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Jul 9, 2018

Dan Hanson: Good morning and welcome to the Health Care in Your Hands podcast with Dr. Lloyd Fielder and Dan Hanson. Uh, today we wanna talk a little bit more about the Kryptopyrrole information that has been circulated, things that are coming about, questions that people have. Our goal is always to stay on top of the news, uh be as far ahead of the research and you know really look for ways that we can always improve and always help other people and just educate people with things that we know but also take questions and so you know, I'd like to start out by um bringing some of Lloyd's content to the table and and seeing hey, you know looks like we got some stuff here. I know you guys can't see us this morning, but Lloyd's got some um laid out, well laid notes I'd like to say, and um I'd love to let you have the floor if you don't mind Lloyd and talk a little bit about the the source of HPL and um what you're thinking this morning that would be meaningful to share.

Dr. Fielder: Yeah, awesome Dan. You know, I think to be straightforward, we go to many conferences throughout the year and the biggest one that we've, um are doing at those conferences are interacting and talking with caregivers and especially physicians that are um curious about Kryptopyrrole testing, Pyroluria, and or and those that are already doing it and um we get just such great questions all over the board and what's just been happening a little bit more frequently and Dan and um myself felt that it was really necessary to address which is really some confusion and misconceptions about the um what is actually being tested and why and what it is and what it's not.

And um this some people out there that apparently have a lot of misinformation and really, that's our mission in part is is actually the large part is educating not only patients but practitioners to exactly what we're testing and what the benefit is gonna be for the patients and the practitioners in their practices so people can get better. And the most recent thing that had come up was the confusion between what we heard as KP versus HP or Kryptopyrrole testing versus Heme Pyrrole testing and um Dan, would you say it's it's pretty um it was confusing at first because we thought that potentially there was something out there to that we weren't covering?

Dan Hanson: Right, absolutely. It it seemed like some of the consumers in the marketplace, meaning caregivers or physicians were exploring the opportunities to use Kryptopyrrole testing or measuring Pyrroles to put it in a in a more blunt and basic level and ultimately, they were maybe abroad or they were working with laboratories outside the US that are saying they're identifying the molecules differently and they're also identifying where the molecules generate from or or generally how they become elevated a little bit differently.

There are, there are main three main theories really to what causes the Pyrrole molecule to become elevated and so what we've noticed is there's a retitling of the test, there is a different way of reporting the results, there is a different theory um being presented as the primary or only theory that really determines why Pyrrole's become elevated, and that's what causes confusion. The physicians that we speak with um particularly in this case, international physicians are saying well, this is a genetic marker and we're measuring HPU, we're measuring um KPU.

We're measuring different values that I don't think you guys are measuring and sometimes, because we're not always there at the conferences, the representatives who work on behalf of DHA are less knowledgeable about how to answer those questions so they, they have the best intentions of reporting back to us to say hey, we think there's research going on with the Kryptopyrrole testing. Um, we think that there might be other molecules being tested, you know please let us know how we can best respond to practitioners, patients and um people really like and marketing groups or media groups that want to promote advanced nutrient therapy and advanced health care. You know, what can we tell them that's important? And so, we've done a little bit about clearing the confusion up in the past, but you know I think that we can go a little bit deeper today into what we're testing, why it's important, and really where some of those misconceptions are.

Dr. Fielder: Right, and I think that's, that's awesome, so specifically that last conference, someone had come over and said you guys are testing KPU. We're interested in HPU and the reason that these international practitioners uh had said we want HPU it's because that's, that's testing for the genetic um cause for Pyroluria, and you guys are doing KPU, which is not the genetic form of Pyroluria, and that couldn't be the furthest thing from the truth. After like, we were a bit confused by it, and it didn't take honestly but five minutes to realize that they were just making a mistake.

