felt numb and his arms ached with a ‘weird feeling’. He was told to just continue with his prescription, because these things ‘take time’.

By the way his pyrrole reading was 30. In the new reference ranges, this is not considered to be elevated.

You may have twigged to the main issue here. Not only was he over prescribed and was now suffering the effects of B6 toxicity (yet told to continue), but the cause of his symptoms was not even looked at.

In this case to discover the cause of his severe gut problems (dysbiosis) I ran some tests which revealed he had a parasitic infestation. No quantity of vitamins and minerals will deal with that, ever.

I was then able to treat his dysbiosis and within three months all his symptoms had cleared. And this was without any B6 (because his levels needed to drop) but he continued with some of the other nutrients like zinc, magnesium and vitamin C.

Case Study 2
Sarah’s HPL (Pyrrole) score was 350, so clearly there was something really going on for her pyrrole wise. Symptoms included extreme fatigue, constipation, bloating, weight gain, anxiety, dry eyes, insomnia sometimes but she could sleep 20 out of 24hrs if allowed to. To top this off she had been unsuccessfully trying to fall pregnant for the previous three years.

When preparing for conception, three years earlier, she visited a naturopath and her doctor to try to remedy her fatigue and was tested for pyrrole disorder. Because her score was extreme, she was placed on very high levels of B6 and zinc along with magnesium, vitamin C and some other supplements. She was tested for thyroid which did show underactive and she also had high levels of antibodies present.

Sarah was placed onto thyroid medication along with her nutrients and after several months her energy, weight and sleep improved, but her anxiety and digestive system was still bad.

The digestive distress was put down to her anxiety and her anxiety was put down to her thyroid, and thus needed antidepressants she was told. Really???

Anyway, she was still not conceiving and found me in an online search. After a thorough consultation and some extra tests, we found she had a double mutation (homozygous) for the MTHFR gene, and her thyroid antibodies were elevated even though her other thyroid parameters were normal.

This was because her immune system had never been treated, only the thyroid hormones. Consequently, this created severe oxidation, making her pyrrole score elevated and her bloating and constipation added to the picture.

In many cases, people with elevated levels of pyrrole are also deemed to be an under-methylator or an over-methylator (see my article Understanding Methylation).

Sarah had been diagnosed as an under-methylator due to some of her symptoms and some ambiguous blood tests. I say ambiguous because often these markers are not so clear cut or accurate, so the practitioner often decides from symptoms, which can work – sometimes.

The problem with being an under-methylator is that they are often told to avoid things like B12, folate and B3. But I realised these were the very things Sarah needed to help her anxiety, which we organised and in turn settled her gut (flight and flight switch).

This also helped her to successfully fall pregnant and have two children (one at a time). Folate in the active form is super needed (sometimes in high doses) for those with MTHFR to have a successful pregnancy and healthy child free of things like ADD, ADHD, Autism, Neural tube defects etc.

In fact, Sarah was neither an under nor over methylator but simply needed her MTHFR enzyme pathway to work properly. The B6, zinc, Vit C, magnesium etc all helped considerably but without the addition of Folate as 5MTHF, methylcobalamin B12, and in her case vitamin D for her immune system, along with a special auto-immune diet, Sarah was on a pathway to having no children.

Now she has restored health and two very healthy children.

Are you being treated properly for your pyrrole symptoms?
If the answer is YES and you feel good, then great, keep doing what you are doing.

If the answer is NO, because your symptoms haven’t improved enough or at all, or even worse, perhaps you need more time, which is sometimes the case. But if you have been following your program for some months or years with no or little resolve, then now is the time to look at what may be missing.

Here are some questions to consider that may help you to decide the next move regarding your health.

  • Do you really have pyrrole disorder? Retest your score with AAL (only available in Australia). Is it above 40 adjusted for urine metabolites?
  • Do you have any underlying causes of your elevated levels, such as leaky gut, heavy metal toxicity, chemical exposure and the like?
  • Have you had your nutrient levels checked? Had your neurotransmitter levels, amino acids or organic acid levels checked?
  • Is your diet suitable for healing or are you consuming toxins to encourage leaky gut such as gluten, processed foods, dairy products, sugar, alcohol, nicotine, or using toxic personal care products?
  • Are you adding to the copper load by being on the contraceptive pill or other Hormone Replacement Therapies, on any medications that can increase your copper levels, or have a copper rich diet of coffee, chocolate, avocadoes and soy products? There are others but these are the main ones.
  • How are your stress levels? Stress via your adrenal glands reduces your caeruloplasmin, which is the protein that binds copper safely so it doesn’t do as much harm. Consider ways to reduce stress, which can also include magnesium to help your body cope better with stress.
  • How is your liver? Your liver has to process all kinds of toxins, help with the conversion of hormones, neurotransmitters and the vitamins and minerals you take to treat your symptoms. Too many supplements can be detrimental for your liver and build to excess, especially if the liver is under strain. Do you drink alcohol or lots of coffee?

My suggestion: Don’t leave any stone unturned to find the source of your imbalances and ensure you get the treatment that’s right for you.

Any questions?

I’m available for consultations via skype, phone or in-clinic at Mooloolaba on the Sunshine Coast. 😊

 

 

 

 

Do you really have pyrrole, or were your results distorted?

by Sue Kira, naturopath, Sunshine Coast

Since I became involved with pyrrole in 2010, I observed how many clients’ tests showed extremely high levels of pyrrole, yet their symptoms were not too bad. Conversely, many clients had relatively low levels of pyrrole, yet had awful symptoms.

As Professor Julius Sumner Miller said: “Why is this so?”

We now know it’s because other components in urine can be detected which can falsely elevate or falsely reduce the true level of HPL (pyrrole). This could have a huge impact on how you are being (or have been) treated.

This inconsistency seemed to be more evident in those who were tested by labs other than the Applied Analytical Laboratories (AAL) based in Queensland.

Consequently, I wanted to ensure that everyone was tested by AAL, who are specialists in pyrrole testing, because I was confident that their results were accurate. Another reason for recommending this lab was because other lab reference ranges were much lower, which could possibly lead to some people being inappropriately treated for pyrrole disorder, when in fact pyroluria may not have been the cause of their symptoms.

It was during AAL’s accreditation process in 2018 (NATA ISO 15189 medical accreditation) that a breakthrough was made that there are other substances that can be found in urine which also test positive for pyrrole, thus spiking the result to be higher than the pyrrole reading alone. 

Urobilinogen can cause approximately 40% increase to the pyrrole reading score, but is different for all samples, because not all samples have raised urobilinogen.

This led AAL to do further research and subsequently, test for these other components, so that the reading is adjusted to reflect only the HPL (pyrrole score) rather than being combined with other metabolites such as urobilinogen. (See Brett Lambert from AAL research findings in additional article below this one)

Urobilinogen and other significant urine detected components such as nitrites, blood, etc. are reported so that the practitioner requesting the test can see not only the pyrrole reading, but also other urine components. This makes it easier for the practitioner to further understand what might be contributing to their clients’ symptoms.

What is urobilinogen?
Urobilinogen is a by-product of bilirubin (see below) which is first formed by the intestines and then taken up by the liver to be excreted via the kidneys in urine.

What is Bilirubin?
Bilirubin is a by-product of the breakdown of red blood cells, as well as being used by the liver to help digest food. High levels of bilirubin can be a sign of liver problems. Some people have ‘naturally high’ levels of bilirubin with a condition called Gilbert syndrome, which is where they have an inherent deficiency of an enzyme needed to break down bilirubin.

