Transcription
[Music] welcome to the holistic psychiatry podcast. i'm courtney snyder, a physician and holistic child and adolescent and adult psychiatrist.
in today's episode, i'll be discussing pyrol disorder, a common underlying factor for many brain-related conditions. those individuals with pyrol disorder can have very low stress tolerance. they can have problems with depression or mood swings, anxiety, angry outbursts, and some even will have severe social anxiety. alcohol and substance abuse are not uncommon. the treatment for this biochemical and nutrient imbalance is rather simple and can have a significant impact.
in this podcast, i'll address what pyrroles actually are, how they impact the brain, symptoms both psychiatric as well as physical. i'll talk about what pyrol disorder can look like in children and the diagnoses associated with pyrol disorder. i'll also talk about how we become what we would describe as pyrolyric and how we treat pyroluria or pyrol disorder. this is a fairly simple treatment and the responses are often relatively quick and quite dramatic. i'll comment on exceptions to this.
so what is a pyrol? a pyrol is a compound that naturally occurs in the body. and pyrol is what is describing its biochemical structure, basically four carbons and a nitrogen in a ring. so pyrroles leave the body through the urine. and there are there are different pyrroles. the one that we're talking about as we talk about pyrol disorder is hydroxy hemopyrulin, which i'll refer to as hpl. you'll also hear people refer to the term kryptopyrrole, which was what the earlier scientists and doctors thought they were seeing when they studied this phenomenon. but in fact, what they were finding, it was actually hpl.
so pyroluria or pyrol disorder is basically the overproduction of this particular pyrol. and all humans excrete small amounts of this hpl. but some individuals, because they are genetically predisposed, will excrete more pyrroles, and especially when they're under more stress. so this could be emotional stress, or it could be toxicity or illness. and it's also been noted that individuals who are dealing with a lot of toxicity, they may not have genetically acquired a pyrol issue, but from high toxicity, they do start to excrete more pyrroles.
and the reason that pyrroles are important when it comes to brain health is that this hpl does appear to bind both b6 and zinc. and so when there are high pyrroles in somebody's urine, they also are low in zinc and low in b6. and both of those are extremely important when it comes to brain health. b6 is important in making serotonin, gaba, and dopamine. so serotonin and dopamine are really important for mood and lowering anxiety. and serotonin specifically also for helping with sleep. gaba is the calming neurotransmitter. and also dopamine helps with attention. so if someone is especially low in b6 and has a deficiency, there can be a wide range of symptoms, again, impacting mood, anxiety, even learning and attention.
zinc is also a big player when it comes to brain health, and i would say arguably the biggest player. it is also important in gut health and for the immune system. and it's fairly well known that they the gastrointestinal tract and microbiome specifically has a big role in brain health. and that the immune system is functioning also has a big role in brain health. and when you hear about all the research that's going into inflammation, that's related to the immune system. but zinc is also important for the functioning of neurotransmitters, and specifically it works at the nmda receptor. and i can go on and on, and i will in a future podcast about zinc and its many roles. but to keep this simple here, again, b6 and zinc can become people can become deficient in those when they have pyrol issues. and again, when someone is under more stress, either emotional or physiologic, the pyrroles will go up, then they will be leaving the urine and taking more zinc and b6, and those will become more deficient.
and keep in mind that the symptoms can fluctuate in intensity, and that again can depend on how depleted someone is becoming in these nutrients, and that could fluctuate with the amount of stress they're dealing with. but one of the hallmark symptoms is poor stress tolerance. so this might be someone starting a new job, starting back to school, having a very stressful event in their life, and during that time, again, pyrroles could go up, and then they beca could become depleted in these very nutrients that are important for stress tolerance and for resiliency.
so we also will see, and people don't have to have all of these symptoms, but other symptoms include severe inner tension, avoiding crowds, new situations, and uncomfortable with strangers. there can be a heightened sensitivity as far as sensitivity to bright light, loud noises, odors, and even certain textures. there also appears to be a heightened immune response. so there's a association with autoimmune disorders, though not everyone with a pyrol issue has an autoimmune condition. there can be unexplained fever, chills, and there can be more food allergies.
