By Courtney Snyder, MD
Historically we've considered mental health and illness as coming from either one's life experiences or coming from one's genetics or biology. We've mistakenly considered the the brain separate from the rest of the body. We are more interconnected than those outdated views suggest. Our physical health impacts our brain health. Likewise, we experience emotions (fear, anger, sadness, and joy) not only in our brains, but in our bodies. Emotions influence our brain's biochemistry, and our biochemistry impacts our emotions, bodies and how we experience our lives.
A perfect example of this is Pyrrole Disorder - an inborn error of pyrrole chemistry. Those who are affected make an excessive amount of this metabolite. Pyrroles themselves are not a problem and do not cause disease. We all have them. They do however, bind Vitamin B6 and Zinc. When pyrroles leave the body (through urine), they take some B6 and zinc with them. This is not a problem either. The problem comes when pyrroles are being overproduced for genetic reasons or because of physical or emotional stress. This can lead to severe B6 and zinc deficiencies.
B6 AND ZINC
While there aren’t many nutrients that seem to directly affect neurotransmitters and brain functioning, zinc and B6 are two of the biggies. B6 is needed to make the neurotransmitters Dopamine, Serotonin and GABA in the brain. Zinc also has a great impact on the brain (and deserves a blog post of it's own). Separately zinc is important for the gastrointestinal and immune systems, both of which influence brain health.
As I mentioned, stress can cause an increase in the production of pyrroles. This stress could be from an a disrupted early attachment, trauma, starting a new school or job, an underlying medical condition, or even a cold or growth spurt.
For some, especially those with more severe elevations, it is believed there’s a genetic component. Though pyrrole disorder can occur in all ethnic groups, it seems to have a higher incidence in Celtic populations. The reason for this is unknown. That I'm of Irish descent brings Pyrrole Disorder particularly close to home for me.
More commonly, however, high pyrroles are a result of high oxidative stress, aka "toxicity." Oxidative stress occurs when there is an imbalance between free radicals (molecules that can destroy cells or impair biochemical processes) and our bodies ability to detoxify them or to repair the resulting damage. The toxins could be biotoxins (ie. mold, yeast or others), heavy metals or chemical toxins. Some electromagnetic fields (EMF) also contribute to oxidative stress
Most brain related conditions involve high oxidative stress. This is why Pyrrole Disorder is associated with Anxiety Disorders, Alcoholism, ADHD, Autism Spectrum Disorders, Bipolar Disorder, Criminal Behavior, Depression, Down's Syndrome, Epilepsy, Tourette’s, Learning Disorders, Oppositional Defiant Disorders, Psychotic Disorders, Substance Abuse and Schizophrenia.
Elevated pyrroles can be a result of these, but at the same time, can worsen these conditions. Pyrrole disorder is one of a handful of biochemical imbalances that affect brain functioning. For example, in depression we may see undermethylation, overmethylation, copper overload, pyrrole disorder and/or metal toxicity.
From the Walsh Research Institute of over 30,000 patients:
ADHD - 18 % (18% of individuals diagnosed with ADHD had elevated pyrroles)
Behavioral Disorders - 28 %
Autism - 35%
Depression - 24%
Bipolar Disorder - 35%
Schizophrenia - 30%
Post-Traumatic Stress Disorder - 12%
Alzheimers Disease - 14%
Healthy Controls (no psychiatric symptoms) - 8%
Most individuals with pyrrole disorder do not have all (or even most) of these symptoms. Some are more apparent in childhood; others are more obvious in adulthood.
There are other reported, though less common associations, including a preponderance of sisters in a family (for a male this could be having a mother with only sisters). This may be due to zinc deficiency. Zinc deficiency can cause infertility in men. Zinc supplementation has been shown to improve sperm count and sperm motility. And interestingly, men with lower sperm counts and slow sperm speeds have a greater likelihood of having daughters. For a woman to carry to term (and not miscarry), she has to have adequate levels of zinc. Relative to fertility treatments, addressing a possible zinc deficiency may be a simpler way to get closer to the root of the problem.
EVALUATION AND TREATMENT
Diagnosis of Pyrrole Disorder is based on both clinical information and a urine test that measures kryptopyrroles. Treatment involves a nutrient protocol that includes zinc, B6, P5P (the active form of B6) , magnesium, Evening Primrose Oil (Omega-6's) as well as antioxidants. Though Fish Oil or Omega-3 fatty acids can be beneficial for many others, they can worsen symptoms in individuals with Pyrrole Disorder and should be avoided initially.
