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Apr 16, 2018

Dan Hanson:    Good morning. Welcome to the Healthcare in Your Hands podcast with Dr. Lloyd Fielder, and myself, Dan Hanson. Today, we're going to talk about Kryptopyrrole Quantitative Urine testing. It's a mouthful of a word and there's some confusion around the Kryptopyrrole test that we want to start by clearing up. And then, we're going to go on some details. Pyrroles are super important for looking at advanced nutrients that are critical to brain health. It's a common topic that we're seeing across several videos, several podcasts, lots of articles online. And with a hot topic like this and a lot of confusions, it's really our job to step in and kind of clear up that confusion because we're both somewhat really well-versed on the topic. A lot of history and Dr. Fielder recently released an article that we're frequently asked questions about really the test itself and questionnaires, clearing up some other confusion.

Dan Hanson:    So what I want to do is just jump right in to what the test is and ultimately, what's some of these strange words are and why they exist and how they all got involved in being used together. And just make sense out of all that for everybody. So let's start out with the test name and then kind of break it down.

Dan Hanson:    The test itself is the Kryptopyrrole Quantitative Urine. And so, Kryptopyrrole is really the name for the test. And quantitative talks about the value. Meaning that we've got a quantitative results in numeric value with an optimal range as opposed to a qualitative result, which could be something like a yes or a no. And it's done in a urine specimen. So that kind of breaks down that major chunk of words, Kryptopyrrole Quantitative Urine. But what's really confusing about the word Kryptopyrrole is that people who are educated on the subject might call it HPL or might call it pyrroles or might talk a little bit about the pyrrole molecule, or we've even heard it called KPU. And so, let's unpack those a little bit.

Dan Hanson:    The pyrrole test itself or the Kryptopyrrole Quantitative Urine is measuring an actual molecule and that molecule is problematic, right? The reason why people are using this is because that molecule when it's over produced, it's responsible for depleting the body on zinc and B-6. It's produced during red blood cells synthesis. Everybody makes pyrroles. It's a normal byproduct of hemoglobin synthesis, but it can become over produced. That's when it's problematic. And so, your bodies since that it's really an unnecessary chemical, just a byproduct. It has a great way of eliminating it through the urinary tract, but when it's over produced, that's when it's going to start attaching the zinc and B6 and removing it through the urinary tract as well and really rendering it biounavailable.

Dan Hanson:    And what's important to understand about the Kryptopyrrole Quantitative Urine and how we're going to get into more detail about what this actually means is that krypto and pyrrole are part of the test. And we're looking to test a particular molecule that's actually hydroxyhemopyrrolin-2-one. And since that's just really a mouthful, people start to abbreviate in different ways. Hydroxyhemopyrrolin-2-one is most commonly, in the scientific world, referred to as HPL. That's an abbreviation for those terms. HPL again is an abbreviation for hydroxyhemopyrrolin-2-one. And that is what the Kryptopyrrole Quantitative Urine test is measuring. But since you're getting the work pyrrole in, out of that major work there, people also call them pyrroles. And it's referred to as the pyrrole test. And we frequently have people call the laboratory or look into the research and Google pyrroles. And so, it's important to make the connection when you're doing a Kryptopyrrole test, you're measuring pyrroles, which are really nickname, or HPL also is really a nickname for hydroxyhemopyrrolin-2-one.

Dan Hanson:    And so, let's look at this as a big picture. You've got a test name, you've got some nicknames. And then you've got the actual molecule name. And that's where a lot of this just gets mixed up. Ultimately, that's confusing enough, but what we also see are that practitioners and patients kind of start to generate their own terms. We've heard it called kryptos, we've heard it called KPU, which has been considered kryptopyrrole uria. I think that's a common term, that was more defined by ... Yeah, in Europe and more defined by Dr. Dietritch Klinghardt. Dr. Klinghardt is a highly regarded specialist in the field of all different types of medicine, but really globally recognized for treating patients who suffer from Lyme and correlating pyrrole testing or Kryptopyrrole Quantitative Urine testing to that patient population. And so, he's also very commonly regarded as the main use of the term KPU, Kryptopyrrole Uria.