That uh, they uh I don't know if it's from any instructors or where this misinformation is being propagated, but uh we're talking about in essence, the same thing but there's some different research articles, so people are just trying to um I don't know if if it's some people are erroneously or mistakenly trying to do a selling point, to push a certain product, and and again, I can't speak to something else, but very simply, for anybody that's listening that um HPU and KPU are essentially the same thing. What I think some people have mistakenly assumed is if you go back to 10 years ago, um there's a couple of articles uh uh a journal articles and it was titled Discerning the Mauve Factor.

There's a part one and part two, and it was by um I believe it was McGuiness who led the study and they addressed right off the bat that there are certain terminologies that are used interchangeably, whether that is Kryptopyrrole, Pyrrole, um Heme Pyrrole, you know Dan, there are some other ones. Mauve Factor, there was I think a a couple of of other different um terminologies, but they were all used interchangeably, and so I think that the um international people tend to use still some of the older nomenclature, um especially referring to it as KPU or Kryptopyrrole you know and so when we're actually testing is it's hydroxyhemopyrrolin-2-one. Correct?

Dan Hanson: Absolutely.

Dr. Fielder: Yeah, and so that's can be looked at is potentially being used as HPU, I think and this, they're identifying this term Heme, hydroxyhemopyrrolin or um seeing an H instead of a K, they suddenly thought this was something new, not realizing that this is what we've always been testing for um on the better part of two decades?

Dan Hanson: Absolutely.

Dr. Fielder: You know, and and they're just learning now with different nomenclature, different terminology, they think suddenly there's something new being tested um and I think that's the most important thing that we had to bring forward to everybody is that we are testing hydroxyhemopyrrolin-2-one which is the only um metabolic that should be being tested if you want to assess Pyroluria and um I think it's pretty fair to say that we do it better than anybody else.

Dan Hanson: Oh, absolutely and I think what would be great is to back that statement up a little bit and start again so we could break out sections that are really meaningful, um one of them I think is is the genetic potential. So, we started out by saying that you know some other people that we've spoken with determine that there was a a genetic test and what's really important to understand about genetics is that right now um we are leading a mass movement of genetic information in the health care provider world and the laboratory testing world, and what's being done is you know, we're identifying what snips our single nucleotide polymorphisms are related to specific conditions, and when or you know uh all kinds of traits for that same matter.

We're looking at the genetic history of your ancestry, so when we're looking at that and and we're looking at these specific snips, we're saying you know if this particular snip is present, if this particular single nucleotide polymorphism is is present in a patient's DNA, they're more susceptible to specific epigenetic occurrences, excuse me like environmental insults, etcera and what's important to know there is that genetics are you know what or excuse me, the genetic theory that that's why people produce elevated Pyrroles, it's been passed down through genes is one of the three major theories on why Pyrroles become overproduced.

Dr. Fielder: Right, and so right and I'm with you 100 percent, so I think what'll also help clear up some of the confusion for some of the docs and some of the caregivers and even patients out there is that um there's really not been any snip or polymorphism that's been strongly identified to um increase the HPL um in the urine directly. There has been one that has been identified pretentiously. It's called C Pox, I believe. It's C-P-O-X and um but again, what you're, what you cannot make the mistake is that does not cause Pyroluria. What the genetic snips do is they affect things like iron deficiency, um unstable hemoglobin, red red blood cell hemolysis, um heme synthesis, so we have identifiable snips for those conditions, but not directly for Pyroluria or elevated Pyrroles in the urine.

So, they're as best as we know and we're really researched and we're really well read, that there is not any kind of single nucleotide polymorphism that is responsible directly for the increase in HPL. There are associated snips that will affect indirectly or you can, associated is the best way that you can really put with it, but um not direct, so anybody out there saying that we do the testing that is for the genetic Pyroluria or the genetic increase in HPU or HPL in in the urine is incorrect as best as we can tell.