as far as mood symptoms, there can be depression, irritability, temper is very common, people that have difficulty controlling their temper, and maybe even having rage episodes. we see this sometimes in children also, mood swings. and when we look at from a nutrient standpoint, bipolar disorder, rapid cycling would be most consistent with bipolar with excuse me, pyrol disorder. now, when someone has more of the classic type of bipolar disorder where they're having episodes of mania that last for a number of days, that would be more consistent with overmethylation. and when someone is more often having depressive episodes, that's more consistent with undermethylation. but the rapid cycling version has been found to have a higher association with pyrroles disorder.
and when i'm referencing these nutrient imbalances, overmethylation, undermethylation, and even pyrol disorder, this comes out of the work of the walsh research institute, who looked at 30,000 individuals with brain-related symptoms and identified the small handful of nutrient imbalances that kept kept showing up. and i discussed that more in a recent podcast on the story of dr. william walsh and his discoveries.
copper overload is another common nutrient imbalance. so sleep, a tendency to stay up late is very common, not necessarily insomnia, but more not feeling tired and not really feeling ready to settle down. there is often little or no dream recall, and this is seemingly associated with a b6 deficiency. substance abuse, including alcoholism, and individuals and or their families can be due in part to pyrol disorder. learning issues can be related to poor short-term memory. reading disorders are common, or a history of reading disorder, if we're talking to an adult, and a history of underachievement.
as you can see, this can be affecting people in a number of ways that could affect their motivation, attention, mood, some physical symptoms that we'll see, and even traits will be dry skin, a tendency to be pale, maybe even having vitiligo, which is when someone has some areas of their skin where there's lack of pigmentation, and this appears to be related to a zinc deficiency. acne is common. psoriasis may be present. there can be an affinity for spicy or salty foods. individuals can have premature graying of their hair. there can be problems with poor circulation of the hands and feet, so maybe having cold hands and feet. white spots on the fingernails is a common symptom and responds to zinc supplementation, which when i talk about the treatment part of that is zinc. the goal is to address the deficiencies. stretch marks, poor wound healing, and some people can have an abnormal distribution of fat, so it could be more at the midsection, and also may have poor muscle tone.
hormonally, someone could have poor growth and then not have a growth spurt until after they're 16. there may also be delayed puberty. there could be for women and girls abnormal or absent menses, or their period being absent or infrequent. headaches are not uncommon either, migraine or cluster. there can be joint pain, and there can also be for children a stitch in the side when they run. for children, they may be shy, but they also may be children that are having significant outbursts and temper tantrums.
associated diagnoses, some of which i've referenced, could be substance abuse, alcoholism, anxiety, rapid cycling bipolar disorder, learning disorders, even psychotic disorders or schizophrenia disorders. very common in autism spectrum. it can be associated with tourette's, with seizures, even with some antisocial and criminal behavior. it has also has an association with down syndrome.
how do we become pyrolyric, or how do we have elevated pyrroles? if we do, it does appear that there is a higher incidence of pyrol disorder for people of celtic and scandinavian descent. there does appear to be a genetic form as well as an acquired form, and these may exist on the same spectrum because there are different pyrroles. and again, this one particular hpl has been identified and is associated with what i've just described in terms of symptoms and traits. there's not clarity on exactly where the hpl is coming from, and there's different theories about this. and again, because these pyrroles can be from various molecules and compounds in the body, but different things that are being looked at and considered are enzymes and stress hormone pathways that have a pyrol structure, as well as particular liver enzymes that involve the cytochrome p450 system, and and others. so it is something that we see people benefit from and respond well to, but in terms of understanding why someone has these, that hasn't been completely pinned down.
it does appear to run in some families, and so there is a genetic piece, but also there is an acquired form where if someone has a great deal of toxicity, they appear to have lower levels than maybe someone with a severe genetic form. and like there can be a combination of both of those. so as i mentioned, stress of any kind can cause pyrroles to increase. stress could be a history of trauma. it could be early attachment disruption in the first three years of life. it could also be from toxicity or inflammation. but even for someone, let's say, who has a genetic form or who's dealing with an acquired form, even something like a growth spurt or a cold could cause a bump in the pyrroles, and again, then a deficiency in those two nutrients, and then difficulty bouncing back and and recovering, let's say, from an illness or a stressful event.
i use the term toxicity, but more specifically, it's high oxidative stress. and that's when there's an imbalance between the free radicals that that basically destroy cells and impair biochemical processes in the body. typically would meet those with our natural antioxidants, but when there's an imbalance and the our body's antioxidants have been overwhelmed, then we will have what is called oxidative stress. and that is when there starts to be damage to cells and different processes in the body. and again, this oxidative stress appears to have as one of its markers elevated pyrroles. another marker, for example, would be low levels of glutathione. that's a main antioxidant in the body, and if that's low, it suggests that it's being depleted, it's being used up faster than it should.
