pyroluria

Essential tremor, dystonia, anxiety and cravings – diet, GABA, tryptophan, zinc and vitamin B6

January 17, 2020 By Trudy Scott 32 Comments

Today I’m sharing how diet, GABA, tryptophan, zinc, vitamin B6 and other B vitamins can resolve essential tremor and sugar cravings in 2 months, and also resolve musician’s dystonia and social anxiety within 4 months.

According to Medical News Today essential tremor is a movement disorder that can cause hand tremors and “is among the most common movement disorders.” … “The tremor usually affects both sides of the body, but it may be more noticeable in the dominant hand. It tends to occur when the person is moving as well as when standing still. Genetics may be responsible for around half of the cases of essential tremor.”

Essential tremor – diet, GABA, tryptophan and B vitamins

This Croatian paper, Treatment of Essential Tremor with Multi-Modal Nutritional Therapy in a Teenage Patient, reports the “case of a 13-year-old boy with [essential tremor] causing severe functional impairment” over the previous 2 years.

“A multi-modal nutritional therapy approach” was used to target three possible areas that could be contributing to the tremors: a poor diet that was high in sugar, low GABA levels and low serotonin. These changes were implemented:

(i) diet (specifically adopting a Mediterranean diet)

(ii) GABA (through oral supplementation) and

(iii) L-tryptophan/vitamin B pathways (Triptobel oral supplement).

The papers states: “After two months of therapy, his tremor decreased significantly and he regained normal function.”

Once the essential tremor resolved, this teen was able to resume his plans to pursue a musical career as a guitar player (which had been put on hold due to the tremor and his inability to play). What wonderful results!

I’m thrilled to see tryptophan and GABA being used for this condition and am really pleased to read this case report. Here is my commentary on the supplements and doses he used for anyone wishing to try and replicate this nutritional approach (keeping in mind there is no one-size-fits-all).

He used 150 mg of the Triptobel supplement three times daily at 8 am, 1 pm, and 6 pm. One capsule of the Triptobel contains 150mg L-tryptophan and a B vitamin complex of thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pantothenic acid (vitamin B5), vitamin B6, folic acid (vitamin B9), and cyanocobalamin (vitamin B12). The total tryptophan dose was 450mg per day. A typical starting dose for someone with anxiety is 500mg 2 x day so his dose was on the low-end. The Triptobel was also used at mealtimes and according to the label “on a full stomach after a light meal, preferably without protein.” I like to use tryptophan between meals (away from protein) and a B complex with meals so I’m intrigued by this application (but wonder when protein was consumed).
He also used 750mg GABA twice daily at 10 am and 4 pm. This is considered a high starting dose for the majority of my clients with anxiety and I start low and build up to this amount.

Anxiety and low mood was not mentioned so I don’t know if they were factors.

It appears sugar and carb cravings were very likely a factor given that his normal daily diet contained “large amounts of refined sugars (chocolate, cake, biscuits, ice cream, etc).” The amino acids would have helped him with those cravings.

With regards to his diet, given how common movement disorders are with gluten issues, I would also consider I gluten-free diet which has been shown to have an adverse impact on neurotransmitter levels and B vitamins. Could gluten have triggered these nutritional deficiencies and the tremors?

And now to share a very similar case in an adult male … with a different and yet related approach.

Dystonia and hand tremors – and the pyroluria connection

This same Medical News Today article also describes dystonic tremor/dystonia as a movement disorder that can also cause hand tremors, stating that “the brain sends incorrect messages, resulting in overactive muscles, abnormal postures, and sustained undesired movements. Young adults and those in middle age are most likely to develop dystonic tremors, which can occur in any muscle.”

If you’ve been reading my recent articles on pyroluria (the pyroluria-vagus nerve connection and the introversion-pyroluria-loneliness connection) I’m sure you’ll be be interested to learn that there appears to be a strong link between pyroluria and focal musician’s dystonia (or musician’s cramp) in some individuals.

As you read in the blog above, Jay, also a guitar player, had to put his professional music career on hold due to musician’s dystonia. He also happened to have social anxiety and he started to notice improvements in his anxiety and tremors within the first 2 weeks. At the end of 4 months of being on the pyroluria protocol, he shared this:

I think it is, at this point, safe to say that the pyroluria treatment [120mg vitamin B6 and 60mg zinc) is, at least in my case, the cure for pyroluria and dystonia. 90%+ of my symptoms have disappeared, I am working extensively on repertoire and I am thinking about getting back into performing.

