vitamin B6

Pyroluria/social anxiety protocol: why aren’t I getting results? (trouble-shooting checklist)

May 16, 2015 By Trudy Scott 118 Comments

How do you trouble-shoot when you score high on the Pyroluria Questionnaire from The Antianxiety Food Solution or even have a positive pyroluria urine test but you don’t seem to be getting the results you expect?

You still have social anxiety, that inner tension that you push through and deal with, and likely still feel uncomfortable when in large groups. You force yourself to put on the confident brave face. You may wish you could be more like your extrovert friends and actual enjoy socializing and speaking in public/on stage – without the fear and anxiety. You may still not be a big breakfast eater and have morning nausea. You may not yet be having pleasant dreams that you always remember.

(If pyroluria is new to you here is the Pyroluria Questionnaire from The Antianxiety Food Solution and here is a nice summary – Pyroluria, social anxiety, introversion: a summary )

This checklist is a starting point to try and figure out what may be the issue. These are the questions I work through with someone who is working with me one-on-one.

I discussed 21 of these in my interview on season 3 of the Anxiety Summit: Pyroluria, Amino Acids and Anxiety: Troubleshooting when you are not getting results

As you heard during the interview, I added MTHFR and I’ve even added a few more since then. I expect this list to continue to grow.

What form of zinc are you taking and is it free from copper? My favorite is Optizinc (zinc monomethionine) as it’s typically well-absorbed
Have you made sure that there is no copper in your multivitamin or other supplements? (this completes with zinc)
Have you been taking evening primrose oil and if yes, how much? (this enhances zinc absorption)
Did you test your fatty acid levels? What are the results? Did it show a need for GLA (I like evening primrose oil rather than borage oil) and no need for omega-3s (pyrolurics typically don’t need to supplement with omega-3s like fish oil)
What is your alkaline phosphatase (a blood test)? Less than 70 may indicate a need for zinc
Have you done the zinc tally/challenge with zinc sulfate and does it taste like water or does it taste really bad? If you zinc levels are good it should taste really bad
Did you test copper and ceruloplasmin, and if yes, what were the results?
Did you do the pyroluria urine test? What are the results?
What’s your score on the pyroluria questionnaire ? And which symptoms do you have?
What is your score on the introversion questionnaire?
What were your dreams like before starting the protocol and now? How high did you go on the vitamin B6? Did you switch to P5P and/or use a combination of both if needed?
On a scale of 1-10, what was your social anxiety before and now (10 is worst)
What is your stomach acid like? And have you trialed HCl supplements? Tested total protein (in blood)
Do you eat grass-fed red meat (a good source of zinc, iron and omega-3s)?
Do you eat sugar? Refined sugar and processed foods? Or even “healthy” sweeteners such as honey in large quantities? (sugar depletes zinc)
Do you eat large quantities of nuts or bake with nut flours? (the copper in the nuts may be affecting your zinc levels)
Do you have a copper IUD, copper pipes, copper pots? (this may also affect your zinc levels, keeping them low)
Have you done a hair analysis and found high copper or high hidden copper? (this may also affect your zinc levels, keeping them low)
How much and how often do you exercise? What about bikram/hot yoga? (sweating depletes us of zinc)
Have you used any of the amino acids? And seen good results? (this could be a clue that zinc and vitamin B6 are low since they are cofactors for making neurotransmitters such as serotonin, GABA, dopamine)
Do you eat gluten and have a gluten sensitivity? If yes, have you healed your gut? If not, you may have malabsorption issues
Are you completely grain-free? (this may be impacting your vitamin B6 levels)
Do you have amalgams/silver fillings? Did you have them removed and did a mercury detox? Were you tested for heavy metals? (zinc absorption can be blocked by heavy metals – we talked about this in season 2)
Do you have the MTHFR polymorphism? It’s common with pyroluria and this may mean you need higher amounts of the supplements
Do you have high histamine/hisadelia or low histamine/histapenia? Pyrolurics often have one or the other
Are you taking benzodiazapines or have recently quit benzodiazapines? Your unresolved anxiety may be due to this fact (we talked about this in season 1)
Do you have parasites, candida, dysbiosis, SIBO or other digestive issues? These can be considered stresses and pyroluria symptoms are worse under stress. Digestive issues also impact absorption
Do you have Lyme disease or another infection? These can be considered stresses and pyroluria symptoms are worse under stress. The immune system also uses up zinc.
Do you have food sensitivities? This may contribute to malabsorption. This can also be considered a stress and pyroluria symptoms are worse under stress
Do you have problems with histamine-containing foods? This can be considered a stress and pyroluria symptoms are worse under stress. Also, vitamin B6 is a co-factor needed for the DAO enzyme, which is responsible for the degradation of histamine.
Do you have issues with oxalates? This can be considered a stress and pyroluria symptoms are worse under stress. Oxalates can also bind to minerals and lower the levels. For some folks vitamin B6 helps with oxalate issues so the need may be higher.
Have you been/are you exposed to mold and other toxins? These can be considered stresses and pyroluria symptoms are worse under stress. The immune system also uses up zinc.
Do you have low oxytocin levels? Do you have a genetic variation in the oxytocin receptor gene (OXTR). Oxytocin has been implicated in anxiety, depression and related stress phenotypes
Is your life super-stressful or have you suffered from a recent trauma (or have old unresolved trauma)? Stress and trauma makes pyroluria worse
Do you have adrenal issues? We need good adrenal function for optimal digestion, being able to handle stress and being able to fight off infections/avoid getting parasites and dysbiosis
Do you have hormonal issues – PMS, perimenopausal or menopausal symptoms? The pyroluria protocol helps and this could be a clue that something is off
Are you on the birth control pill or have used one in the past? Oral contraceptives cause low vitamin B6 and zinc, reduce serotonin levels and increase anxiety.
Are you on any other prescription medications? Many medications deplete B vitamins and zinc.
Do you have vagus nerve issues? Good vagus nerve function is key for digestion, immunity, inflammation, neurotransmitter production and so much more. Also, forcing yourself to socialize when you have pyroluria is stressful and impacts the vagus nerve
Do you have inflammation and/or immunity issues? Vitamin B6 plays a role in reducing inflammation and immune modulation

