Pyrrole Test

 

The urinary pyrrole fraction occurs in the urine when the body is under stress. The test results indicate to your practitioner the stress severity. The associated mental health issues are related to the stress. Repairing the stress should lower the pyrrole and reduce mental health issues.

Symptoms are related to the individual’s biochemistry and the underlying cause of the stress.

Elevated pyrroles (aka “pyroluria” or “Pyrole Disorder“) have not been proven to be genetic or a disorder.

A high level of urinary pyrroles, when combined with clinical signs of mental health issues, and other related pathologies can give the patient direction towards resolution. A return to normal health is possible.

Urinary pyrroles are highly reactive waste products so must be collected and transported correctly to prevent the product degrading. Read further about Pyrrole Testing Test here

It is UNEQUIVOCAL that kryptopyrrole is NOT what is being measured.

“HPL” is an artefact of the testing process and not the product which is being tested (although, its molecular weight is used in calculations as chemically, it the most closely related reasonably stable common intermediate in the oxidative degradation of regulatory haem components.

If a patient fails to respond to treatment, possibilities include : the test has been conducted incorrectly, the diagnosis is incorrect or treatment plan is inadequate. “[intro to medicinal diagnostics 1A]”

The assay reagent (p-N,N-dimethylaminobenzaldehyde) also reacts Regulatory haem components such as bilirubin and urobilinogen causing interferences. AAL has taken great care to characterise the interferences (such as bilirubin and urobilinogen) and correct for their influence on test levels. Bilirubin is a bile component and urobilinogen is the result of gut microflora action on bilirubin in bile. These compounds are not directly related to oxidative stress, rather they are related to adrenal, liver and kidney function.

A separate measure of Urobilinogen can offer differential diagnostic ability to ascertain other underlying issues which may present as mental distress, anxiety and digestive system dysfunction i.e. in cases of blocked bile flow, anxiety and digestive dysfunction (diarrhea) may be present.

Elevated “pyrroles” can be corrected with the appropriate treatments, which correlate with improvement of symptoms.

This simple test requires you to provide a urine sample. The DMAB active pyrroles are a waste product not found in healthy urine and indicates that your body is under stress. Co-testing of Zinc, copper and other biomarkers informs your practitioner what you need to repair your biochemistry and reduce your symptoms. The test also measures a by-product from gut function called Urobilinogen.

Urine sample collection can occur at your practitioner’s rooms if they have been approved by AAL.

Most collection occurs at a collection agency. See below for your nearest agency or ask your practitioners office. If the sample is not collected, handled correctly, or doesn’t arrive at the laboratory in appropriate condition, AAL will order a recollect. Click Here

Under normal circumstances, AAL usually tests the urine sample within in seven working days. The results are uploaded, faxed, phoned, or emailed to your practitioner.

Your practitioner will receive:
– Measure of Pyrrole
– Measure of Urobilinogen
– Specific Gravity
– Siemens 10SG Point of Care urinalysis.
– Results, report and after service consultation.

Your first Pyrrole test should be before commencing treatment. Re-testing is required after a few months to evaluate your response to treatment and to then review your management plan.

AAL test sample preparation protocols have not changed since commencing operation. The results have been refined to account for the major interference(s) with the pyrrole measure. A separate measure of Urobilinogen has provided a far more valuable test for the practitioners as it provides much more information. Using the correct two factor analysis means that AAL has largely eliminated the generation of false positive and false negative results
The AAL urinary pyrrole test is the most accurate urinary pyrrole test available.

Samples that display unusual characteristics are explored to confirm the source of the unusual event. Under NPAAC guidelines the practitioner is alerted to results that lay outside the testing range.

To reiterate, Elevated urinary pyrroles has not been proven to be a condition, syndrome, disorder, genetic or an auto immune disease. It tells your practitioner if you have high levels regulatory haem fragments (as a result) of oxidative stress. This “fragmentation” is the body’s “last resort” oxidative protection – which means high levels should not be ignored and must be managed!
Re-testing also shows practitioners the response to treatment.

