I never heard the term pyroluria mentioned during my residency in psychiatry, which is kind of crazy, given that it is not at all rare and can profoundly effect mental health. It is a condition found in many people who have serious psychiatric disorders, including severe depression, anxiety, mood swings, explosiveness and violent behavior, alcoholism, memory problems, attentional problems, academic underachievement, autism spectrum disorders and psychosis.
You would think that given how relatively common it is, how debilitating, and how treatable, that it would have been part of the curriculum. But hey, we were not taught a thing about the effect of diet on mental health either. Pyroluria is also present in people with chronic medical illness, including auto-immune conditions, as it is a general sign of oxidative stress in the body.
Many individuals with poor gut health suffer from elevated levels of pyrroles. I have pyroluria, as do many of the patients in my psychiatric practice, who are of course, a self-selected group. It is diagnosed by a simple inexpensive laboratory test that measures the level of pyrroles in the urine.
Pyrroles are a normal breakdown product of hemoglobin, the molecule that carries oxygen in your blood. When pyrroles are excreted from the body they bind with two nutrients that are essential to mental health, zinc and B6. Individuals with a genetic abnormality that causes elevated production of pyrroles will become relatively deficient in zinc and B6. The combined effect of B6 and zinc deficiency is a disaster for brain function as well as the immune system. B6 is required for the synthesis of three critically important neurotransmitters; serotonin, dopamine and GABA. Zinc is a component of more than 200 enzymes and other special proteins that play a role in cell division and gene expression, insulin regulation, as well as necessary in the maintenance of the blood brain barrier, which prevents harmful chemicals from entering the brain.
Here is Dr. Walsh’s list of some of the symptoms correlated with pyroluria: Poor stress control, sensitivity to bright lights and loud noises, morning nausea, tendency to delay or skip breakfast, very dry skin, pale skin, inability to tan, high irritability and temper, history of underachievement, little or no dream recall, auto immune disorders, white spots on the finger nails, poor growth, coarse eyebrow hair, stretch marks on the skin, severe anxiety and/or depression, fearfulness, obsessions with negative thoughts, delayed puberty, dark or mauve colored urine, affinity for spicy and salty foods, abnormal fat distribution, delicate facial features, extreme mood swings, history of dyslexia, severe inner tension, frequent infections, premature graying of hair, poor muscle development, spleen area pain, joint pain, poor wound healing, psoriasis, tendency to stay up very late, abnormal or absent menstrual periods.
Pyroluria is often found in children who have behavioral dysregulation, attentional problems, learning disabilities and tantrums. Symptoms can be exacerbated when a child has a growth spurt, because growing increases the body’s demand for zinc and B6. With appropriate supplementation, symptoms can improve rapidly. Dr. Walsh said that he was always happy when he tested a kid and found elevated pyrroles, because treatment can make such a dramatic difference so quickly.
