Pyrroluria - What is it and how to treat it

By Quilla Watt, Integrative Naturopath

You may have been recently diagnosed with pyrroluria, or know someone who has. You may have heard that it can be a factor in many mental health issues and you’re trying to find more information. But for many, this may be the very first time you have ever heard of pyrroluria. This condition is not very well known, and not very well understood or accepted by the wider medical community. We see pyrroluria quite often in our clinic, and when treated correctly, we can see profound results.

Pyrroluria is also referred to as pyrrole disorder, kryptopyroluria, kryptopyrole disorder, Mauve disorder or Mauve factor.

 

What is pyrroluria?

In pyrroluria, the body produces excess amounts of a chemical called HPL (hydroxyhemopyrrolin-2-one), which is excreted in the urine. HPL binds strongly to zinc and vitamin B6, and pulls them out of the body. This causes deficiencies in B6 and zinc. These two nutrients are essential to the normal functioning of many pathways in the body. Zinc is essential to normal immune function, digestion, growth and repair, memory, blood sugar regulation and DNA replication. Zinc and B6 are both needed to produce important brain chemicals like serotonin, melatonin, and GABA, which are important for mood, sleep, and feeling relaxed. They are also important for making cortisol, the hormone that helps you cope with stress.

For some people, pyrroluria is genetic, and may require lifelong management. For others, it can be caused by exposure to environmental toxins or high stress. HPL excretion increases with emotional or physical stress; and with digestive issues like leaky gut. In these cases, we need to address the underlying issues rather than focus all our attention on the pyrroluria.

Many of the symptoms of pyrroluria are actually symptoms of severe zinc and B6 deficiency. Common signs and symptoms include:

  • Anxiety, nervousness, and severe inner tension
  • Depression, mood swings, and episodic anger
  • Insomnia
  • Poor memory and concentration
  • Poor dream recall (B6 deficiency)
  • Poor stress control
  • Morning nausea
  • Light/sound/odor intolerance
  • White spots on fingernails (zinc deficiency)
  • Hypoglycemia/sugar intolerance
  • Food and environmental allergies
  • Joint pain
  • Headaches (especially migraine headaches)
  • Irritable bowel syndrome (zinc deficiency and stress both create leaky gut, which is often associated with higher pyrrole readings)

 

So how do we test for Pyrroluria?

A urine test can measure the amount of HPL the body is excreting. The collection procedure for the urine has to be very specific. HPL is highly unstable. Exposure to light, temperature changes, or preservatives that might be found in test tubes can mess with results. For accurate results, the urine sample needs to be collected in a dim room, snap frozen and transported to the lab on dry ice. At The Health Lodge we can organise the testing for you.

 

What about treatment?

Supplementing with zinc and B6 is the cornerstone of pyrroluria treatment. Supplemental zinc and B6 fix the deficiency issues caused by the amounts lost through the urine. Zinc and B6 also reduces the amount of HPL created. For this reason, it is important to not be taking zinc and B6 before testing for pyrroluria, as you may get a false negative result.

Improvement can be seen within a few days to a few weeks of starting treatment. Clinically, we see higher pyrrole readings in patients with more severe symptoms. These patients may require larger doses of B6 and zinc, and may take longer to see improvement.

Treating pyrroluria is not quite as simple as just taking zinc and B6. Detoxification pathways and antioxidant defenses can also be impaired, and part of treatment involves supporting these pathways. It is also important to address stress levels and leaky gut as they are major drivers of high HPL levels.

More recently, it has been suggested that people with pyrroluria may also have lower levels of biotin and omega 6 fatty acids. Biotin deficiency is known to cause neurological disease in animals and humans. Omega 6 fatty acids are important for normal immune function, brain function, growth and repair. Evening primrose oil (EPO) is an excellent source of omega 6 fatty acids that actually has an anti-inflammatory action. What’s more, EPO helps enhance zinc absorption, and decreases the intestinal permeability seen in leaky gut. Some pyrroluria patients may need to take omega-6s in combination with omega-3s.

Frequent supplementation with zinc can throw-out your copper and manganese balance. Serum copper and serum manganese, along with plasma zinc should be tested to assess treatment. Even with regular (and often high dose) zinc supplementation, the aim is to have all levels within normal range.

