AAL works actively with quality researchers at top universities who have quality ethical and research protocol standards. At AAL we trust our ability to understand the science. We are excited by the future research possibilities now we have proven the molecular origin of pyrrole and the relationship to oxidative stress. We regularly work with post graduate students.
AAL works closely with Bio Balance Health Ltd. This organization introduced the pyrrole test into Australia as a prerequisite for commencement of the training of doctors by the USA experts in 2004.
AAL and BBH have always shared the core belief:
Mental health is often associated with a biochemical set of conditions which can be measured and managed.
If a body is given the materials and components to repair itself, it will.
Our research findings are an essential validation of this belief.
Our research findings will populate our lectures on pyrroles in the BBH Doctor training.
Urinary Pyrrole Test? Some quick facts.
The range of symptoms are related to the individual’s biochemistry and the underlying cause of the stress.
Pyrrole is not proven to be genetic or a disorder or a condition.
Pyrrole measure has no purpose unless it is scientifically proven to be useful in improving outcomes for patient care.
A high level of pyrrole, when combined with clinical signs of mental health issues, can give the patient hope that the problem can be resolved and a return to normal health is possible.
Pyrrole is a waste product so it must be collected and transported correctly to prevent the product disintegrating. Read further… link to pyrrole testing page
If the pyrrole is not isolated and instead is measured together with other chemicals like urobilinogen, then it is not a useful clinical test.
Kryptopyrrole is NOT what is being measured.
HPL is an artefact of the testing process and not the product which is being tested.
If a patient fails to respond to treatment, then the test has been conducted incorrectly or the diagnosis or treatment plan is wrong.
Urobilinogen is a by-product from the gut. It is not related to oxidative stress. Separate measure of UB can demonstrate other underlying issues which may present as mental distress i.e. blocked bile duct.
A high measure of pyrrole, when combined with clinical presentation of mental health issues, can give a patient hope that the problem can be managed and resolved and a return to normal health is possible. A practitioner who does not use a test which isolates the Pyrrole measure is not serving their clients well.
Publication will occur in due course.
Whats Included In Our Pyrrole Test
This simple test requires you to provide a small urine sample. Pyrrole is a waste product not found in healthy urine. It indicates your body is under stress. Co-testing of Zinc 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 your gut called Urobilinogen. If there are any extreme measures the laboratory will extend the test to other products in the urine and report immediately to your practitioner.
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 or handled correctly, AAL will order a recollect. Click Here
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
Full urinalysis if required.
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 tests have not changed since commencing business. The results are now refined to account for the major interference with the pyrrole measure, the gut by product, Urobilinogen. Separate measure of UB has meant a far more valuable test for the practitioner as it provides much more information. Using the correct two factor analysis scientific method to account for Specific Gravity means AAL does not produce false positives or false negative pyrrole measures.
AAL test is the most accurate pyrrole test available.
Samples that display unusual characteristics are explored to confirm the source of the unusual event. Under NPAAC guidelines we will alert the practitioner of results that lay outside our testing range
The Pfeiffer/ Walsh team correctly expressed Pyrrole is a measure of oxidative stress. They did not have the technology to prove this is so. AAL have proven that their original premise of this test applies.
To reiterate. It is not a condition, a syndrome, a disorder, genetic or an auto immune disease. It tells your practitioner if you have high levels of oxidative stress which must be managed. Re-testing also tells your practitioner how well you respond to treatment.
Pyrrole is only found in urine. Any practitioner who asks you to do any other test to measure pyrrole does not understand the biochemistry.
The DMAB active which is testing as pyrrole is mostly UROBILINOGEN. Sullivan and Nicolaides, in 2016, conducted in house testing 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 and adjustment of collection times is not enough to account for this. The use of the second morning void is chosen as prior to eating there should be less Urobilinogen in the sample. However, assay distinguishing Pyrrole and Urobilinogen can still detect more Urobilinogen than Pyrrole, confounding the results. 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 quite 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 al samples using an automated Siemens 105G 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.