[August 2021: the above list was updated extensively]

This list is NOT exhaustive and it’s NOT in my book The Antianxiety Food Solution because I gathered this information after the book was published. However, the pyroluria questionnaire, detailed protocol and testing information is in the book. There is an entire chapter on pyroluria.

Keep in mind that most folks do the pyroluria questionnaire, start on the recommended protocol of zinc, vitamin B6 and a copper-free multi and start to see improvements in a week. These can be dramatic improvements for many folks. And many folks see decent improvements in a few weeks and tweak things over the next few weeks before landing on the ideal doses.

This blog is for you if this doesn’t happen.

Did you miss this interview or want this and the other great interviews for your learning library? You can purchase the MP3s or MP3s + transcripts and listen/read when it suits you. You can find your purchasing options here: Anxiety Summit Season 1, Anxiety Summit Season 2, and Anxiety Summit Season 3.

Feel free to share your results in the blog comments and what you figured may be the issue/s for you.

If you tweak something and it helped do let us know too. That way we all help each other.

And feel free to ask questions in the comments too.

Pyroluria and focal musician’s dystonia or musician’s cramp

February 6, 2015 By Trudy Scott 50 Comments

In May 2014 a gentleman named Jay asked this question on my Pyroluria Questionnaire blog: “have you come across a connection between pyroluria and focal musician’s dystonia (musician’s cramp)?

I responded saying “I have not and until I looked it up I was not aware of this condition. I’m curious why you’re asking? Do you or someone you know have symptoms of pyroluria and focal musician’s dystonia?”

I’m a very curious person and always turn to the research and like to look for connections. I started to dig and came across the The Dystonia Society, a UK based organization that provides support, advocacy and information for anyone affected by the neurological movement condition known as dystonia. They have this definition on the About Dystonia page:

Dystonia is a neurological movement disorder. Faulty signals from the brain cause muscles to spasm and pull on the body incorrectly. This forces the body into twisting, repetitive movements or abnormal postures.

The various types of dystonia are listed and they discuss managing symptoms and say:

Remission from symptoms does sometimes occur but is rare – occurring in around 5-10% of cases.

I posted some feedback, starting a dialogue (both in the comments and via email) that led to me learning a whole lot more about dystonia and the finding out there does seem to be a connection to pyroluria, a social anxiety condition that is not well-recognized in the medical or mental health community. Symptoms include inner tension and discomfort in big groups. Many introverts relate to the symptoms of pyroluria too.

In the process Jay saw wonderful results, we heard from Dave and his success. And we’re getting to share this information in the hope of helping others like him and Dave.

Much of the information is buried in comments on various blogs so I’ve decided it needs a separate blog post – with the connections and research I discovered and some of the inspiring feedback from Jay and Dave.

Dystonia and possible connections with pyroluria

This is most of what I originally posted (with a few slight revisions).

