Pyroluria – A Zinc and Vitamin B6 Deficiency

Pyroluria Woman Suffering From Symptoms

Written by Changing Habits

June 13, 2012

Pyroluria. What is it, how do you know you may have it and how can you help treat it?


Pyroluria, (originally known as malvaria) and also known as kryptopyrroluria, is a chemical imbalance involving an abnormality in hemoglobin synthesis. People who have this condition produce too much of a byproduct of hemoglobin synthesis called kryptopyrrole (KP).
Kryptopyrroles bind to pyridoxine (vitamin B6) and zinc and make these very important nutrients unavailable for physiological and chemical functions including working as co-factors for enzymes in metabolism.  These essential nutrients when bound to kryptopyrrole are removed from the bloodstream and excreted into the urine as pyrroles.
The effect of pyroluria and the deficiency of zinc and B6 can be mild, moderate, or severe depending on the severity of the imbalance. Symptoms may include: unable to deal with stress, nervousness, anxiety, mood swings, severe inner tension, episodic anger, poor short-term memory and depression.
Its onset usually occurs during teenage years with a traumatic incident or stress, such as a change in school, loss of a loved one or moving towns. Even though the disorder does not show until teenage years it is thought to be genetic.  Depending on the degree of the disorder there may be severe depression, schizophrenia, alcoholism, autism, bipolar disorder (manic-depressive disorder) or on rare occasions, DID (dissociative identity disorder more commonly known as multiple personalities). All of these are different manifestations of pyroluria.
Unfortunately pyroluria is not a recognized condition by many mental health practitioners or general practitioners but the following tables shows a significance in many mental disorders – I find the more places I look for these statistics the more varied they are, it is important to know that pyroluria does have some significance in these disorders.
Disorder % with Pyroluria
Autism                        50%
Alcoholism                  40%
Depression                 70%
ADD/ADHD                 30%
Bipolar                        18%
Schizophrenia             40%
General Population     11%

How Pyroluria is Diagnosed

Pyroluria is diagnosed by a simple urine test which detects KPU in urine. Most people have less than 10 mcg/dL of KP. Persons with 10-20 mcg/dl are considered to have “borderline” pyroluria and can benefit from treatment. People with levels above 20 mcg/dl are considered to have pyroluria, especially if the following emotional and physical characteristics are present as well as signs of autism, depression, ADD and ADHD and other maladies already spoken about.  In Australia SAFE Analytical Laboratories specialise in KPU testing and I would suggest you use them as opposed to other as the chemical analysis for KP is difficult due to the tendency for this chemical to decompose.
Sometimes it is necessary to repeat the urine test to properly determine the level of KP being excreted. For the initial diagnosis, no vitamins or minerals should be taken for two days before the urine is collected (This is to avoid false negative results). The specimen should be handled properly as well – collected and frozen immediately and protected from any light by being placed in aluminum foil. A repeat test after treatment to determine if the condition has been improved will be helpful.
Common emotional and physical characteristics of pyroluria 
•    Poor morning appetite and/or tendency to skip breakfast
•    Morning nausea
•    Pale skin, poor tanning or burn easy in sun
•    Sensitivity to bright light
•    Hypersensitive to loud noises
•    Reading difficulties (e.g. dyslexia)
•    Histrionic (dramatic)
•    Argumentative/enjoy argument
•    Mood swings or temper outbursts
•    Much higher capability & alertness in the evening, compared to mornings
•    Anxiousness
•    Preference for spicy or heavily flavored foods
•    Abnormal body fat distribution
•    Significant growth after the age of 16
•    White spots on finger nails
•    Little or no dream recall