Clearly, correctly treating pyrroluria is about more than just taking zinc and B6. The information in this article is of a general nature only, and should not be used as a substitute for medical advice or consultations with you health care provider. We advise you to consult a qualified health practitioner before considering commencing any new therapies.

 

Your integrative team of healthcare specialists

At The Health Lodge, we believe that a multidisciplinary team of health care professionals is essential in addressing all aspects of your health. Your team may include general practitioners, naturopaths, psychologists, and acupuncturists. This comprehensive and holistic approach is designed to support your physical, mental, and emotional wellbeing.

 

Some extra stuff…

For some, this next bit may be a bit boring. For others, it may be a bit confusing. Safe to say the really important info has already been covered, but we wanted to take the opportunity to straighten a couple of things out, especially for any health praccies reading this.

  1. We don’t actually know how HPL is made. HPL is commonly thought to be a by-product of haemoglobin synthesis. This was a theory put forward in the 1970s by Carl Pfeiffer. It is true that when the body makes haemoglobin, pyrroles are produced. However, we don’t actually know that this is how HLP is made. Interesting preliminary evidence is now suggesting that gut bacteria may be involved in its production.
  2. It’s not kryptopyrrols. Mauve factor was incorrectly identified as kryptopyrrols in two articles published in1969 and 1970. However, later research shows that kryptopyrrols are not found in human urine, and the mauve factor is actually HPL. Also, the term pyrroles is not specific enough. Pyrroles are a family of chemicals with similar structures, so the term Pyrroluria doesn’t actually mean much. It is specifically HPL that we are interested in when we are talking about Pyrroluria.

 

For health practitioners after more info, we recommend two articles co-authored by William J. Walsh, an internationally recognized expert on biochemical imbalances and founder of Walsh Research Institute, a non-profit organization dedicated to unraveling the biochemistry of mental disorders.

Discerning the Mauve Factor, Pat 1 Woody R. McGinnis, MD, Tapan Audhya, PhD, William J. Walsh, PhD; James A. Jackson, PhD; John McLaren-Howard, DSc, FACN; Allen Lewis, MD; Peter H. Lauda, MD; Douglas M. Bibus, PhD; Frances Jurnak, PhD; Roman Lietha, MD; Abram Hoffer, MD, PhD ALTERNATIVE THERAPIES, Mar/Apr 2008, VOL. 14, NO. 2

Discerning the Mauve Factor, Part 2 Woody R. McGinnis, MD, Tapan Audhya, PhD, William J. Walsh, PhD, James A. Jackson, PhD; John McLaren-Howard, DSc, FACN; Allen Lewis, MD; Peter H. Lauda, MD; Douglas M. Bibus, PhD; Frances Jurnak, PhD; Roman Lietha, MD; Abram Hoffer, MD, PhD ALTERNATIVE THERAPIES, May/Jun 2008, VOL. 14, NO. 3

So if you have been diagnosed with Cancer what do you do? Integrated Cancer Care – Part 3

Treatment options:

A doctor who specialized in the treatment of cancer is called an oncologist. He or she may be a surgeon, a specialist in radiation therapy, or a medical oncologist.

The first option is usually surgery to treat the cancer; the second, radiation therapy; the third, chemotherapy and related treatments. There is consultation between medical team to develop a treatment plan for each particular patient.

The treatment is based on the type of cancer and the stage of the cancer. In some people, diagnosis and treatment may occur at the same time if the cancer is entirely surgically removed when the surgeon removes the tissue for biopsy.

Although patients may receive a unique sequenced treatment, or protocol, for their cancer, most treatments have one or more of the following components: surgery, chemotherapy, radiation therapy, or combination treatments (a combination of two or all three treatments).

Individuals obtain variations of these treatments for cancer. Patients with cancers that cannot be completely removed by surgery usually will get combination therapy, the composition determined by the cancer type and stage.

