Pyrrole, Kryptopyrrole, Pyrrole Disorder, Pyrrole Condition, Pyrroluria, Kryptopyrole

These are all names applying to a chemical found in the urine which has been clinically shown to be associated with a number of chronic health issues. Please note the current correct term is High or Elevated Urinary Pyrroles. Research in Australia, not yet ready for publication, has shown Urinary Pyrroles is A Bio Marker of severity of oxidative stress.

No research has been conducted to show it is a condition, syndrome or disorder. It is not a diagnosis, but a measure of oxidative stress which must be managed for long term reduction of symptoms.  Work has also shown, as Urinary Pyrroles are unstable, it is essential that collection and transportation of urine is done under strict standardized conditions to maximize reliability of results. Poor collection and handling can result in false readings.

What is important is the additional focus on both the urine measures and on identifying and managing the underlying oxidative stress. A doctor trained by Bio Balance Health in the Walsh/Pfeiffer method will know how to do this and manage the process which is individualised to each patient. Exploration of a product in urine associated with mental health started with Abram Hoffer and Carl Pfeiffer (physician and biochemist) when they noted extracts of urine from schizophrenics turned mauve upon the addition of a specific reagent.

The identification of High Urinary Pyrroles has changed many lives as reduction of the pyrrole measure correlates with reduction of symptoms of many unexplained health issues. The understanding that very High Urinary Pyrrole is also often associated with some forms of mental ill health has reduced the stigma and the loss of hope felt by many with a mental health diagnosis. The processes to reduce high pyrroles are not meant to replace current chronic health management but to enhance it. Symptoms associated with high pyrrole vary as the underlying stress varies. This explains why there are so many symptoms and how each person with high pyrroles manifest different responses.

It is apparent to Bio Balance Health doctors that management of high pyrrole has been life changing for many people. Bio Balance Health supports further research in this area.

In 2018, an Australian laboratory (Applied Analytical Laboratories) became the first to include measurement of urobilinogen in their testing process. Urobilinogen is a by-product of normal gut function as opposed to oxidative stress and is co-measured in the assay. Separation of these urine components allows for identification of additional pathologies (e.g. obstructed bile duct, haemolytic anaemia, or hepatitis) and is critical for correct interpretation. The distinction allows a more accurate identification of the composition of the sample as falsely treated results can exacerbate symptoms and/or lead to vitamin B6 toxicity.  The laboratory report will give clear reference ranges.

If you wish to support further understanding of High Urinary Pyrroles and therefore ensure it becomes recognised by the broader medical world then please hit the donate button on this site and we will direct funds to assist the current research. If you or your family have been assisted by the understanding of how urinary pyrrole levels affect your health, then please make life better for others by supporting this research. A receipt for tax deduction will be issued with your donation.

Bio Balance Health recommends you use a doctor trained by them who have experience in managing the process. Self-diagnosis and self-medication is fraught with difficulties and will not achieve optimal results.

Pyrrole Collection Process

After receiving your request form from your doctor please go to the nearest collection agency. Double check the Collection agency does send your sample to the laboratory requested by your doctor. If it is sent to a different Laboratory you will have to repay for the test.

The collection process is as follows.

Patients must be naïve of zinc supplements or cease supplements 72 hours prior to tests if it’s the first time (to establish a base-line).  Do NOT cease Zinc if it is a follow-up test.

Medications used with Rheumatoid Arthritis and/and Urinary Tract Infections can interfere with the test, as does Rifampicin which changes the urine to a red/mauve colour.  If you are taking these medications consult your physician as you will need to complete the course and/or abstain for a wash out period of 4 weeks prior to collecting a sample. For some, this is not possible.

Blood does NOT affect the test result, so spotting at the beginning or end of menstrual cycle will not interfere with the result.  It is NOT recommended to collect during peak menstruation. 

Very high levels of urinary bilirubin DO also interfere. However this is rare and you will be informed if this is the case. The time of collection needs to be noted on the form in order to help account for obtained Urobilinogen levels.