NOTE WELL:
The ONLY way to measure the Pyrrole/pyrrolenone  fraction is by urinary analysis. Any practitioner who asks you to do any other test to measure pyrrole does not understand the biochemistry.

In 2018, an Australian laboratory (Applied Analytical Laboratories) became the first to include measurement of urobilinogen in their testing process.

Urobilinogen is a by-product of normal gut function as opposed to oxidative stress and is co-measured in the assay.
Urobilinogen is much more stable than the pyrrole fraction and does not breakdown as rapidly in light and heat (although, it still does). Hence failure to follow the strict collection, storage and transport protocols results in the break-down of the Pyrrole fraction of the urine and only the Urobilinogen portion is measured.

Separation of these components allows for identification of additional pathologies (e.g. obstructed bile duct, haemolytic anaemia, or hepatitis) and is critical for correct interpretation. The distinction allows a more accurate identification of the composition of the sample as falsely treated results can exacerbate symptoms and/or lead to vitamin B6 toxicity.

The AAL laboratory report gives clear reference ranges for both Urobilinogen and Pyrroles.

The DMAB active which is testing as pyrrole is mostly UROBILINOGEN. Sullivan and Nicolaides, in 2016, conducted in house investigation and found this so and ceased collection of urine for Pyrrole testing. Since 2018 AAL have distinguished Pyrrole and Urobilinogen in the assay and given measures for both.

Interference studies show Urobilinogen interferes greatly with the pyrrole reading (even at the “recommended” second void specimen), thus adjustment of collection times does not adequately account for this. The use of the second morning void historically been chosen due to a minimum of urobilinogen at this time however, urobilinogen levels at this time can still be greater than the pyrrole fraction. This is not to say the use of this method has been of no value. The demonstration that there is a product in the urine which has some association with Mental Health has given patients hope and directed patient care. AAL have studied the degradation of both the Urobilinogen and the Pyrrole fraction and have confirmed Pyrrole is the result of oxidative stress (as taught by Bill Walsh), not the cause of ”pyrroluria” as it has commonly become confused. In comparison, the Urobilinogen is relatively stable, while the pyrrole fraction degrades rapidly. This demonstrates the need for careful collection, transport, and storage, as per the AAL SOP 3001 Urinary Pyrrole Protocol.

Benefits of a separate Urobilinogen measure

AAL now screen all samples using an automated Siemens 10SG system (and AAL participate in RCPA run proficiency testing for this system) This also enables AAL to continue to provide a fixed stable reference assay, ties our assay in with current conventional haematology and provides an extra level of assurance to aid diagnosis with the additional detection of bilirubin, blood, leukocytes, Nitrites, Protein, Ketones, and Glucose. The 10SG urobilinogen also offers a confirmation of the AAL measurement at urobilinogen levels >16µmol/L.

Provided samples are collected correctly the absence of Urobilinogen can also indicate biliary obstruction, for which AAL has a distinct profile.

The providing of a Urobilinogen measure as a possible differential diagnosis of mental health issues provides a level of care not previously possible.

Pyrrole, Kryptopyrrole, Pyrrole Disorder, Pyrrole Condition, Pyrroluria, Kryptopyrole, Pyroluria, Pyrrole Syndrome.

These are all names used to describe a chemical found in the urine which has been clinically shown to be associated with several chronic mental health issues. It has also historically been referred to as the MAUVE FACTOR.

No research has been conducted to show it is a condition, syndrome, or disorder, or genetic in origin.

Our research has shown:
A measure of pyrroles in urine is not a diagnosis, but a biomarker of oxidative stress.
For treatment, the stress must be managed for long term reduction of symptoms, along with re-balancing of biochemistry.
The correct term is: High or Elevated Urinary Pyrroles.

Urinary Pyrroles are unstable; thus it is essential that collection and transportation of urine is done under strict standardized conditions to maximize reliability of results. Poor collection and handling can result in false negative readings, or false positive.

No research has been conducted to show it is a condition, syndrome or disorder, autoimmune disease, or genetic.

To repeat. It is not a diagnosis, but a measure of oxidative stress which must be managed for long-term reduction of symptoms.