Complications

There are many complications that may occur with cancer; many are specific to the cancer type and stage and are too numerous to list here. However, some general complications that may occur with both cancer and its treatment protocols are listed below: (5)

  • Fatigue (both due to cancer and its treatments)

  • Anemia (both)

  • Loss of appetite (both)

  • Insomnia (both)

  • Hair loss (treatments mainly)

  • Nausea (both)

  • Lymphedema (both)

  • Pain (both)

  • Immune system depression (both)

 

What else is there if you have been diagnosed with Cancer

Integrative medicine is a total approach to medical care that combines standard medicine with the complimentary medicine practices that have shown to be safe and effective. They treat the patient's mind, body, and spirit. (6)

How can alternative medicine help people with cancer?

Alternative cancer treatments may not play a direct role in curing your cancer, but they may help you cope with signs and symptoms caused by cancer and cancer treatments. Common signs and symptoms such as anxiety, fatigue, nausea and vomiting, pain, difficulty sleeping, and stress may be lessened by alternative treatments.

Integrating the best of evidence-based complementary and alternative cancer treatments with the treatments you receive from your doctor may help relieve many of the symptoms associated with cancer and its treatment.

Working closely with a medical doctor to determine the right balance between traditional medicines and alternative cancer treatments offers the best outcome.

Dr Kelley

Dr. Kelley, and John Beard before him, believed to defeat cancer you don’t create some new method of defence that does not mimic the human body, you create a method of defence that acts LIKE the human body, and the body uses pancreatic proteolytic enzymes in the natural fight against cancer.(7)

Henry Osiecki

Suggested nutritional guidelines to improve the treatment of Cancer

  • pH and electrolyte balance – includes both extracellular and intracellular pH

  • Energy balance of aerobic and anaerobic states

  • Tissue oxygenation

  • Immune balance – including controlling inflammatory functions

  • Eliminating or destroying various toxins

  • Maintain and control cellular reproduction and cellular death

  • Maintain cognitive functions to avoid stresses and support health functions (8)

 

Gawler Institute Philosophy

Healing is possible and achievable by taking a holistic approach to lifestyle choices. Health is influenced by how we eat, think, exercise, relax and relate to ourselves and others. This belief is based on ancient wisdom combined with the real life experience of many thousands of people who have been through our programs and increasingly our philosophy is being validated through scientific research as well. (9)

 

What is Blastocystis?

Blastocystis spp. infection- Blastocystosis

Blastocystis spp. is a group of parasites that is sometimes found in the lower intestine (large bowel). Infection with Blastocystis spp. is called blastocystosis. Blastocystis spp. is thought to be transmitted through oral-fecal contact from poor hand washing and hygiene practices, ingesting contaminated food or water, and exposure to animals.

Our understanding of Blastocystis has been revised several times. Up until 1996, Blastocystis was thought to be some type of yeast or fungi. It was only when Blastocystis DNA was studied that we realized it was a parasite. For a long time, we thought there was only one type of Blastocystis- Blastocystis homminis. We now know that there are actually 9 different subtypes, which are collectively called Blastocystis spp. 

There is still debate about whether Blastocystis spp. is even an infectious agent. This is because Blastocystis spp. can be found in the fecal specimens of many people who appear healthy and have no symptoms at all. There is a huge variation in the symptoms people experience, and how well treatment works. Why would there be such variation in symptoms and treatment response? Researchers suggest it is because of the different subtypes of Blastocystis having different effects in the body, and reacting differently to treatment.

 

Signs and symptoms of blastocystosis

In people who do experience symptoms, signs and symptoms can include:

·         Diarrhea

·         Constipation

·         Nausea

·         Vomiting

·         Abdominal cramps

·         Bloody stools

·         Bloating

·         Excessive gas

·         Anal itching

·         Loss of appetite

·         Weight loss

·         Dizziness

·         Headaches

·         Depression

·         Fatigue

·         Rash

Diagnostic considerations

At The Health Lodge, if we suspect you have blastocystosis, we may be interested in performing some tests to give us more information. These include:

·         Testing for Blastocystis spp. A common method to test for Blastocystis spp. is by stool culture, however we prefer to use a variation on this method that involves extraction of DNA followed by polymerase chain reaction (PCR) testing. This is considered the most sensitive testing method.

·         Screening for nutrient deficiencies, as Blastocystis spp. can contribute to nutritional deficiencies, especially iron.