Dan Hanson:    So everybody has kind of a different term for the test. And it's just really important that regardless of what anybody's calling it that in order for you to receive an accurate test and for physicians to receive an accurate test and to have something that's clinically relevant, that you're looking at the true molecule of hydroxyhemopyrrolin-2-one. And so, that should help clear up the confusion. One more time, you've got the Kryptopyrrole Quantitative Urine test and that can be referred to as pyrroles. That can be referred to as HPL. That can be referred to as KPU, but what's most important there is that we're measuring that key molecule hydroxyhemopyrrolin-2-one. And we're doing it in an accurate way.

Dan Hanson:    And so, I kind of got a little bit into that. Why that testing is important and I think that would be a great ... Dr. Fielder you want to jump in and talk a little bit about why you think it's important outside of-

Dr. Fielder:    Yeah. Absolutely. And I think also, to add ... Just a little bit, just to what you're saying because you did an unbelievable explanation. If you go back to its first inception, some of the other terminology, you might also see Mauve Factor. So Mauve Factor is the original descriptor that they used because of the way that they did a chromatography on the samples and how it would stand in using I think Mauve Factor was-

Dan Hanson:    Right. It's a colorimetric assay.

Dr. Fielder:    Right.

Dan Hanson:    So the specimen actually turns a color during the process. And a depth in that color is utilize to ultimately determine the density of the pyrolle molecule. And that's what Dr. Fielder's referring to.

Dr. Fielder:    Right. But in terms of the importance the lab test itself, it is invaluable when assessing brain health, brain functions and emotional symptomatology, which was how this all started with doctors Abram Hoffer, Dr. Carl Pfeiffer, William Walsh, Dr. Mensah today and many many others, that they notice that with certain nutrients applications, symptomatology for some of these mental and emotional conditions were improving. And so, they were able to ultimately identify the molecule of HPL to be able to actively and accurately measure it and see when it was potentially problematic and address things more specifically. So what that means is, in modern days, it's an accurate assessment for the potential loss of B-6 and zinc in an individual, which has a huge effect.

Dr. Fielder:    And the reason for that is that zinc and B-6 as I'm sure Dan, you know, you talk about this so much every day, but it has a huge effect on neurotransmitters especially dopamine and GABA. What ends up happening I think, really to make a long story short, even especially currently at this day, so many doctors are overprescribing or trying to figure out how to best intervene with medications, which are ultimately, potentially, unnecessary because their trying to address something, which is just nothing more than a simple nutrient imbalance. And that's where pyroluria pyrroles come in, is that we are looking at this being the cause of the depletion of B-6 and zinc, which leads to the imbalance in neurochemistry, which then leads to an imbalance and symptoms.

Dr. Fielder:    So what can you add to what we're starting to talk here about?

Dan Hanson:    Yeah. Well, I think what's also important to address in this subject of the topic is where pyrroles fall in line with specific conditions because we can tell that hey, zinc and B-6 are two key nutrients necessary to producing GABA to producing dopamine, to producing norepinephrine. But when you're looking at key research and some of the research I'd like to throw out and that we like to reference as well is generally featured in one of the great locations to find it is Dr. William Walsh. Dr. William Walsh has a great book called Nutrient Power: Heal Your Biochemistry and Heal Your Brain. There is a chart, a table that talks about the incidence of pyrrole overload in clinical population. And so, these clinical populations will show various types of negative symptomatology and whether in this particular chard, it studied ADHD or excuse me, patients who suffer from ADHD behavioral disorders, autism, depression, bipolar disorders, schizophrenia, post traumatic stress, Alzheimer's. And also, there's a fair amount of test on unhealthy controls.