What does it mean to have elevated urobilinogen or bilirubin?
We all have a small amount of both bilirubin and urobilinogen in our urine, but certain factors will increase these metabolites. Apart from Gilbert syndrome, other causes of this elevation can include, but not limited to, conditions such as:

  • Leaky gut syndrome
  • Dysbiosis of the gut
  • Kidney disorders including infections in bladder/kidneys
  • Liver disorders
  • Gall bladder disorders
  • Heart disease & other vascular disorders
  • Pernicious anaemia (inability to absorb enough B12)
  • Certain viruses
  • Hepatitis
  • Elevated liver enzymes
  • Neurological dysfunction
  • Falsely elevated results of bilirubin and urobilinogen can also come from:
  • High carbohydrate diet
  • Elevated nitrates (from a bacterial infection in bladder/kidneys)
  • When the sample is taken – afternoon samples inherently have higher levels
  • Certain drugs/medications can create both a false negative or an actual elevation due to damage to the liver

My Facebook Poll
This brings to light a poll I ran on Facebook some time ago regarding pyrrole scores above and below 50.

48% of responders had scores of less than 50. In their case, if they had other metabolites in their urine when they were tested, it’s possible their HPL reading may have been false and they are well within range and not have pyrrole at all. Consequently, some may have been incorrectly treated.

However, many people do well with extra B6, zinc, magnesium etc irrespective of their condition. But if they have been on high doses of any of these (except magnesium), without first having their nutrient levels tested, that could cause problems.

If your HPL level was around 50 or less and you were diagnosed with pyrrole, or, the test was conducted by a lab other than AAL, or, conducted by AAL before October 2018, then you may consider retesting with AAL, the only lab providing urobilinogen corrected results.   

If you want to be tested by AAL, please email me the town or city where you live, and I’ll return email the appropriate request forms (unfortunately this only applies to Australian residents because of sample collection protocols).

What does all this mean?

If you have a falsely elevated reading of pyroluria then it’s possible the treatment strategies given to you are relying on false data, which means you may not be getting the right treatment.

I will be covering more on this in the next article titled: Are you getting the correct treatment for your Pyrrole symptoms?

PS Can you please provide feedback in the comments below about where your test was done, your score and if the score reflects the level of your symptoms or not e.g. high score low symptoms, low score high symptoms, high score high symptoms etc. I’d appreciate your input as this is valuable information to share with each other.

Latest in Urinary Pyrrole research – Applied Analytical Laboratories (AAL)

written by Brett Lambert (M.App.Sc, B.App.Sc(Chem)), Principle Scientist and Director, AAL

Following is the latest research from Brett Lambert, Principle Scientist and Director at Applied Analytical Laboratories. Although written for practitioners who send client samples to the lab, Brett has given me permission to share this valuable information with you. It’s quite technical, however you can still gather important bits of information relevant to you. If not, feel free to pass this to your practitioner for further interpretation. Please pay attention to the details about your sample collection.

The objective of this newsletter is to inform practitioners of the recent advances made to our urinary pyrrole test that further distinguish it from the others. Our test is in review for NATA ISO 15189 (medical) accreditation. Note: now fully accredited

The information disclosed is to inform practitioners that the research we are carrying out is novel, and we have the scientific competencies to make leading discoveries in the field. We aim to separate ourselves from our national and international competitors in providing research that backs up our results.

There is a number of Ehrlich “positive” components found in urine that can be distinguished and it was brought to our attention by NATA during an assessment that the urinary pyrrole test was susceptible to significant interference by urobilinogen. We found this to be accurate following spiking studies where known quantities of urobilinogen were added to samples (the effect of which was measured).

Our spiking studies revealed data that enables us to now provide corrected results for the Urobilinogen, which is estimated to cause interference to the Ehrlich reading by approximately 40% (urobilinogen can cause an approximately 40% increase to the reading, but is different for all samples).

We found that small amounts of blood as well as supplementation with vitamin B6 do not interfere with results prior to testing.

However, treatment strategies relying on uncorrected/false positive or false negative results, have given us cause for concern regarding general B6 toxicity. The role of Zinc and magnesium are of increasing importance.

Key Research
Pilot study research (involving 567 patients) to investigate the viability of diagnosis and treatment using “Pfeiffer/Walsh” regime;
ACNEM Journal; Vol 29 No.3 – 2010 “The Effectiveness of Targeted Nutrient Therapy in Treatment of Mental Illness – A pilot Study”; Stuckey, Walsh, & Lambert.

Study to verify pyrroles as a bio marker for schizo-effective psychosis (4 peer reviewed publications to-date, another in prep)
1 Biomarker Research, (2015) 3:3 DOI 10.1186/s40364-015-0028-1; “Biomarkers of a five-domain translational substrate for schizophrenia and schizoaffective psychosis” Fryar-Williams & Strobel.

2 Open Journal of Psychiatry, 2015, 51 78-112 dx.doi.org/10.4236/ojpsych.2015.51011; “Biomarker Symptom Profiles for Schizophrenia and Schizoaffective Psychosis”, Fryar-Williams & Strobel.

3 Frontiers in Psychiatry, 2016; doi 10.3389/fpsyt.2016.00048; “Biomarker Case-Detection and Prediction with Potential for Functional Psychosis Screening : Development and Validation of a Model Related to Biochemistry, Sensory Neural Timing & End Organ Performance.” Fryar-Williams & Strobel.

4 Frontiers in Psychiatry, 2016; doi 10.3389/fpsyt.2016.00172; “Fundamental Role of MTHFR 677C-T Genotype and Flavin Compounds in Biochemical Phenotypes for Schizophrenia and Schizoaffective Psychosis”, Fryar-Williams.

Study of treatment outcome based on Walsh protocols for child and adolescent violent offenders –
Journal of Child and Adolescent Psychopharmacology; doi 10.1089/cap.2016.0199 “Micronutrient Therapy for Violent and Aggressive Male Youth: An Open-Label Trial”; Hambly, Francis, Khan, Gibbons, Walsh, Lambert, Testa, & Haywood.

Study validating the aetiology of the elevated bio-marker and the result of treatment (in prep)
Interference studies – samples spiked with potential interferences and their effect determined on results (NATA requirement – AAL in-house development)

Characterisation of the Ehrlich and pyrrole chemistry (Combined Griffith University and AAL research – ongoing)

Treatment response studies
AAL will be involved in the bio-marker project phase III arm (with over 800 participants). This Precision Scientific research project will be collecting data on a national scale.

The key findings our research has led us to so far are as follows:

1 We have characterized the components of the fraction tested by “Pfeiffer” affiliated laboratories and found the fraction to comprise of urobilinogen and to lesser concentration, bilirubin. Therefore, laboratories using the “Pfeiffer” method are measuring the interference components – not the analyte, ie the clinical significance of their results are questionable.

2 We have characterised the mechanism and products of the Ehrlich reaction by NMR and have gained profound insight into the chemistry occurring – casting doubts over some “currently accepted” chemical structures.

3 Urine urobilinogen concentration naturally peaks in the afternoon, which is why we have previously and still recommend 2nd or 3rd morning voids for testing (as urobilinogen interference is minimized at these times). We can also provide urobilinogen results.

4 Spectroscopic studies we have performed have resolved the difference between derivatives of urobilinogen, bilirubin and a ‘hydroxyhemepyrrole-like’ compound. Further elucidation is on-going.

5 We can now provide urobilinogen corrected results giving the most accurate urinary pyrrole results of any comparable laboratory in the world.

6 More accurate results have aided more accurate treatment strategies and we have found B6 toxicity to be of increasing concern.