Work has also shown, as pyrroles in urine are a waste product, therefore unstable, it is essential that collection and transportation of urine is done under strictly standardized conditions to maximize the reliability of results. Poor collection and handling can result in false readings and poor patient outcomes.

What is important is the focus on the urine measure as a biomarker of oxidative stress which directs patient care to identify and manage the underlying oxidative stress. A doctor trained by Bio Balance Health will know how to do this and manage the process which is individualised to each patient.

The identification of High Urinary Pyrroles has changed many lives as reduction of the pyrrole measure commonly correlates with reduction of symptoms.

The understanding that very High Urinary Pyrroles is also often associated with some forms of mental ill-health has reduced the stigma and the loss of hope felt by many with a mental health diagnosis.

The process to reduce high pyrroles enhances current chronic health management.

Symptoms associated with high pyrrole vary as the underlying stress varies. This explains why there are so many symptoms and how each person with high urinary pyrroles manifests different responses. It is important your practitioner lists all your symptoms so which symptoms show treatment response can be observed. High Urinary Pyrroles are only found in certain types of mental health.

In 2018 Applied Analytical Laboratories became the first to have selectivity in their assay which enables the distinction between chemical species pyrrole from urobilinogen, and provides separate measures for both, as well as the CORRECT scientific measure of Specific Gravity (SG).

Urobilinogen is a by-product of normal gut function as opposed to oxidative stress and is co-measured in the assay.
Separation of these urine components allows for identification of additional pathologies (e.g. obstructed bile duct, haemolytic anaemia, or hepatitis) and is critical for correct interpretation.

The distinction allows a more accurate identification of the composition of the sample as treatment plans based on false results can exacerbate symptoms and/or lead to vitamin B6 toxicity.

The AAL Laboratory report will give clear reference ranges.

AAL recommends you use Bio Balance Health trained doctors who have experience in managing the process. Self-diagnosis and self-medication are fraught with difficulties and will not achieve optimal results.

Applied Analytical Laboratories Pty Ltd (AAL) is the only dedicated Pyrrole testing laboratory in Australia. AAL are the leaders in investigating the origin of elevated urinary pyrroles, both in their own processes and quality control, and through active research collaboration with university researchers.

SOME MORE SCIENCE

For those who want a bit more science.

The Pyrrole moieties that are measured are labile (reactive) intermediate fragments produced by the attack of reactive oxygen species on regulatory haem. This system has been suggested as a” last resort” anti-oxidant system of the body (bilirubin, for example, is a powerful anti-oxidant yet is physiologically toxic (we have scientific references for this).
The coordination, or reaction, between pyridoxine/pyridoxal and any pyrroles, or indoles, does NOT occur (if there was reaction of this nature all muscle contraction of every species on earth would not occur as serotonin/5HT is an indole).

No research has been performed or published to show Pyrrole is genetic or a disorder.

Conversely, we suggest that it is a condition manifested by excess oxidative stress.

Kryptopyrrole is 3-ethyl-2,4-dimethyl pyrrole and is used as one of the calibration references used for AAL’s assay.

Kryptopyrrole is NOT the active measured in the assay. It also has found successful application in our laboratory as a research chemical (where it has been used to produce HPL (the pyrroline-one form) and associated analogues for study. This work has made major inroads into elucidation of the mechanisms of the free radical oxidation (oxidation with reactive oxygen species).

Hydroxyhemepyrrolenone (aka HPL) is generated as an artifact during the testing process and is not the actual form of the analyte measured. HPL is also unstable (and rapidly disassociates) under the typically employed mildly acidic chromatographic conditions (which is why it is also difficult to measure accurately with current HPLC-MS technology).

Urobilinogen is a by-product of normal gut function, and levels can fluctuate greatly from morning to evening under normal circumstances, or times of adrenal stimulation/relaxation (through anxiety). It is not directly related to oxidative stress.

Separate measure of Urobilinogen can demonstrate other underlying issues which may present as mental distress, for example, biliary obstruction or renal failure. This makes this test very useful as an insight to other pathologies.