Dan Hanson:    And so, what they've done is, is looked at 40,000 urine pyrroles and ultimately looked at percentages of these patient populations that have elevated pyrroles. And what's really interesting is then correlating that study to various patient populations like, schizophrenia, also patients who suffer from depression and looking at this as a key element or one of they call the biotypes. One of the main reasons why people get the negative symptoms or some negative symptoms of these conditions. And so, there are a fair amount of negative symptoms that can be treated and a healthy amount of case studies that are shown in these particular book. Again, it's Nutrient Power: Heal Your Biochemistry and Heal Your Brain by Dr. William Walsh.

Dan Hanson:    And so, we like to reference that book specifically to talk about patient populations that are well-studied. Look at a test that really reviews pyrroles or the Kryptopyrrole Quantitative Urine in a large scale. Again, there's this table Dr. Walsh's work is referencing 40,000 urine pyrrole results for people with mental and emotional conditions.

Dr. Fielder:    Which I don't think you can emphasize enough. I mean the amount of work that he has put in. The amount of research and I don't know anybody else that has even remotely, the amount of data that he's accumulated over the last several decades especially just referencing the fact that he has a database of over 40,000 Kryptopyrrole test.

Dan Hanson:    Right.

Dr. Fielder:    And that's not the only test, he does a bunch of other testing as well as doing things like questionnaires and he's able to, across the board, put it all together. So it's not just simply he did 40,000 kryptopyrrole testing, that's all he has, he's got a ton of other ... I mean it's probably fair to say this, he got well over hundred thousand test all together to really put everything in much more comprehensive picture. And that's what I love about the book is that, it's not book about pyroluria, it's a book about mental health. And he is just ... I think, I don't know anybody that has put in the time, energy, research and concrete data that he has, to put it kind of all together.

Dr. Fielder:    And I think one of the perfect examples is understanding that someone who is excreting excessive amounts of HPL, because of its affinity zinc and B-6, what's going to end up happening is someone ... A depletion of zinc at a very high level. It's going to affect things like copper. And this is why he doesn't only test for pyrroles, he's also looking at things that are extremely integral like, copper levels as well.

Dan Hanson:    Right.

Dr. Fielder:    And that's why I think the book is great for anybody who's interested in this topic, to really learn the importance of testing for other things like copper and understanding its role in mental health as well.

Dan Hanson:    Right. I hundred percent agree and that couldn't have been said better. I think that ... And to touch on some of the data. I've heard numerous researchers and numerous physicians and Dr. Walsh himself, say that there are in total, and could be incorrect here, but I want to say that it was over a million chemistries in total, across a large number of patients. And all of those patients are falling into negative symptoms that relate to mental and emotional conditions. And so, he's considered to have the world's largest database of nutritional chemistries for patients that suffer from autism spectrum disorders. And that comes with a great deal of weight.

Dan Hanson:    Dr. Walsh is not a traditional physician. He's not out here supporting any of the companies that produce these particular tests in an outgoing way, outside of looking for good results. And-

Dr. Fielder:    He's not selling himself from us. He's not trying to make a buck from anything.

Dan Hanson:    Right. What he's doing is writing a non for profit, that's based in research. And he's really leading that game well. And he stays true to the idea of science. I want to say that he was originally from Argonne National Laboratory and took a personal liking to this particular field. And really dedicated his life to understanding brain chemistry and how the development of the brain works and how certain people can have epigenetic events that change the way that DNA is expressed and why one person might be some way in a particular environment and another person in the same environment might be another way and really focusing on mental and emotional conditions. So really special work there.

Dan Hanson:    But to again, touch a little bit further into what Dr. Fielder said, is that pyrroles are a huge part. Looking at a kryptopyrrole test is a huge part, just one piece of puzzle and I think of the book Nutrient Power is really powerful because it talks about the repeat offenders. It's saying, "Hey, we looked at all these patients. And we have all these case studies. And we rent all types of labs, not just these labs, not just the ones that I'm going to talk about, but thousands of different chemistries across the board and what we found was there were repeat offenders. And so, in our research we determine that methylation is extremely important in mental health." Free copper and percentage of free copper or unbound copper is extremely important in mental health.

