The pyroluria urine test is not a waste. It’s actually fascinating how it’s done. However, it’s often misrepresented, leading patients to believe they’re being diagnosed with a genetic disorder when the science isn’t there yet. Understanding its limitations is key.
What is pyroluria?
Pyroluria is sometimes described as a genetically linked chemical imbalance related to hemoglobin synthesis. The theory is that excess kryptopyrroles (KP) in the urine bind to vitamin B6 and zinc, depleting the body of these nutrients, which can contribute to mental health symptoms such as anxiety or depression.
The typical scenario
Someone with anxiety or depression is tested with a urine kit. If KP levels are above 20 µg/dL, they may be told they have pyroluria and advised to take zinc and B6, sometimes indefinitely. But the big question is: what actually causes high KP?
Conditions and factors associated with elevated KP include:
• Acute intermittent porphyria
• Down Syndrome
• Schizophrenia
• Manic depression
• Epilepsy
• ADHD
• Alcoholism
• Stress
• Infection
Notice anything? There is no single gene linked to KP overproduction. Claims that pyroluria is genetic are not supported by scientific literature.
Think of it like iron testing. High ferritin can indicate a problem with iron storage, but we only confirm it as genetic hemochromatosis with further testing. Similarly, high KP may indicate nutrient depletion or other conditions, but it is not a confirmed genetic disorder.
Why this matters clinically
Some patients are prescribed zinc and B6 long-term, which can actually lead to toxicity including neurological symptoms, fatigue, nausea, copper deficiency, and dizziness. Factors like alcohol use or psych medications can also deplete zinc and B6, raising KP in the urine. This means KP elevation may simply reflect a nutrient deficiency rather than a genetic disorder.
How I use the test
I typically run the pyroluria test when I want an actionable picture of zinc and B6 status, rather than to diagnose a genetic disorder. While the test itself doesn’t reveal underlying causes, it can give useful clues about nutrient depletion that may be contributing to mental health or other symptoms. From there, I combine it with targeted nutrient testing and clinical evaluation to create a safe, individualized supplementation plan that supports neurotransmitter balance, stress resilience, and overall health.
Bottom line
Pyroluria is not a proven genetic disorder, and long-term zinc or B6 supplementation without testing may be harmful. The urine test can be helpful for assessing zinc and B6 status, but it should not be treated as a diagnostic tool for mental health conditions. Testing nutrients directly allows for safe, individualized supplementation that truly supports the body and mind.
Sources
Warren B, Sarris J, Mulder RT, Rucklidge JJ. Pyroluria: Fact or Fiction? J Altern Complement Med. 2021;27(5):407-415.
Mikirova N. Clinical Test of Pyrroles: Usefulness and Association with Other Biochemical Markers. Clin Med Rev Case Rep. 2015;2:027.