Pyroluria is managed in part by restoring vitamin B6 and zinc.  The type of replacement therapy is very important as zinc must be provided in an efficiently absorbed form. Vitamin B6 is also available in several forms. Other nutrients may assist include niacinamide, pantothenic acid, manganese, vitamins C and E. Food sources and nutritional supplements containing copper and red/yellow food dyes should be avoided.
People with mild-moderate pyroluria usually have a fairly rapid response to treatment if no other chemical imbalances are present. People with severe pyroluria usually require several weeks before progress is seen and improvement may be gradual over 3 – 12 months. Features of pyroluria usually recur within 2 – 4 weeks if the nutritional program is stopped.  Thus, the need for treatment is indefinite.
Diet of course is also extremely important. A diet filled with real foods including green leafy vegetables, meat, fish, chicken, fruit, nuts, seeds, eggs, and good quality dairy. I would stay away for the most part from many grains and cereals as they may bind with the zinc.
Food sources high in zinc are most meats, chicken, fish, turkey, pumpkin seeds, yogurt and cashews but the highest form of zinc is oysters.
Food sources high in B6 are; tuna, salmon, beef liver, chicken, potatoes. banana, red pepper, pumpkin, shitake mushroom, chickpeas (cooked) spinach to name a few. Check out our recipes here.
Being a vegetarian or vegan with pyroluria would not be a smart food regime. And if you are avoiding meat and meat products for humane reasons, perhaps its time to look at some humanity for yourself with regards to getting yourself well.
Though pyroluria was identified over 40 years ago, it has only been recognised as a medical condition for as little as 10 years and many mental health practitioners are not taught about it at university. People with pyroluria don’t respond well to common anti-depressants such as SSRIs and are often suicidal.  And the sad truth is that most people with pyroluria go undiagnosed.  Sadder is that many mental health and general practitioners do not think that diet has much to do with these conditions that are expressed with pyroluria.

Do I Have Pyroluria?

Some questions to ask yourself or loves ones, but this does not determine whether you have Pyroluria it merely points to a blood test may be in order.
1.   Do you tend to skip breakfast or have morning nausea?
2.   Do you tend to be anxious?
3.   Do you have other members in your immediate or extended family with schizophrenia?
4.   Are there members of your immediate or extended family who have committed suicide?
5.   Do you have white spots on your nails?
6.   Did you get a “stitch” in your side when you ran as a child?
7.   Did you have moderate to severe acne as a teenager?
8.   Do you have pain or creaking in your knees?
9.   Do you have cold hands and feet?
10. Do you have stretch marks as an adolescent or adult even without a large weight gain or loss?
11. Are your teeth or were your teeth before orthodontic treatment crowded with teeth growing over teeth?
12. Did puberty start a little later for you than others?
13. Are you easily tired?
14. Do you tend toward apathy?
15. Do you have a tendency toward iron-deficiency anemia or test borderline?
16. Do you have eczema or psoriasis?
17. Do you have tingling sensations or even tremors in your arms or legs?
18. Do you tend to have paler skin than other family members?
19. Do you tend to get overwhelmed in stressful situations?
20. Do you have trouble remembering your dreams?
21. Are you now or have you been a vegetarian?
22. Are you now or have you before been an alcoholic?
23. Do you find yourself socially withdrawn and dependent fairly strongly on one person? 
If you answer yes to 12 or more of these questions, then you may have pyroluria and should consider getting a urine test done.
Updated February 2020

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  1. Susan MacDonald

    I have not had a reply to my email yet and I wonder if it will come soon as I am anxious to have the test.

  2. Marinus

    Hi. Marinus here. Is there a laboratory in South Korea that I can do this Test?

    I suffered for long enough and want to know whats wrong

    • Tessa Pennick

      Hi Marinus,

      Unfortunately we don’t have any recommendations on where to get the testing done in South Korea as we are Australian based. Perhaps you could consider seeing a holistic health care practitioner for further advice. Apologies we couldn’t be more helpful.

  3. Mike Livesey

    Hi, I’m in the UK and have only just come across this site by accident, the majority of the symptoms listed I have suffered with for many years. I was diagnosed in senior school with depression and given prozac, but later was diagnosed with ADHD. Please bear in mind I am now 52 years of age still searching for answers. I think this may be it.