·         Screening for food allergies and intolerances. We find that many of our patients with Blastocystis infection also have food allergies or intolerances. Blastocystis spp. has been found to increase the permeability of the gut wall, which allows large proteins that are usually broken down to pass through into the blood stream. These proteins can interact with the immune system and trigger a reaction.

·         We may be interested in screening for Blastocystis spp. in patients with irritable bowel syndrome or irritable bowel disease (Crohn’s disease, ulcerative colitis). Blastocystis infection has been associated with these diseases, and it may be an underlying cause or contributing factor in some cases.  

Treatment considerations

Common treatment for Blastocystis infection includes the antibiotic metronidazole (Flagyl). However, the high failure rates of eradication using single drug therapy has led to the use of combination therapies of multiple antibiotic and anti-parasitic medications. At The Health Lodge, we find the best results are often achieved with a combination of antibiotic therapy and complementary therapies.

At The Health Lodge, our goals in treating Blastocystosis include eradicating the Blastocystis infection, correcting nutrient deficiencies, identifying and managing food allergies and intolerances, and repairing the gut wall and digestive function. We believe that a multidisciplinary team of health care professionals is essential in managing all the aspects of health. Depending on your individual needs, your multidisciplinary team may include general practitioners, psychologists, dietitians or nutritionists, naturopaths, osteopaths, and acupuncturists. This comprehensive and holistic approach is designed to support your physical, mental, and emotional wellbeing.

Lyme disease - Integrative Treatment Approach Part One

Lyme disease, or Lyme Borreliosis, is caused by a species of bacteria called Borrelia. It is transmitted to humans by ticks. Some ticks carry Borrelia, and when they attach and suck blood, they can regurgitate the bacteria into their host. The most common strain is Borrelia burgdorferi. This is the cause of most cases of Lyme disease in America. In Europe, the main strains are B. garinii and B. afzelii.

 

What are the symptoms of Lyme disease?

Borrelia bacteria are slow growing. Symptoms may take days or months to appear. In some cases, the disease may lie dormant for years, and surface after a stressful event such as illness, surgery, or physical or emotional trauma. One of the earliest and most defining signs of Lyme disease is a rash that spreads out from the site of the tick bite. The rash resembles a bulls-eye. At this early stage you may feel like you have the flu- fatigue, fever, headaches, muscle and joint aches and pains, and swollen lymph nodes are common.

The later stages of Lyme disease can take months or years to develop, and can cause problems in the joints, heart, and nervous system, and may affect mood and cognition.

 

Lyme disease in Australia, why the controversy?

The question of whether Australian ticks carry the bacteria that causes Lyme disease is controversial. The Australian government denies that Australian ticks carry the Borrelia bacteria, and suggests that people with Lyme disease must have contracted it while overseas. However, switched-on health practitioners are finding that not all patients with Lyme disease have been outside of Australia.

So why is there so much disagreement on Lyme disease in Australia? In 1994 a study by Russell and Doggett set out to answer the question of whether Australian ticks carry Borrelia bacteria. They collected 12 000 common Australian ticks and did not isolate any Borrelia DNA, concluding that Australian ticks do not carry the bacteria that causes Lyme disease. However, there were a number of issues in this study. Of the 12 000 ticks, only 1038 were actually tested for Borrelia. Russell and Doggett also worked on the assumption that only the burgdorferi strain of Borrelia causes Lyme disease, yet European studies have found that B.garinii and B.afzelii can also cause Borreliosis.

In 1959 Mackerras isolated Borrelia from Australian kangaroos, wallabies and bandicoots. Russell and Doggett did not mention this study in their own work. In 1962 Carley and Pope discovered an Australian strain of Borrelia, called Borrelia Queenslandica. Again, Russell and Doggett made no mention of this in their study. In 1995 Barry, Wills and Hudson isolated and grew Borrelia bacteria from Australian ticks. They also tested people with symptoms of Lyme disease, and 20% were positive for B.garinii, B.afzelii or B.burgdorferi.

