How do you trouble-shoot when you score high on the Pyroluria Questionnaire from The Antianxiety Food Solution or even have a positive pyroluria urine test but you don’t seem to be getting the results you expect?
You still have social anxiety, that inner tension that you push through and deal with, and likely still feel uncomfortable when in large groups. You force yourself to put on the confident brave face. You may wish you could be more like your extrovert friends and actual enjoy socializing and speaking in public/on stage – without the fear and anxiety. You may still not be a big breakfast eater and have morning nausea. You may not yet be having pleasant dreams that you always remember.
(If pyroluria is new to you here is the Pyroluria Questionnaire from The Antianxiety Food Solution and here is a nice summary – Pyroluria, social anxiety, introversion: a summary )
This checklist is a starting point to try and figure out what may be the issue. These are the questions I work through with someone who is working with me one-on-one.
I discussed 21 of these in my interview on season 3 of the Anxiety Summit: Pyroluria, Amino Acids and Anxiety: Troubleshooting when you are not getting results
As you heard during the interview, I added MTHFR and I’ve even added a few more since then. I expect this list to continue to grow.
- What form of zinc are you taking and is it free from copper? My favorite is Optizinc (zinc monomethionine) as it’s typically well-absorbed
- Have you made sure that there is no copper in your multivitamin or other supplements? (this completes with zinc)
- Have you been taking evening primrose oil and if yes, how much? (this enhances zinc absorption)
- Did you test your fatty acid levels? What are the results? Did it show a need for GLA (I like evening primrose oil rather than borage oil) and no need for omega-3s (pyrolurics typically don’t need to supplement with omega-3s like fish oil)
- What is your alkaline phosphatase (a blood test)? Less than 70 may indicate a need for zinc
- Have you done the zinc tally/challenge with zinc sulfate and does it taste like water or does it taste really bad? If you zinc levels are good it should taste really bad
- Did you test copper and ceruloplasmin, and if yes, what were the results?
- Did you do the pyroluria urine test? What are the results?
- What’s your score on the pyroluria questionnaire ? And which symptoms do you have?
- What is your score on the introversion questionnaire?
- What were your dreams like before starting the protocol and now? How high did you go on the vitamin B6? Did you switch to P5P and/or use a combination of both if needed?
- On a scale of 1-10, what was your social anxiety before and now (10 is worst)
- What is your stomach acid like? And have you trialed HCl supplements? Tested total protein (in blood)
- Do you eat grass-fed red meat (a good source of zinc, iron and omega-3s)?
- Do you eat sugar? Refined sugar and processed foods? Or even “healthy” sweeteners such as honey in large quantities? (sugar depletes zinc)
- Do you eat large quantities of nuts or bake with nut flours? (the copper in the nuts may be affecting your zinc levels)
- Do you have a copper IUD, copper pipes, copper pots? (this may also affect your zinc levels, keeping them low)
- Have you done a hair analysis and found high copper or high hidden copper? (this may also affect your zinc levels, keeping them low)
- How much and how often do you exercise? What about bikram/hot yoga? (sweating depletes us of zinc)
- Have you used any of the amino acids? And seen good results? (this could be a clue that zinc and vitamin B6 are low since they are cofactors for making neurotransmitters such as serotonin, GABA, dopamine)
- Do you eat gluten and have a gluten sensitivity? If yes, have you healed your gut? If not, you may have malabsorption issues
- Are you completely grain-free? (this may be impacting your vitamin B6 levels)
- Do you have amalgams/silver fillings? Did you have them removed and did a mercury detox? Were you tested for heavy metals? (zinc absorption can be blocked by heavy metals – we talked about this in season 2)
- Do you have the MTHFR polymorphism? It’s common with pyroluria and this may mean you need higher amounts of the supplements
- Do you have high histamine/hisadelia or low histamine/histapenia? Pyrolurics often have one or the other
- Are you taking benzodiazapines or have recently quit benzodiazapines? Your unresolved anxiety may be due to this fact (we talked about this in season 1)
- Do you have parasites, candida, dysbiosis, SIBO or other digestive issues? These can be considered stresses and pyroluria symptoms are worse under stress. Digestive issues also impact absorption
- Do you have Lyme disease or another infection? These can be considered stresses and pyroluria symptoms are worse under stress. The immune system also uses up zinc.
- Do you have food sensitivities? This may contribute to malabsorption. This can also be considered a stress and pyroluria symptoms are worse under stress
- Do you have problems with histamine-containing foods? This can be considered a stress and pyroluria symptoms are worse under stress. Also, vitamin B6 is a co-factor needed for the DAO enzyme, which is responsible for the degradation of histamine.
- Do you have issues with oxalates? This can be considered a stress and pyroluria symptoms are worse under stress. Oxalates can also bind to minerals and lower the levels. For some folks vitamin B6 helps with oxalate issues so the need may be higher.
- Have you been/are you exposed to mold and other toxins? These can be considered stresses and pyroluria symptoms are worse under stress. The immune system also uses up zinc.
- Do you have low oxytocin levels? Do you have a genetic variation in the oxytocin receptor gene (OXTR). Oxytocin has been implicated in anxiety, depression and related stress phenotypes
- Is your life super-stressful or have you suffered from a recent trauma (or have old unresolved trauma)? Stress and trauma makes pyroluria worse
- Do you have adrenal issues? We need good adrenal function for optimal digestion, being able to handle stress and being able to fight off infections/avoid getting parasites and dysbiosis
- Do you have hormonal issues – PMS, perimenopausal or menopausal symptoms? The pyroluria protocol helps and this could be a clue that something is off
- Are you on the birth control pill or have used one in the past? Oral contraceptives cause low vitamin B6 and zinc, reduce serotonin levels and increase anxiety.
- Are you on any other prescription medications? Many medications deplete B vitamins and zinc.
- Do you have vagus nerve issues? Good vagus nerve function is key for digestion, immunity, inflammation, neurotransmitter production and so much more. Also, forcing yourself to socialize when you have pyroluria is stressful and impacts the vagus nerve
- Do you have inflammation and/or immunity issues? Vitamin B6 plays a role in reducing inflammation and immune modulation
This list is NOT exhaustive and it’s NOT in my book The Antianxiety Food Solution because I gathered this information after the book was published. However, the pyroluria questionnaire, detailed protocol and testing information is in the book. There is an entire chapter on pyroluria.
Keep in mind that most folks do the pyroluria questionnaire, start on the recommended protocol of zinc, vitamin B6 and a copper-free multi and start to see improvements in a week. These can be dramatic improvements for many folks. And many folks see decent improvements in a few weeks and tweak things over the next few weeks before landing on the ideal doses.
This blog is for you if this doesn’t happen.
Did you miss this interview or want this and the other great interviews for your learning library? You can purchase the MP3s or MP3s + transcripts and listen/read when it suits you. You can find your purchasing options here: Anxiety Summit Season 1, Anxiety Summit Season 2, and Anxiety Summit Season 3.
Feel free to share your results in the blog comments and what you figured may be the issue/s for you.
If you tweak something and it helped do let us know too. That way we all help each other.
And feel free to ask questions in the comments too.
A 2014 paper published in the Journal of Psychiatric Research looked at how 