He says his experience was “akin to rebirth as a musician and also as a person.” How wonderful is that to read. Jay’s musician’s dystonia resolved and so did his social anxiety.

The outcome for the teen and Jay were similar and yet the approaches used were seemingly very different. This isn’t actually the case since zinc and vitamin B6 are co-factors that are needed to make GABA and serotonin.

Do you experience tremors, or have you been diagnosed with essential tremor or dystonia (or know someone who has)? And have you considered a nutritional approach?

Do share if you’ve seen success with either of the above approaches, and also experienced reduced anxiety or felt more social?

Why social anxiety, introversion and loneliness can be lethal and a simple nutritional solution

January 10, 2020 By Trudy Scott 36 Comments

It was an honor to be selected as one of fifteen participants for The Future of Health presentations at Mindshare in August 2019. I presented this to my peers in the integrative health and nutrition space but it’s applicable to everyone and I’d like to share it with you today.

Here is my video presentation: Why social anxiety, introversion and loneliness can be lethal and a simple nutritional solution (click below to watch the video)

Here are some additional reading resources on much of what I cover in my 5 minute presentation:

Pyroluria is a social anxiety condition that is not well recognized in the medical community. It responds really well to a few key nutrients, with zinc and vitamin B6 forming the foundation. I cover this in this blog post: Pyroluria, high mauve, pyrrole disorder, malvaria, elevated kryptopyrroles and social anxiety.
Here is a link to the Pyroluria Questionnaire from my book The Antianxiety Food Solution (which has an entire chapter on the topic). I created this questionnaire using the work of Carl Pfeiffer and Joan Mathews-Larson, modifying it based on feedback I receive from my clients.
I discuss how I first discovered the pyroluria-introversion connection here – Am I an anxious introvert because of low zinc and vitamin B6? My response to Huffington Post blog. I wrote this in response to the Huffington Post article, “23 Signs You’re Secretly An Introvert”, by Carolyn Gregoire.
Here is the webmd loneliness article with this quote: “Loneliness has the same impact on mortality as smoking 15 cigarettes a day, making it even more dangerous than obesity” ~ Douglas Nemecek, MD, chief medical officer for behavioral health, Cigna
And this loneliness paper, Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review
In this blog I write about how Increased sociability improves vagus nerve function: the role of social anxiety, pyroluria and low zinc

This is the the amazing and inspiring group of speakers who I shared the stage with:

Amie Apigan – Why Attachment is the New Field of Medicine
Lauryn Lax – Eating Healthy is Killing You
Jess Sherman – Raising Resilient Kids in a Complex World: Will we Rise to the Challenge
Terry Wahls – Creating an Epidemic of Health – My Radical Path
Susanne Bennett – The Kimchi Revolution: How an Ancient Food Can Transform the Future of Health
Razi Berry – Love is Medicine
Kaylea Boutwell – I’ve Got Your Back: Novel Pain Therapies Transforming Spinal Care Outcomes
Dana Cohen – Hydration: 8 Glasses a Day is not the Way!
Elisa Song – Breathing Life into Your Kids
Joel Sprechman – Creating 1M Super Poopers & Evolving Crohn’s Colitis
Katy Kimball – My Plan to Empty Your Waiting Rooms (the Real Root Cause of Poor Health)
Heather Paulson – Why Choose? Using the Best of Both Worlds to Experience Health with Cancer
James Maskell – Group Visits: How Functional Medicine Reaches the Vulnerable
Mehgan Walker – Life, Liberty and the Pursuit of Chronic Disease: Why Chasing Happiness is Making us Sick

(do let me know if you’d like me to share any of these presentations in the follow-up blog)

Mindshare 2019 green room — Here are some of us in the backstage “green room” and getting ready to go on stage!

We each had a maximum of 5 minutes to present and were not allowed slides or notes. The last time I had memorized my talks and had them timed was 15 years ago when I was in Toastmasters. Before that it was when I was in school. I wasn’t even sure if I could do it when I entered my proposal to speak. When practicing the day before I was still unsure I could manage. Because of my Lyme disease, my memory and word recall isn’t as great as it used to be.

If you pay close attention and you’ll notice the spot where I almost freeze – everything just went out of my head! I simply breathed in calmly, made an attempt to look like I had paused and was fortunate that most of the ending came back to me! Whew!

