This year has been a steep learning curve but this is exactly as I had hoped and planned for. I strapped myself in for my roller-coaster ride, a series of intensive upskilling initiatives undertaken with mentors and experts in specialist areas, and I haven’t hurled yet or screamed loud enough to make the operator stop the ride (seriously this happened to me in about 1997 on a Pirate Ship in Rosebud!)…but I have come close 😉
One of the really big lessons has come from getting more into the science behind pyrroluria and urinary pyrrole testing again. What motivated me to tackle this spikey beast? Well, like many people who have been introduced to the concept of pyrrole testing and pyrrole driven mental health presentations – I had a lot of questions that hadn’t been adequately answered. Those gaps left me with some uncertainty about the validity of this investigation and about the interpretation of the results. I also have introduced this pyrrole theory to many naturopaths and hence feel a responsibility to polish up my knowledge on this and set the record straight.
Last but not least, in our local area we reputedly have a ‘pyrroluria plague’ at play – every man woman and their dog is getting this diagnosis and it had added not only to my misgivings about testing but also my concern about misdirected & unsafe treatment.
Lucky for me, I was out walking one day and I tripped over one of the key experts in pyrrole chemistry. Ok it didn’t happen quite this way but I did get introduced to him at a recent conference. He is a highly qualified and experienced chemist who set up the first pyrrole tests in Australia and more than a decade down the track has continued to tenaciously chase more scientific understanding of this phenomenon. Since then, I have had several lengthy meetings with him, thrown all my curliest pyrrole ‘but why?’ questions at him, which he has gone a long way to satisfying and also, much to his credit, has been upfront with the questions that as yet can not be answered. Too boot, I’ve interrogated a couple of clinicians who have extensive clinical experience with ‘pyrroles’ and seems that our collective knowledge is now reaching a consensus with the new emerging science…at last.
All this new information has really changed my thinking around pyrroles…enough to prompt me to say, ‘I recant!’ In the past I and others, have got some of this wrong & I’m keen to set the record straight.
I recant! I recant! I recant!
Here are the headlines:
- Hoffer & Pfeiffer’s original discovery of the ‘mauve factor’ in the urine of schizophrenic patients has finally been replicated in a published study in a scientific journal, the research for which was conducted in an Australian cohort – we’ve got a long way still to go but after 60 years we finally have this!
- Our understanding of pyrroluria, its chemistry & causes etc has changed significantly from Hoffer and Pfeiffer’s ideas thanks to advances in analytical techniques and scientific understanding – that’s not surprising of course but it also means we should embrace some of the new evidence that challenges the old that was based more on conjecture
- As part of this improved scientific understanding we need to recognise that elevated urinary pyrroles (HPL) are a non-specific marker of oxidative stress, and in this way, can reflect high oxidant exposure (dysbiosis, heavy metals, severe pathophysiology such as cancer, CVD) as well as probably reflecting a constitutional tendency in some but not all.
- Inaccurate urinary pyrrole (HPL) testing is happening here in Australia and leading to incorrect interpretations and mismanagement of patients – we need to update our testing protocols and procedures based on the science
My latest UU30 podcast is all about up to date scientific understanding of pyrroles, correctly identifying & treating pyrroles in practice has for some of my patients brought great results…I just wanted to get better at this aspect of mental health assessment & management and expand my knowledge in this area. It’s very exciting to be able to pass what I’m learning on…anyone need to stop the ride? 😉
Rachel’s latest UU30, ‘Moving Ahead on Mauve Factor’, drills down into the truth about urinary pyrrole testing and how recent scientific progress has really changed our perspective on their presence, how we define ‘normal’ V ‘clinically significant’ and the biochemistry that drives elevated pyrrole production. These critical details will change your practice behaviours & ideas about treatment, and will answer a lot of questions that have gone unanswered before.