Urinary pyrroles (kryptopyrrole): what the research shows

In short: "Pyrroles" in urine are compounds that some researchers think may be a marker of oxidative stress in the body. Bio Balance Health (BBH) introduced urinary pyrroles testing to Australia in 2004 and supported research published in 2023. No research has shown that "high pyrroles" is a distinct condition, syndrome, disorder or inherited trait. This page explains what is known, what is not, and where incorrect information comes from.

What are urinary pyrroles?

Pyrroles are small molecules. A small amount is passed in urine. They form when the body breaks down certain substances, including parts of old blood cells (haem). Researchers have asked whether higher amounts may be a marker of oxidative stress, which is the general term for when cells face more reactive oxygen species than their defences can easily handle. BBH looks at the specific biochemistry behind it. See Oxidative stress.

BBH introduced the pyrroles-in-urine test to Australia in 2004 and has since supported efforts to refine its accuracy through research and the observations of practitioners.

Common myths and what the research shows

What you may have read	What the research shows
"Pyroluria is a disorder."	No conclusive research has established it as a distinct condition, syndrome, disorder or genetic trait. It is a measure found in urine.
"It is genetic."	Not established. Research so far describes a marker, not an inherited condition.
"High pyrroles means you have a mental illness."	A marker is not a diagnosis. Not all mental health issues are linked to high urinary pyrroles.
"Any laboratory test is the same."	No. Accuracy depends on the laboratory and how the sample is collected and handled. Some laboratories combine pyrroles and urobilinogen into one figure.
"Everyone with high pyrroles needs B6 and zinc."	BBH-supported research found that pyrroles (which can chelate, or bind, metals) do not attach to zinc or vitamin B6, so B6 is not a way to clear pyrroles. Vitamin B6 is not directly part of the cell's reactive oxygen species defence enzymes. Zinc is needed by the defence enzyme SOD. Taking high doses of vitamin B6 without supervision can cause harm, including nerve damage. See Vitamin B6.
"You can tell from your symptoms."	You cannot. Only a test can measure it, and only a registered health professional can interpret it.

The words people use

You may see: pyrrole, kryptopyrrole, pyrrole disorder, pyrrole condition, pyroluria, pyrroluria, kryptopyrrole, pyrrole syndrome and the mauve factor. These words describe a compound found in urine. Research supported by BBH has identified pyrroles as a potential biomarker of unquenched reactive oxygen species (Lambert 2023).

BBH uses "high" or "elevated urinary pyrroles" as the accurate term. It is a biomarker, a measure of oxidative stress, rather than a definitive diagnosis. Managing that stress, rebalancing biochemistry and limiting the effect of reactive oxygen species are the focus of BBH's teaching. See Reactive oxygen species.

What the published research says

In February 2023, Brett Lambert, Annalese Semmler, Cristina Beer and Joanne Voisey published Pyrroles as a Potential Biomarker for Oxidative Stress Disorders in the International Journal of Molecular Sciences. BBH supported the research. It explores whether pyrroles could be a biomarker for oxidative stress disorders and whether they help identify biochemical imbalances linked to various disorders, including bile disorders.

Evidence level: early biomarker study. It suggests a potential marker. It does not show that pyrroles cause symptoms, or that lowering them improves anyone's health. Read the references

Where the information comes from

Much of what is online about pyrroles contains errors. BBH identified the molecules involved in this test and has supported the published research on it. BBH's position is that the most reliable information is the published research and BBH's own material. Treat claims from other sources with care, and check them against the studies listed on this page.

What BBH has observed

These points come from BBH's experience and practitioner observation. They have not been tested in controlled trials. Evidence level: observation.

• BBH teaches health professionals that appropriate pathology testing can inform a care plan specific to each person. The BBH course covers this material.
• Before urinary pyrroles testing, it was difficult to measure the severity of some people's stress response. Modern laboratory methods can separate pyrroles from urobilinogen, which improved understanding.
• Practitioners trained to interpret pyrrole levels have developed personalised management plans for each person. They follow changes in pyrrole level alongside changes in symptoms.
• Some people whose levels fell to near normal have reported improvement in their wellbeing. Reports from individuals are not proof that a treatment works.
• Getting better is not quick. Some people need ongoing management over the long term. Others improve more quickly and only need attention to pyrrole levels during times of high stress.
• Not all mental health issues are associated with high urinary pyrroles. For people with elevated levels, understanding the underlying cause may offer reassurance and practical options, with a registered practitioner.