Dan Hanson:    They're looking at zinc is really important. And that's why pyrroles can be this real cause, but also when you're looking at copper and you're looking at zinc, you're getting this great functional copper to zinc ratio, which is extremely important for measuring the brain's capability to produce key neurotransmitters. And that's what that model is all about. And that's why the Kryptopyrrole Quantitative Urine or the Kryptopyrrole test, you know, when it's measuring HPL or this crazy word, this hydroxyhemopyrrolin-2-one, what it's really saying is, we're trying to get to the root cause of what helps you produce neurotransmitters. And we're trying to as a laboratory or as a test relate that to the right patient populations.

Dr. Fielder:    Right. And that's why as a practitioner or a patient, you're out there and you come across all these different terminologies especially pyroluria. Pyroluria has been probably the most common diagnostic maybe that I hear other practitioner's using. And we really go into it, into a much greater detail in the article that I've written about ... It's a questionnaire, the kind of questionnaire that diagnosed me as having pyroluria, or is it more effective than the test itself. And just to cover that really briefly, I think it's really important to understand what pyroluria is in terms of the actual word. And it was according to medical dictionary, it just means that there is a presence of pyrroles in your urine. And it's become synonymous to mean that you have this genetic error, where your excreting way too many pyrroles.

Dr. Fielder:    And so, we're taking it from that standpoint, that what pyroluria is pyrrole disorder truly is. Is this genetic predisposition? And the genetics refer to probably morphisms or SNP, single-nucleotide polymorphisms. Sometimes practitioners just call them SNPs. And that means like what Dan was saying about, the biotypes and the different types and the reason it's so important identify pyroluria as far as part of your intervention and diagnosis for patients is that, this, according to all the research, it shows that it does not change. Meaning that once a person has this genetic predisposition, they're always going to be this way. Doesn't mean that you can't address it and make it improve so that it's affecting patient any longer, but it does mean that more than likely their going to need to be in zinc, B-6, and potentially, some other supplementation for a lifetime.

Dr. Fielder:    And if you just simply as a practitioner, give somebody zinc, B-6, Evening Primrose Oil and they improve and they get better, and they don't know that they don't have this condition of pyrrole disorder, then what happens is they get off it and then they get worse. And they do not understand why. And so, it's important as a practitioner they you identify this. And this is a percentage of these conditions. And this is also what leads to confusion because someone thinks that they have pyroluria or practitioner doesn't do the testing and only does the questionnaire and think that someone does have a pyroluria and they administer zinc and B-6, and the person, in short term, improves, they then say, "Oh, that's confirmatory." And therefore, they're addressing the pyroluria.

Dr. Fielder:    Well, what happens is, if they do not in fact, have this consistent loss of zinc and B-6, in a very short time, they could become overloaded in zinc and B-6. And that can cause a whole host of other issues that we see probably the short term, one of the most frequent things, insomnia, agitation, anxiety because they do not have pyroluria and have been misdiagnosed as having pyroluria. And intervene what they thought was the right way. And unfortunately, it was not the right thing to do.

Dr. Fielder:    So we really can't emphasize enough testing, not only for pyrroles, but copper, zinc, ceruloplasmin, other things as well, but that's just what I want to add to that Dan.

Dan Hanson:    Yeah. Absolutely. That's wonderful. I greatly appreciate you going into detail there. It's really important that people understand that this is an acid that's critical to an effective treatment. And if you're looking at a holistic approach to optimizing neurotransmitters, to optimizing the environment for producing neurotransmitters and really effectively taking an integrated prefunctional approach to reducing negative symptom ology, that you accurate test result, and you treat appropriately based on those test results and follow up appropriately. And so, the idea of a questionnaire in our mind is absolutely absurd and with anybody who's listening would like to give us the other side, I'm certainly open to learning more about why certain people do value questionnaires. And I'd love to have my mind change, but science says, it's just not going to happen.