No less important is addressing factors that may be causing high oxidative stress (ie. an underlying illness, diet, gut flora imbalances, intestinal yeast overgrowth, toxicity etc) or emotional stress. Psychotherapy, lifestyle changes, exercise, mindfulness, learning to prioritize and develop coping skills can all go a long way. Unaddressed stress can leave a person persistently pyrroluric, and thus deficient in zinc and B6. In some cases, such as during times of change, illness, and even growth spurts, stress dosing may be needed. This involves temporarily raising the dosages of zinc and B6/P5P.
Though first identified in the 1950's and first treated using zinc and B6 in the 1980's, Pyrrole Disorder is still relatively unknown. Until one year ago, I had never heard of it, though I'm sure in my previous practice, I saw many children and adults who would have benefited from this understanding. For many of those who do receive treatment, a lifetime of chronic inner tension, anxiety and fearfulness can begin to change within a few days to a couple of weeks of starting the nutrients. What was once impossible becomes possible.
If you are looking for a physician in your area trained in evaluating or treating Pyrrole Disorder or are a physician interested in training visit the Walsh Research Institute Resource Page. (Practitioners knowledgeable in Pyrrole Disorder are not limited to those trained at the Walsh Research Institute.)
10/2/2015 04:23:52 pm
Congratulations Courtney! You have explained so much in such simple and easy to comprehend terms. I will be referring all that I come into contact with who are suffering the above conditions to your article. I fully intend to begin a small clinic on the Gold Coast in Queensland to offer affordable help to those families who cannot seek help due to financial stress.
10/8/2015 08:21:02 pm
Hi Patti, I am currently being treated for Pyrrole and undermethylation and have been since the start of this year, but so far without any improvement. Am I able to contact you? I live in Ipswich, Qld and am feeling quite desperate!
10/10/2015 04:36:39 am
Check MTHFR Gene - blood test
7/13/2016 06:14:35 am
Dear Kylie, I have Pyrole and I have discovered you need many things to improve it. A good probiotic to improve gut and flora. Remove dairy, coffee, white flour products. I've discovered a drink of veg - kale, celery, cucumber and beetroot has improved me incredibly - a huge step up and I know others this has helped too. Use a nutri bullet or nutri ninja to break the veg to a cellular level and have one every day. If you sip some after dinner this helps to digest your food and improves sleep. I was so desperate too but finally after fifty years have found a good doctor. You also need MSM Alive from TVSN pharma botanica. Massive improvement on this incredible product. You will improve on these things. All the very best.
10/1/2016 04:55:23 pm
5/12/2017 06:05:49 pm
1/18/2017 03:06:23 pm
10/8/2015 02:44:38 am
Thank you, Patti, for your note. I'm glad you found this useful.
10/8/2015 02:55:44 pm
Thanks for the information. It's great to see information out there on this to inform in a clear and not too technical style for those just learning about Pyrrole. One area that there is still mixed messages about is about the Omega 6 / Omega 3 balance. Walsh is frequently misquoted in this area. Treatment can involve Omega 3's - I think it's important to recognise it's the balance that's important. It's only some people that can't tolerate the fish oil in early treatment but longer term they may also benefit from very high quality Omega 3's such as those from countries with the highest stardards of cleaning. It's an area to be open to Walsh's latest research and information on.
10/8/2015 04:35:57 pm
Your welcome, Debra. In my own training and in reviewing my materials, I don't find mixed messages about using Omega-6 (and not Omega-3's) for pyrrole disorder, but please share where you have Dr. Walsh quoted as saying otherwise. In the below video at 22:10, Dr. Albert Mensah (who trains physicians with Dr. Walsh) is clear in reccommending Omega 6's and not Omega 3's (which he suggests avoiding in pyrrole disorder). As they have many more years of experience than I do, I defer to them, but as you suggest, there's still a great deal to be learned over time. Thank you for your comments.