Some changes we have made over the past few months.

AAL corrects for urobilinogen interference, although we still recommend collection of morning voids to keep the error margins to a minimum, and to provide the most accurate result possible. It is essential that the time of sample collection is provided to us on our request forms that accompany samples, so that we can distinguish between elevated pyrroles, peaks in urobilinogen concentration, and provide the most accurate reading for both.

Measurement of urobilinogen concentration is important and a low urobilinogen result can be just as significant as a high result. (ie low urobilinogen (and low pyrrole) with normal S.G., often with a trace of blood can indicate biliary obstruction and should be investigated further).

AAL provides this measurement and provides additional measurements (leukocytes, protein, nitrites, ketones, glucose, bilirubin, and blood (lysed and whole) using a Siemen Advantix urinalysis system) on samples that are outside the reference ranges (ie, both high and low).

Sample Collection
The compounds of interest in the sample are unstable and reactive with natural and artificial UV light and x-rays. Thus, it is pivotal that whatever sample pots are provided, they must be covered with foil to protect and preserve the analyte. The opaque pots provided by other laboratories (without foiling) are inadequate. It is also essential the sample must be immediately frozen and must remain frozen until testing starts.

Reference Ranges
We have made changes to the reference ranges for the results we provide, based on real population and study data (validation of the testing protocol).

Paediatric (<14yrs)
[HPL] < 10 ug/dL Normal
10 ug/dL < [uHPL] < 20 ug/dL Borderline
[HPL] ≥ 20 ug/dL Elevated

Adults
[uHPL] ≤ 40 ug/dL Normal
40 ug/dL < [HPL] < 150 u/dL Mild Elevation
150 ug/dL < [HPL] < 400 ug/dL Moderate Elevation
[HPL] ≥ 400 ug/dL Severe Elevation

The majority of results release is done by up-load through secure portal to practice software using an encryption service. As soon results are available, they’re uploaded to your system. If a result has not been uploaded to your practice within 6-10 workings days of collection, it means we have not received the sample – so please contact us urgently for follow up. All discrepancies are documented in Non-conformance registers.

In summary
The major difference medical practitioners should note is that it is now clear the “Pyrrole” test measures a BIOMARKER of oxidative stress and is not a confirmation of a mental health condition called “Pyrrole disorder”. This actually makes the test more important and more useful to practitioners.

By understanding that there is a direct correlation between severity of symptoms and the larger measurement range and that the product is a definite measure of oxidative stress there can be a better understanding of treatment response. The extra information provided to practitioners when the results are very low or very high give a very useful tool to investigate other conditions.

Currently it appears the treatment process should not markedly change except to be able to provide future illuminations as per the comments above. Please re-read the references cited above so you understand the research behind this clarification. Please be assured we are continuing to research to improve the understanding of this important mental health biomarker.

Feel free to contact us if you have any queries.
Yours Faithfully
Brett Lambert (MAppSc, BAppSc(Chem)), Principle Scientist and Director, AAL

October 2018
Shop 6, 11 Logandowns Drive,
Meadowbrook Qld 4131
Ph 07 3133 1615
E – info_apan@bigpond.com

Side effects warning for SSRI’s and Pyrrole

WARNING. Side effects and reactions to SSRI antidepressants, methylation support and pyrrole treatments

Dear friends, recently a colleague was distraught because his close relative committed suicide after being on an SSRI antidepressant for only three days. It was brought to my notice that the relative suffered from depression and was also an over-methylating pyrrole (high copper, low histamine). Seeking help from a new GP he was prescribed an SSRI antidepressant and three days later took his life.

Although I didn’t know this person, it had a profound effect on me and I felt strongly that this needs to be known by as many people as possible (please share). Admittedly he was already in a bad space but this situation has happened time and time again where an anti-depressant has made someone feel worse to the point of suicide.

I have seen and heard of situations in the treatment of pyroluria where methylation support products, such as SAMe or Methionine, significantly aggravated symptoms such as anxiety, panic disorders and paranoia. This happens because patients were treated inappropriately as under-methylators when in fact they were over-methylators. Or it can occur when an under-methylator has high levels of copper. Reactions can also arise if the dosages of products are too high. For some it can lead to ‘serotonin syndrome’, a very serious reaction where symptoms are exacerbated. (Normally this happens with antidepressants or when antidepressants are mixed with ‘natural’ serotonin support).

To assess under or over-methylation, tests can be arranged such as histamine and Caeruloplasmin, plus copper and zinc levels and their ratios. Copper and zinc should be tested via blood and hair as both are necessary to show if the copper is unbound or bio-unavailable. In other words the blood may show low copper and hair may show high copper. It is also important to assess B12 levels and look at genetic variations on the CBS pathways and COMPT as well as MTHFR. (more on this an another article to come)

If you haven’t been tested and uncertain if you have over or under-methylation as an adjunctive issue to pyrrole disorder, be aware that if you have hay-fever or sinus or respiratory allergies then your histamine will normally be high and you will then be classified an under-methylator. Having said that, if you don’t get respiratory allergies this doesn’t automatically mean you are an over-methylator; you could be neither as you can have pyrrole without being an over or under-methylator.

Either way it is still important to get copper, zinc and B12/Folate levels checked with both blood and hair (B12 and folate cannot be tested with hair only blood). Elevated copper to zinc ratios can be especially serious for persons with low blood histamine (over-methylation). If you know you have high copper levels then use caution with prescriptions and over the counter products that increase serotonin levels or support methylation pathways. ‘Go slow and low’ has always been my motto.

For more information on methylation, copper, zinc and other testing please visit this link

Pyroluria is not for life

pyrrole image 2Pyroluria is not for life. It can be treated and eliminated!

Previously it was believed that when you were diagnosed with pyrrole, you had it for life, and any treatment with nutritionals was also for life.

In some cases this is true, but only if you don’t eliminate the cause of the elevated pyrrole.

The misconception of ‘pyrrole for life’ evolved from the idea that pyrrole was inherited. Some factors that lead to pyroluria can be inherent, but the condition itself isn’t genetic at all but rather a condition that results from oxidation in the body.

We can have defective genes that make pyroluria more likely, but the fact is that there is a cause behind it that can be healed.

Epigenetics (our diet, lifestyle and environment) have the biggest impact on our chances of developing elevated levels of pyrrole.

I have covered some of these epigenetic factors before, such as ‘leaky gut’, small intestine bacterial overgrowth (SIBO), large intestine bacterial overgrowth (LIBO), parasitic infections, mould illness, heavy metal toxicity, other mineral imbalances like too much copper, and insufficient zinc.

Diet plays an important role because of: damage created by acidic, processed, hydrogenated, genetically modified and toxic sprayed foods; eating or drinking too much sugar, alcohol and caffeine; and not consuming enough vegetables, water or fibre.

Then there’s the big one most of us can relate to: STRESS! What’s your stress resilience like and how well do you manage it?

So when you have some or all these things going on that affect you, how do you support your body and mind?

First, work with a good practitioner to help rebalance those imbalances you don’t currently have control over, such as healing the gut, detoxing the toxins that shouldn’t be in your body, and go for an anti-inflammatory diet that is rich in antioxidants and the vital nutrients you need to support our body.

Reduce or eliminate foods and drinks that affect your liver such as caffeine, alcohol and other toxins, and those substances that inflame your gut like gluten, dairy, sugar and processed foods.

Drink plenty of water. Look to specific dietary programs for ‘Leaky Gut’, SIBO/LIBO, a heavy metal detox, Pyrrole Support Diet or at least a gluten, dairy and sugar free diet.