I’d love to hear what you think of my message and if it resonates with you or a loved one. Feel free to share your pyroluria score and how you score on the introvert questionnaire.

Please also share if you’ve seen the benefits of no social anxiety, introversion and/or loneliness (or much less) when on the pyroluria protocol.

Increased sociability improves vagus nerve function: the role of social anxiety, pyroluria and low zinc

December 13, 2019 By Trudy Scott 14 Comments

With the objective of taking a deeper dive into some of the favorite topics of the recent Anxiety Summit: Gut-Brain Axis, today’s blog is about the vagus nerve since Dr. Navaz Habib’s interview, Vagus Nerve Activation to Reduce Anxiety, was voted one of the favorites. I’m focusing on one tool that improves vagus nerve function that we didn’t have time to get into in great detail – and that is how increased sociability helps. It’s all good and well to recommend getting out and hanging out with more people but if you have the social anxiety condition called pyroluria it’s really challenging, hard work and very stressful. Added stress makes pyroluria worse so it becomes a vicious cycle.

Let’s start with the research that supports the connection between the vagus nerve and increased anxiety and mood problems. In the interview with Dr Navaz, we discussed this paper: Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders which states that “vagus nerve stimulation is a promising add-on treatment for treatment-refractory depression, posttraumatic stress disorder, and inflammatory bowel disease” and how stimulation of vagal fibers that go from the gut to the brain (afferent fibers) influences neurotransmitter production and “play crucial roles in major psychiatric conditions, such as mood and anxiety disorders.” The gut bacteria play a major role too, “partly by affecting the activity of the vagus nerve.”

In our interview we end with very practical ways to activate your vagus nerve

Deep breathing exercises (mentioned in the above paper, together with yoga and meditation) and cold showers (which makes you breathe harder)
Gargling and using the gag reflex
Humming, chanting and singing (I used these approaches for my vagus nerve issue – more here on that)
Auricular acupuncture (which is also very effective for addictions)
And finally, social interaction or increased sociability, which I want to cover today

The research on the vagus nerve and being more social

Let’s look at the research on the vagus nerve or vagal tone and being more social. This paper, Upward spirals of the heart: autonomic flexibility, as indexed by vagal tone, reciprocally and prospectively predicts positive emotions and social connectedness, reports that that vagal tone and connectedness or being more social is a two-way street i.e. it’s reciprocal

“…increases in connectedness and positive emotions predicted increases in vagal tone” and
“Adults who possessed higher initial levels of vagal tone increased in connectedness and positive emotions more rapidly than others”

In summary, the more social and happy you are, the healthier your vagus nerve is and a healthier vagus nerve leads to feeling more connected and happy.

This study was done with adults in a community-dwelling setting over 9 weeks: “adults were asked to monitor and report their positive emotions and the degree to which they felt socially connected each day.”

Address pyroluria in those who have social anxiety

Pyroluria, the social anxiety condition, was not part of the study because it’s under-recognized as a factor in anxiety. I’d like to propose that we address pyroluria in those who have social anxiety in order to further improve social connectedness and their vagus nerve function.

Many folks with pyroluria put on a brave face in social settings and even “extrovert” which is extremely stressful. The added stress makes pyroluria worse (zinc and vitamin B6 are dumped in much higher amounts) so it becomes a vicious cycle.

Others, who are not willing to even show up because of their severe social anxiety, are not getting that social interaction and connectedness that is so crucial for improved vagus nerve function and better overall health.

Here is the pyroluria questionnaire and the pyroluria/introvert connection.

Connecting the dots further we have

research that reports that vagus nerve stimulation has potential in autism treatment and we know pyroluria and social issues are common in autism
one of the key nutrients for pyroluria, zinc, plays a role in vagus nerve function
another key nutrient in pyroluria is vitamin B6 and it plays a role in reducing inflammation
according to the vagus nerve study above, the vagus nerve “plays important roles in the relationship between the gut, the brain, and inflammation”
both zinc and vitamin B6 are needed for neurotransmitter production, so increasing both GABA and serotonin will further improve mood and reduce anxiety
and finally, the more social and happy you are, the healthier your vagus nerve is and a healthier vagus nerve leads to feeling more connected and happy

By addressing the social anxiety called pyroluria with a foundation of zinc and vitamin B6, we can increase sociability and thereby improve vagus nerve function.