how do we diagnose pyrol disorder? there is a urine pyrol test, and different labs offer it. and basically, it measures the amount of pyrroles in the urine. the only lab that i use for this, and i'm not i don't have any financial relationship with this lab, but dha laboratory, which is outside of chicago. when they measure the pyrroles in the urine, they also measure the specific gravity or the concentration of the urine, and then factor that in when they're giving the result. so if a lab does not do that, and many of them do not, then you could be getting a lab result that could be very different depending on how much fluids the person has had. that particular test is not covered by insurance. it is a test, even from dha, that individuals can order for themselves.
keep in mind that the levels can fluctuate on pyrroles depending on how much stress someone is under. so just having a normal test, let's say somebody does the test when they're chilled out and relaxed on the weekend, that doesn't necessarily mean they don't have a pyrol issue. certainly people with a genetic form that are chronically running high pyrroles in their urine would expect that to to evidence itself. but if someone doesn't have such an extreme form, or if it's fluctuating so widely, then it's possible to have a normal number. and so part of the diagnosis is very much based on someone's symptoms and the timeline, and again, looking closely at how well someone does bounce back from stressors.
when i check pyrol levels, i'm typically also checking zinc levels, which would be a blood test, as well as copper levels, and these other specific nutrient imbalances that affect brain health, namely copper, zinc, and whole blood histamine, which is a screener for methylation. something that i've talked about in a previous podcast. methylation relates to the balance of methyl and folate.
how do we treat pyrol disorder? basically, it's with a specific nutrient protocol. and the doses that we would use would depend on, for example, what someone's zinc levels showed, also their age and their weight. i would typically start someone on zinc along with p5p, b6, evening primrose oil, which is omega-6. if they had especially high pyrroles, i would stop any omega-3s. people that have very high pyrroles have problems in the specific metabolism there, and we would only use omega-6 in the form of evening primrose oil. magnesium and biotin are important, as are other antioxidants. say other because zinc is an antioxidant, others would be vitamin c, vitamin e, and selenium.
if someone is doing well with their protocol, but then they're under more stress, they could have a return of symptoms, maybe not as severe. so sometimes what we'll do is use what we call stress dosing, where we may temporarily increase the dose of zinc and the b6. so b6 and p5p is the active form of b6, so one or both of those could be could be increased temporarily.
i also talk to individuals and parents about the importance of recognizing this issue with stress tolerance. now, treatment does help someone with resiliency and being able to tolerate more stress. however, just from a temperament standpoint, a lot of individuals that have pyrol disorder can really thrive if they're not trying to do sort of the typical high-intensity, non-stop, pressured, stressful existence that our culture seems to encourage. so they can be more mindful about decisions they make, not to hold themselves back, but to meet their their body where it's at and do what really everyone should be doing, is being more present, doing what they love, not over scheduling.
so education is important, and addressing sources of toxicity and inflammation. many people can do great and respond great to a pyrol treatment. as i mentioned, i see a lot of people who are particularly sensitive, and many people with mold toxicity, and they may need to go slower on starting the protocol. they often do not tolerate b6 particularly well, but can do fine with p5p, so they can still get a form of b6. and the zinc might have to go be increased more slowly because they are highly toxic. and zinc's a strong antioxidant, and if we push things too too quickly, the same would be with metal toxicity. if someone has a lot of metal toxicity, things could be moved too quickly if the zinc is started too fast, and then may not not only not benefit right away from the treatment, but feel feel pretty bad.
if you want to learn more about pyrol disorder, and dr. walsh discusses pyrol disorder in his book called nutrient power. i have a blog post on pyrol disorder on my website at courtneysnydermd.com.
[Music] who could this be helpful for? i would say anyone with brain-related symptoms. it's that common. so again, red flags could be a personal or family history of alcoholism, problems with low stress tolerance, a child or adult with problems managing anger or having mood swings, and even those individuals who seem to have personality changes that happen when under stress.
i will be talking about copper overload in the upcoming podcast, and that is something that can occur when someone has zinc deficiency. so someone can have high pyrroles, become low in zinc, and then develop high copper. i hope this was helpful, and i'll look forward to connecting with you in the next podcast. take care. bye.
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