The patient: Jane, a 34-year-old commercial pilot and Hawaii resident.

Why she came to see me: Working long, demanding hours in what she called “a man’s world,” Jane was familiar with stress and its myriad effects. For the past six months, however, the low-grade anxiety she’d experienced off and on since adolescence had skyrocketed. Panic attacks, isolation, exhaustion, frequent colds and flu, and joint pain were just a few of her complaints. She also had “very little appetite,” felt cold all the time (despite living in a tropical climate) and, along with persistent anxiety, vacillated between bouts of anger and spells of depression.

How I evaluated her: Through our initial discussion, I discovered that Jane had an extensive family history of anxiety and depression. Her brother was diagnosed with Attention Deficit Disorder (ADD) when he was a child, her mother and sister were both taking anti-depressants, and her grandfather had had chronic depression and alcoholism.

Jane’s anxiety began in her teens and continued through college. It seemed to level out in her mid-20s but had progressed in recent years. She’d been at her job for eight years, generally liked her life, and had not experienced any recent trauma, significant life changes or heartache. And yet, she said her anxiety “was worse than ever.”

Outside of work, Jane’s lifestyle was admirably healthy. A self-described flexitarian, she favored a vegetarian diet and always made sure to hit the gym on her various layovers. On her days off, she swam, surfed and gardened. However, she was burning the candle at both ends with the long hours she worked. She also frequently flipped time zones, which added even more pressure to her life.

Because of her family history and symptoms, I decided to order a urine test that specifically evaluates for a genetic condition called Pyrrole Disorder (also called Pyroluria or “Mauve Factor”). This test measures for a byproduct of hemoglobin metabolism called kryptopyrrole. People who don’t process pyrroles well will often show high levels of kryptopyrroles in their urine. If test results are positive for these compounds, it indicates that the individual has an increased need for vitamin B6 and zinc. Pyrroles bind to these key nutrients and cause them to be flushed from the body in substantial amounts. Through blood work, I also measured Jane’s levels of zinc, copper, ceruloplasmin (the bound form of copper in the blood), and vitamin D (aka “the sunshine vitamin”).

What my evaluation revealed: As I suspected, Jane’s urine test showed she had very high levels of kryptopyrroles. She also had low zinc, which explained her chronic anxiety. The reason that anxiety can stem from a pyrrole condition is that zinc is necessary to activate vitamin B6. The activated form of vitamin B6, also known as P5P, is central to stimulating vital brain chemicals (or neurotransmitters), such as serotonin (which makes you feel happy), dopamine (which makes you feel hopeful), and GABA (which makes you feel calm).

My evaluation also revealed that Jane had high copper and average ceruloplasmin. This, too, was contributing to her anxiety. When zinc levels are low, copper is able to accumulate in the body, and excessive copper levels (hers were off the charts) may contribute to inflammation and anxiety. Jane also had low levels of vitamin D even though she lived in Hawaii. Essential to the production of dopamine, insufficient vitamin D can also lead to the very symptoms Jane was experiencing.

How I addressed her problem: I prescribed zinc picolinate (100 mg), vitamin B6 (150 mg), and pyridoxal 5’ phosphate (P5P) (100 mg). I also prescribed vitamin D (5,000 iu) and 500 mg of magnesium malate (a form of magnesium that is easily absorbed in the body) per day, as people with an abnormal overproduction of pyrroles may have an increased need for magnesium.

The patient’s progress: Within a week of starting nutritional supplementation, Jane reported a noticeable—and very welcome—improvement to her mood. Within three months, she said she’d never felt so grounded and emotionally stable. By adjusting her nutrient levels—and giving her doses well above the recommended daily intakes—we were able to restore her zinc levels to normal, raise her vitamin D levels to optimal levels, support her production of neurotransmitters, and decrease inflammation in her body.

I also advised her to increase the doses of the prescribed nutrients when she’s under excessive stress in the future, and to maintain moderate levels of key nutrients by keeping up her supplement routine. People with Pyrrole Disorder can’t get enough of these nutrients consistently in food and most patients experience a relapse of symptoms when supplements are discontinued.

I retested Jane after two months of treatment, and her kryptopyrrole levels had dropped to within normal limits. Her immune system also improved (gone were those frequent colds), her energy was higher and she felt stronger and more competent overall. She also said that she felt better-equipped to handle the stressors of her job and the rigors of her schedule. What’s more, she claimed she no longer felt alienated from her co-workers, and didn’t feel like she was the odd person out in “a man’s world.” In other words, she was positively soaring.

To learn more, visit Dr. Laurie Steelsmith’s website,, or click her to read her most recent book, Growing Younger Every Day: The Three Essential Steps for Creating Youthful Hormone Balance at Any Age.

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