    • Jordan Pie

      Hi Mike, we recommend that you work with an integrative GP so you can get to the bottom of your health issues. Happy to hear this blog may have helped too 🙂

    • Cecilia Reed

      Hey Mike, I am also in the uk (Bristol) and have stumbled upon this article which is ringing too many bells. Did you find a dr that could test?

      • Bonnie

        Doctors won’t test here in the UK. I had my diagnosis through a naturopath who sent my test to the lab.

    • Ed

      Hi Mike,

      I’m in the UK, too. Did you get tested for this?

  4. Teresa

    Could you recommend a good Natural Therapist who understands this condition and treatment please. I live in Brisbane Qld.
    Thank you

    • Jordan Pie

      Hi Teresa, you could look at the following link to see if there is anyone that specialises in this;

  5. Kathryn cooke

    Who do you recommend in melbourne as intergrative gp please?

    • Brenda

      Check out NIIM in Hawthorn.

    • Ember

      Try ordering from for supplements – I have found it far cheaper than anywhere instore in Australia. Or yes, your doc might be able to make a script to take to a compounding pharmacy that should be cheaper than just going to a health food store.

  6. Di Collins

    I have been treated for this condition for several years now and feel great. A lot of mental health problems in my family. My problem now is the cost if testing $230.00. Also supplements keep going up $530.00 lasting 100 days. On aged pension. Any other suggestions?

    • Jordan Pie

      Hi Di,
      I’m so happy to hear you’re feeling so much better now. I would suggest talking to your chosen health care practitioner and ask them for more affordable options as they would know your health history. They may be able to provide you with some other alternatives or suggestions for you too.

  7. Gail Reed

    I had the test done & it came back borderline ?‍♀️ I have EVERY symptom listed & have been taking a good zinc supplement for a year but testing shows I am depleted in this .
    Because my integrative GP Is treating me for many other complaints, mostly brought on by my depression/ anxiety/ PTSD , he has put my treatment of this aside for the moment . I would like to start treating this immediately as I have a strong feeling that if this Is under control ,than everything else will fall into place . ????
    Will supplementation of a good quality zinc & B6 start me on the road to recovery . I already have my diet under control !. ?‍♀️

    • Jordan Pie

      Hi Gail,
      I would highly recommend you continue working with your Integrative GP and ask them if they recommend you take a quality supplement as they know your health history and current health situation too. All the best 🙂

  8. Ashleigh

    I’m borderline but have 90% of these symptoms. I am vegetarian (8 years now). I am taking supplements and just bought Zinc today. Are you suggesting a vegetarian cannot manage Pyroluria even with eating a bountiful diet of greens etc…?
    Thank you!

    • Kerry White

      So sorry to hear that you are suffering from many of these symptoms. Being vegetarian, this is when supplements may be used therapeutically and that is okay. You may like to seek advice from a trusted practitioner or our nutritionist for further advice and what foods or supplements may be best for you.

  9. Janet Leeman

    My son was diagnosed with Pyroluria after more than 2 years of a downward spiral of health. He has been severely ill with a combination of gut issues, chronic fatigue and weight loss. He is severely sick every morning with nausea and vomiting and most days he doesn’t eat until well after 1pm. In the second part of the day he feels better but is mostly so tired from fighting so hard to get through the morning. He has been under an integrated GP and on supplements for a month now, so what I’d like to know is why are the mornings so extremely bad compared to afternoons and is there anything you could suggest for severe nausea or to make the mornings easier? I have seen him struggle day in and day out for so long now I am trying to gather as much information as I can in order to help him.

    • Kerry White

      We are so sorry to hear of what your son is going through, though pyroluria seems like it would be just a snippet of his health issues and unfortunately without further question and more detail on his case which would be achieved through a personal consultation, it is difficult to advise. However, our nutritionist Sheridan suggests something like activated coconut charcoal or bentonite clay may assist the nausea and can be taken at least an hour away from food and supplements. It sounds like he needs a lot of gut support and diet changes in order to alleviate symptoms. Here is where you can find more information about personal consultations:

  10. Tim

    Hi there, if common antidepressants don’t work well for pyrolurics, are there any that do work well for us? Thanks


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