Welcome to the seventh article in The OCD series. I’m Francesca, a Nutritionist who has lived with OCD since I was 10. At age 15 and then again at age 29, I hit rock bottom with OCD – it was so distressing and debilitating that it left me feeling suicidal and at one point, partially housebound. Now, after investing time, money and effort in creating a mental health tool box and fighting for my health and happiness, I have been living largely free of OCD since 2012. And I’m sharing everything I’ve learned to support people with OCD who want to get their lives back.
The first article in The OCD series looked at a key nutritional tool that supports your nervous system and mental health. More recently, we've looked at the role of trauma in OCD and anxiety, and what my experience of OCD relapse was like.
This article returns the focus to nutritional biochemistry, and discusses stress-driven and genetic factors that can play a role in OCD and other mental health conditions, such as generalized anxiety, ADHD, childhood behavioural problems, tics, Bipolar Disorder, all types of depression and schizophrenia.
Pyrrole Disorder / Pyroluria
Teens and adults…. Are your moods on a rollercoaster? Do you explode in anger, affecting your relationships with loved ones, teachers and colleagues? Does sleep elude you? Low morning appetite?
Do stress and change make everything worse for you? Do you experience paranoia and delusional thoughts? Have you experienced ongoing nausea, abdominal pain or other gut issues that elimination diets haven’t helped?
Have you been diagnosed with depression, Bipolar Disorder, schizophrenia or OCD? Do you use alcohol or drugs to 'self-medicate'? Did your parents or grandparents use alcohol or drugs to 'self-medicate', too?
Mums and Dads…. Does your child cry easily and have frequent tantrums? Do they have little appetite? Get ill frequently, or become car sick easily? Have skin issues that creams from the doctor aren’t helping? Is keeping to their routines VERY important to them?
Do they struggle with concentration and learning? Have they been diagnosed with OCD, Bipolar Disorder, ADHD, learning difficulties or something else?
And do your son’s or daughter’s symptoms and behaviours get worse during growth spurts or times of change?
These can be red flags for pyroluria, also known as Pyrrole Disorder (and in the past, as Mauve factor or Malvaria). All humans produce pyrroles but when an excess of these is produced (identified by having a high concentration of pyrroles in your urine), many cognitive, affective and neurological symptoms can occur.
Pyroluria is not uncommon and nutrient therapy can be very supportive for reducing symptoms. It was first discovered in the 1950s by Doctors Abram Hoffer and Carl Pfeiffer, pioneers of nutrient therapy for mental health.
For the person with pyroluria, the pyrroles (byproducts of heamoglobin synthesis) bind to a number of nutrients, especially vitamin B6 and zinc, leaving them unavailable for use by your body. Note that B6 and zinc are particularly important for nervous and mental health, building neurotransmitters, magnesium absorption, building stomach acid, digestion, creating white blood cells, and immune function.
When B6 and zinc are bound by excessive pyrroles, they are rapidly excreted from your body via urine, meaning the person with pryoluria can become deficient or severely deficient in these nutrients. Stress seems to worsen pyroluria and it is thought it can have a genetic basis, with the disorder sometimes running in families.
Common signs that pyroluria should be investigated by your health professional:
poor appetite (especially in the morning)
aching or cracking joints
sensitivity to noise and bright lights
dislike of eating meat (can feel difficult to digest)
frequent colds and flus, infections
history of significant stress
And if you have OCD, one study found that zinc and other micronutrients like iron and magnesium were deficient in people affected by OCD. All these nutrients are needed to build neurotransmitters, and zinc in particular is also needed for neurotransmitter storage and release.
The good news – testing and treatment
A nutritionist or naturopath, particularly those who offer support for mental health, will be familiar with pyroluria and can support you with assessing the symptoms of pyroluria, arranging diagnostic testing (if desired) and giving you informed advice on diet, lifestyle, and high-quality supplements to help you reduce the symptoms of pyroluria/zinc and B6 deficiency.
It is possible to live well with pyroluria. A knowledgeable health professional will help you understand this condition and how it affects you, the required nutritional support and especially, why stress reduction is so important.
SNPs – genetic variations
Now let’s look at SNPs (pronounced ‘snips’ and stands for Single Nucleotide Polymorphisms). SNPs can affect your body’s nutritional needs and status, ability to detoxify and repair, and in turn, your mental health.