Dr. Fielder:    Right. And of course, we both feel the same way. Just to elaborate that a little bit is that, it's not that we don't think that you shouldn't use a questionnaire, in fact, we shouldn't only a questionnaire because Dr. Walsh uses questionnaires as part of his intake in his program. It's just that he does a lot of testing and he uses it in conjunction so that people ... You know, one of the best tools is for patient from patient point of view, it's that they feel that they're being understood. So many times, when you have a mental and emotional issue, you can go from doctor to doctor and caregiver to caregiver and just feel like nobody gets you. Nobody understands you. And you feel as if you truly are crazy because you try to explain things and people are not ... Kind of blowing you off in a way.

Dr. Fielder:    When someone gives you a questionnaire, you go, "Oh my gosh! I do feel this way. Oh my gosh! I do have this." Then immediately what you have is report because the person finally, maybe for the first time in their whole long ordeal, feels like someone gets them. And it think that's extremely important in their relationship of a caregiver and someone whose looking for care.

Dr. Fielder:    Again, just absolutely, to reiterate the point, it should not only be through a questionnaire because there is having zinc deficiency or B-6 deficiency or insufficiency is going to have some similar symptoms as a pyrrole disorder. And so, therefore, that's where our biggest is, is that you think that the questionnaire is diagnosing pyroluria, when most probably, it symptomatically just addressing the zinc and the B-6 issues.

Dan Hanson:    Right. Absolutely. There's so many co-factors in zinc deficiency. As you said, it's just imperative to truly understand if you're going to say somebody has Kryptopyrroluria or kryptopyrrole or pyroluria or elevated pyrroles, that ultimately, they've done test because there are just too many co-factors. That was said really well. And so-

Dr. Fielder:    I'd love to actually just address maybe for two minutes how awesome the testing is here at DHA Laboratory, when it comes to ... Because I think, especially for practitioners that are out there, obviously, for patients as well, needing to understand how important quality of testing is for an accurate interpretation, diagnosis of having elevated pyrroles, HPL, kryptopyrrole urinalysis kind of result that we see that there are maybe some less than our goals and standard of where the kind of test pyrroles. Can you maybe-

Dan Hanson:    Sure. Yeah. You know, the test is highly sensitive. It's affected by light. It's affected by time. It's affected by temperature. And so, it's really ... And it's also not an FDA regulated specimen. So when you're looking at things that have a myriad of different conditional effects that can truly degrade the result, it's imperative that you're working with a laboratory. Especially when there's no standard of regulation. It's imperative that you're working with a laboratory or a company in general that is considering a high quality result.

Dan Hanson:    When you're looking at providing key elements of nutrients that allow neurotransmitters to fire and produce appropriately, you gotta do that with pinpoint accuracy. And it's going to be based off of data. And that data better be accurate. And so, you have to work with teams like ours that, at DHA Laboratory, we have specific shipping days. Because when the specimens are coming in, they're being run on a timely basis based on their arrival. And we've got specific shipping instructions, specific thermal safe shipping instructions, specific preserving agents and specific instructions for freezing. And so, what we've done is looked at all elements that can possibly degrade the pyrroles and come up with a test kit that people within a 24-hour delivery range can utilize to receive effective and accurate results. And you'll find laboratories out there that might have some sort of a freezing aspects to the test, but might not actually be utilizing protocol that allows that to maximize its benefits.

Dan Hanson:    It's a very very touchy task. We have a preservative that we utilize in our tubes, which if off by a 10th of gram, can cause the results to be affected by roughly 22% decrease. So it's really important that every thing is on point and also, that the specimen is measured in with a co-specimen that gives you the concentration or dilution and that's applied to the result. Meaning that, "Hey, if you're not drinking a lot of water, if you don't have a lot of liquids, yeah, you know, it's common sense that your urine specimens, in general are concentrated." You can see it in color. There are various indicators of a concentrated urine specimen. And that could affect results that don't indicate they're taking that concentration into consideration when producing your test results.

Dan Hanson:    And so, what DHA does is considered the gold standard. We've consulted with laboratories around the world, that are utilizing this test effectively. We're familiar with laboratories around the world that are not utilizing this test effectively. It's a bit of a troubling market out there, but that's why we're doing things like this so we can educate people on what the facts are and the terminology. What the facts are and the science based matter for the test kit itself. What the facts are in terms of, "Hey, why is it important to do this test? When is it important to do this test? And why is it important if I've done a questionnaire to be sure of it?"