Reduce stress. Make time for walks, sunshine, Epsom salts baths and relaxation. Go to bed earlier and get extra sleep on the weekends.

The more you look after yourself the easier it will be for your body to heal.

What else can you do to support your body with this oxidative (think corrosive) process? You may already be taking certain vitamins and minerals to help balance your body, but also consider Anti-Oxidants. When there is an oxidation process going on, it makes serious sense to use anti-oxidants.

Even if you are already taking many supplements, there are probably some that you may not need any more, particularly if you have been taking supplements for a long time and you are on a good diet. It’s important to have your vitamins and minerals monitored to find out what you may be able to discard from your regime.

For example, Vitamin B6 was once considered to be essential to treat pyroluria because it was thought that pyrrole binds to B6 along with zinc. But new research shows us that this is not true.

There are now many people who have toxic overload symptoms from too much B6 in their body, whether from Pyridoxine Hydrochloride or Pyridoxyl 5 Phosphate (P5P). But some do need B6 and plenty of it at times.

So don’t take B6 just because you have been diagnosed with pyrrole, unless you first had your B6 levels tested. Otherwise you could waste money, add toxins to your body, and take a pill daily that could be replaced with something more helpful.

It’s a good idea to have your supplements reviewed regularly rather than take them indefinitely, however do not stop taking something prescribed unless you have been given the all clear to do so. This is very important.

Also, listen to your body. We often intuitively know when a certain supplement is not right (even if it’s just for that day) but we often override this feeling. Anything taken for a medical condition must NEVER be stopped or adjusted without first speaking with your prescribing practitioner. I want to be super clear on that point.

So back to the topic of antioxidants, which solely don’t cure pyrrole, but are great to reduce the effects of oxidation and hence pyrrole levels. However, you need to work on the various causes of oxidation as mentioned above.

Which are the best antioxidants to use? There are many to choose from and following are some of my favourites. Be aware that some may not suit you, which is why you need the support of a good practitioner. Don’t try and use ALL of them, but find a combo that has a few key antioxidants and add some key herbs and spices to your diet.

Antioxidants to consider

  • Milk Thistle (Silybum marianum), aka St. Mary’s Thistle – liver antioxidant
  • Artichoke (Cynara scolymus), fresh, canned, jar, or powder –liver antioxidant
  • Beetroot (Beta vulgaris), fresh is best but can use powder – liver antioxidant
  • L-Glutathione (reduced)- this is our number one liver antioxidant for detox
  • N-Acetyl Cysteine (NAC) – supports the body to make and utilize glutathione
  • R-Alpha Lipoic Acid – is one of the best antioxidant in existence
  • Taurine – powerful antioxidant and anti-inflammatory agent
  • Grape Seed Extract (Vitis vinifera)- amazing antioxidant
  • Alpha Lipoic Acid – also helps make glutathione & detox
  • Turmeric (Curcuma longa), powder, fresh, concentrated extract of cucuminoids – this is a very powerful anti-inflammatory, antioxidant, antiviral & a great spice
  • Bilberry Extract (Vaccinium myrtilus), or fresh blueberries, raspberries and blackberries
  • Cranberry (unsweetened, juice, berries or powders) – berries are great fruit antioxidants
  • Rosemary (Rosemarinus officinalis) – you can add this to your cooking, as well as parsley, coriander (cilantro) all good herbal antioxidants.
  • Bromelain (from Pineapple) and Papain from papaya – great antioxidants
  • Citrus Bioflavonoids – from the ‘white’ in citrus skins – powerful antioxidant
  • Quercetin – awesome antioxidant and anti-inflammatory, also anti-allergy
  • Co enzyme Q10 – only available as a supplement, but powerful antioxidant
  • Ginger root, fresh, or powder in cooking, better than a pill
  • Green Tea – popular antioxidant that is easy to incorporate into your lifestyle
  • Astaxanthin – very powerful antioxidant. It’s the pink in salmon & trout
  • Vitamin C preferably from fresh fruits and vegetables but can use sups if needed

I really prefer antioxidants from diet – those you obtain from food, so you also get the bonus ‘life force’ of the vegetable, spice, herb etc. And then it doesn’t feel like you are supplementing.

Eliminating pyroluria is all about looking after yourself, or to be more accurate, constantly treating yourself with love. Now that’s a real treat!

If you need a practitioner to help guide you with pyrrole or antioxidant choice, I’d love to have a consultation with you. You can find my booking form here.

For specialised therapeutic diets like ‘Leaky Gut Healing’, SIBO/LIBO, Parasite Cleanse, GF/DF/SF, Diet for Pyrrole Disorder and many more, (coming soon E-books)

All the best, Love Sue x

Latest in Urinary Pyrrole Research

Latest in Urinary Pyrrole research – Applied Analytical Laboratories (AAL).

Below is the latest research from AAL, which although written for practitioners who send samples to the lab for testing from their clients, Brett from the lab has given me permission to share this valuable information with you. Whilst a lot of it may be quite technical, you will still be able to gather the important bits of information relevant to you. If not, feel free to pass this info on to your practitioner for further interpretation. Please pay particular attention to the details about collection of your sample.

The objective of this newsletter is to inform practitioners of the recent advances made to our urinary pyrrole test that further distinguish it from the others. Our test is in review for NATA ISO 15189 (medical) accreditation. (now fully accredited)

The information disclosed is to inform practitioners that the research we are carrying out is novel, and we have the scientific competencies to make leading discoveries in the field. We aim to separate ourselves from our national and international competitors in providing research that backs up our results.

There is a number of Ehrlich “positive” components found in urine that can be distinguished and it was brought to our attention by NATA during an assessment that the urinary pyrrole test was susceptible to significant interference by urobilinogen. We found this to be accurate following spiking studies where known quantities of urobilinogen were added to samples (the effect of which was measured).

Our spiking studies revealed data that enables us to now provide corrected results for the Urobilinogen, which is estimated to cause interference to the Ehrlich reading by approximately 40% (urobilinogen can cause an approximately 40% increase to the reading, but is different for all samples).

We found that small amounts of blood as well as supplementation with vitamin B6 do not interfere with results prior to testing.

However treatment strategies relying on uncorrected/false positive or false negative results, have given us cause for concern regarding general B6 toxicity. The role of Zinc and magnesium are of increasing importance.

Key Research
Pilot study research (involving 567 patients) to investigate the viability of diagnosis and treatment using “Pfeiffer/Walsh” regime;
ACNEM Journal; Vol 29 No.3 – 2010 “The Effectiveness of Targeted Nutrient Therapy in Treatment of Mental Illness – A pilot Study”; Stuckey, Walsh, & Lambert.
Study to verify pyrroles as a bio marker for schizo-effective psychosis (4 peer reviewed publications to-date, another in prep)
1 Biomarker Research, (2015) 3:3 DOI 10.1186/s40364-015-0028-1; “Biomarkers of a five-domain translational substrate for schizophrenia and schizoaffective psychosis” Fryar-Williams & Strobel.
2 Open Journal of Psychiatry, 2015, 51 78-112 dx.doi.org/10.4236/ojpsych.2015.51011; “Biomarker Symptom Profiles for Schizophrenia and Schizoaffective Psychosis”, Fryar-Williams & Strobel.
3 Frontiers in Psychiatry, 2016; doi 10.3389/fpsyt.2016.00048; “Biomarker Case-Detection and Prediction with Potential for Functional Psychosis Screening : Development and Validation of a Model Related to Biochemistry, Sensory Neural Timing & End Organ Performance.” Fryar-Williams & Strobel.
4 Frontiers in Psychiatry, 2016; doi 10.3389/fpsyt.2016.00172; “Fundamental Role of MTHFR 677C-T Genotype and Flavin Compounds in Biochemical Phenotypes for Schizophrenia and Schizoaffective Psychosis”, Fryar-Williams.
Study of treatment outcome based on Walsh protocols for child and adolescent violent offenders –
Journal of Child and Adolescent Psychopharmacology; doi 10.1089/cap.2016.0199 “Micronutrient Therapy for Violent and Aggressive Male Youth: An Open-Label Trial”; Hambly, Francis, Khan, Gibbons, Walsh, Lambert, Testa, & Haywood.
Study validating the aetiology of the elevated bio-marker and the result of treatment (in prep)
Interference studies – samples spiked with potential interferences and their effect determined on results (NATA requirement – AAL in-house development)
Characterisation of the Ehrlich and pyrrole chemistry (Combined Griffith University and AAL research – ongoing)

Treatment response studies
AAL will be involved in the bio-marker project phase III arm (with over 800 participants). This Precision Scientific research project will be collecting data on a national scale.

