Pyrolluria or Bipolar Disorder?

The Biologic Basis of Bipolar Disorder

Summary

Someone has said that you have bipolar disorder, but you’ve read about pyroluria. Could you have that? could you get better on Vitamin B and zinc?

Well that’s obviously an important question. Who would want a label of “bipolar disorder” when they had a “medical” problem?! and who would want to take the treatments usually prescribed for bipolar disorder when they could just take vitamins and minerals?!

So, how do you tell the difference? The short answer is: if your condition is mild and you can wait for an answer, you could try treating whatever you’ve got as pyroluria and see what happens. But if your symptoms are more than mild, particularly if they’re severe, probably better get on with approaches that have more evidence that they work.

Here’s what you’ll find on the page below.

• What is pyroluria?
• Similarity to bipolar disorders
• How to tell the difference?
• Who is making money here?
• Why is pyroluria getting such attention if there’s no money behind it?
• Who wouldn’t prefer “pyroluria” to “bipolar disorder”?
• Making smart decisions

What is pyroluria?

Presumably you already know something about pyroluria, else why would you be reading this page? For more, it would be good to read the wikipedia entry on pyroluria, as a start. But when you google pyroluria, you find numerous other sites which are not as skeptical as the wikipedia description.

Who are you to trust? That’s a big question; I’ll come back to that below. First let’s look first at the symptoms of “pyoluria” (numbered symptoms are from a board-certified holistic nutritionist, per her blog) .

If a description is broad enough, it applies to many people. In medicine, we have a measure for this, called “specificity”: how many people who don’t have disease X do have the symptom or trait or lab test result? Think about how many people who don’t have pyroluria or bipolar disorder but do have pale skin or skip breakfast or have poor short term memory.

But what if one person has a whole bunch of these traits? Does that identify a “syndrome”? Perhaps.

Who are you to trust? — Evidence

When people ask about pyroluria in my office, I find myself chasing after evidence. Maybe they’re on to something! Okay, where to turn for reliable evidence? How about the National Library of Medicine — that’s where all medical research that’s been published is stored, and the search engine, PUB MED, is really good. It’s like Google but just for published research. It’s simple if you want to try it. Put in pyroluria. You’ll find two articles, from 1978 and 1986. Remember, the National Library houses all research articles in medicine. Here we have just two? from 25-35 years ago?

For comparison, go to PUB MED and enter bipolar nutrition (a very poorly studied realm). You’ll find 150 articles, as of 6/2013. Why aren’t there more articles on pyroluria? What about the articles that you see on websites about pyroluria?

Internet Evidence

As you know, you can find nearly anything on the internet: someone touting some product or explanation. Usually they’re making money somewhere, those are easier to discount. By the way, that’s why throughout my PsychEducation.org website, when I say “This is So” I always try to provide a reference hyperlink, usually the first author’s name. The links go to the National Library of Medicine where the article I’m referencing is described.

But some websites aren’t clearly selling anything (including mine, I’ve hoped you’ve noticed). Yet some such websites explain pyroluria in great detail. Aren’t they on to something? Well, they could be. I’m waiting for more solid evidence, as I am on many things (unless the treatment involved is free or very cheap, has little or no short- or long-term risk, and has some decent rationale, i.e. some basic science of some kind to back it up.

But let’s take an example. Take the website of a guy who’s been treated by a doctor who specializes in pyroluria and Lyme Disease. (I’ll link the website in a moment but first allow me to give you some perspective on it.) The website is passionate and detailed. It references a bunch of work by Dr. Dietrich Klinghardt, M.D. , who has treated Scott F, the author. Scott is not making money with this site, near as I can tell. He’s just showing the virtues of Dr. K’s approach. But if you read all the way, you’ll find that Dr. K’ has treated Scott with a remarkable number of things which are all required to deal with pyroluria after the Vitamin B and zinc. It’s far worse than some of my medications that cause problems requiring another medicine, e.g. people taking lithium sometimes need to take thyroid hormone too.

Why such websites, if they’re not selling anything?

Here are two possible reasons. Believe it or not this is the short version.

Reason One: extending placebo effects

A. Placebos are remarkably effective, especially with mood and anxiety disorders. They generally get clearly positive results about 25-30% of the time. And that’s even more likely if the person taking the placebo treatment believes the treatment will help.

So a good doctor/practitioner will try to help her/his patient head out toward a treatment with a positive frame of mind about that treatment. Now here’s the key to this interesting process: if the doctor/practitioner her- or himself believes the treatment will help, she/his is much more likely to be able to get the patient/client to believe that too.

And now the loop comes back: some patients will get better no matter what one gives them for treatment, as long as they believe it’s going to help, right? that’st the placebo effect. But if they come back and say “wow, that really helped”, this makes the doctor believe more in the treatment. When the doctor believes in it, she can convince more patients it will help, which makes her get better results with that treatment. Eventually she may become so convinced of the benefits of this treatment, she is getting 1 out of every 4 or even one out of every 3 patients better with it.

That’s still a placebo response but heck, one in 3 patients getting better is nothing to sneeze at! Unless the treatment is costly, or has some risks.

(What about me — aren’t I at risk of this same process? Absolutely. How can I tell whether some treatment I’m suggesting is working simply because I believe it can work? Well, if I’m getting far better results than most of my colleagues do with the same treatment, that’s one way to suspect this “I believe-you believe, and get better – so I believe more” loop. Maybe that’s true of my “amber lenses” hypothesis, I’d certainly grant (but they only cost $7 and they’re not harmful even if they don’t work, presumably).)

B. “If it helped me, it will help you”: saying that out loud makes it help me more, you see? It makes me believe all the more in the treatment, and believing in a treatment is a huge factor determining how well the treatment works. So offering a testimonial can actually make the benefit stronger. The general psychological principle here is that talking about one’s beliefs tends to strengthen them.

Reason two: who wants “bipolar disorder?”

Who wants to be sick? Isn’t it more appealing to have a rare, nutritionally curable problem, than “bipolar disorder”? think of kitchens and gardens and minerals, or think of psychiatric inpatient units and pharmaceuticals and doctors. Not really a brain problem. Not even a mood problem (which is somehow more of a moral failure than having some sort of neurologic thing, like a muscle paralysis). Just a nutritional imbalance. Sounds much better, doesn’t it?