Given that three out of four studies isolated Borrelia species from Australian fauna, a review of the government position on Lyme disease in Australia would be wise. We need more research to fully understand Lyme disease in Australia, and more public awareness of Lyme disease, to ensure people receive the correct diagnosis and best treatment.

 

Why is Lyme disease so difficult to diagnose?

Aside from the clear roadblocks that the controversy of Lyme disease in Australia causes for diagnosis, a number of other issues make diagnosis difficult. Firstly, less than 30% of patients with Lyme disease can recall getting a tick bite. Secondly, the bulls-eye rash that is a defining feature of Lyme disease occurs in less than 30% of cases.

And the list of reasons goes on: Borrelia can live inside cells and inside the central nervous system, and so may not come up in blood tests, especially in chronic cases. The tests currently used are very poor at detecting Borrelia, and results may come back falsely negative. None of the tests, either in Australia or overseas, test for strains of Borrelia specific to Australia, like Borrelia Queenslandica.

Because Lyme is difficult to diagnose, and awareness of Lyme disease in Australia is poor, patients are being misdiagnosed. People with Lyme disease have been misdiagnosed with fibromyalgia, motor neurone disease, Parkinson’s disease, Alzheimer’s disease, and chronic fatigue syndrome.

 

The complexities of Lyme disease

Lyme disease is not your average bacterial infection. Ticks often carry other organisms, including Babesia, Anaplasma, Ehrlichia, and Bartonella. These can be transmitted to humans at the same time as the Borrelia bacteria, causing co-infection. It is incredibly important to test and treat these co-infections as well. Animal and human studies show that these co-infections can cause more severe and treatment-resistant Lyme disease.

Borrelia is also capable of creating a biofilm. A biofilm is a slippery, glue-like coating that some bacteria create to act as a protective shield. The plaque on your teeth is a type of biofilm produced by Treponema denticola, which causes gum disease. To create the biofilm, the bacteria clump together and build a complex matrix around themselves. They can do this on a range of surfaces including our soft tissues. Other organisms, including the co-infections common in Lyme disease, can live inside the biofilm. The biofilm protects the bacteria from attacks from the immune system and antibiotics.  The Borrelia biofilm is one of the reasons Lyme disease and its co-infections are so difficult to treat.

 

Diagnostic considerations for Lyme disease

At The Health Lodge, we understand that the diagnosis and treatment of Lyme disease is complex. Therefore, we suggest a comprehensive diagnostic work-up to gather information relating to your health, including:

  • Screening for Borrelia
  • Screening for co-infections
  • Testing for nutrient deficiencies. Practitioners have found vitamin B12 and magnesium deficiency are common in patients with Lyme disease
  • We may test levels of stress and thyroid hormones. Thyroid and adrenal function is often impaired in Lyme disease
  • Screening for markers of inflammation, as chronic inflammation is an issue in Lyme disease
  • Assessing the health of your detoxification organs. Lyme disease and its co-infections can release toxins that attack the body, especially the nervous system. It is very important that the liver, kidneys, and digestive system are working well to get rid of these toxins. Unfortunately, in many patients with Lyme disease, these detoxification organs are under-functioning.
  • Heavy metal screening. Heavy metals can be incorporated into the bacterial biofilm, and affect the body’s ability to detoxify.

 

Treatment considerations for Lyme disease

Treatment of Lyme disease can be a long and difficult journey. Many people with Lyme disease do not get the treatment they need due to misdiagnosis.  Lyme disease is incredibly complex, and best treated by a team of health practitioners. At The Health Lodge, our treatment plan for patients with Lyme disease may include:

  • Supporting detoxification
  • Breaking down the biofilm
  • Treating Borrelia and co-infections
  • Decreasing inflammation
  • Supporting affected organs and systems
  • Heavy metal chelation
  • Correcting nutrient imbalances
  • Psychological support

 

Your integrative team of health care specialists

We believe that a multidisciplinary team of health care professionals is essential in managing all the aspects of Lyme disease. The multidisciplinary team may include general practitioners, psychologists, dietitians or nutritionists, naturopaths, osteopaths, and acupuncturists. This comprehensive and holistic approach is designed to support the patient’s physical, mental, and emotional well being.

For enquiries call The Health Lodge on 02 6685 6445