Maureen O'Hara Krenzer
10/8/2015 02:58:19 pm
Very interesting article, especially that males often come from mothers with only sisters in their family. I am of irish descent, 4 girls, have 2 sons, and have discovered i am homozygous c677t mthfr, and my children have hetero 1298c or c677t, anxiety issues, etc. I have been doing extensive research and am excited to read your article. Thank you. I look forward to learning more from your research. Maureen krenzer, R.N.MSH
10/8/2015 04:47:36 pm
Thank you, Maureen. You may want to read the post I wrote on epigenetics, methylation and MTHFR, as it summarizes some of Dr. Walsh's work in this area. It is not uncommon for someone to have more than one biochemical imbalance (ie. under- or over-methylation and pyrrole disorder) and for the imbalances to be impacting one another. This is why those of us trained through the Walsh Research Institute will usually evaluate methylation status, zinc and copper, pyrroles as well as Vitamin D and thyroid functions. Usually there is more than one thing needing to be addressed. Best to you and your family as you learn and seek out more information.
Thank you so much for such a clear informative article. The best I've read on pyrolle disorder. I've experienced a psychiatric nightmare. With misdiagnosis and wrong medications from a lot of well meaning but misinformed doctors. Through self study including Dr. Walsh material I'm medication free. Still suffering but improved with nutrition ,supplements & meditation. I'm going to try the primrose zinc and b6 . I wish you had some practitioners in Vancouver BC.
11/3/2015 07:30:39 am
Thanks Phyllis. Glad you find the article useful and thank you for sharing your story. Good for you, for persisting. There are so many who may never bump up against this type of information. Hopefully with time, there will more and more practitioners in Vancouver and elsewhere. Take care, Courtney
5/29/2017 02:06:33 pm
Maybe I have a new MD who is very alternative - I mentioned to him & he wasn't aware of it which surprised me as he is quite up on alternative.
10/8/2019 10:05:09 pm
Phyllis, Dr. Markus Ploesser is an integrative psychiatrist who has training in the Walsh Protocol. He serves patients in BC only via on-line appointments, which are covered under MSP.
2/15/2020 06:15:54 am
Thank you I will look him up . I have now been healed by a TCM with acupuncture and herbs . A lot of my problem was due to complex PSTD that had been retriggered and now I am free from these symptoms. Although I have to be very careful what I eat as it effects me mentally. But I have a young friend who needs a good psychiatrist and I will give her this information. I only just saw this post . Thank you.
10/10/2015 01:07:15 pm
Very interesting and clearly explained. I found this article some how through searching oxalates. This is explains so much about me and my life of dealing with stress. Thank you!
11/3/2015 07:41:19 am
Thank you Yvonne and you're welcome. If you're looking for further resources, you may want to look at Dr. William Walsh's book, "Nutrient Power." Best to your on your path, Courtney
2/26/2017 11:36:50 pm
Good article :).
5/12/2017 12:56:19 pm
3/20/2017 07:56:49 pm
Thanks so much for this article. I was recently diagnosed after trying to figure out what made my fibromyalgia activate seemingly overnight. It's been near impossible to find any info on Pyroluria but explains why I feel so much better now that I'm on a good B6 supplement
5/12/2017 12:58:00 pm
Your welcome, Ashley - great to read that you are having good results. I hope your healing process is continuing to go well. Courtney
8/17/2017 10:30:37 am
Hi, great article! Thank you! Are there any Walsh practitioners in Virginia for a friend who has schizophrenia?
8/17/2017 05:33:30 pm
Thanks Maria - here is a resource list and map from the Walsh Research Institute.
8/17/2017 07:19:31 pm
Thank you! Do you treat out of town patients?
9/22/2017 07:13:17 am
Omg! Yes! Dr Charles Parker of corepsych.com! He is in Virginia Beach, does office, phone or video consults. Has discounted rates through the two top labs for these types of test! He is world renowned. He is my ten year old's private specialist. He saved my son's life!
10/16/2017 02:02:43 pm
This is great, thank you! I'd love to talk more with you about this!
8/18/2017 05:57:03 am
the family with mostly females & lookalike sisters is unfounded, this is not true for our family. I have heard this question asked of others with PD & it was not true for them either, it sounds ridiculous to me, i imagine some sisters may look alike in many families who do not have PD.
8/18/2017 12:47:02 pm
Hi Cheryl - Thank you - I don't disagree and you make a good point. As I tried to indicate in the blog, these are not traits in all people with pyrrole disorder, nor are any of them specific to pyrrole disorder. They are more associations. It's even arguable if it should be called a "disorder." All that being said, your comment does make me question how useful that particular reported association is to list here. Thanks for your comment.