Have you got pyroluria and has addressing it nutritionally allowed you to be more sociable? Do you find you have better vagus nerve function when you are more sociable? What other avgus nerve exercises have you found helpful?

Buddy Bench for introverted adults with social anxiety, shyness and feelings of overwhelm?

July 26, 2019 By Trudy Scott 6 Comments

Buddy Benches or Friendship Benches are being used in many countries around the world in schools to help children who feel lonely or are shy or anxious. I propose we do something similar for introverted adults with social anxiety, shyness and feelings of overwhelm or intimidation when they attend conferences.

This BBC article, How ‘Buddy Benches’ are making playtime less lonely shares this about how they are helping children fit in more:

The school playground can be a lonely place for a child if they haven’t got anyone to play with. But a special type of bench is helping pupils make friends.

The idea is simple – if a child feels lonely, they can go to the bench as a signal that they need someone to play with. Another child will see them, go and talk to them and include them in their games.

Also from the BBC article, we learn that Buddy Bench Ireland is taking it a step further and trying to do something different with them, using the bench to engender empathy and as

a reminder for children of things like communication, mutual support and opening up about feelings

Other objectives of these Buddy Benches in schools is:

reducing social isolation
improving mental wellbeing
end bullying

I propose we take these Buddy Benches – that work so well with children – to another level and set them up at conferences for adults too. I believe they could work very well for introverts (who make up around 50% of the population) with social anxiety and/or anyone feeling overwhelmed and/or intimidated and/or shy.

I get kickback when I talk about introverts feeling socially anxious but it’s common as you can see by these comments from introverted individuals

It isn’t always a comfortable place to be when I must be in a crowd.
The hardest aspect of living life as in introvert is we all live in an extroverted world. School pushes kids to do group projects, that are just awkward and when you don’t do well in it you’re doing something wrong or something is wrong with you. The moment I step out of the door I am no longer me, I am a character that has to put on a show in order to succeed in the work place.
Sometimes I can communicate with friends well and sometimes I fake it really badly. I always wonder if people can see past my half smile and fake laugh. It’s painful to be honest. But there are times when I don’t mind so much.

One big question is this: would adults use one or would they feel more self-conscious than children? Would they worry more about what others will think if they sit down at an empty bench waiting for someone to join them, essentially saying “I’m shy” or “I’m anxious” or “I’m an introvert” or “I feel intimidated”?

In the BBC article they address this stigma and worry aspect:

But do children actually use the bench? And are they worried about how it makes them look?

“They don’t see it as stigmatised,” says Sinead McGilloway, director of the Centre for Mental Health and Community Research at Maynooth University, who led a study of 117 pupils at three schools which have benches.

Forty per cent of the children she questioned said they had used the bench, and 90% said if they saw someone else sitting on it they would talk to them.

I have these questions for you about using a Buddy Bench at a business or health conference:

1) How likely are you to use a Buddy Bench as an adult diagnosed with social anxiety and/or know you have the social anxiety condition called pyroluria and you’re working to address your symptoms with nutrients but are not quite there yet.

2) How likely are you to use a Buddy Bench as an adult who identifies with being an introvert and are easily overwhelmed at the networking and mingling aspects that comes when you attend a conference?

3) How likely are you to use a Buddy Bench as an adult who feels shy and/or easily overwhelmed and/or intimidated in new settings with large groups of people you don’t know?

4) How likely are you to be the “Big Buddy” (I just made this term up because it makes me think of Big Brother or Big Sister) and go up to someone sitting on a designated Buddy Bench in order to offer moral support, conversation, connection, encouragement and kindness?

Of course, I love the idea of these Buddy Benches and would have used one for support and connection in the past. I have pyroluria and used to have dreadful social anxiety (and considered myself an introvert). But now that I’m on the pyroluria protocol I feel like a social butterfly and I am very relaxed at big group events. I would definitely go and buddy-up with someone looking for support.

And let’s not forget that Buddy Benches are just one part of the solution – for both children and adults – and we don’t want to forget food, nutrients and functional medicine:

While you’re figuring out the role of diet, gut health, adrenal/thyroid health, toxin exposure etc, a good place to start is to assess for and address low GABA and low serotonin with the amino acids GABA and tryptophan. This provides quick nutritional support for worry, fear, anxiety, tension, overwhelm, lack of confidence and feelings of intimidation.
My next step would be to assess for and address pyroluria with zinc and B6 (and other key nutrients) to help ease and often eliminate the social anxiety completely. Believe it or not, there is a strong connection between pyroluria and introversion and many of my clients and folks in my community no longer feel introverted when they address their pyroluria. I write about this in another blog: Am I an anxious introvert because of low zinc and vitamin B6?

