Got fair skin and white spots on your nails and go a bit off-grid in stressful situations? Thinking it’s pyrroles? Well, you’re probably wrong!  Man. I’ve been waiting a long time, since being introduced to the pyrroluria biochemistry and diagnosis over a decade ago in fact, to get something that looks anything like validated scientific clarification about this condition: what exactly we’re measuring in the urine test, where the line is between healthy & unhealthy with these results and a clear set of physical and psychological traits that actually correlate with this disorder and therefore can help to screen your patients in order to determine in whom testing for urinary pyrroles is really warranted and most likely to bear fruit. And finally we’re getting somewhere! Cue Crowded House ditty 😉
With mental health patients, understanding their unique biological & psychological contributions and drivers is the key to individualised treatment and optimal outcomes but in terms of biological assessment, we can’t just order ‘one of everything’, using a dragnet approach & drain their bank account along way.
Previously, what I had learned, 1st and 2nd hand about patients with pyrroles left me with uncertainty about the specificity of the clinical picture. Then when I caught glimpses of the incredibly, (ridiculously) long list of symptom attributions being made with pyrroluria online via public and some practitioner forums, I felt even more uneasy.  It was becoming more likely a Dolly quiz – that’s a mag from the 80s young folk 😉 – than a credible way to pick up pyrroles in patients.  And like every health fad, it seems to have been reaching scapegoat and panacea heights. Consequently, it really lead me to question my own convictions about how this condition presents and the significance of that. I started ordering the test left often.

Research to the Rescue! Faced with a dearth of scientific evidence for years, there are finally several independent studies underway or just completed that are long overdue in clarifying this condition.  The one I have been learning about most recently, speaks to the physical and psychological traits and features that best predict a positive urinary pyrrole result..and it is not a moment too soon!
As a result of these exciting new findings (pending this is seriously hot off the pre-press), I’ve created a new Pyrrole Screen, featuring 11 characteristics, all of which have been shown to independently correlate with a raised urinary pyrrole result, with statistical significance.  What will surprise you is not only what made the list but all those ‘accepted key clues’ that failed to! Spoiler alert…white spots on nails, plasma zinc levels and anxiety are all out!! Hallelujah…faith restored! I’m reassured I know what I am looking for and when to test. If you want help with this too, check out the latest Update in Under 30.
Working in mental health? Do you wonder which of your patients really should be tested for pyrroles so you can avoid wasting your time and their money?  At last, urinary pyrroles as a biological driver, is moving in from the margins of pseudo-science and starting to be the subject of  more rigorous research.  With these investigations have come the opportunity to test our old ideas about what to look for and who to test…and surprise! many of those old markers and traits have been thrown out as a result.  It’s time to smarten up our knowledge in this area and our ability to start really Picking up on Pyrroles.