1/24/2018 11:34:13 am
Hi, I was excited to see someone in my area that talks about pyrroles. My child tested positive for the MTHRF gene a few months ago. Since then I ha e been doing a lot of research. I read Dr. Walsh's book just a few days ago. When I presented all of this to the Dr., he said he agreed and wanted to test for pyrroles. However, the 2 local hospitals, Baptist Floyd and Clark Memorial, do not test for it. Neither does her Dr.'s office. Can you tell me somewhere in southern Indiana that might do the test? Or, Louisville is just a few miles away, do you run tests from another Dr., or would I have to try to get her test scheduled though seeing you? Thank you!
2/1/2019 01:55:54 pm
Hello Somer, my daughter was just tested and found to have elevated pyroles. I used Dr. David Epstein who is in Atlanta, GA but he does everything via telehealth/telemedicine. I ordered the test from him, he sent me the test kit and we did the test at home and mailed it in. Here is his website: http://secondopinionphysician.com/
1/28/2023 08:17:42 pm
3/1/2019 02:28:36 pm
I applaud you for learning about pyroluria and other Walsh protocols. They've been life changing for my son, and I share the info as much as I can. So much suffering could be prevented if this information was mainstream!
2/15/2021 07:02:43 am
Thank you, Becky, for the comment. Apologies, I didn't see this back when you had commented. Courtney
3/26/2019 04:24:18 pm
Has anyone diagnosed with Pyrrole Disorder been unable to tolerate p5p-b6 or zinc? I'm told I'm undermethylated w low Zinc and b6 but I get REALLY agitated and angry when I take it. I also struggle w high copper levels and high histamine. Im currently doing a Hydrogen Sulphide Toxicity protocol bc my Cystathionine was high and my Stool test showed hydrogen sulphide producing bacteria and high e-coli. Been at this religiously for 12 yrs now. Any advice is helpful. My doc & I are at a loss as to why I cant take zinc and p5p and I'm not his only patient with this issue. I am also Irish, bipolar and suffer from CFS and MCS. My chemical sensitivities have isolated me from family and friends. Thank you! Love n Hope!😊
3/28/2019 06:41:07 am
Melissa Gibson, skip all that and just order The Gupta Programme from the UK for CFS and fibro, it works!
8/8/2019 02:13:57 pm
Hi Melissa. I’m very sorry, I didn’t see your comment sooner. You may have already found your answers. When I have patients who can’t tolerate zinc and B6, it makes me wonder if it is causing them to mobilize toxins faster than they can tolerate. I have seen this a number of times with mold toxicity which I find to be very common in those with brain related symptoms. Candida toxins and metal toxins may do the same. Another consideration would be if the supplements or the detoxification is triggering mast cell activation which can cause a number of symptoms. It took me many months to be able to get onto a therapeutic dose of zinc. It was later that I learned that I had mold toxicity and mast cell activation (which is fairly common with mold toxicity). I hope this is helpful and again, I apologize for the very late response. Courtney
7/26/2021 06:40:30 pm
This is a great post and information. My husband has recently been diagnosed with Pyrrole with an extreemly elevated reading. He has struggled for many years and has been in and out of clinics and rehab being treated for major depression as well as alcohol and substance issues. I have seen a history in his family and I believe that his late mother would have also had Pyrrole although undiagnosed. He is currently in the care of a Psychiatrist who he sees fortnightly. He is also been going to a holistic GP clinic where it was suggested that he be tested. His Psychiartrist has told him that he does not believe in Pyrrole. This is very dissapointing. I am hopeful that he will see an improvement soon but he has been advised it could take a few months. I am keen for any additional tips that may help....he is also on strong antidepressants.
7/30/2021 01:24:58 pm
Hi Sue. You and your husband are fortunate to have found someone who is knowledgable about pyrrole disorder. Aside from this post, if you are looking for more resources, Dr. William Walsh's book, Nutrient Power, goes in depth. Also there are resources on the Walsh Research Institute Website and at Mensah Medical. There is also a nice article you can easily find online that is for therapists, that discusses the role of stress in pyrrole disorder. When I see someone who has pyrroles that are very high, I consider sources of toxicity (mold toxicity or other biotoxins especially) or inflammation or trauma that may be contributing. That doesn't mean that there can't be a very positive response to the treatment specifically for pyrroles. Again, it sounds like you are finding your way. Best to you both, Courtney
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Courtney Snyder, MD
I'm a conventionally trained child, adolescent and adult psychiatrist. My current approach to health is both holistic (pertaining to the whole person) and functional (addressing the root causes of illness). I write this blog to share what I've learned.