I do see some overlaps with dystonia and mood so it’s possible there is a connection between pyroluria and musician’s dystonia:

(1) The Dystonia Society is a wealth of information and has this on their mental health page: “it is now thought that people affected by dystonia are more likely to experience mental health conditions such as depression, anxiety and OCD even before the physical symptoms of dystonia appear. It is not known why this is – but it appears that whatever causes dystonia may also affect mood and behaviour in some way.” Now I wonder how common social anxiety is for those with dystonia?

(2) “An additional relation between dystonia and mental health conditions is that some drugs used to treat psychoses can cause tardive dystonia / dyskinesia. With the new generation of these drugs (called dopamine receptor blockers) this is much less likely than it used to be – but unfortunately a small risk remains.” (this is also from the above dystonia page)

(3) The drug treatments they recommend are also often used for anxiety and depression. I’d suggest assessing for low GABA, low serotonin and low catecholamines first (using the amino acid questionnaire and determining if targeted individual amino acids may give the same relief. I would avoid benzodiazapines – Dr. Catherine Pittman shared the many side-effects and withdrawal effects during the Anxiety Summit.

(4) If you have pyroluria, you’ll also have low levels of zinc and vitamin B6, key co-factors in making serotonin and GABA and other neurotransmitters which affect anxiety and depression.

(5) Depression, anxiety, pyroluria and dystonia have a possible autoimmune/gluten/diet connection. This paper “Movement disorders in autoimmune diseases” discusses how “Tremors, dystonia, chorea, ballism, myoclonus, parkinsonism, and ataxia may be the initial and even the only presentation of these autoimmune diseases.” And here is a case study where the dystonia resolved on a gluten-free diet: “She had complete resolution of her neurological symptoms with introduction of a gluten-free diet.” We know gluten can damage the gut and lead to low levels of nutrients such as zinc and also cause low serotonin.

(6) Wilson’s disease (a serious condition of high copper/low zinc) can have symptoms of dystonia. This 2012 paper states: “The clinical manifestations of neurologic Wilson’s disease include variable combinations of dysarthria, dystonia, tremor, parkinsonism, ataxia, and choreoathetosis.”

I’m so pleased Jay asked this question. I learned a lot by looking in to this initially and since then have learned a great deal more.

Jay and Dave: their results implementing the pyroluria protocol

And take a look at the fabulous results Jay and Dave saw when they implemented only the pyroluria protocol (the starting dose I use with clients is 100mg vitamin B6 and 30mg zinc and 1300mg Evening Primrose Oil):

From Jay in June 2014

I started taking B6 (Pyridoxine Hydrochloride) 120mg and Zinc USP 60mg 2 weeks ago and do find some relief already. As you may have guessed, I have had dystonia for a long time and had to put a professional musician’s career on hold, and when I read your site, I found that I have a large number of symptoms from your list – I am hopeful.

From Jay in September 2014

I think it is, at this point, safe to say that the pyroluria treatment 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.

Dave in September 2014

just writing here to say that i too have battled focal dystonia over the past 8+ years. actually started as writer’s cramp and then worked it’s way into my guitar playing. about 3 years ago i noticed symptoms lessened based on different things i ate and shortly after came across pyroluria. in all questionairs i answer yes to most if not all questions.

anyway, for the past 2 years i’ve been on zinc and b6 and have had vast improvements. for me, the muscle disorders don’t go away without retraining, but the b6 and especially zinc make retraining much more successful. however, sometimes i do hit the jackpot and my hands work almost normal without the efforts of retraining. my dose fluctuates between 25-60 mg zinc and 50-100 mg b6 which i seem to have more trouble taking. i also experimented with methyl b12 but that led to a very painful rash.

the funny thing about all of this is that i feel nowadays that focal dystonia was only the canary in the coal mine for other symptoms that paid little or no attention to because i was only focused on being a musician. as a result of taking supplements most of those other symptoms are much better and i’m soooooo close now to having proper movement in my fingers.

it’s really great to see what you and jay have posted here because it really validates what i’ve been doing. i too believe there are many that can be helped by this.

Jay in October 2014

I am so happy to read this dystonia related success story! After my own experience, I still say an experience akin to rebirth as a musician and also as a person, this was the reason for me to post on this blog – to help get this out to musicians who are victims of dystonia and inadequate medical treatment.

Low GABA levels in focal and cervical dystonia

Update: Dec 6, 2024

I’m adding this section on a GABA connection to dystonia because cervical dystonia came up as a question in the GABA Quickstart 2.0 program this week. The research finds that there seems to be a low GABA connection to many different types of dystonia.