When cells within our bodies divide to make new cells, they copy our DNA structure. However, sometimes a single building block of DNA – known as a nucleotide – will be substituted by another during the copying process. These resulting alterations in our genetic code (for genes are made of DNA) are SNPs.
SNPs are fairly common and are passed from parents to their children. They are *not* ‘genetic mutations’, although they are sometimes incorrectly referred to this way. They are genetic variations.
It is estimated there are millions of different SNPs in humans, and some SNPs can affect human health. For example, you may have heard that women who have certain genetic variations are more likely to develop cancers of the breast and ovaries. This is why some women have genetic testing (especially if they have a family history of female cancers) and some even choose to undergo hysterectomy or mastectomy (as the actress Angelina Jolie did).
One way genetic variations can affect your mental and physical health is by reducing your body’s capacity, at enzymatic level, to metabolize specific nutrients. This can lead to being prone to deficiencies in certain nutrients, which can increase your likelihood of various health problems, physical and mental.
Perhaps some of the most well known genetic variants linked to mental health problems are variants on the MTHFR gene. We all have the MTHFR gene. It provides instructions for making the methylenetetrahydrofolate reductase enzyme involved in methylation, a process that occurs in almost all cells in your body. The methylenetetrahydrofolate reductase enzyme is also needed to metabolize vitamin B9, or folate, so folate/B9 deficiency is common among people who have this genetic variation, as is deficiency in vitamin B12. Because B vitamins are crucial for healthy function and structure of your nervous system, having an MTHFR genetic variation can lead to B vitamin deficiencies (especially B9 and B12) and mental health symptoms.
People with MTHFR variations can be more prone to OCD, depression, addiction, tics, Tourette Syndrome, schizophrenia, Bipolar Disorder, Parkinson’s disease, Alzheimer’s, chemical sensitivities, insomnia, fertility problems and possibly other mental health problems.
MTHFR SNPs are reported to be higher among Hispanics and Italians, and people of Hispanic and Italian descent. Although I have personally yet to be tested for MTHFR variations, I have Italian ancestry, and a history of low B12 and folate on my blood tests, and, of course, OCD. I have also seen a number of clients with Italian and Spanish ancestry who have either tested as having MTHFR variations, or whose blood work shows very low B12 and folate that can’t be explained by dietary choices (e.g., they are eating plenty of meats, fish and green vegetables, the best food sources of these nutrients).
The good news – testing and treatment
A nutritionist or naturopath can support you with arranging blood tests and thorough interpretation of these. What one health professional may have told you in the past is a “normal” or “fine” level of folate or B12 often is not, and this will be reflected in how you’re feeling, so keep seeking support until you find it.
A nutritionist or naturopath can also arrange testing for SNPs if you wish to delve deeper, and will guide you on nutrition and lifestyle tools to address deficiencies, support your unique genetic make up, and reduce the negative effects of your SNP.
Note that people with MTHFR SNPs need to be especially careful when taking supplements, as some supplements may worsen your symptoms by overloading your body with non-bioavailable forms of nutrients that your body has reduced ability to metabolize in the first place. Keep in mind that synthetic, non-bioavailable vitamins commonly found in supermarket and pharmacy supplements or some multilevel marketing supplements, such as folic acid or cyanocobalamin, aren’t formulated by knowledgeable health professionals.
So again, it is worth your health, happiness and future investing in seeing a qualified nutritionist or naturopath for support. We can provide you with nutritionally bioavailable supplements and safe dosing for your individual situation, that will help you feel better. Additionally, because stress, trauma, environment and poor diet play a significant role in triggering the effects of a SNP, supplementation alone isn’t a magic fix. Your nutritionist or naturopath can provide guidance around diagnostic testing, your food choices, sleep hygiene, the nutrient-depleting impacts of any medications you’re taking, stress reduction practises, knowledge of environmental chemicals to avoid, and more, to help you minimize the effects of any genetic variants.
It’s empowering to know our health isn’t determined solely by our genetics. You can take actions to support your physical and mental health and happiness, whichever genetic hand of cards you’re playing with.
I hope this article helps you better understand some common factors that may play a role in your mental health, or the mental health of someone you love.
If you’d like to learn more about how nutrition can support your OCD recovery, check out my ebook - it's the world's first evidence-based guide to Nutrition for Your OCD Recovery. I also offer online appointments worldwide.