The key findings our research has led us to so far are as follows:

1 We have characterized the components of the fraction tested by “Pfeiffer” affiliated laboratories and found the fraction to comprise of urobilinogen and to lesser concentration, bilirubin. Therefore laboratories using the “Pfeiffer” method are measuring the interference components – not the analyte, ie the clinical significance of their results are questionable.

2 We have characterised the mechanism and products of the Ehrlich reaction by NMR and have gained profound insight into the chemistry occurring – casting doubts over some “currently accepted” chemical structures.

3 Urine urobilinogen concentration naturally peaks in the afternoon, which is why we have previously and still recommend 2nd or 3rd morning voids for testing (as urobilinogen interference is minimized at these times). We can also provide urobilinogen results.

4 Spectroscopic studies we have performed have resolved the difference between derivatives of urobilinogen, bilirubin and a ‘hydroxyhemepyrrole-like’ compound. Further elucidation is on-going.

5 We can now provide urobilinogen corrected results giving the most accurate urinary pyrrole results of any comparable laboratory in the world.

6 More accurate results have aided more accurate treatment strategies and we have found B6 toxicity to be of increasing concern.

Some changes we have made over the past few months.

AAL corrects for urobilinogen interference, although we still recommend collection of morning voids to keep the error margins to a minimum, and to provide the most accurate result possible. It is essential that the time of sample collection is provided to us on our request forms that accompany samples, so that we can distinguish between elevated pyrroles, peaks in urobilinogen concentration, and provide the most accurate reading for both.

Measurement of urobilinogen concentration is important and a low urobilinogen result can be just as significant as a high result. (ie low urobilinogen (and low pyrrole) with normal S.G., often with a trace of blood can indicate biliary obstruction and should be investigated further).

AAL provides this measurement and provides additional measurements (leukocytes, protein, nitrites, ketones, glucose, bilirubin, and blood (lysed and whole) using a Siemen Advantix urinalysis system) on samples that are outside the reference ranges (ie, both high and low).

Sample Collection
The compounds of interest in the sample are unstable and reactive with natural and artificial UV light and x-rays. Thus, it is pivotal that whatever sample pots are provided, they must be covered with foil to protect and preserve the analyte. The opaque pots provided by other laboratories (without foiling) are inadequate. It is also essential the sample must be immediately frozen and must remain frozen until testing starts.

Reference Ranges –
We have made changes to the reference ranges for the results we provide, based on real population and study data (validation of the testing protocol).

Paediatric (<14yrs)
[HPL] < 10 ug/dL Normal
10 ug/dL < [uHPL] < 20 ug/dL Borderline
[HPL] ≥ 20 ug/dL Elevated

Reference Ranges – Adults
[uHPL] ≤ 40 ug/dL Normal
40 ug/dL < [HPL] < 150 u/dL Mild Elevation
150 ug/dL < [HPL] < 400 ug/dL Moderate Elevation
[HPL] ≥ 400 ug/dL Severe Elevation

The majority of results release is done by up-load through secure portal to practice software using an encryption service. As soon results are available, they’re uploaded to your system. If a result has not been uploaded to your practice within 6-10 workings days of collection, it means we have not received the sample – so please contact us urgently for follow up. All discrepancies are documented in Non-conformance registers.

In summary
The major difference medical practitioners should note is that it is now clear the “Pyrrole” test measures a BIOMARKER of oxidative stress and is not a confirmation of a mental health condition called “Pyrrole disorder”. This actually makes the test more important and more useful to practitioners.

By understanding that there is a direct correlation between severity of symptoms and the larger measurement range and that the product is a definite measure of oxidative stress there can be a better understanding of treatment response. The extra information provided to practitioners when the results are very low or very high give a very useful tool to investigate other conditions.

Currently it appears the treatment process should not markedly change except to be able to provide future illuminations as per the comments above. Please re-read the references cited above so you understand the research behind this clarification. Please be assured we are continuing to research to improve the understanding of this important mental health biomarker.

Feel free to contact us if you have any queries.
Yours Faithfully
Brett Lambert (MAppSc, BAppSc(Chem)), Principle Scientist and Director, AAL; October 2018
Shop 6, 11 Logandowns Drive,
Meadowbrook Qld 4131
Ph 07 3133 1615
E – info_apan@bigpond.com

Dr Walsh Podcasts

I have some exciting links to share with you today to help further your education on things related to pyrrole and similar biochemical imbalances.

Dr. Bill Walsh, internationally recognized expert in the field of nutritional medicine and a key scientist paving the way for nutrient-based psychiatry and nutritional medicine has 3 podcasts you might find interesting (actually there’s more but these 3 are possibly the most relevant). These discussions were held with Dr Parker from the ‘Core Brain Journal’, the site that holds these interviews with Dr. Walsh (and other guest speakers). You may like to join their newsletter or Facebook group for more updates and interviews.

A bit of background info on Bill…..

Over the past 30 years, Dr. Walsh has developed biochemical treatments for patients diagnosed with anxiety, depression, behavioural disorders, ADD and ADHD, autism spectrum, bipolar disorders, schizophrenia and Alzheimer’s disease. His treatment plans are the basis of the training he personally gives integrative doctors around the world including Australia, via places like the MINDD.org and Bio-balance.org. Both are also great sites to visit for heaps of articles, research and loads of ‘sciency’ stuff for those needing help to convince friends, family and even general doctors that this is all very real and not made up.

I feel the three podcasts are certainly worth listening to if you know anyone with Autism or any biochemical imbalance like pyrrole disorder, anxiety, depression, bi-polar or even Alzheimer’s disease. I loved the methylation podcast which helps to further understand the difference between an under methylator and an over methylator, as well as getting the gist on why some people don’t respond well to undermethylation treatment. This may be of particular interest to those who are treating their SNP variants to the MTHFR genes with folate.

In the podcast ‘The end of Autism’ Bill Walsh shares how he feels that Autism will one day be like Polio, just a thing of the past. Not so great for those already diagnosed, but certainly for future generations.

Probably the best information that I gleaned from these discussions, was that most conditions like pyrrole, autism, Alzheimer’s and even cancer are all epigenetic, which means we do have control over them, even if we have some dodgy genes to start with. Epigenetics can be supported by healthy clean living, clearing and healing the gut, and a good diet, even if a process has already manifested.

Here are the links to the podcasts, and it’s best to listen to them in order as listed, so you understand what he speaks about as they progress. I hope you enjoy them.