Dan Hanson: Absolutely, unless they can show you the snip and they can show you the research behind this particular snip and uh you know that that would be a great way to perceive. We've never seen it. It's not out there. I'm not familiar with it. It's not on the forefront of research for really any major reason. Um, and you know further even if the snip was present, this is a probability game. When somebody has a snip, that doesn't mean that that snip is present and expressing itself in the patient. We see that a lot with methylation status.

Uh, we look at the MTHFR snip profile to determine if a patient is at risk for a methylation issue, and ultimately there are people out there who have double snips in that pathway and methylate optimally, and that's why in our in the model that really DHA has dfounded to support, the model of advanced nutrient therapy that was developed by Doctor Carl Pfeiffer, Doctor William Walsh, practiced by thousands of physicians today um you know they're looking at advanced markers that determine methylation status. You know, how is the methyl chemical being produced and how is it being uh dumped or excreted from the body appropriately because hey, you can have a snip but that doesn't mean it presents in the patient.

Dr. Fielder: Right, which is why especially as the laboratory, we are really um adamant about being tested. This is why testing is primary. Um, questionnaires are great interviewing. History's a great um you know taking even some supplementation can be beneficial without you know doing anything else, but it's a shot in the dark. So, our recommendation always is you know test incorporate that in, make your clinical um recommendations, and then retest and so that you can see actually how somebody's functioning uh because we do know just as Dan just really just nailed it right now is that because you have a polymorphism does not mean that it is influencing your physiology the way you think it should.

Dan Hanson: Absolutely, and the terminology since we've backed up and we went to the beginning of Doctor Fielder's original statement, and we talked about genetics then excuse me, two major terms that were mentioned there were HPU and KPU, and this is something that we really work to cover in the clearing up confusion podcast, but it's absolutely worth repeating. These terminologies, how you determine you're going to name a test is completely up to the laboratory that's providing with you the test. If I come up with a test tomorrow that determines the PH of my body, I can call it the Dan Hanson test if I like, and if you refer to it as the Dan Hanson test to another laboratory, chances are they won't be really familiar with what you're talking about and that will lead to confusion.

So, when we're talking about people using the term HPU, they realistically, the derivative is the HPL molecule, the hydroxyhemopyrrolin-2-one molecule, um with the term urine added to the end of it, and and that's what they're doing. You'll notice that famous physicians like Doctor Dietrich Klinghardt are using terms like KPU and that's because that's the way that they're familiar expressing the test. They call it Kryptopyroluria, that term is developed um in Doctor Klinghardt's work and he utilizes that successfully to uh get the practitioner audience and the patient audience that he's speaking with engaged in the conversation and it works successfully. Are all of those terms something that are 100 percent accurate to use when you're relating to the molecule? No.

You know, the Kryptopyrrole is the name we put on the test. It's the name that was most commonly utilized for the test. Uh, the Kryptopyrrole quantitative urine is a drawn out name that lets you know this is a historically determined version of measuring HPL. What's important here is that when you're looking through all the research, when you're looking through the basis of the developing uh advanced nutrient therapies and treating patients who suffer from mental and emotional conditions, I think Doctor Fielder referred to a great uh publication uh research document that was Discerning the Mauve Factor, part one and part two. You will notice that the test itself is referred to in various ways but the molecule is always referred to as a shortened version of HPL, which again stands for hydroxyhemopyrrolin-2-one uh Lloyd refers to it a little differently. How do you say the word heme? Is it used as heme, is that, is that what you said?

Dr. Fielder: Yeah, it's again, yes. That's correct.

Dan Hanson: I'm sure that uh Doctor Fielder's correct on that.

Dr. Fielder: Oh. (laughs)

Dan Hanson: (laughs) And I'm mispronouncing it.

