Porphyrins Profile - Urine

The Porphyrins Profile can help identify the severity of heavy metal toxicity or organic chemical exposure in patients. Chemical exposure and a heavy toxic burden can have physiological effects resulting in impaired metabolism and cellular function.

Porphyrin testing also helps you monitor therapy in your patients.

Porphyrin testing helps identify:

• Levels of biochemical damage caused by toxicant exposure
• Physiologic burden of a person's level of toxins
• Levels of porphyrin elevation correlated with levels of toxic interference
• Toxicity of patients before and during chelation therapy
• Toxicity of therapeutic drugs

Why Evaluate Porphyrins?

Porphyrins are proteins involved in the formation of heme measured in urine. Heme is essential for the proper function of many proteins including oxygen transport, energy production, and detoxification. Proper porphyrin production is essential for our body's capacity to detoxify toxins.

Porphyrins are particularly well suited for assessing heavy metal toxicity. First, the heme pathway is a constantly-changing pathway that is active in almost every cell of the body. Any disturbance in the pathway tends to cause rapid and relatively large accumulations of intermediates, such as porphyrins. Second, the enzymes of the pathway are widely distributed in human tissues, and are highly sensitive to the presence of various toxins, creating the large accumulation of porphyrins in the pathway.

Porphyrins and Autism

Studies are demonstrating urinary porphyrin testing is successful in:

• Demonstrating the role of mercury in ASD populations
• Identifing the physiologic burden of children and adults exposed to mercury
• Tracking mercury excretion from affected children undergoing treatment

Test name(s)

0060 - Porphyrins Profile*

Description

The Porphyrins Profile evaluates the biomarkers of toxicity. Patterns of specific porphyrin elevations in urine may serve as functional markers of toxicity from toxic metals, such as mercury, lead, arsenic, or other organic chemicals. The Porphyrins Profile measures seven porphyrins, total porphyrins, and two ratios to help you differentiate heavy metal toxicity, as well as monitor therapy in your patient.

Method

LC/MS-MS

Turnaround time

10 - 14 days, 10 days average

Analytes

Uroporphyrin I and III
Heptacarboxyporphyrinogen
Hexacarboxyporphyrinogen
Pentacarboxyporphyrinogen
Precoproporphyrin**
Coproporphyrinogen I
Coproporphyrinogen III
Total porphyrins
Pre/Uro I & III Ratio
Copro I/Copro III Ratio

 

*Not available in New York

**Atypical porphyrin consistent with precoprophyryrin reported in the literature.^1,2 
Precoproprophyrin is reported as a ratio of peak area to internal standard peak area in units of response/g creatinine

1. J.S. Woods, M.A. Bowers, H.A. Davis, Toxicology and Applied Pharmacology 110, 464-476 (1991).
2. D. Echeverilia et. al., Neurotoxicology and Teratology 28 (2006) 39-48.

Specimen Collection Instructions

• Porphyrins-KI.pdf

Sample Reports Example of how test results will be reported, including reference ranges and graphs indicating high and low percentiles of each analyte.

• Porphyrins-SR.pdf

Interpretive Guides Information on individual analytes and possible patterns that may be indicated on your test results. Further supplement recommendations, diet modifications, and other treatment options may also be included to help guide your treatment.

• Porphyrins-IG.pdf

Patient Briefs

• Porphyrins-PB.pdf

Additional Downloads

• Autism Brochure

If you do not have the free Adobe Acrobat Reader, download it here.

Articles

• President's Cancer Panel: Reducing Environmental Cancer Risk - With the growing body of evidence linking environmental exposures to cancer, the public is becoming increasingly aware of the unacceptable burden of cancer resulting from environmental and occupational exposures that could have been prevented through appropriate national action.
• Choosing the Best Specimen for Element Testing - There is no single best specimen for simultaneous, optimal status assessment of essential elements and toxic heavy metals. For each element there are merits and limitations of the specimens commonly tested.

Books

• Laboratory Evaluations for Integrative and Functional Medicine - Your evidence-based resource for the biochemical basis of chronic illness. A must-have desk reference for laboratory testing associated with nutritional and metabolic medicine.

LEIFM Excerpts

• Urinary Porphyrin Profiling - Porphyrinopathy is an umbrella term for any disorder in porphyrin metabolism. This book excerpt explains what porphyrins are and how urine testing can detect their metabolic disorders and toxic effects.

Podcasts

• Toxic Metal Assessment in Children with ASD - Listen to this discussion with Julie Matthews and David Traver, MD on the complicated topic of toxic metal assessment in children with ASD.
• Why is it important to understand total toxic body burden? - Part 1 - With so much in the news today about toxicity and the environment, it’s hard to ignore the chatter and and how it affects our health. Time to ask someone in the know.
• Why should we test for toxic exposure? - Part 2 - This is the second installment of my conversation with Dr. Walter Crinnion on toxicity and the environment. He is a wellspring of information on this subject, and he answers the question about the need for testing in this week's podcast.
• How do toxins affect mitochondria? - Part 3 - In this third installment of my conversation with Dr. Walter Crinnion, we consider the function of the mitochondria, those “cellular power plants” that provide most of our cell’s supply of adenosine triphosphate (ATP).
• Immunotoxicity - First to the party - Part 4 - We take a deeper look into how toxins affect the immune system this week. Dr. Crinnion says immunotoxicity is usually the first problem that shows up in a person’s history, typically manifesting itself as allergies or asthma...
• Hey Fathead, your brain is an easy target for toxins - Part 5 - The brain is one of the largest fatty organs in our body. Dr. Crinnion says that many environmental toxins are fat-soluble and easily pass the blood/brain barrier.
• Who’s your mama? Is your generation at risk? - Part 6 - The endocrine system is another major target of environmental compounds. Did you know this system directly affects fertility and reproduction? Dr. Crinnion shares a story about the result of persistent, man-made chemicals being transfered from across generations...
• Which test is best? - Part 7 - With so many tests available to clinicians, it can be overwhelming for them to determine which one is the best for their patients. In this podcast, Dr. Crinnion gives his suggestions on testing for toxic exposure.
• Autism and Laboratory Testing - April is the month where many organizations focus on raising awareness of autism, and Metametrix would like to contribute by generating awareness of the laboratory tests that can help to uncover metabolic factors that may be treated in each individual with this complex disease.

Presentations

• Evaluating Environmental Effects on the Body's Biochemistry and Cancer - This presentation explores the impact of environmental toxins on the body's metabolism. There are over 80,000 chemicals on the market that we are exposed to, with the added insult of combined exposures being more toxic to the body. Metametrix testing is explored and various analytes are explained as markers for toxicity.
• IFM: The New Paradigm of Medicine - This PowerPoint presentation was developed by the Institute for Functional Medicine. It provides a concise explanation of the new paradigm of medicine that focuses on underlying causes of disease and treatment from that level rather treating symptoms alone, the approach often taken by modern medicine.
• Laboratory Markers of Toxins and Detoxification - PowerPoint presentation on the detection of toxic burden in the body.
• Interpreting Urinary Porphyrin Profiles - Richard Lord and Terry Pollock discuss five cases of high porphyrin marker levels and the significance of each case.

References

• Porphyrins References