Introduction
“Too much water hast thou poor Ophelia” (Hamlet, Act 4, Scene 7)
Shakespeare lived in a world where health was impacted by four mysterious substances called humors;
- Blood (sanguine) for courage and adolescence
- Phlegm (phelgmatic) or water for maturity
- Bile (choleric) for the fire of childhood and
- Melancholia (black bile) for old age
An imbalance of these humours was determined to unbalance a person’s temperament, health and being. Whilst we might now regard this as folklore and superstition, it has its origin in the metabolic derangements that can sometimes really throw off our body and mind.
Our bodies need nutrients in order to survive and thrive. Many of us are familiar with the big macronutrients; proteins, fats and carbohydrates. However, this is not the full story. Our cells also need many other ingredients to do well. These include certain metals, called trace minerals, as well as a long list of other very important substances loosely called vitamins.
What these minerals, nutrients and vitamins do is to enable cells to function well. Every now and then, something can accumulate or enter the body that retards a particular cell function in a very unique way. Anything from alcohol to snake poison can do it.
Sometimes, our own body can’t balance the nutrients that flow in and out of the body and this can impact cells in a unique way. Pyrrole disorder is a reasonably common disorder of a breakdown product in the body accumulating and stealing key micronutrients that are needed by our cells. It manifests as a cause of anxiety and depression that is helpful to consider in these difficult cases.
What are Pyrroles?
Pyrroles, specifically Hydroxyhemopyrrolin-2-one (HPL), are a chemical byproduct of the synthesis of Haem in our bodies. Haem forms a part of Haemoglobin, the molecule in our red blood cell that carries oxygen.
Pyrroles are found normally in our body, broken down and then excreted. In some people, there is too much HPL or pyrroles and they bind to important vitamins such as Zinc and B6 leading to excessive loss of these nutrients in the urine.
This leads to a host of problems with the body in terms of skin, digestion and also critically the ability of nerve cells to function well. Pyrrole sufferers tend to be low in Zinc and B6 and have mental health symptoms such as anxiety, nervousness and depression. Pyrrole disorder is also associated with excess copper; this leads to anxiety, depression and irritability.
In children, pyrrole disorder may present as behavioural problems.
What are the problems associated with too much pyrroles?
Pyrrole disorder is associated with cognitive, behavioural and mood issues. It is considered to be similar to Bipolar disorder and other mood issues:
- Depression
- Autism
- ADD
- Neuroses
- Alcoholism
- Anxiety
- Learning difficulties
- Epilepsy
It should be noted that pyrrole is only one cause of mental health disorders.
What parts of our health are affected by pyrrole disorder?
Pyrrole disorder occurs as the pyrroles bind important nutrients including zinc, magnesium, biotin, manganese and B6. A deficiency of these leads to issues in a range of body tissues:
- Digestion
- Brain function
- Well-being
- Emotions
Clinically, this can look like :
- Difficult dreams
- White spots on the nails
- Pale
- Stretch marks
- Poor digestion, bloating, irritable bowel-like symptoms
- Anxiety
- Mood swings
- Joint pains
- Sensitivity to light and noise
Why does pyrrole disorder affect mental health?
Pyrroles are made more copiously in the setting of oxidative stress; this is where cells are not able to balance damage and damage repair leading to poorer cell function. The build up of pyrroles leads to a lack of calming neurotransmitters such as GABA and serotonin as well as digestive, cognitive, mood and other problems. Furthermore, low zinc is linked to low mood and B6 is involved in the synthesis of all of these neurotransmitters.
This may manifest as…
- Moodiness
- Irritability
- Behavioral issues
- Highly sensitive emotionally
- Some neurotransmitters affected by pyrrole disorder include:
- GABA: inhibits nerve activity leading to calm and relaxation is diminished in pyrrole disorder
Glutamate, an excitatory neurotransmitter is elevated in pyrrole disorder.
Serotonin: Controls mood, appetite, and sleep as well as gut symptoms such as bloating
Dopamine: The reward chemical, is implicated in alertness, energy, concentration, mood, and depression
Noradrenaline: Is linked to adrenalin, the fight or flight pathway, and can trigger anxiety and depression
How is pyrrole disorder diagnosed?
A urine test is used to assess for pyrrole disorder. Generally, people have less than 10mcg/dL of HPL in their urine. Amounts greater than 20 mcg/dL are considered to be positive for pyrrole disorder.
Typically, there is often an elevated histamine in these patients; this is an allergy molecule that causes hives.
Low zinc can mean that this test is falsely negative; the test relies on the presence of zinc on the pyrrole ring in the urine. If the zinc is very deficient, it will not be present despite there being a pyrolle disorder.
NB: Patients must not take Zinc or B6 supplements in the 3 days prior to the test.
How is pyrrole disorder treated?
- Managing oxidative damage and body inflammation
- Treating any underlying gut issues
- Optimising nutrition
- Ensure high-quality sleep
- Fish oil, omega3 and other antioxidants
- Supporting the adrenal gland
- Avoiding extra copper supplementation
It is important to monitor Zinc and copper as well as urinary HPL over time.
Additional brain inflammation support may be given by…
- NAD boosters
- Phosphatidyl choline
- Low dose naltrexone
- Psychological support
How do I know if I have pyrrole disorder?
Pyrrole disorder has many features common to other illnesses. The symptoms of Pyrrole disorder are commonly seen in:
- POTS or autonomic dysregulation
- Depression and anxiety
- Bipolar disorder
- Chronic inflammatory response syndrome
- Chronic fatigue
- Estrogen dominance
- Sleep deprivation
In many cases, the copper excess and zinc deficiency may be a common denominator; however for reasons other than pyrroles.
You can read about relevant health topics by clicking the articles below:
- The body and the mind: medical factors for mental health
- Zinc
