Pyroluria: A hidden mental disorder

When health and convention medicine reduces your diagnosis down to one cause and is largely managed with palliative treatment, focused on alleviating symptoms, medication is the logical treatment despite long term adverse effects often. Addressing health with an holistic approach such as nutrition, and beyond meeting nutritional needs, for its beneficial role in many diseases, is better positioned to provide long-term rather than short-term benefits. Disease and health issues rarely happen suddenly, but are a long term slow burning fire that finally over burdens the body until it becomes insufficiently supported and cannot look after itself if current lifestyle and nutrition continues.

Pyroluria is a condition quite unknown, often inherited, and can affect persons of all ages. Pyroluria is the disruption of synthesis of any haem-producing molecule in the body, including hemoglobin.

 Common Symptoms of Pyrrole Disorder:

Poor stress control
Sensitivities to lights, odours, sounds, textures
Highly irritable
Short temper
White spots on finger nails
Severe depression
Poor growth
Inner tension
Severe anxiety
Mood swings
Inability to tan
Thin skin
Joint pain
Poor short term memory
Frequent infections
Spleen area pain (stitch)
Poor immunity
Candida overgrowth
Increased intestinal permeability
Irritable bowel syndrome
Nausea in the morning
Little or no dream recall
Unusual fat distribution

Pyrrole Disorder sufferers produce excessive amounts of the metabolite HPL (hydroxyhemopyrrolin-2-one) which renders normal cell receptors unable to properly utilize zinc, Vitamin B6 and biotin while at the same time enhancing their excretion in the urine when attached to the pyrroles. This leads to depletion of these key nutrients which are co-enzymatic cofactors for mood and methylation modulation as well as for amino acid and neuro-transmitter metabolism. The deficiencies can contribute to all types of mental health conditions, including depression, anxiety, OCD, ADHD, schizophrenia and suicidal tendencies. It is noted that there is a higher rate of pyroluria in people with autism and autism spectrum disorders. (1)

Testing for pyroluria is quite simple using a urine sample and easy for children. Until we begin to look at mental illness through a wider lens, with greater curiosity and less judgment, we will continue to shame and close down creative solutions. I have tested and supported many clients, both children and adults, who displayed pyroluria-based symptoms, and for most, they were labelled as suffering from either depression, autism spectrum or as having chronic fatigue.  Some people are able to recover from pyroluria, especially with comprehensive nutritional and stress management practices. Others need to continue with ongoing specific nutrient therapy, and others will require nutrient therapies only in times of very high stress supporting levels of zinc, B6 and biotin.

Pyroluria and the Gut

Individuals with pyroluria have a much higher risk for leaky gut syndrome involving damage to the very delicate lining of the digestive tract or intestinal mucosal barrier. (2) Increased intestinal permeability makes a person more susceptible to all types of pathogenic infections, food sensitivities and symptoms such as skin rashes, migraine, joint inflammation, low energy/fatigue, loss of a lust for life. Digestive issues greatly affect uptake of nutrients from the diet leading to a wide range of effects which can be difficult to diagnose until the cause is identified.

The first step in stabilizing any condition is the assessment of metabolic nutrition needs and initiation of an individualized nutrition program. This is necessary in order to generate the energy to produce healing/repair of the gut and rebalancing of related biochemical pathways often presenting as emotional and mental conditions.

 Walter Last, a German Research Chemist, Biochemist and Toxicologist practicing in Nutrition Therapy has dedicate his life to scientific research and chronic disease. He claims the main cause of pyroluria appears to be intestinal dysbiosis with overgrowth of Candida, and possibly Lyme disease/Borreliosis. His scientific research has tracked the wider effects of viruses and how they may invade the liver and affect its functions. “They also seem to be able to insert some of their own DNA into liver genes, especially changing our mitochondrial DNA involved with energy production. This then causes the acquired condition to be inheritable, and it often runs in families”. Antibiotic overuse and other drugs are associated with Candida which can spread beyond the gut into the internal organs. Normal medical tests do not discover the fungal form of Candida in internal organs, only the less harmful yeast form. (7)

Pyroluria and Haem Synthesis

Pyroluria involves the malfunction of haem-containing molecule and zinc, vitamin B6, and biotin are all required for the production of haem. The loss of these nutrients through pyrrole affinity and excretion creates a major disruption in heme levels. Your Complete Blood Cell Panel may indicate low haem levels. Proper balances of haem are required for many other body functions as well, including oxygen regulation and electron transfer, two very critical homeostatic functions.

Haem is depleted by stress and heavy metal exposure. (4) Naturally in the presence of mood disorders and mental illness, there are going to be considerable internal and external stresses in the lives of the persons affected. Notably also, vitamin B6 and zinc are two of the most critical cofactors for detoxification/methylation.