  1. Methylation – CBJ/115– Essential Brain Function (start here)
  2. Copper & Kryptopyrrole – CBJ/137– Next Step for Multiple Conditions
  3. http://corebrainjournal.com/141 – The end of Autism

 

The normal HPL range is now higher

27 August 2017

 Breaking news: the ‘normal’ HPL range is now higher

If you, or someone you know, has a HPL score between 20 to 40, then this information is important.

New extensive research studies have established that there is need for a significant change in the ‘normal’ HPL score for adults. These results were formulated, based on improvements to assay sensitivities, and from consultation with practitioners regarding their clinical observations.

Previously a HPL (pyrrole) adult score of less than 15 or 20 (depending on the lab) was considered normal. The new adult reference level is now a HPL reading of less than or equal to 40ug/dl. Thus, the new HPL adult scores are:

  • Normal adult: 40 or less
  • Mild elevation: above 40 and less than 150
  • Moderate elevation: above 150 to 400
  • Severe elevation: above 400 & further haematology (blood tests) advised

The current values for paediatric levels remain the same, which is: HPL]<20ug/dL being normal for children i.e. less than 20ug/dl is normal for kids.

At this stage, I’m not certain what age criteria is used for a child, but in normal naturopathic circumstances, such as for doses of herbals etc, it’s usually less than 12, unless they are big for their age, in which case it could be 8-10 years. Let’s say less than 40kg as a guide, but if I find it’s different I’ll get back to you.

Here is how the new table will look for new reports for adults, along with your specific HPL score.

 

[HPL]≤40µg/dL Normal adult
40µg/dL<[HPL]<150µg/dL Mild elevation
150µg/dL<[HPL]<400µg/dL Moderate elevation
400µg≤[HPL] Severe elevation (further haematology advised)

You will notice in any future tests that the reports have some small changes, such as the term ‘Critical Values’ replaced by ‘Reference Ranges’ to make it easier to understand.

So what does this mean for all who thought that they had pyrrole disorder with scores between 20 and 40, the ‘new’ extended normal range?

It simply means that just when you thought that all your symptoms were related to pyrrole disorder, something else might be going on. I can almost hear some of you sighing with relief, while others sigh with despair, particularly when it was so good to know what caused all those horrible feelings and symptoms.

For some, it means, back to the drawing board. But before you throw your expensive supplements into the bin, assess how you have responded to treatment so far.

Do you feel better or worse for the treatment?

The reason I ask this is because there are other biochemical/metabolic disorders and imbalances, many that don’t even have names yet, that just might respond to the same treatment you are using for pyroluria. Vitamins and minerals such as B6, B12, zinc, magnesium etc are central to many different biological processes that go on in the body. If you are deficient in these nutrients, then supplementation may be able to manage your disorder more efficiently.

However, if supplementation treatment makes you feel worse, which does happen a lot, then it may be worthwhile to be reassessed by your practitioner. I have seen many clients who felt worse on supplements due to genetic variants that don’t allow methylation processes to work properly. In these cases, even though there were nutrient deficiencies, their bodies could not process high doses (and sometimes low doses) of certain supplements.

In this situation, food is your best medicine – but not just any food. You need food that is rich in the nutrients required to make methylation processes work more efficiently. These include folate rich foods such as leafy greens, zinc rich foods like seafood, meat and pumpkin seeds etc, B6 rich foods like bananas, meats etc and the list goes on. I have more information on this from a previous post, but you can also find it here at http://truevitalityau.wpengine.com/articles/foods-for-pyrrole-disorder/

While this article is about foods to support pyrrole disorder, be aware that these same foods can help many other metabolic disorders (particularly if this new information suggests you might not have pyrrole disorder).

In a few months, after more than five years of development, we will be launching an amazing program that will provide an array of specific, simple to follow recipes to support pyrrole, as well as another 65 or so other health conditions, plus many other features to make food and recipe selections much easier. We’ll let you know when it’s ready.

What if you feel that you still have pyrrole disorder, even though your score was say 35, yet all your symptoms ‘fit the classic picture’ of pyrrole disorder?

It is still possible that you have pyrrole disorder for various reasons. For example, your test results were inaccurate because:

  • the sample was affected by daylight
  • poor transportation if the sample was sent in the post
  • urine was too watered down from drinking lots of water to be able to ‘pee on command’ (usually the watery pee would be noted and you should have been asked for a retest)
  • you just came back from a restful, stress-free holiday and you ate really healthy food

See your practitioner

If you find that you are now within the ‘normal’ reference range, you may not have pyrrole disorder, but rather a condition that has many of the same symptoms such as methylation defects, leaky gut syndrome, heavy metal toxicity etc. In my previous post on the Pyrrole Australia Facebook page, we discussed the potential root causes of pyroluria, which is quite relevant to this article.

Or, as mentioned, you may still have pyrrole disorder, but need to be retested. In either case, it’s best to reassess your situation with your health practitioner. Much of this reassessment will depend on that question above, “Do you feel better or worse for the treatment?”

How will, or how does, this new information about the changes to the reference range affect you? I’d appreciate your feedback.

All the best, love Sue xx

Testing for Pyrrole / Pyroluria

Overview of Urinary Pyrrole/Mauve Factor Analysis

The following information about Testing for Pyrrole / Pyroluria (Urinary Pyrrole analysis) is written by Brett Lambert of Applied Analytical Laboratories Brisbane. Brett answers important questions often asked about how a sample should be collected properly, what pyroluria is, some important references and also a brief history about himself.

Urinary pyrrole (hydroxyhemopyrroline-2-one or HPL, Mwt; 123gmol-1) is a labile intermediate lactam generated during the oxidative degradation of heme and its derives (biliverdin, biliruben and urobilinogen) in situ1,2. . Increased excretion of HPL can result from a range of factors including (but not limited to) a genetic disorder affecting haemoglobin synthesis, the accelerated oxidative degradation of heme and its derivatives (a form of oxidative stress), or from the disruption of this endogenous cycle and has been described as a common feature of many behavioural disorders (also referred to as Pyrroluria)3,4,5. HPL is detectable in human urine, faeces, blood, and cerebrospinal fluid and can be eliminated by dialysis6.

A practical and reliable blood test for HPL is not possible due to the myriad of interfering substances12, thus urine remains the preferred testing substrate. In fact, the most common (and very high) false positive results arise from the presence of blood in the specimen. . HPL is commonly mis-represented as kryptopyrrole (Figure 1), a chemically similar compound used as the standard for colorimetric HPL assay7. This distinction has been confirmed by synthesis8,9,10, Gas-Liquid chromatography (GC)10 and liquid chromatography-mass spectrometry (LC-MS)12.

These methods compared favourably (linear r=0.98) with the colorimetric method used in this laboratory12 (urinary HPL levels are measured quantitatively by solvent extraction, reaction with a developing reagent, and spectrophotometric measurement at 540nm)4,7.

Second morning void (or random – providing it’s not the first) specimens are collected into vials containing preservative, and snap frozen (-30oC). Samples are transported on dry ice (-30oC) to ensure the temperature remains constant and they remain frozen and protected from light until analysis. .

Figure 1 – HPL and kryptopyrrole chemical structures. HPL and kryptopyrrole chemical structures HPL is very reactive and decomposes as soon as it leaves the body. It has a half-life of 10-12 hours11 (which means that if not frozen, after the first 24 hours, the level of HPL in the sample will be approximately 20% of the original value and 5% of the original value after 48 hours – which is also dependent on ambient temperature and other factors).

