Do I have HPU?

HPU is diagnosed via urine

An HPU test measures the hemopyrrols excreted with the urine, which have bound vital substances such as zinc, vitamin B6 and manganese. The chemically correct name for the complex excreted with urine in HPU is 5-hydroxy haemopyrrollactam-zinc chelate complex.

The urine test tube contains vitamin C, which keeps the 5-hydroxy haemopyrrollactam-zinc chelate complex stable for 5 days. The urine sample should then be analysed at the latest.

Tip: Avoid samples that arrive in the laboratory on Saturdays.

Morning urine test or 24-hour urine test?

On the KEAC website you will find both a morning urine test and a 24-hour urine collection test. Both measure the same pyrroles. Since about 5% of HPU sufferers do not excrete pyrrole until after a warm main meal, the morning urine in these people would be negative.
The 24-hour collection urine test is a little bit more expensive and time-consuming to perform, but the result is certain.

The HPU test from KEAC

The original test was developed by Dr. Kamsteeg in the Netherlands, who discovered HPU in 2000. Kamsteeg founded his research institute called KEAC (Clinical Ecological Allergy Centre) in 1989. To this day, the institute conducts research on HPU, thyroid diseases and environmental diseases.

You can order the keac HPU-Testkit® in Holland via the KEAC website.

KEAC-HPU-Test® costs

24-hour HPU test:


65,50 Euro + 7,50 Euro Shipping

(+ VAT if the test is not obtained from a therapist)

Morning urine HPU test:

53,63 Euro + 7,50 Euro Shipping

(+ VAT if the test is not obtained from a therapist)

Attention: The morning urine test should take place with the 1st urine in the morning. If you go to the toilet during the night, the result may be falsified.

You should observe these points in the HPU-Test® according to KEAC:

  • Do not take zinc, vitamin B6 (or the activated form P5P), manganese or biotin as food supplements for 14 days before the test. Otherwise the test may be false negative.
  • Do not test during or shortly after antibiotic treatment. Antibiotics can also negatively affect the amount of HPL excreted.
  • Do not test during or shortly after menstruation. During and in the first days after menstruation, the amount of excreted HPL complexes is greatly reduced. The highest values are measured around ovulation and shortly before menstruation.
  • Do not test if you have drunk large amounts of alcohol the day before.
  • Do not test immediately after an iron infusion. The test will then be negative.
  • The test should arrive in the laboratory as soon as possible. Avoid sending the test shortly before the weekend.

Other HPU Tests

The company Medivere also offers a test that, according to its own statements, “probably detects haemopyrrole in morning urine”. While KEAC’s patented test method is based on antibodies that specifically detect the hemopyrrollactam complex, Medivere’s test is based on a less specific separation method (HPLC) of pyrroles in urine. It cannot be excluded that other pyrroles other than the hemopyrrollaktam complex may be detected. These can also be excreted after extreme stress or toxin exposure, for example.

Why micronutrient analysis is not enough to diagnose HPU

HPU can cause a chronic deficiency of zinc, vitamin B6 and/or manganese. This suggests that a diagnosis can be made on the basis of a blood count alone. But not with each HPU patient a lack is present with all 3 micro nutrients.
The following blood values can indicate a HPU:

  • P5P (active form of vitamin B6) reduced
  • Homocysteine increased
  • LDL and cholesterol increased
  • Biotin degraded
  • Leukocytes lowered
  • Zinc reduced
  • MCV or MCHC increased
  • alkaline phosphatase (zinc dependent enzyme) reduced
  • Red cells reduced

HPU patients may even have elevated levels of vitamin B6, as the impaired metabolism cannot utilize the non-activated vitamin B6.

The body needs energy in the form of ATP to absorb vitamin B6 from the blood. It is precisely this energy that HPU sufferers often lack because HPU is often associated with mitochondriopathy (a weakness of the mitochondria) and thus with ATP deficiency. This manifests itself in exhausted, chronically tired patients who often suffer from anemia (anaemia, reduction of the haemoglobin concentration in the blood).

What is the difference between HPU and KPU?

KPU = Cryptopyrrolluria, HPU = Hemopyrrollaktamuria

Tabelle auf Smartphone bitte scrollen
AbbreviationKPUHPU
Full NameCryptopyrrolluriaHemopyrroluria
Common NamePyrroleuria (Pyrrolics)
Substance detected in urine2,4-dimethyl-3-ethylpyrrole5-hydroxy-hemopyrrollactam-zinc chelate complex
Cost of proof Cheap (approx. 30 Euro)Expensive (approx. 85 Euro)
TherapyAlmost the same

HPU and KPU are both disorders of heme metabolism, but not identical. Kamsteeg, for example, describes: “42 percent of people with HPU have (anti-TPO) antibodies in their blood against the thyroid gland. This high percentage is not found in KPU.

Why a KPU test does not diagnose HPU

HPU and KPU (cryptopyrroluria) are similar but not identical. In both metabolic disorders, pyrroles are excreted, which the body incorrectly assembles due to enzymatic weaknesses and then has to excrete due to their toxic effect. KPU excretes 2,4-dimethyl-3-ethylpyrrole (cryptopyrrole), HPU excretes 5-hydroxy-hemopyrrollactam-zinc chelate complex (HPL).

The KPU was already discovered in the 1960s – HPU only 40 years later. The KPU test is carried out quite unspecifically with the Ehrlich reagent and is always positive when there are pyrroles in the urine. This can also be the case, for example, after taking certain drugs or after exposure to toxins. Dysbioses in the intestine can also lead to the excretion of pyrroles.

HPU detection, on the other hand, is much more accurate. It only detects HPL, which is exclusively associated with HPU.

A high-dose micronutrient therapy over a longer period of time should only be considered in the case of a positive HPU test.