This 2002 paper, Impaired brain GABA in focal dystonia, reports on patients with writer’s cramp, a task specific dystonia, revealing “that brain GABA levels are decreased in specific brain regions of the focal dystonia patients compared to normal controls” and concludes that the “reduction of brain GABA in dystonia patients may explain the clinical symptomatology of focal dystonia.”

Cervical dystonia, “also called spasmodic torticollis, is a painful condition in which your neck muscles contract involuntarily, causing your head to twist or turn to one side. Cervical dystonia can also cause your head to uncontrollably tilt forward or backward.”

The objective of this 2021 paper, Cervical Dystonia Is Associated With Aberrant Inhibitory Signaling Within the Thalamus, was “to investigate whether alterations in the neurotransmission of gamma-aminobutyric acid (GABA) in the thalamus are present in patients with cervical dystonia compared to healthy controls.”

The authors report that “aberrant inhibitory signaling within the thalamus contributes to the pathophysiology of cervical dystonia. Additionally, these results suggest that an inadequate ability to compensate for the loss of GABA through upregulation of GABAA receptors may underlie more severe symptoms.”

Keep in mind that zinc and vitamin B6 are cofactor nutrients that are needed to make GABA. It’s common for someone with low GABA symptoms to also be on the pyroluria protocol.

I would be exploring low GABA in addition to low zinc and low vitamin B6 (and possibly pyroluria if someone has any type of dystonia.

Additional resources when you are new to using GABA and other amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low GABA or other neurotransmitter imbalances may be an issue.

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control (this is covered in an entire chapter too), sugar cravings, anxiety and mood issues.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms). This is a paid online/virtual group program where you get my guidance and community support.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Wrapping up and your feedback

I appreciate Jay and Dave for sharing their dystonia success stories. I am curious if using GABA too would have helped them see results more quickly.

We’re hoping we can generate some interest from various dystonia organizations/groups/forums and help more musicians find symptom resolution – certainly more than the 5-10% the Dystonia Society reports. The more people reporting success, the more likely approaches like this will be studied, accepted by the mainstream medical community and included on sites like the Dystonia Society.

If you relate to any of this please do comment and let us know what your results have been.

If you know someone with musician’s dystonia (or another form of dystonia) and pyroluria/social anxiety please do share this with them.

The Anxiety Summit: How zinc and vitamin B6 prevent pyroluria and social anxiety

June 15, 2014 By Trudy Scott 217 Comments

How zinc and vitamin B6 prevent pyroluria and social anxiety

– an interview with Trudy Scott, host of the Anxiety Summit (interviewer is Corey Schuler, who presents on Tuesday)

This interview was done on day 7 of The Anxiety Summit: Nutritional approaches for eliminating anxiety, social anxiety, panic attacks and OCD.

You can read/learn more about the summit in my opening talk/blog “Why the Anxiety Summit? Stats, trends and gems.”

Pyroluria/social anxiety

Low levels of the mineral zinc and vitamin B6 are 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. 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.

This constellation of symptoms is often the result of a genetic condition called pyroluria, also known as high mauve, pyrrole disorder, pyrroluria, pyrolleuria, malvaria, and elevated kryptopyrroles.

Here is the online version of the Pyroluria Questionnaire from The Antianixety Food Solution.

Be sure to read the comments for a wealth of information. You’ll see the dystonia question here.

If you need more information I have a whole chapter on pyroluria in my book:

The Antianxiety Food Solution: How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood and End Cravings (New Harbinger 2011).

The pyroluria chapter includes very detailed sections on the background, the questionnaire, testing and pyroluria supplement protocol.
It does not mention introversion, miscarriage and dystonia as these are new areas that I’m looking into

Here are other great books that also address pyroluria:

Joan Mathews Larson Depression Free Naturally

Carl Pfeiffer Nutrition and Mental Illness

Eva Edelman Natural Healing for Schizophrenia and Other Common Mental Disorders. As Corey said, this one is more for the practitioner.

The pyroluria-introversion connection

This is the blog post I wrote in response to the Huffington Post article, written by Carolyn Gregoire and called “23 Signs You’re Secretly An Introvert”

“Am I an anxious introvert because of low zinc and vitamin B6? My response to Huffington Post blog”

Be sure to check out the 23 signs and the responses from my wonderful followers.

I’d like to invite you to do both questionnaires and comment on the blog. Tell us that yes you are an introvert and yes you score over 15 on the pyroluria question or whatever the outcome is.

