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