Pyrroles can present in many different ways. In my clinic I have seen individuals who have struggled with depression for as long as they can remember, while others note an inability to cope with stress without developing unrelenting anxiety and insomnia. There is often a family history of mental illness and on reflection, many can report having problems at school either socially, or with their learning capabilities.
While the cause is not fully understood, there is evidence of a strong genetic link.  Pyrrole disorder can first manifest during times of increased growth (children, teenagers) when demands for zinc are heightened or during periods of high stress. There is often concomitant digestive issues and possible leaky gut.  While not every person struggling with a mood or behavioural disorder will have pyrroles, a careful case history can normally indicate if there is a need for further testing.
It is though that 18 – 35% of the population diagnosed with psychological disorders such as anxiety or depression, behavioural issues or learning disorders have an underlying pyrrole disorder.  Some conditions associated with pyrrole disorder include;
So, what is pyrrole disorder?
In a nutshell, pyrroles is a biochemical imbalance that occurs in the body due to abnormally high levels of a chemical known as hydroxyhaemopyrrolin-2-one (HPL or pyrroles for short). HPL is produced in the body as a bi-product of haemoglobin production. In most people levels of circulating HPL remain low and never cause a problem, however in those with pyrrole disorder, HPL levels remain abnormally high. HPL is like a toxin to the body and binds to specific nutrients, essentially leaching them from the body leading to longstanding nutritional deficiencies.
The two main nutrients that are affected are vitamin B6 and zinc, however there are other nutrients involved including magnesium, manganese, biotin and omega 3 & 6 fatty acids. 
Zinc and B6 are essential for many different body systems including digestion, immunity, learning, memory and a healthy functioning nervous system.  Signs and symptoms of pyrrole disorder can vary widely and are mostly attributed to zinc and B6 deficiency. Some common symptoms include;
poor morning appetite
white spots on fingernails
pale ‘china doll’ complexion & an inability to tan
preference to vegetarian diets (possibly due to low stomach acid levels)
low tolerance to stress
sensitivity to noise and lights
poor immunity and
joint and skin complaints 
Pyrroles, Depression, Anxiety and Behavioral Disorders.
Both Vitamins B6 and zinc are critical nutrients needed for production of important brain chemicals such as serotonin, dopamine and GABA. These brain chemicals (neurotransmitters) are needed for a happy positive mood, keeping anxiety levels under control as well as motivation levels. A deficiency in any one of these neurotransmitters can lead to depression, increasing anxiety that seems to come from nowhere, anti-social behaviour and low motivation. In children, pyrroles disorder can first present as behavioural issues including temper outbursts, an inability to focus at school, anxiety and learning difficulties.
Once detected, pyrroles disorder is surprisingly simple to manage. Specific nutritional supplementation with bio-available forms of zinc, B6 and P5P (activated B6) will reduce HPL levels and address nutritional deficiencies, however this is most likely long term. The correct doses of nutrients will vary depending on HPL levels. Doses that are too low may not have any effect at all therefore the guidance of a qualified health practitioner is highly recommended. 
How to Test for Pyrrole Disorder
Levels of HPL can be measured in urine, therefore detection of pyrrole disorder can be achieved through a simple and inexpensive urine test. If pyrroles is suspected, a test kit can be ordered and completed in your own home. Click here for more information.
Due to a close genetic link, if one family member is diagnosed, it is highly recommended that all other family members are tested also. If one parent has pyrroles, there is a 50% chance it can be passed onto a child, this increases to 75% if both parents have the disorder. [3,4]
Long Term Prognosis for Those with Pyrrole Disorder
The sooner it’s picked up the better, however it is never too late to start treatment. Depending on HPL levels the benefits of nutritional supplementation may be felt as soon as 2 weeks although in more severe cases it can take up to a year to normalize HPL levels and correct nutritional deficiencies.
I also use herbal medicine to help manage the wide array of mental, emotional and physical symptoms associated with pyrrole disorder. The herbs I choose to use will depend on which medications my client is on (if any). There are many wonderful and clinically trialed herbs that can be used safely alongside prescription medications or on there own to help manage stress levels, reduce anxiety, insomnia, lift mild to moderate depression or to help with skin and digestive issues.
Addressing all factors that can trigger pyrroles is key to managing the condition long term. In my experience a collaborative approach works best with open communication between the client’s medical practitioners if possible. Successful treatment involves a holistic approach that includes specific nutritional supplementation, consideration of dietary and lifestyle factors that might exacerbate gut inflammation and most importantly managing stress levels!
References 1. Pyrrole Disorder - an Overview. Mindd Foundation. Viewed 9 February 2018, https://mindd.org/pyrrole-article/ 2. McGinnis WR, Audhya T, Walsh WJ, et al. Discerning the mauve factor, part 1. Altern Ther 2008;14(2):40-50. [Abstract] 3. McGinnis WR, Audhya T, Walsh WJ, et al. Discerning the mauve factor, part 2. Viewed 9 February 2018, https://www.biobalance.org.au/_downloads/discerning-the-mauve-factor-part-ii-galley.pdf 4. Fay B. Pyrrole Disorder: Identification and Treatment. FX Medicine 2016, Viewed 7/02/2018, www.fxmedicine.com.au/blog-post/pyrrole-disorder-identification-and-treatment