Pyroluria: What It Is, How It Impacts Mental and Physical Health and Hope for Those Who Suffer

Pyroluria is a condition, often inherited, that can affect persons of all ages. The condition is causative in multiple mood disorders and imbalances yet is quite unknown in both mainstream medicine and mental health care. Pyroluria is the disruption of synthesis of any heme-producing molecule in the body, including hemoglobin. Pyrroles are a natural byproduct of the degradation of heme-containing molecules which accumulate in excess with the presence of this imbalance. 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 (which have an affinity for these nutrients). This leads to depletion of these key nutrients which are coenzymatic cofactors for mood and methylation modulation as well as for amino acid and neuromediator 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)

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Dr. Carl Pfeiffere was the primary pioneer in the arena of pyroluria, its impacts and its requirements for individual nutrient therapy. Dr. William Walsh and Dr. Albert Mensah have been modern-day champions and medical leaders in the effort to make the condition of pyroluria more well-known and accepted. At right is a chart from Dr. Mensah with many of the common presenting symptoms of pyroluria:




Below is a list indicating urine measurements of HPL in numerous challenging conditions of mental illness as well as criminal behavior. HPL is placed in relationship to creatinine, a waste product produced from kidney filtration (2):

Diagnosed Ailment/% of HPL in urine (as ratio to creatinine):

  • Acute Intermittent Porphyria/100
  • Down's Syndrome/77
  • Latent Acute Intermittent Porphyria/70
  • Acute schizophrenia/59-80
  • Chronic schizophrenia/40-50
  • Manic depression/47-50
  • Depression (Non Schizophrenic)/12-46
  • Epilepsy/44
  • Autism/46-48
  • Learning Difficulties/40-47
  • ADD/ADHD/40-47
  • Criminal behavior, adults with sudden deviance/71
  • Criminal behavior, youth violent offenders/33
  • Alcoholism/20-84

Clearly, there are high levels of HPL in the majority of these conditions. Fortunately, testing for pyroluria is quite simple using a urine sample with both calculated and uncalculated kryptopyrrole results, creating high reliability. The test is also quite affordable. and easy for children to use. It is unfortunate that there is not greater acceptance and understanding of this problem in the medical community, as many children and adults have had dramatic improvement in their lives as a result of easy testing and safe therapeutic application to correct the problem. Clearly, also, there could be direct and positive impacts for our correctional and mental health services systems, reducing burden and lack of effective therapeutic and rehabilitative approaches. 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 not one single client who has been adequately tested and supported with a proper targeted protocol has failed to heal and move on to lead a much more normal life. 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, while yet others will require nutrient therapies only in times of very high stress.

Pyroluria and the Gut

Individuals with pyroluria and associated higher levels of HPL also have much higher risk for leaky gut syndrome. (2) Many know that leaky gut syndrome involves damage to the very delicate lining of the digestive tract called the mucosal barrier. The barrier, aptly named, is responsible for protecting the digestive tract from pathogen invasion. When damaged, a person is much more susceptible to all types of pathogenic infections. Unfortunately, leaky gut syndrome also contributes to further elevation of HPL - it is a double-edged sword in this scenario. With pyroluria, there are also associated changes in fatty acid metabolism, causing lower levels of arachidonic acid, a polyunsaturated fatty acid present in the phospholipids of cell membranes. Its presence is high in the brain, muscles and liver, all of which have roles in healthy digestion. HPL also prevents the proper manufacture of Gamma Linolenic Acid (GLA), an important Omega 6 fat.Thus, careful attention to nutrition, gut repair, and stabilization of HPL production are all necessary with pyroluria.

At True Nature, 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 is the most effective nutritional approach I have seen in decades of practice.

It should be noted additionally that pyroluria does exist in people who are not symptomatic with mental/emotional conditions. In one study, one quarter of those tested for elevated pyrroles with physical conditions such as arthritis, fibromyalgia, and chronic fatigue tested positive for pyroluria.(3) In some people, abnormal pyrrole accumulation and excretion appear to be general indicators of oxidative stress, infections, intoxication, and/or compromised digestion. Some other symptoms or indicators that pyroluria is at play include joint pain, reduced morning appetite, white spots on fingernails, poor short-term memory, inability to tan, thin skin, poor dream recall, abnormal fat distribution, sensitivity to light and sound, and frequent infections. 

Pyroluria and Heme Synthesis

Remember that pyroluria involves the malfunction of heme-containing molecule degradation and excess production of HPL. Animal studies have shown that excess levels of HPL cause a decrease in liver heme and the heme-containing detoxification enzyme cytochrome P450. It is estimated that this decrease can measure up to 55% (3). Zinc, vitamin B6, and biotin are all required for the production of heme. The loss of these nutrients through pyrrole affinity and excretion creates a major disruption in heme levels. Proper balances of heme are required for many other body functions as well, including oxygen regulation and electron transfer, two very critical homeostatic functions.

It has also been discovered that heme 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. This brings us to our next topic around pyroluria...

Pyroluria and Methylation

With an increased risk for heavy metal exposure in pyroluria, we now have to consider increased risks for overall toxicity and possibly impaired detox pathways. It has already been brought to light that the CYP detoxification functions are compromised in pyroluria with declining heme stores. CYP is responsible for detoxification of many substances, but especially toxic hormone byproducts, petrochemicals, pharmaceutical substances, and plastics. Without proper balance in CYP function, risks for all kinds of toxic buildups increase, many of which have associations with cancer risks as well. 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 its antagonist for balance is zinc. Symptoms of copper toxicity include yeast infections, mono, PMS, racing mind, achy muscles, dry skin, panic attacks, eating disorders, and much more.

Shifting the Paradigm to 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. Our paradigms in medicine and mental health care are often very limited, scoping through a myopic lens which separates the person's behavior from their overall health and integrated physical function. That lens is also quite small as it relates to pigeonholing mental illness. If we are to create more and better opportunities for those who suffer with mental illness and possibly with pyroluria, it requires a rather wide lens, and one 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. Hence the saying that our biography is our biology, and vice versa. A new paradigm of comprehensive physical healing along with the restructuring of beliefs and habits will allow much greater potential for all of us around conditions like pyroluria. For more information on mind/body and core belief work, please read  here

At True Nature Health Consulting, every person is respected in this type of paradigm. If I may help you with a suspected case of pyroluria and the creation of a fresh perspective, please email me at




2) "Discercing the mauve factor", part 1: Alt Theapies, Mar/Apr 2008. Vol.14, No.2

3) Graham DJM, Thompson GG, Moore MR, Goldberg AA. "The effects of selected monopyrroles on various aspects of heme biosynthesis and degradation in the rat". ArchBiochem Biophys. 1979

4) Atamna H. "Heme, iron, and the mitochondrial decay of ageing". Ageing Res Rev. 2004

5) N. Mikirova, "Clinical Test of Pyrroles in Psychiatric Disorders: Association with Nutritional, Immunological and Metabolic Markers", Journal of Nutritional Therapeutics, 2015

6) A.Heitzman, P. Gosek, W Lechowicz, R. Wardenski, T. Stepien, "Elevated hydroxylactam of hemopyrrole level in urine in perpetrators of extremely violent acts diagnosednwith psychosis", Psychiatr. Pol. 2017