In terms of results, this property results in enormous variability (which is not desirable for a reliable diagnostic test). In early development work on the urinary pyrrole test in Australia by this author, it was also found that exposure of samples to direct sun-light (or collection in a room illuminated by direct sunlight) resulted in almost instantaneous elimination of all HPL activity.

In almost all cases in this laboratory, no detectable HPL has been found in samples that have thawed during transit (or arrived unfrozen). As a laboratory providing a national diagnostic service, it is imperative to provide the most reliable, accurate, precise, and consistent results as possible and as a result we have developed a uniform collection and transport protocol for all samples.

The freezing of samples (and for them to remain frozen until analysis) is crucial to the successful and accurate analysis of urinary HPL at this time. In the future, Applied Analytical Laboratories will be introducing a technique (currently under development) for room temperature stabilization of the analyte using a novel process. This technique has shown promise, however more validation is required before roll-out. .

The working ranges for urinary HPL levels using the method employed at Applied Analytical Laboratories are as follows: . [HPL] < 10μg/dL: Normal 10 μg/dL <[HPL] > 20μg/dL: Borderline [HPL] > 20μg/dL: Elevated These ranges have been validated by clinical trial where mental health in-patients (150) and controls (50) were tested. .

References

1.Stryer, Lupert, Biochemistry, 2nd edition, 1981 P.507-508, Freeman Press 2.http://en.wikipedia.org/wiki/Urobilinogen 19/08/2012 3. McGinnis, W: Pyroluria: Hidden Cause of Schizophrenia,Bipolar, Depression, and Anxiety Symptoms. International Guide to the World of Alternative Mental Health. Orlando 21May 2004. 4. Hoffer, A.H. “The Discovery of Kryptopyrrole and its importance in diagnosis of Biochemical Imbalances inSchizophrenia and in Criminal Behaviour”, Journal of Orthomolecular Medicine, Vol 10, No.1, 1995. 5. William J Walsh, Laura B. Glab, Mary Haakenson; Reduced violent behaviour following biochemical therapy, Physiology & Behaviour 82, 2004 835 -839. 6.Durko I, Englehardt J, Szilard J., et al; The Effect of haemodialysis on the excretion of the mauve factor in schizophrenia. J. Orthomolec Psychiatry. 1984; 13:222-232.3 7. Sohler A, Holsztynska MS, Pfeiffer CC. A Rapid Screening Test for Pyroluria; useful in distinguishing a schizophrenic Population. J. Orthomolec Psychiatr. 1974; 26:21-28. 8. Wooldrige TA, Lightner DA. Synthesis of “oxidized” hemopyrrole and kryptopyrrole: porphyric monopyrroles. J Heterocyclic Chem. 1977; 14:1283-1284. 9. Irvine DG. Pyrroles in neuropsychiatric and porphyric disorders: confirmation of a metabolite structure by synthesis. Life Sci. 1978;23:983-990. 10. Irvine DG. Hydroxy-hemopyrrolenone, not kryptopyrrole, in the urine of schizophrenics and porphyrics. Clinical Chem. 1978;2069-2070. 11. Graham DJM. Quantitativedetermination of 3-ethyl-5-hydroxy-4,5-dimethyl-[delta 3]-pyrrolin-2-one in urine using gas liquid chromatography. Clin Chim Acta. 1978; 85:205-210. 12. McGinnis WR, Audhya T, Walsh WJ, Jackson JA, McLaren-Howard J, Lewis A, Lauda P, Bibus DM, Jurnak F, Lietha R, Hoffer A . Discerning The Mauve Factor, Alternative Therapies, Vol 14 No.2 – 3; 2008. .

Author’s Brief History. Brett Lambert is a highly qualified scientist with over 25 years’ experience in research & development (pharmacology, pharmaceutical lead discovery, separation science and structural elucidation), as well as commercial laboratory management. Brett was approached in 2003 by the Bio-balance Health Group to determine the feasibility of urinary pyrrole analysis in Australia.

Following adaptation and development, the test was introduced to and used by medical practitioners undergoing specific training in the field of treating mental health. Since its introduction, Brett has performed approximately 30,000 urinary pyrrole tests and is the most experienced scientist in Australia performing this work. In 2013, Brett was acknowledged by the Bio-Balance Health group for his support and contribution to medical practitioner training in Australia. Applied Analytical

Laboratories provides a urinary pyrrole analysis service for medical practitioners through national pathology collection agencies and its analysis method has been developed to provide a reliable and consistent testing service to all regardless of geographic location.

Brett’s details:
Brett Lambert M.AppSc, B.AppSc (Chemistry)
Director, Applied Analytical Laboratories, Pty Ltd
 6/11 Logandowns Dr, Meadowbrook QLD 4131
Ph 07 3133 1615  Email: info_apan@bigpond.com.au 

Pyrrole Disorder

What is Pyroluria, pyrrole disorder, mauve factor?

Pyrrole disorder, also known as pyroluria, kryptopyroluria, kryptopyrole or Mauve disorder is a biochemical imbalance involving an abnormality in haemoglobin synthesis that can be purely genetic or acquired through environmental and emotional stress and especially from ‘leaky gut syndrome’ and the over use of antibiotics.

Pyrrole disorder is caused by the overproduction of hydroxyhempyrolin (HPL).  HPL is a biomarker for oxidative stress and is neurotoxic. Stress of any kind will increases production of pyrroles/HPL which in turn decreases zinc, B6 magnesium and other vital nutrients.

The main biochemical features are of zinc deficiency or an imbalance between zinc and copper levels. Zinc is essential for 100’s of processes in the body and is particularly important for healing, immune function, digestion, neurotransmitter activation, physical growth, memory, insulin sensitivity, and control of blood sugars, DNA replication and more….

Zinc along with B6 are essential for production of neurotransmitters such as serotonin (our happy hormone), melatonin (our sleep hormone), GABA (our relaxation hormone), and acetyl choline which is important for memory. They are also involved in production of our steroid hormones such as cortisol (our anti-inflammatory, anti-allergy hormone and stress hormone) and the conversion of oils in the body (fat metabolism, liver and gall bladder issues and weight control). The oils EPA/DHA but mostly GLA are found to be low in those with pyrrole disorder and are damaged by oxidative stress/free radicals/toxins created by pyrrole.

Signs and symptoms suggestive of someone having pyroluria.

White spots on fingernails (zinc deficiency) is a strong sign of this problem. Hypoglycemia/sugar intolerance is common, as are food and environmental allergies.
Other common symptoms are joint pains (especially knee pain), fatigue, headaches (especially migraine headaches), bowel dysfunction such as irritable bowel syndrome, easy bruising, dizziness, insomnia, poor memory and difficulty concentrating. Poor stress control, nervousness, anxiety, mood swings, severe inner tension, episodic anger, poor short-term memory and depression are other common symptoms

Obviously, such symptoms are common, and not everyone who has them will have pyroluria and not everyone with this disorder will have all of the symptoms and may even have only two, but have difficulty treating these symptoms with the usual methods.

The treatment to correct the imbalance commonly involves taking zinc, vitamin B6 and/or pyridoxal 5-phosphate (activated B6), GLA, an essential omega 6 fatty acid found in evening primrose, borage and black currant oil, Vitamin C, Vit E and magnesium along with treating any causative factors like leaky gut, heavy metal toxicity and other oxidative stressors.

However, just because the treatment seems relatively simple to describe does not mean that it is easy to do. As people start to take these needed nutrients they may feel terrible as heavy metals and other toxins are released into circulation and their immune system is activated, causing microbial toxins to also be released.