Provided samples are collected correctly the absence of Urobilinogen can also indicate biliary obstruction, for which AAL has a distinct profile.
Pyrrole, Kryptopyrrole, Pyrrole Disorder, Pyrrole Condition, Pyrroluria, Kryptopyrole, Pyrole, Pyrrole syndrome:
No research has been conducted to show it is a condition, syndrome or disorder or autoimmune disease or genetic. 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 Urinary Pyrroles are a waste product, therefore unstable, 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 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 identifying and managing 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 Pyrrole 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 processes 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 pyrroles manifest different responses. It is important your practitioner lists all of your symptoms so treatment response can be observed. 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 provide 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 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 is 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 some 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).
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 in one of the calibration references used for AAL’s assay. It 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 photo-oxidation (oxidation with reactive oxygen species or oxygen radicals).
Hydroxyhemepyrrolenone (aka HPL) is generated as an artifact during the testing process and is not the actual form of the analyte. HPL is also unstable (and rapidly disassociates) under the typically employed chromatographic conditions (which is why it is difficult to measure 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 UB can demonstrate other underlying issues which may present as mental distress, for example, bilary obstruction or renal failure. These do find these in our testing process. This makes this test very useful.
Urine Collection Process for Pyrrole Analysis
“Where do I get a Urine Pyrrole Test ?”
Get a Urinary Pyrrole Test Request Form
If your Doctor has provided you with an Applied Analytical Laboratories Urinary Pyrrole Test request form, click to find your nearest collection agency.
If you are a new practitioner looking to refer a patient, please email to request an AAL Urinary Pyrrole Test request form.
First time test? Patients must have not started zinc supplements or cease supplements 72 hours prior to tests (to establish a base-line).
Follow up test? Do NOT cease Zinc if it is a follow-up test.
Medications used with Rheumatoid Arthritis and/and Urinary Tract Infections can interfere with the test, as does Rifampicin which changes the urine to a red/mauve colour. If you are taking these medications consult your physician as you will need to complete the course and/or abstain for a wash out period of 4 weeks prior to collecting a sample. For some, this is not possible.
Time of Collection?
Any time of the day is possible. Early in the day is preferable.
It is important that the time of collection needs to be noted on the form in order to help account for obtained Urobilinogen levels. Very high levels of urinary bilirubin DO also interfere. However this is rare and you will be informed if this is the case.
Blood does NOT affect the test result, so spotting at the beginning or end of menstrual cycle will not interfere with the result. It is NOT recommended to collect during peak menstruation.
Use Applied Analytical Specimen Jar
Urine is to be collected only in the AAL specimen jar containing medical grade preservative and immediately covered with foil which protects it from light and heat and from incidental high energy electromagnetic radiation (EMR). Any other jar will not have the required preservative inside the jar.
The sample is to be frozen immediately to -30’C and kept covered and frozen from the time of collection, during transport, and until the time of testing in the laboratory.
Transport (Collection Agency)
Samples are transported in dry ice to keep the relative temperature below freezing (at -30oC). Your results will be sent back to your doctor.
Pyrrole Results very high or very low?
According to NPAAC guidelines, we will notify the practitioner when the urinary pyrrole result is greater than 400ug/dL, urobilinogen is greater than 16µmol/L, or other parameters are detected (such as, bilirubin, blood, ketones, protein, nitrites and leucocytes). These can illuminate if a patient has liver/kidney function issues, diabetes, infection or other protein dysregulation factors. Applied Analytical Laboratories (AAL) is the only facility to meet this requirement and successfully participate in RCPA conducted proficiency programs for this system as an extra level of assurance. YOUR DOCTOR WILL BE NOTIFIED IMMEDIATELY OF RESULTS NEEDING URGENT ATTENTION.
Your collection agency will charge you separately for collection and handling fee.
Some practitioners in the Brisbane and Gold Coast area have an arrangement where the sample is collected on behalf of AAL and this reduced handling fee is included in their request form.