Dr. Fielder: And again, it's because you have porpho, bili, biligens, you have porphyrins, you have um Kryptopyrrole, you have Pyrroles, you have a lot of words that can be interchangeable and it can be confusing. That's why we use clearing up the confusion as much as possible, and I think you using the example of Doctor Dietrich Klinghardt and his use of KPU um and also some of the practitioners that followed him using HPU versus KPU, I think it's a really strong uh point because this growing understanding of the association between Pyrroles, Kryptopyrrole, HPL, HPU and Lyme Disease.

Lyme Disease is a huge subject these days. It is um epidemically affecting not only people in this country, but you know others and so what we're trying to do is get people the right information so that they can make the best decision possible in the best interest of their patients, so with Doctor Klinghardt's use of Lyme Disease and identifying KPU, Pyroluria, and addressing that which is awesome. We just wanna make sure that these practitioners which is many of them are doing the right thing, because to then take it to the next level is we just are really, really um adamant about how precise you have to be with regards to capturing the samples from the patients, how you ship those samples to our lab, and then how that specimen is handled so that you get accurate um numbers so that you can assess properly and intervene correctly.

Dan Hanson: Absolutely. During the process of researching, hey what other tests are out there? What are people talking about? We encountered a laboratory that is working out of Australia and they are providing Pyrrole results. They are performing a Kryptopyrrole test, and they actually mention in the reference of the result that Kryptopyrrole is not a scientifically correct name for the molecule, which is a great way to present that. What we also noticed when we were measuring those results was is excuse me several items that were absolutely incorrect in terms of calculations, in terms of uh viability of particular specimen volumes and and specimen um indicators for quality.

So, it's really important to work with people that can help you understand in a given instance what is most appropriate for a specimen and what is not appropriate for a specimen and where the science lies behind that and that opens the floor for any listener to deliver results directly to the laboratory and allow us the opportunity to explain where inconsistencies in terms of whether that's just a label on a molecule or that's a label on the test, or that's a confusion between why we're calling something a particular name over another or why we feel there could be a um you know a a a process or there could be a point in the process that would basically cause those results to be void.

As this is not FDA regulated testing, it's imperative to work with the leaders in the industry who are educated on all of the factors that would cause deterioration of results or cause results to be voided, and I certainly believe that the team here at DHA, and this is based on years of being integrated into functional medicine, are the leaders in being able to describe these inconsistencies, uh describe these deterioration points and provide the research that backs them accordingly.

So you know again, I wanna open the floor if there's any practitioners or um even patients out there that are really interested in knowing did I get an accurate test? Why do you think this isn't accurate? What molecules are we measuring? Is this HPU? Is this KPU? Is this HPL? Are we talking about the same things? What's the difference in the Kryptopyrrole name in your test and the Kryptopyrrole name here? Send the questions our way. We'll personally answer them for you and if we feel it's something we should address to everybody that we somehow missed in this podcast, we'd be happy to bring it up on a future podcast and make sure we clarify it for the entire audience.

Dr. Fielder: Absolutely. I am in full agreement with you.

Dan Hanson: So, you know that kinda, in my you know recent history here has has wrapped up most of the inconsistencies that I've seen. We've dug as we said deep into these questions, into looking into genetic markers for Kryptopyrrole, genetic markers for HPL, um claims based on what other physicians were stating were available in other countries and what we found were massive inconsistencies between the information the physicians were providing and the information the laboratories were were reporting, and we clarified those with all the parties included, and of course we wanted to include you.

Dr. Fielder: Yeah, and so let me just say lastly too Dan, is I think the thing that we can't ever overlook is that we have access to and we're, I think we're absolutely privileged to is our connection to the Walsh Research Institute and Doctor William Walsh. We have been his laboratory of choice for many, many years and because we have that relationship, we also have access to something that nobody else does, which is literally was it fair to say it's almost one hundred thousand different lab tests that he's done? His-

Dan Hanson: Yeah, I I wanna say that you know I might've heard again, we're just speaking on behalf of Doctor Walsh's work and and I'm not here to cite anything at this very moment, but I have heard that it's the world's largest database of children on the autism spectrum and it's millions of chemistries um that run over you know hundreds of thousands of patients.