These nutrients should be introduced gradually with the supervision of a qualified practitioner and often need further support on an individual basis. It is not advisable for people to self medicate as B6 & zinc toxicity can also be an issue for some people if their body still can’t utilise these nutrients properly and so close observation by an experienced practitioner is important.

Adding the nutrients that will correct the pyroluria will not make all of the patients problems go away, as those who have this tend to have chronic microbial infections, a sea of accumulated toxins and a history of emotional wounds to still deal with. Correcting the pyroluria, however, will allow them to respond appropriately to other treatments that would have been previously ineffective and help them to finally move down the road towards true healing.

Unfortunately pyroluria is not a recognized condition by many health practitioners. It is wide-spread and mental health experts estimate as high as 20% of all psychiatric patients and 40% of people with schizophrenia and 5% of ‘normal’ people have pyroluria. I personally am seeing this statistic a lot higher in my clinic in ‘normal’ clients. It seems to affect women more than men but unfortunately most people with pyroluria go undiagnosed.

Diagnosis of pyroluria / pyrrole disorder

Pyroluria is diagnosed by a simple urine test which detects KPU in urine. Most persons have less than 10mcg/dL of KPU. Persons with 10-20 mcg/dl are considered to have “borderline” pyroluria and may still benefit from treatment. Persons with levels above 20 mcg/dl are considered to have pyroluria. Some have levels in the hundreds. Note new research now indicates that a reading over 40 mcg/dl is needed to confirm pyroluria.

Treatment of pyroluria / pyrrole disorder

Pyroluria is managed in part by restoring vital nutrients nutrients. The type of replacement therapy is very important as most nutrients need to be provided in an efficiently absorbed form, often called ‘active’ form of vitamin. Vitamin B6 is also available in several forms such as pyridoxine hydrochloride or pyridoxyl 5 phoshate (P5P). Other nutrients may assist include niacinamide (B3), pantothenic acid (B5), methylcobalamin (B12), manganese, vitamins C, E and magnesium.

Food sources and nutritional supplements containing copper and red/yellow food dyes should be avoided. Copper is commonly high in people with pyroluria and needs to be detoxified. It is advisable to have mineral and metal levels, ratios and balances performed by a Hair mineral analysis to get the treatment correct. I prefer to use a lab in the United Sates as they have an excellent reporting system that is usually around 38 pages long.

People with mild-moderate pyroluria usually have a fairly rapid response to treatment if no other imbalances are present. People with severe pyroluria usually require several weeks before progress is seen and improvement may be gradual over 3 – 12 months. Features of pyroluria usually recur within 2 – 4 weeks if the nutritional program is stopped.  Thus, the need for treatment is thought to be indefinite, but with good management and healthy lifestyle and emotional balance I feel that it is possible to need no supplementation once the correct balance is created and a fairly stress-free life is sustained.

The history of pyrrole discovery

Pyroluria, was first noted by Abram Hoffer MD, PhD and Humphrey Osmond, MRCS, DPM in the early 1960’s in their research on metabolic imbalances in people with schizophrenia This condition has been found to be relatively common in people with schizophrenia and bipolar disorder (manic depressive disease) by orthomolecular psychiatrists (psychiatrists who focus on nutritional therapies); they have found approximately 20% of schizophrenics have this condition, and they tend to respond well to treating it. But Dr. Klinghardt and others have found that not everyone with this condition suffers from such extreme psychiatric problems (though many may have some tendency towards anxiety and/or depression). Indeed, the breakthrough Dr. Klinghardt has made is in recognizing how common this condition may be in other people with chronic illness.

In the early 1970’s Carl Pfieffer MD PhD found evidence of kryptopyroluria in 5 % of normal people he tested (people without serious psychiatric illness). This may represent the percentage of the population with a strong genetic tendency to kryptopyroluria, but it is possible the number of people with this problem has increased due to our increasing exposure to environmental stressors (microbes and toxins) as well as increasing emotional unrest (stress increases pyrroles) and the higher use of electronic devises (positive ions) which also leads to less ‘natural living’ and less exercise and fresh air.

Testing for pyrrole disorder

Pyrrole is extremely sensitive to light and heat (particularly heat) and so a urine sample must be collected in an environment with the least exposure to heat as possible, in a container with a preserving agent such as vitamin C, wrapped in alfoil upon sample collection, snap frozen and then sent to the testing laboratory on dry ice. For this reason it is not advisable to send your urine sample in the post even if frozen first. Many a person has been misdiagnosed this way and then missed out on appropriate treatment, not to mention the loss of cost of the test.

Testing laboratory – Applied Analytical Laboratories – Brisbane

There are a few testing laboratories in Australia, but the most accurate and reliable one I have used is a lab that is dedicated to only testing for pyrrole and nothing else, so they are specialists in this field and dedicate all of their time to this testing, research into pyroluria as well as research and development of better collection systems. They are AAL. For a list of places around Australia that a collection can be done and for your practitioner request sheet, please email me via my ‘contact’ page, not the ‘comments’ section below, so that I can then speak to you directly and give you the right details and sheets. Note please give me your area that you live in so I can give you the place closet to you.  Brett from AAL has written a post to answer questions on why correct collection procedures are important and the science behind it all. Very well worth a read. You can find this post by clicking here.

Important notes to read before getting tested for pyrrole disorder

Please note, that it is super important how the collection of the urine sample is taken and even more important that it is handled correctly to get to the lab without the pyrroles in the sample deteriorating. The sample must be collected in a dimmly lit room if possible (artificial light is fine), in a special container that has a preservative. The urine must not be pre-collected, but done directly into the specimen container and then immediately wrapped in aluminum foil, as pyrrole levels are affected by light and heat (esp heat). Then the sample must be snap frozen and delivered to the lab with dry-ice, not just frozen and posted as some labs do, or there will be a false negative or low reading. see above link.

The best time of day to do the test is from the second or third morning urine sample of the day so when booking your time with the collection center please take this into account when booking your time. You do not have to be fasting, only off zinc, unless retesting to check if your dose is working.

Please know that I can offer any tests needed (via pathology request sheet), but there is no medicare rebate with Naturopaths pathology requests.  If you would like the rebate then you will need to find a good GP that tests for nutritionals. Medicare generally does not cover vitamin testing (except iron), but it is not expensive to do.

Please note that pyrrole screening is not covered by Medicare even if requested by a GP or Integrative doctor. The pyrrole screening also needs a request sheet which I can also offer and then we can have an in clinic, phone or skype consultation. To organise this please contact me via my ‘contact’ page and NOT on the comments below. Comments below are for sharing of experiences of pyrrole with others or you can visit the Pyrrole Australia Face Book page and have discussion and comments with others with pyrrole disorder by clicking here.

Important Note: I am very often asked if I know of a practitioner or G.P that I could recommend for treatment. I do not keep a list of practitioners, but I do however have a list of places to get your sample taken, but you will need to contact me via the ‘contact page’ not the comments below and let me know here you live, so that I can direct you to the correct collection center. Thank you.

For a link to the Pyrrole Australia Face book page click here

Important Note: I am very often asked if I know of a practitioner or G.P that I could recommend for pyrrole treatment. I do not keep a list of practitioners, but am happy to help you any way I can personally either via in clinic consultation or via Skype or phone consultation. I do however have a list of places to get your sample taken, but you will need to contact me via the ‘contact page’ (see links above) NOT the comments below (please) and let me know where you live, so that I can direct you to the correct collection centre. Please note that collection centres are not laboratories, just places to collect the sample. Thank you.

For information on Common adjunctive testing done alongside Pyrrole screening click here.

For information on the food that best suit someone with pyrrole disorder and foods rich in B6 and zinc click here.