What Are The Symptoms Of Pyrrole Disorder or Pyroluria?

red blood cells | pyroluria or pyrrole disorder | Perpetual Wellbeing

What is Pyroluria or Pyrrole Disorder? What are the symptoms and how can it be treated? In this blog post we aim to highlight some of the most common symptoms that people experience, how to establish whether pyroluria is the issue and how we develop a treatment plan to support patients with elevated levels of HPL.

Think you may have pyroluria? Do you tick yes to experiencing any of the below?

  • Mood and behavioural symptoms (e.g. anxiety and stress intolerance, depression, inner tension, social withdrawal, explosive temper and mood swings)
  • Abdominal pain and/or morning nausea
  • Impotence in males
  • Acne
  • Irregular periods and/or delayed puberty
  • Allergies and intolerances
  • Sensitivity to light, sound and odour
  • Migraines
  • Attention deficit/hyperactivity
  • Irritable Bowel Syndrome
  • Poor dream recall
  • Stretch marks in the skin and/or white spots on fingernails

Could you have Pyroluria / Pyrrole disorder?

Pyrroles are primarily normal by-products of haemoglobin synthesis. Pyrrole Disorder is an abnormality in biochemistry resulting in the overproduction of a haemoglobin metabolite known as hydrox¬yhemopyrrolin-2-one (HPL) – or simply “urinary pyrrole”. Excess pyrroles have little or no function in the body and are effectively excreted in the urine. Individuals who produce excessive amounts of this haemo­globin waste product (HPL) are deficient in B6 and zinc because these elements are bound up by the HPL, rendering them unavailable for normal functions, and are excreted from the body via the urine.

Pyroluria affects up to 10% of the population, and the incidence can increase to 18-35% in people with psychological disturbances, learning or behavioural problems.

How do I know if I have Pyroluria?

A pyrrole test is a very sensitive urine test that simply tests for the concentration of HPL in the urine. Samples containing levels of urinary HPL of 0 – 10 μg/dL are considered normal or negative, samples of 10 – 20 μg/dL are considered borderline, and samples above 20 μg/dL are considered elevated.

We chose to use a laboratory that specialises only in pyrrole testing, because it is such a sensitive test. Pyrroles are extremely sensitive to light and heat and so a urine sample must be collected in an environment with the least exposure to light as possible, in a container with a preserving agent, wrapped in alfoil upon sample collection, snap frozen and then sent to the testing laboratory on dry ice. If this procedure is not followed correctly then false negatives or low HPL readings are possible. Your practitioner will guide you through the collection instructions. Pyrrole testing costs between $75-$135.

What is the treatment for Pyroluria?

It is often more complex than supplementing with vitamin B6 and zinc. Firstly, it is being recommended the correct form and dose of these nutrients, but there are also a whole lot of other factors that will impact a treatment plan.

HPL may be a stress-induced factor. It has been proposed that emotional and physical stress increases HPL excretion very quickly. It is also believed that stress and high HPL may affect the production of heme, the iron carrier in red blood cells. This has a detrimental effect on energy production and increases oxidative damage to the cells, as the body is unable to produce enough antioxidants and other important detoxification factors.

Research also suggests dysbiosis and intestinal permeability can lead to higher circulating levels of HPL (and zinc is important for maintenance of intestinal integrity). Therefore improving intestinal integrity and addressing dysbiosis may be an important step in reducing urinary HPL.

Genetics is another factor for us to take into consideration. Poor vitamin B6 and zinc status will negatively impact healthy methylation processes, which is confounded by the presence of SNPs on genes encoding for enzymes involved in methylation.

We do not have one treatment plan that fits all. Your practitioner is here to look at the big picture, we will consider each of the above in conjunction with a full health assessment to get you onto an individualised treatment plan specific for you!

The team at Perpetual Wellbeing can help you. Book an appointment today with one of our expert practitioners.