What has changed in BBH's teaching

BBH's teaching has moved on since urinary pyrroles testing was introduced.

• Pyrroles are not part of BBH’s current course. They are a biomarker, not a measure of the components of the redox reaction.
• Vitamin B6 and pyrroles. BBH-supported research published in 2023 found that pyrroles do not bind to vitamin B6 or zinc. (Lambert 2023) Long-term high doses of B6 can damage nerves, so high doses should only be taken under a doctor’s or pharmacist’s supervision and only when testing demonstrates deficiency.
• Where BBH looks now. BBH’s current course starts from the cell: the role of reactive oxygen species, the cell’s defence enzymes and the minerals they need. See Reactive oxygen species and Tri-alloy.

What triggers the production of pyrroles?

BBH's understanding is that pyrroles appear when the body fails to break down old blood products properly, which signals a stress response. The stress could come from many sources and is very individual. For some people it may be linked to financial stress, poor diet, workplace pressure, bullying or exposure to toxic substances. Urinary pyrroles are a measure of how severe that stress response is. BBH's approach is to look for the root cause. Evidence level: observation and early research. Not established.

Testing: why the laboratory matters

• The accuracy of a pyrroles-in-urine test depends on the laboratory doing the analysis.
• Urinary pyrroles are unstable. Collecting and transporting a sample needs a strict, standard protocol, or the result may be unreliable. Poor handling can give false readings.
• Some laboratories include urobilinogen, a by-product of normal gut function, in a combined figure.
• It is the responsibility of medical and health practitioners to make sure that their plans are based on accurate and reliable information.

Who does pyrroles in urine testing?

Applied Analytical Laboratories (AAL) carried out the BBH-supported research and provided a test that BBH considered accurate. Other laboratories may include urobilinogen as a major part of the combined figure. BBH does not currently recommend any Australian laboratory for urinary pyrroles testing, because current laboratories do not meet our standards.

Urobilinogen

In 2018, AAL began to measure urobilinogen separately. Urobilinogen is a normal by-product of gut function that was co-measured with pyrroles in the assay. Being able to separate the two is important for identifying other conditions, such as an obstructed bile duct, haemolytic anaemia or hepatitis, and for correct interpretation. Treating a falsely high result can worsen symptoms or lead to vitamin B6 toxicity. See Urobilinogen.

Please note

• This is not a diagnosis, and BBH cannot diagnose or treat. Only a registered health professional can.
• Please do not self-diagnose or self-medicate. Results are likely to be better with a qualified practitioner.
• Do not stop or change medication without talking to your doctor.
• A practitioner who has completed BBH training can be found in the Approved Practitioner Directory when it opens.

Learn more

• Look up terms in the Glossary.
• Read Our research.

Bio Balance Health is an education organisation. It is not a clinic or a medical practice and cannot give medical advice. See your registered doctor for advice about your health.

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References

1. Lambert B, Semmler A, Beer C, Voisey J. Pyrroles as a Potential Biomarker for Oxidative Stress Disorders. International Journal of Molecular Sciences, 2023. Reference 1
2. Fryar-Williams S, Strobel JE. Biomarkers of a five-domain translational substrate for schizophrenia and schizoaffective psychosis. Biomarker Research, 2015. Reference 3
3. Fryar-Williams S. Fundamental role of methylenetetrahydrofolate reductase 677 C to T genotype and flavin compounds in biochemical phenotypes for schizophrenia and schizoaffective psychosis. Frontiers in Psychiatry, 2016. Reference 5
4. Fryar-Williams S, Strobel JE. Biomarker case-detection and prediction with potential for functional psychosis screening. Frontiers in Psychiatry, 2016. Reference 4
5. Stuckey R, Walsh W, Lambert B. The effectiveness of targeted nutrient therapy in treatment of mental illness: a pilot study. ACNEM Journal, Vol 29 No 3, November 2010. Reference 8
6. Hambly J, Francis K, Khan S, Gibbons K, Walsh W, Lambert B, Testa C, Haywood A. Micronutrient therapy for violent and aggressive male youth: an open label trial. Journal of Child and Adolescent Psychopharmacology, 2017; 27(9): 823-832. Reference 6