Pyroluria and fear of public speaking

Sontine is a client of mine who made diet changes, lifestyle changes like walking and added the key nutrients like zinc and vitamin B6 (and a few others) and found she too had no more fear of public speaking – and she actually started to really enjoy it! She also started to sleep well and had good energy. She was skeptical that this was possible for her but curiosity got the better of her and she’s so pleased with the results. Read more and watch her video testimonial here.

Do you have a fear of public speaking ? Did it improve when you addressed pyroluria? Please comment and let us know.

And here is the info about the zinc taste test and Kelly’s funny video! Enjoy

find that the majority of my clients with anxiety, pyroluria, depression and/or sugar and carb cravings are low in zinc. I have all my clients do the zinc status test when we start working together and then we retest their levels each week until they have good zinc levels. I use zinc sulfate, a liquid zinc that tastes a certain way depending on zinc levels. – See more at: https://www.everywomanover29.com/blog/zinc-deficiency-and-using-the-zinc-taste-test/#sthash.0hriWmqc.dpuf

My interview on pyroluria airs on The Anxiety Summit on Sunday June 15th from 9am PDT (USA time) until 8:59am the next day. You can get access to this interview and all the interviews here www.theAnxietySummit.com – Enjoy!

~~UPDATE: the summit concluded on Tues 6/24 – season 2 of The Anxiety Summit will be in November 2014. If you’d like to be on the notification list just sign up here www.theAnxietySummit.com~~

Missed this interview or can’t listen live? Or want this and the other great interviews for your learning library? Purchase the MP3s or MP3s + transcripts and listen when it suits you.

You can find your purchasing options here: Anxiety Summit Season 1, Anxiety Summit Season 2, and Anxiety Summit Season 3.

You can pre-register for future seasons of The Anxiety Summit here: www.theAnxietySummit.com

Nutritional interventions in postpartum depression and anxiety

May 9, 2014 By Trudy Scott 17 Comments

A 2013 paper published in Yale Journal of Biology and Medicine and titled “Nutritional interventions in depression and perinatal depression” states the following:

In pregnancy three “different physiological causes of depression have been identified: low serotonin, dopamine, and norepinephrine levels in the brain; altered neuromembranes and the impact of polyunsaturated fatty acids on these membranes; and hormones, especially hormonal changes that occur during and after pregnancy. Each of these pathways is affected by specific nutrients and may be altered by nutritional approaches.”

The paper lists the following possible nutritional deficiencies to consider:

Folate, vitamin B12 and vitamin B6 – which help maintain sufficient levels of neurotransmitters in the brain . These B vitamins are critical factors in homocysteine metabolism and homocysteine is a necessary precursor in the biosynthesis of serotonin, dopamine, and norepinephrine.
omega-3 fatty acids (EPA and DHA) – which keep neuronal membranes fluid and thereby enhance neurotransmitter production
SAMe – which has an antidepressant effect

The authors also discuss the importance of addressing possible imbalances of sex hormones, cortisol and thyroid hormones.

The paper concludes with this:

“Nutritional interventions may be a cost effective way of preventing and treating depression in pregnancy. When used prophylactically, nutritional interventions may decrease the incidence or severity of perinatal depression. When used as treatment methods, nutritional interventions may reduce the utilization of or the necessary dose of psychotropic drugs. Decreasing the amount of psychotropic drugs used during pregnancy may reduce the risk of harm to the fetus, while still providing the mother with an equivalent amount of therapy.”

In addition to the above, there is also research on: tryptophan, melatonin, zinc, and the role of inflammation in postpartum depression and anxiety.

It should be noted that by addressing many of these factors, both depression and anxiety may be alleviated. Also, since each person has their own unique biochemistry, it’s important to figure out what factor plays a role for that person.

I recently had the opportunity to share and more when I exhibited at the “California Maternal Wellness Summit: Postpartum Depression and Beyond.”

I met some wonderful women and groups who are doing amazing things to support women who have postpartum anxiety and depression. The response to my book, The Antianxiety Food Solution, and all the research on the powerful food mood connection was wonderful!

Because I feel this topic is so important, I’ve interviewed Christa Orrechio for “The Anxiety Summit.” The topic of her interview is: “Preventing and Quelling Post-Partum Anxiety.”

“The Anxiety Summit” is a free online virtual event that runs June 9 to June 22 and will be bringing together experts from all over the world – to share nutritional approaches to end anxiety, social anxiety, panic attacks and OCD. You can register for “The Anxiety Summit” here.

UPDATE: the summit concluded on Tues 6/24 – season 2 of The Anxiety Summit will be in November 2014. If you’d like to be on the notification list just sign up here www.theAnxietySummit.com