Urine is to be collected in the supplied specimen jar and immediately covered with foil which protects it from light and heat and from incidental high energy electromagnetic radiation (EMR).

The sample is to be frozen immediately and kept covered and frozen from the time of collection till the time of testing in the laboratory.

Samples are transported in dry ice to keep the relative temperature below freezing (at -30oC). Your results will be sent back to your doctor.

Pyrrole Results very high or very low?

The laboratory is obliged to notify the doctor when the urinary pyrrole result is greater than 400ug/dL, urobilinogen is greater than 16µmol/L, or other parameters are detected (such as, bilirubin, blood, ketones, protein, nitrites and leucocytes. These can illuminate if a patient has liver/kidney function issues, diabetes, infection or other protein dysregulation factors. Currently Applied Analytical Laboratories (AAL) is the only facility to meet this requirement and successfully participate in RCPA conducted proficiency programs for this system as an extra level of assurance.  

Who does Pyrrole testing?

The only dedicated Pyrrole testing laboratory in Australia is Applied Analytical Laboratories Pty Ltd (AAL). AAL are the leaders in investigating the origin of elevated urinary pyrroles.

Others use a kit form or other in-house kits which are not yet validated.

“SAFE” Analytical Laboratories, who were the first Lab to agree to do Urinary Pyrrole testing in 2004 are conducting a research trial with Endeavour College as part of their accreditation process and are restricted to only collect samples from patients currently participating in that trial.

Applied Analytical Laboratories’ collection, transportation and extraction method has not changed since commencement of their Urinary Pyrrole testing activities in early 2010.

As a result of their regulatory review and further research, what has changed is

  1. Improvement in the sensitivity of the testing process
  2. Reference ranges are now specific to adult Australians, and
  3. Distinct separation of pyrrole and urobilinogen, and the reporting of both.

References

The following are references from Australian Research which has advanced understanding of measuring urinary pyrrole. Applied Analytical Laboratories data has been used and/or they have actively participated in the studies published in 1,2,3,6 & 7 below and are currently involved in ongoing research.

  1. Biomark Res. 2015 Feb 6;3:3. doi: 10.1186/s40364-015-0028-1. eCollection 2015.  
    Biomarkers of a five-domain translational substrate for schizophrenia and schizoaffective psychosis. Fryar-Williams S1, Strobel JE.
  2. Biomark Res. 2016 Nov 9;7:172. eCollection 2016.
    Fundamental Role of Methylenetetrahydrofolate Reductase 677 C → T Genotype and Flavin Compounds in Biochemical Phenotypes for Schizophrenia and Schizoaffective Psychosis. Fryar-Williams S.
  3. Front Psychiatry. 2016 Apr 14;7:48. doi: 10.3389/fpsyt.2016.00048. eCollection 2016.
    Biomarker Case-Detection and Prediction with Potential for Functional Psychosis Screening: Development and Validation of a Model Related to Biochemistry, Sensory Neural Timing and End Organ Performance.
    Fryar-Williams S1, Strobel JE.
  4. Clinical Psychological Science, 2016. Vol. 4(1), 144-162,
    Nutritional interventions in clinical depression. Rechenberg, K. (2015)
  5. Psychiatr. Pol 2014; 48(1): 75-88,
    Does the usual dietary intake of patients with depression require vitamin mineral supplementation?
    Stefańska EWendołowicz AKowzan UKonarzewska BSzulc AOstrowska L.
  6. ACNEM Journal, Vol 29 No.3, 2010
    The Effectiveness of Targeted Nutrient Therapy In Treatment of Mental Illness – A Pilot Study”; Richard Stuckey, William Walsh, Brett Lambert.
  7. Journal of Child & Adolescent Psychopharmacology, 2017 Nov; 27(9): 823-832;
    Micronutrient Therapy for Violent and Aggressive Male Youth: An Open Label Trial;
    Hambly, J., Francis, K., Khan, S., Gibbons, K., Walsh, W., Lambert, B., Testa, C., & Haywood, A., doi: 10.1089/cap.2016.0199. Epub 2017 May 8.