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HPU-Diagnosis

Click on the test

HPU/KPU diagnosis is made via urine analysis.

During the diagnosis, pyrroles in the urine are measured, which in healthy individuals are excreted through the stool.

Pyrrole determination by Medivere

The German diagnostic provider medivere offers a cost-effective and uncomplicated measurement of hemopyrrole in first-morning urine. The sample is analyzed by the ISO-certified Ganzimmun laboratory in Mainz (since 2024 operating under a new name and design, but with an unchanged testing method).

Pyroluria Urine Test by medivere:

Order here, simply click on the test.

These are the points you should consider before taking the test.

Do not take zinc, vitamin B6 (or its activated form P5P), or manganese supplements for 7 days before the test. Otherwise, the test may produce a false negative result.

If you have been taking vitamin B6 and zinc for more than 3 months, you should pause taking them for 4 weeks before taking the test.

Do not test during or shortly after antibiotic treatment. Antibiotics can also negatively affect the amount of HPL excreted. (14 days later)

Do not test during or shortly after menstruation. During and in the first few days after menstruation, the amount of excreted HPL complexes is significantly reduced. Menstrual blood can distort the test result.

Don’t drink alcohol the day before your HPU test.
My tip: If you suffer from symptoms typical of HPU, it’s advisable to avoid alcohol altogether. Alcohol is a liver toxin, and HPU is a detoxification disorder.

Do not drink alcohol the day before the HPU test.
Do not test within the first four weeks after an iron infusion. The test will then be negative.

Evaluation: The upper bar indicates the concentration of your urine. The lower bar shows the pyrroles in the urine. In the red zone, we assume HPU (hemopyrrole).

Why a micronutrient analysis is not sufficient for diagnosing HPU

HPU can cause a chronic deficiency of zinc, vitamin B6 and/or manganese. This suggests that a diagnosis could potentially be made based solely on a blood test. However, not every HPU patient has a deficiency in all three micronutrients.

The following blood values may (but do not necessarily) indicate HPU:

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Homocysteine increased

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LDL and cholesterol levels are elevated

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Biotin lowers

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Reduced white blood cell count

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Decreased erythrocytes

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Zinc reduced

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alkaline phosphatase (zinc-dependent enzyme) is reduced

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P5P (active form of vitamin B6) decreases, while simultaneously high vitamin B6 levels in the blood serum are present.

HPU patients may show elevated vitamin B6 levels in blood serum, as the disrupted metabolism cannot utilize the inactive form of vitamin B6.

What is the difference between HPU and KPU?

KPU = Kryptopyrrolluria, HPU = Haemopyrrollactamuria

HPU and KPU are both disorders of heme metabolism and are treated the same. Therefore, differentiating between testing for HPU and KPU is not helpful for those affected. In the USA, both disorders are referred to as “pyroluria.” I recommend this term in German-speaking countries as well.

KPU

Full Name: Kryptopyrroluria

Common Term:
Pyrroluria (English: Pyrrolics)

Substance Detected in Urine:
2,4-Dimethyl-3-Ethylpyrrole

Treatment: almost identical

HPU

Full Name: Hemopyrrollactamuria (HPU)

Common Term:
Pyrroluria (English: Pyrrolics)

Substance Detected in Urine:
5-Hydroxy-Hemopyrrollactam Zinc Chelate Complex

Treatment: almost identical

From the blog

Keto for HPU: How a Ketogenic Diet Can Help

A ketogenic diet is a very low-carbohydrate way of eating in which the body primarily uses ketone bodies instead of glucose for energy production. Is this beneficial for someone with HPU?

Magnesium threonate in HPU – What it does in the brain and why it is different?

Magnesium-Threonat kann die Blut-Hirn-Schranke besser überwinden als alle anderen Magnesiumverbindungen und eignet sich daher besonders für HPUler mit kognitiven Problemen, Brainfog und dauerhafter Erregung des Nervensystems.

Firm connective tissue in HPU: Collagen, but which one?

Collagen is good for connective tissue. But what if you can’t tolerate it? This is the case for many people with HPU, because sufficient stomach acid is needed to digest collagen.

Disclaimer and general information on medical topics:

The content presented here is for informational and educational purposes only. The texts make no claim to completeness, nor can the accuracy, timeliness, or balance of the information provided be guaranteed. These texts are in no way a substitute for professional medical advice from a doctor or pharmacist and should not be used as a basis for self-diagnosis or for starting, changing, or stopping any treatment for illnesses. Always consult your doctor with any health questions or concerns! I assume no liability for any inconvenience or damage resulting from the use of the information presented here.