Addressing pyroluria – A functional medicine approach to treating lyme disease


In functional medicine, professionals will always refer to finding the multiple root causes of a chronic condition. Root causes of any chronic issue may include digestive issues, heavy metal toxicity, bacterial, fungal, viral, or parasitic overgrowths, nutrient deficiencies, and more.


In the case of patients with Lyme Disease, many protocols to address the issues these patients face include detoxification and supporting the detoxification pathways. As most practitioners will delve into getting rid of toxins, recent research shows that the best way to begin a protocol for Lyme disease is to first look at pyroluria.


What is Pyroluria?

Pyrroles are a byproduct of heme synthesis, and we all excrete pyrroles through urine in small quantities. However, in people with pyroluria, a particular pyrrole called hydroxyhemopyrrolin-2-one, or HPL, remains longer in the blood and binds to important nutrients, such as zinc, vitamin B6, biotin, omega 6 fatty acids, and manganese. Then, they are excreted in the urine in larger quantities than normal.


The condition was discovered in 1958 when a higher amount of HPL was detected in the urine of patients with schizophrenia. After developing the assay to detect this substance, Dr Carl Pfeiffer, MD, PhD, found that there were clinical improvements in patients taking high doses of zinc and vitamin B6.


There seems to be a strong correlation between Lyme Disease and pyroluria (aka KPU), as a high percentage of people with Lyme Disease score high on the Pyroluria Functional Questionnaire.

Although pyroluria is thought to be a genetic disorder, new research indicates that it could also be caused by emotional or psychological trauma, chronic infections such as those found with Lyme disease, or environmental toxicity. Treating pyroluria may be very effective in leading Lyme patients back to better health.


Why are zinc, vitamin B6, manganese, omega 6 fatty acids, and biotin so important?

Zinc – Zinc deficiency can result in emotional disorders, insulin resistance, rough skin, low stomach acid, stretch marks, lowered libido, white spots on fingernails, and a lowered immune system to name a few. Lower levels of zinc are also associated with lower glutathione, a vital antioxidant needed for optimal detoxification.


Vitamin B6 – B6 deficiency may lead nervousness, insomnia, poor absorption of nutrients, a decrease of enzymes and cofactors involved with amino acid metabolism, impairment of synthesis of neurotransmitters and hemoglobin, neuropathy and more. Low vitamin B6 levels are also correlated with low levels of glutathione.


Biotin – Biotin deficiency can cause dry skin, rashes, seborrheic dermatitis, fine or brittle hair, or hair loss. Biotin is an important cofactor in the production of energy and is essential for optimal brain and nervous system function.


Manganese – Manganese deficiency may be associated with joint pain, inflammation, and arthritis. Manganese is essential for growth, glucose utilization, lipid metabolism, and production of thyroid hormones.


Omega 6 fatty acids – A deficiency in omega 6 fatty acids can affect the leukocytes of the immune system making a person more prone to infection. It can also lead to dry skin and hair, slow wound healing, hair loss, and kidney dysfunction to name a few.


As one can see, a deficiency in only one of the above nutrients can lead to many different issues. Especially issues that interfere with proper metabolic pathways involved in the detoxification protocols needed for a chronic illness such as Lyme disease.


What does having Pyroluria mean for different issues that affect Lyme patients?

Methylation – Many patients and practitioners are quick to give patients methyl groups to aid in methylation. However, taking zinc and B6 could be a safe and more effective way to support methylation in patients with pyroluria prior to any further supplementation.


Heavy Metal Toxicity – Adding B6 and zinc where it is deficient support proper glutathione synthesis and therefore detoxification. Vitamin B6 and zinc can actually displace heavy metals. Therefore, it is important to use detoxification methods when a pyroluria protocol is started in order to bind and release the heavy metals that are displaced by zinc and vitamin B6.


Histamines – Pyroluria patients are typically much more sensitive to elevations in histamine levels than patients without pyroluria. It has been found that treating patients for pyroluria may stabilise mast cells and lower the response to relative changes in histamine levels, especially if coupled with other adjunct strategies.


Hypothyroidism – Patients with an underactive thyroid and pyroluria can begin to feel hyperthyroid symptoms once pyroluria is addressed. This is a good sign because one can work with their doctor to decrease thyroid medication as one’s cells begin to metabolize more efficiently.


How is Pyroluria diagnosed?

There are several tests that one can do to determine pyroluria, but oftentimes, these tests can show false negatives. As a first step, you can answer a specific questionnaire and count how many YES answers you score. If you would like to delve further into this, you can ask the Neomed team to give you a pyroluria assessment.


Treatment of Pyroluria

Treatment involves taking zinc, vitamin B6, manganese, omega 6 fatty acids, and biotin. As every patient is different, it is important to work with your naturopath or functional medicine practitioner in order to find which forms and doses work best for you.


Lyme disease is a complex chronic issue. Addressing pyroluria may be an integral piece of the puzzle in finding health on one’s healing journey. Ask your doctor or naturopath about pyroluria. It may be the missing link to getting better.


Article author: Tina Christoudias-Spyrou, Functional Medicine Practitioner at Neomed

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