Do you know that moody friend, or family member that can be beaming rays of sunshine one minute, then oozing black moods and taking a swipe at you the next? Perhaps this is something you’re struggling with yourself, but your doctor has written you off as suffering depression or anxiety and simply prescribed an antidepressant. Well before you write off your friend or family member, or even yourself as just being ‘moody’ or depressed, you may want to consider that there maybe something biochemical at play, and no I’m not talking about a split personality disorder! I’m talking about an easily diagnosable and largely treatable condition known as pyrrole disorder.
What is pyrrole disorder?
Pyrrole disorder or Pyroluria, is a hereditary condition caused by the abnormal synthesis and metabolism of the haemoglobin molecule – which is responsible for carrying oxygen in your blood. The by-product of haemoglobin is a metabolite known as hydroxyhemopyrrolin-2-one (HPL) – also known as pyrrole, that binds with pyridoxine (vitamin B6) and zinc. A person suffering from Pyrrole disorder produces excessive amounts of HPL, which in turn binds to, or inhibits the absorption and utilisation of specific nutrients.
The main nutrients the body fails to absorb and utilise in Pyrrole's disorder are:
Deficiencies in these three essential nutrients can be the underlying cause of a combination of symptoms that will vary in each individual. But before you ask if taking a B complex supplement is enough to combat the symptoms of Pyrroles disorder, bear in mind that sufferers have much higher needs for these individual nutrients than what is contained in a B complex, so they will need to supplement with additional zinc, B6, biotin and magnesium.
Upon testing patients, I also find many sufferers also require additional vitamin D, along with other individual nutrients like iron, vitamin C and sometimes iodine – to help promote positive mood, metabolism and energy. I also find many sufferers of Pyrrole's disorder concurrently test positive to the MTHFR gene defect. You can read more about the effects of this here.
So what are some of the ramifications of the nutrient deficiencies associated with Pyrroles disorder? Well considering that magnesium is a cofactor in more than 300 enzyme systems that regulate a diverse range of biochemical reactions in the body, including muscle and nerve function, blood glucose control, and blood pressure regulation, you could say it ranks as one of the most important minerals for maintaining optimal health. Magnesium is also a natural calmative and muscle relaxant, effective for promoting restful sleep, mood, regular bowel function and healthy cardiovascular function.
B6 is necessary for the production of red blood cells and increases energy levels and helps to optimise cognitive function, not to mention helps us to cope with the effects of stress. A deficiency in B6 will often cause inflammation, depression, and in some cases anaemia – something I see in a vast majority of my patients.
Zinc is vital for memory, concentration, cellular growth and repair, healthy immune defenses and digestion. A deficiency in zinc can lead to leaky gut syndrome, poor immunity and hormonal imbalances – in particular reproductive hormones.
Major signs and symptoms of pyrrole disorder:
insomnia, wrestless sleep
constipation / IBS
learning difficulties – ADHD
cognitive dysfunction – Autism
addictions – alcoholism
anxiety, panic attacks
poor concentration and memory
sensitivity to light and sound
poor dream recall
inability to handle stressful situation
craving for high-sugar and high-carbohydrate foods
poor morning appetite / tendency to skip breakfast
sweet, fruity breath and body odour
overcrowded teeth and poor tooth enamel
white spots on the fingernails
Although it’s not uncommon for sufferers of pyrrole's disorder to experience debilitating depression, (I routinely test any patient who presents to me on an antidepressant medication for pyrrole's disorder), they don’t always present with obvious symptoms, nor all of those listed above, which is one reasons many sufferers go undiagnosed. Symptoms can of course vary in severity and scale from one sufferer to another. But the classic tell tale symptom in sufferers of pyrrole's disorder, is their inability to cope with stress and propensity for fluctuations in their mood and blowing their fuse almost without warning.
You might be wondering why you have not heard about this condition, or why your Dr has not tested you for it if you have complained to them about a combination of the above symptoms? Well, the reason is because it’s still a relatively unknown condition to the general population and GP’s – who often misdiagnose Pyrroles disorder with some other mood or neurological condition - often just prescribe an antidepressant or refer the patient onto a psychiatrist.
Testing for pyrrole disorder
The only definitive test for pyrrole disorder is with a urine screen. Your health practitioner can order this test from a pathology clinic set up for HPL analysis.
Treatment for pyrrole disorder
Simply treating pyrrole's disorder with nutrient therapy in isolation, is not effective enough to resolve the problem. As with any health condition, the best results will come from applying a multi faceted approach to treatment. By this I mean combining an anti inflammatory diet with healing your gut, in combination with nutrient therapy to replenish any underlying deficiencies.
Diet has a massive impact in influencing mood and the typical western diet is highly inflammatory and will only exacerbate the associated symptoms of pyrrole's disorder. It’s also a given that if you suffer from pyrrole's disorder, you will suffer from a leaky gut, which will significantly impair your body’s ability to absorb and utilise the nutrients in your food, not to mention have a negative impact on the function of your brain. I also find people with pyrrole's disorder greatly benefit from including cognitive behavioral therapy and meditation in their treatment approach, as these both help to provide better stress coping skills, and an ability to ‘unlearn’ certain learned stress response reflexes. Similarly, psychotherapy techniques will not be effective without the combination of diet and nutrient therapy.
It’s important to remember that not all cases of pyrrole's disorder present in the same way, nor to the same degree and the severity of symptoms is exacerbated by stressful and traumatic situations (due to higher haemoglobin metabolism) and/or poor diet and/or underlying food sensitivities and leaky gut.
Because of the complexity of pyrrole's disorder and other associated conditions that may be present, (like the MTHFR gene defect), I strongly recommend consulting a qualified nutritionist, naturopath or functional medicine doctor who is experienced in these conditions, to ensure the appropriate assessment, diagnosis, and management of pyrrole's disorder.
Remember, because pyrrole's disorder is a lifelong condition, there is no silver bullet to treatment, or 'cure' as such, but rather carefully managing it through a combination of DIET; NUTRIENT THERAPY; COGNITIVE THERAPY & RELAXATION TECHNIQUES, sufferers will experience a significant improvement in the way pyrrole's disorder impacts their life and relationships, and that means a happier and easier life for all.