Methylation and How Critical it is for Health

“Methyl” refers to nutrients that are involved in a biochemical process called methylation. During methylation, chemicals are added to and bond with proteins, DNA, or other molecules. Methyl donors are composed of a carbon atom attached to three hydrogen atoms, signified as CH3.

Methylation is crucial to active nutrients such as vitamin B6, vitamin B12, folate, choline, and methionine, an essential amino acid that is used in the production of proteins. Other nutrients involved in methylation include N-dimethyl glycine (DMG), S-adenosylmethionine (SAM-e), and dimethyl-amino-ethanol (DMAE).

Pyroluria and Methylation

 Methylation is aligned with a number of disease states because it affects a very crucial stage of many pathways by its role to methylate. Homocysteine needs methylating otherwise high levels increase cardiovascular risk, Dopamine needs methylating to be formed from Dopa and affects cognition, mood and behavior, methylation is critical to detoxification and oxidation. Low methylation is likely to disrupt histamine and cause an increased sensitivity to allergic triggers and to risk impaired detox pathways.

Also affected are the stores of the antioxidants glutathione, superoxide dismutase (SOD), and catalase, through the loss of vitamin B6 and zinc. All three enzymes rely on these nutrients to some degree for production and successful detoxification. Glutathione is the major antioxidant required for the removal of heavy molecules such as heavy metals. With increased heavy metal exposure risk (caused in large part by the displacement of zinc in pyroluria), people afflicted with pyroluria are also facing increased risks of all diseases and conditions associated with heavy metal toxicity, from cancer to dementia, heart disease and diabetes.

Copper toxicity is a frequent finding in pyroluria, as it requires zinc to keep it in balance. Symptoms of copper toxicity include yeast infections, mono, PMS, racing mind, achy muscles, dry skin, panic attacks and eating disorders.

Which foods are good methyl donors?

Finding foods that are good sources of methyl donors isn’t difficult because there are so many from which to choose:

  • Folate: chickpeas, lentils, pinto beans, leafy greens (e.g., spinach, kale, collards, mustard greens, bok choy), strawberries, and citrus (e.g., grapefruit, oranges, lemons)
  • Vitamin B6: grass-fed beef, pistachios, pinto beans, avocado, blackstrap molasses, tuna, sunflower seeds, sesame seeds
  • Vitamin B12: fish, organic meats, seaweed (laver and nori), eggs
  • Methionine: Brazil nuts are a super rich, sesame seeds, roasted soybeans, parmesan cheese, tuna, eggs, and white beans
  • Choline (which oxidizes to a methyl called betaine, or trimethylglycine (TMG): beets, Brussel sprouts, broccoli, liver, eggs, raw cauliflower, cooked beet greens, cooked asparagus
  • DMG: beans, brown rice, pumpkin seeds
  • DMAE: anchovies, salmon, sardines
  • SAM-e: Although there are no direct food sources of SAM-e, it is a compound made from methionine, so it is acquired indirectly

A good balance of methyl donor foods, as part of a natural foods diet, can help promote and support proper methylation. In addition, getting a sufficient amount of probiotics (beneficial bacteria, which help produce and absorb B vitamins) as well as zinc and magnesium (which support methylation) can be advantageous to your health.

Nutrition – The Whole Person Therapy

Pyroluria is a condition that is relatively simple to work with, once identified and dealt with in a whole person paradigm. Not only is it important to confirm the condition with appropriate, reliable testing, but also to look at the whole person in the process. That includes addressing the gut, detoxification, and the immune system along with the emotional aspects. It is natural that our beliefs/thoughts/feelings and behaviors become intertwined with our biochemistry.

References:
1) http://www.mensahmedical.com/pyroluria-pyrrole-disorder/
2) R. McGinnis R, Woody & Audhya, Tapan & Walsh J, William & Jackson A et al (2008) Discerning the Mauve factor, Part 2. Alternative therapies in health and medicine. 14(2). 56-62.
3) Graham DJM, Thompson GG, Moore MR, Goldberg AA (1979) The effects of selected monopyrroles on various aspects of heme biosynthesis and degradation in the rat. Arch Biochem Biophys.
4) Atamna H (2004) Heme, iron, and the mitochondrial decay of ageing. Ageing Res Rev;3(3):303-18.
5) Mikirova N (2015) Clinical Test of Pyrroles in Psychiatric Disorders: Association with Nutritional, Immunological and Metabolic Markers. J of Nutr Therapeutic; 4. 4-11.
6) Heitzman A, Gosek P, Lechowicz W et al (2017) Elevated hydroxylactam of hemopyrrole level in urine in perpetrators of extremely violent acts diagnosed with psychosis. Psychiatr Pol. 51(3):413-423.
7) Last W (2016) Pyroluria and Candida – Twin causes of modern diseases. Nexus Newsfeed.