Feel free to comment and let us know what you think about Buddy Benches for adults. Do you have other ideas as to where these adult Buddy Benches could be used?

Let us know if you’ve seen these Buddy Benches work successfully with children and what ideas we could take away to get similar results for adults using them.

And do share if a nutritional approach or if addressing pyroluria has eased your social anxiety, and maybe got you wondering if you are an introvert after all.

Feel free to post your questions too.

Ginger, pressure-point wrist-bands, the horizon and vitamin B6 for sea-sickness

July 5, 2019 By Trudy Scott 18 Comments

We had an amazing day snorkeling on the Great Barrier Reef earlier this week. As you know, I always like to keep it real. I was not very happy on the 2.5 hour boat trip to the Great Barrier Reef. It was supposedly calm, but it felt very rough to me (look at the horizon behind the boat!)

I’ve always suffered from various degrees of motion sickness and this day was no exception. However, I was able to keep it together and not throw up by using pressure point wrist bands, ginger tea and ginger tablets, sitting where I could feel the sea air blowing on me and by looking at the horizon pretty much the entire time. As someone with pyroluria, my vitamin B6 status is good too and this always helps with nausea prevention.

pressure point wrist band — Here is a close-up picture of the pressure-point wrist bands, with the pressure “button” placed two finger widths from the wrist joint. It’s important to put these on before the motion starts.

The tour company, Adrenalin Dive, offered these excellent TravaCalm Natural ginger tablets to everyone. These were new to me and I took 2 shortly after we left Townsville.

tulsi tea — I also sipped Organic India Tulsi Ginger tea for the entire journey, in both directions. I always carry ginger tea with me.

Next for me is vestibular neuro-rehab with a functional neurologist to hopefully sort out this motion sickness thing once and for all!

The good news is that it was so much calmer once we got to the reef and I felt 100% when snorkeling. I’m in awe of the beauty of this place: the amazing blues, the colorful coral and fish, together with spending hours in the ocean!

I think we need a new term similar to forest bathing called “reef bathing” as I’m sure the physiological benefits are similar – a combination of calming, lowered blood pressure and heart rate, lowered cortisol and even boosting serotonin (we could not stop smiling!) and endorphins (the feeling of pure joy is still with us).

Since I’m on holiday, I’ll share more with the supporting research about vitamin B6, ginger and pressure point wrist-bands in an updated version of this blog.

Until then feel free to share what works for you if you’re prone to motion sickness.

Pectus excavatum and pyroluria: is there a connection?

June 7, 2019 By Trudy Scott 17 Comments

I recently received a question about the possible connection between pectus excavatum and pyroluria, a social anxiety condition. In layman’s terms, pectus excavatum is a depression or indentation in the chest wall and is related to problems with connective tissue. This Medscape article describes it as follows:

Pectus excavatum, also known as sunken or funnel chest, is a congenital chest wall deformity in which several ribs and the sternum grow abnormally, producing a concave, or caved-in, appearance in the anterior chest wall.

It’s not something I’m familiar with other than seeing someone with this condition at the beach once (I share some pictures below) and when doing the research for this blog.

The question was posed in relation to a blog on Joint hypermobility / Ehlers-Danlos Syndrome, a connective tissue disorder that does seem to be common in those with pyroluria.

In case you’re new to pyroluria, it is a genetic condition that is frequently associated with a type of anxiety characterized by social anxiety, avoidance of crowds, a feeling of inner tension, and bouts of depression. People with this problem experience varying degrees of anxiety or fear, often starting in childhood, but they usually manage to cover it up and push through. They tend to build their life around one person, become more of a loner over time, have difficulty handling stress or change, and have heightened anxiety symptoms when under more stress. You can read more about it here.

There are also connective tissue symptoms with pyroluria with the following commonly a factor: joints popping, cracking, or aching; pain or discomfort between the shoulder blades; and/or cartilage problems. This is often due to low levels of zinc. Here is the entire pyroluria questionnaire.