Dr. Fielder: Right, and so I guess my point bringing that up is that um he values highly accuracy.

Dan Hanson: Absolutely.

Dr. Fielder: His standards when it comes to research is second to none, and we are honored that he chooses to work with us and also the numbers that we get to pull from from his published research is that these there's, there's incredible data to support what we're talking about. So, it's not like we're just making some stuff up. It's coming from research and literally hundreds of thousands of tests, which I don't know any of the laboratory that's testing for HPL, HPU, KPU, any of the nomenclature you wanna use, any of those, but for HPL, who else has this kind of backing to say that they they've had their tests run that many times and has a collection of data around that?

Dan Hanson: Absolutely. Uh, it's it's bar none, as they would say in my opinion, and you know I'm I'm out there looking at who is, who is performing the test, where the information being published is, being published from and who those practitioners are working with and and every one of those instances I believe that you'll find practitioners that are working with DHA, and all the practitioners who have been using Kryptopyrrole testing or HPU testing or KPU testing that get the opportunity to speak with one of our team leaders at a conference or you know reach out to a laboratory for access to the testing, turn on and they don't turn off and the reason is because there's security in knowing that we have a very detailed process when it comes to specimen integrity, and when it comes to specimen collection transport and reporting values.

Uh, there's a long history behind how you can take a Pyrrole molecule and equate it to the concentration of a specimen and ultimately report that correctly. That has been tried and tried again and some of those are you know that that process in particular is the reason why some of those laboratories we mentioned earlier are kind of beat around mentioning earlier um are falling short and why they're unable to is because it's really easy to get your minimum viable product to market. It's really easy to say I wanna offer a Kryptopyrrole test. I wanna offer a Pyrrole analysis. I wanna measure Pyrroles in urine, and name it something and then produce a procedure since this isn't regulated by the FDA, that's sub par. Um, at that point in time, it just comes out your success level is determined by your ability to get a test to market and then market it accordingly, but what we've noticed is in the long run uh you'll always butt heads with the smart physicians and if you make a market impact, chances are we'll have an opportunity to uh overshadow your abilities to be successful.

Dr. Fielder: Right.

Dan Hanson: And I don't mean it in a bossy way. I mean it more in a you know in a factual way, and-

Dr. Fielder: Yeah, it just, it just would, would sell, right? You know, it's just the way it works.

Dan Hanson: Right, and I I also look at it like hey, you know what? McDonald's is is a great burger seller, so is Burger King, but guess what? They're all pushing burgers, and that's why people love burgers and at the end of the day, the more people that are out there that that need gas and the more gas stations there are are gonna drive more gas sales and I've always viewed Pyrroles that way, too. The more laboratories that are out there supporting the Pyrrole analysis, the Kryptopyrrole testing, whatever you wanna call it, HPU, KPU, HPL, hey. We're still getting people aware of these functional elements of treating mental and emotional conditions in the research that's behind it and the further we go down that thought train and the more physicians that are exposed to this information the better, so um I welcome everybody that wants to engage in the conversation.

Dr. Fielder: I think that's awesome, Dan. I think that's a great way to maybe wrap it up.

Dan Hanson: Yeah, any concluding thoughts further?

Dr. Fielder: No, I agree with you wholeheartedly. I think whether it's anxiety, depression, autism, um you know ADHD, um ODD, of Oppositional Defiant Disorder, you know whatever's going on, I think that um we can't talk about it enough, and trying to clear up the confusion around it is only that much better, so we appreciate everybody's time listening to the ramblings of a couple of crazy dudes on this end who are committed towards you know getting people better.

Dan Hanson: Absolutely. Thanks for your time, Doctor Fielder.

Dr. Fielder: It's my pleasure, Dan. Thank you, too.

Dan Hanson: All listeners, have an awesome day. We look forward to hearing from you in the future and being back in touch.