Dan Hanson:    So that's kind of my breakdown on why it's important and I stand behind DHA Laboratory a hundred percent, to perform this test accurately and provide it to all people and all practitioners in a way that allows accurate result. We're certainly not going to accept your test, run it and report a result that we don't 100% stand behind. And we work with people all around the world and we require in those scenarios, where it's more than 24 hours, dry ice, we won't take a specimen in other way. And so, dry ice allows the pyrroles to stay in a stable method. It's really increasing the time length that it can be frozen for. Pyrroles when their frozen are fairly stable, or excuse me, extremely stable for a fair amount of time. And that's what important to understand.

Dan Hanson:    So I think for practitioners and patients alike, what you can do to best understand these intricacies, if you're interested are not only looking at dhalab.com and look at the patient discovery side of the site. And look into the research and the articles, but query additional experts in the area. We're talking a little bit today about ... Or a lot of it, really about Dr. William Walsh. Well, the Walsh Research Institute is non for profit, that trains physicians worldwide. And they're world renowned for doing that in incredible measures with extremely effective results. And you can query their website for numerous videos and numerous articles, numerous studies and publications that have been involved and are extremely science based and talk specifically about everything that we're discussing today. And there are also great videos out there that we support by the Mensah Medical Group, where they discuss pyrrole disorder in detail and they're experts in being hands on with patients.

Dan Hanson:    I like to reference Dr. Charles Parker, he's got a practice CorePsych and he's got the Core Brain Journal Podcast as well. It's a great listen. So I'd love to give him a shout out and plug here because he's also talking about pyrroles and bringing on experts. And there are people out there that are super smart about this. And there are clinicians that take an effective approach to treating their patients in a careful way with pinpoint accuracy. And if you're working with people who aren't doing that, and aren't taking those considerations and aren't talking about the detailed science that we're talking about today, chances are they haven't given it the type of consideration that's essential to producing a truly helpful and holistic treatment program. And so, I might not support that.

Dan Hanson:    But again, if you have any questions or concerns or just source out here that you want to discuss with us, shoot us an email. And you know-

Dr. Fielder:    What's that email?

Dan Hanson:    The email info, you can use info@dhalab.com. And so, if you just want to hop on your browser, log in to your email and shoot an email at info@dhalab.com. Send us any sources. Send us any questions. Send us any concerns. Anything that you feel that we can answer or talk about, not only will we respond to every single one of those emails, but if we get some good ones, we'll bring them here on the podcast. We'll talk about them in future episodes and we'll say, "Hey, last time when we did this great podcast, you know, we got this question and we just want to bring it up to you in case we weren't super clear, or if we can provide more light because we feel it's really important."

Dr. Fielder:    Absolutely.

Dan Hanson:    So do you think you want to talk about anything else that you think practitioners or patients can do?

Dr. Fielder:    Get tested.

Dan Hanson:    Yeah. Get tested. Right. Anybody can, you know, we offer a wonderful program at DHA. You can hop on dhalab.com and look through the ability to receive consultation and testing directly. We work with practitioners all around the world. And so, it's right, get tested. It's important to know your pyrrole levels.

Dr. Fielder:    Absolutely. I think that really is a good chunk of the information I want to really going to get across about pyrrole testing, pyroluria. I feel pretty good.

Dan Hanson:    Yeah. Me too. Absolutely. It's always a pleasure to have the opportunity to broadcast quality information like this and talk with awesome people like yourself. And so, again, please don't hesitate to email us info at dhalab.com. It was Dan Hanson and Dr. Lloyd Fielder today. We look forward to answering great questions and being available to cover topics like this in the future. Dr. Fielder have an awesome day.

Dr. Fielder:    Thanks. You too, Dan.

Dan Hanson:    Bye guys.

Dr. Fielder:    See you.