Addressing low levels of the mineral zinc and vitamin B6, together with some other nutrients and stress management, are key to addressing pyroluria symptoms. The social anxiety can typically be lifted in a week and the joint and pain problems often ease in 1 to 2 months.

So now that I’ve set things up with an overview of pyroluria and EDS and the connective tissue problems, let me share what I uncovered about pectus excavatum and why I feel there is very likely a connection with pyroluria.

Pectus excavatum and low zinc – impacting connective tissue and psychological impairment

According to this 2012 paper, Pectus excavatum: history, hypotheses and treatment options

Pectus excavatum (PE) … is the most common chest wall deformity, representing 90% of all cases. Depending on the severity of PE, deviations of thoracic organs and spine deformities are known. Although PE in most instances has little or no influence on the function of the inner organs, the cosmetic appearance of the patients leads to psychological impairment which requires therapy.

In the above paper, they write about one of the hypotheses: weak cartilage through metabolism dysfunction. They report decreased levels of zinc in the pectus excavatum patients, suggesting “the lack of zinc in the diet results in a lower metabolic activity of chondrocytes.” Chondrocytes are cells found in cartilage connective tissue. In summary, one hypothesis is that low dietary zinc affects cartilage connective tissue in some individuals with pectus excavatum.

Observe the mention of psychological impairment. Could the low zinc be playing a role in this too? I address this below.

Pectus excavatum and Ehlers-Danlos, plus dental crowding

This paper, Pectus Excavatum and Heritable Disorders of the Connective Tissue, make the connective tissue and Ehlers-Danlos connection:

It seems clear that several patients affected by pectus excavatum display a typical association with connective tissue disorders, which may span from mild form like simple laxity without morbidity associated, to more severe forms such as MFS and Ehlers-Danlos syndrome

This paper also mentions “Highly arched palate with dental crowding” which is common in pyroluria and seems to be related to low levels of zinc.

The image below illustrates a moderate/severe form of pectus excavatum.

Vitamin B6 and high homocysteine

With regards to vitamin B6, one of the other key nutrients needed for pyroluria, one paper, Pectus carinatum repair in an adolescent with hyperhomocysteinaemia: Anaesthetic implications reports a case of a 14-year-old boy with high homocysteine. his level was 18.5 μmol/l (normal levels are within 7–10 μmol/l). He was treated with folic acid, Vitamin B6 and B12 supplements. Is this common in all cases of chest wall deformities? I don’t know but it would interesting to find out.

Pectus excavatum: social anxiety and depression

There are some older studies that report mental health symptoms, including social anxiety are common. In this 1999 paper, Funnel chest. Psychological and psychosomatic aspects in children, youngsters, and young adults, they report these reactions in children older than 11:

embarassment reactions, social anxiety, feelings of stigma, limited capacity for work, orientation towards failure, reduced tolerance of frustration and temptation, limited capacity for communication and even markedly depressive reactions are observed.

It’s understandable that the physical manifestations of this condition would lead to some of these feelings but I have to question how much of this could also be related to low zinc and low vitamin B6. Both nutrients are needed for easing pyroluria/social anxiety symptoms and making neurotransmitters such as serotonin.

Other than trying to make some connections with the research, when this question was asked on facebook, a number of people said they (or a family member) has both pyroluria and pectus excavatum.

If you do have pectus excavatum and pyroluria, getting on the pyroluria protocol will:

ease some of the social anxiety and depressive symptoms
very likely lead to less pain and discomfort
very possibly prevent further connective tissue issues
feasibly prevent pectus excavatum in future children or perhaps reduce the severity in the instance where zinc is a factor (this one is a long shot that I feel is worth further research)

I’d love to gather more information and am looking for feedback so please do share your symptoms and experiences in the comments. Let us know if you or your child or other family member has pectus excavatum and any of the following:

A score 15 or more on the pyroluria questionnaire and/or suffer from social anxiety
Have low zinc
Have low B6 (poor dream recall or nightmares is a clue)
Have high homocysteine i.e. above 10 μmol/l
Ehlers-Danlos syndrome or joint hypermobility
Dental crowding

Resources for you

My book The Antianxiety Food Solution (my Amazon affiliate link) has an entire chapter on pyroluria. Read it and become a savvy health-advocate for yourself. Share a copy with your doctor and point out the references.
Here is a blog if you’re new to pyroluria and the associated conditions.
Here is the pyroluria questionnaire.
You can find the pyroluria products in my supplement store here.