Urinary Porphyrin Profile
Dr. Weyrich's Naturopathic Functional Medicine Notebook
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Test Overview
Urinary porphyrins are an indicator of heavy metal toxicity.Test Indications
- Suspected metal toxicity.
- Autism.
CPT CODES
| CPT-Code | Description | Comments |
|---|---|---|
| 84120 | Porphyrin, qualitative, each, ??? | * number of analates |
| 82570 | Creatinine |
Labs Performing Test
| Name of Lab | Lab Code | Estimated Cost | Processing Time | Comments |
|---|---|---|---|---|
| Great Plains | $109 | Cash discount and some insurance |
Costs cited are subject to change and may be reduced by insurance or cash discounts and increased by sample collection fees.
Theory
High levels of porphyrins may be caused by genetics, numerous environmental chemicals, drugs, diseases, and alcohol [GP, Doss2000, Elder1972].Younger children, in general, have much higher porphyrin values than older children [Shaw].
A small percentage (2.8 %) of patients on the autistic spectrum screened by The Great Plains Laboratory showed abnormal porphyrin results. The chelation challenge test is probably a more effective way to screen for heavy metal toxicity [Shaw].
Uroporphyrins (UP)
- High levels have been associated with As and Pb exposure [GP, Fowler1978]
- High levels have been associated with Porphyria cutanea tarda [GP, Doss2000]
- High levels are associated with acute intermittent porphyria and porphyria variegate [GP, Doss2000, Elder1972]
Heptacarboxy (7-CP)
- High levels have been associated with Porphyria cutanea tarda [GP, Doss2000]
Hexacarboxy (6-CP)
- High levels have been found in Autistic children [GP, Nataf2006]
Pentacarboxy (5-CP)
- High levels have been found in Autistic children [GP, Nataf2006]
- High levels have been associated with Hg exposure [GP, Woods1991, Woods1993, Woods1996]
- High levels are suggestive of Aluminum exposure [GP, Nasiadek2001]
Precoproporphyrin (PreCP)
- High levels have been found in Autistic children [GP, Nataf2006]
- High levels have been associated with Hg exposure [GP, Woods1991, Woods1993, Woods1996]
Coproporphyrins I, III (CP)
- High levels have been found in Autistic children [GP, Nataf2006]
- High levels have been associated with Hg exposure [GP, Woods1991, Woods1993, Woods1996]
- High levels have been associated with As and Pb exposure [GP, Fowler1978]
- High levels are associated with acute intermittent porphyria and porphyria variegate [GP, Doss2000, Elder1972]
Creatinine
Used to standardize concentration of sample.Precoproporphyrins
- Not included in Great Plains Laboratory test results, these are thought to be spurious [Shaw].
References
Unless specifically noted above, references used in the construction of this web page include the following:[FDM] Lecture notes from Functional Medicine University.
[SCNM] Lecture notes from Southwest College of Naturopathic Medicine.
[UT] Lecture notes from the University of Tennessee graduate programs in Chemistry and Biochemistry.
[GP] Great Plains Laboratory Physician Training lecture notes and documentation.
[Woods1991] Woods JS, Bowers MA, Davis HA. Urinary porphyrin profiles as biomarkers of trace metal exposure and toxicity: studies on urinary porphyrin excretion patterns in rats during prolonged exposure to methyl mercury. Toxicol Appl Pharmacol. 1991 Sep 15;110(3):464-76.
[Woods1993] Woods JS, Martin MD, Naleway CA, Echeverria D. Urinary porphyrin profiles as a biomarker of mercury exposure: studies on dentists with occupational exposure to mercury vapor. J Toxicol Environ Health. 1993 Oct-Nov;40(2-3):235-46.
[Woods1996] Woods JS. Altered porphyrin metabolism as a biomarker of mercury exposure and toxicity. Can J Physiol Pharmacol. 1996 Feb;74(2):210-5.
[Nataf2006] Nataf R, Skorupka C, Amet L, Lam A, Springbett A, Lathe R. Porphyrinuria in childhood autistic disorder: implications for environmental toxicity. Toxicol Appl Pharmacol. 2006 Jul 15;214(2):99-108.
[Fowler1978] Fowler BA, Mahaffey KR. Interactions among lead, cadmium, and arsenic in relation to porphyrin excretion patterns. Environ Health Perspect. 1978 Aug;25:87-90.
[Nasiadek2001] Nasiadek M, Chmielnicka J, Subdys J. Analysis of urinary porphyrins in rats exposed to aluminum and iron. Ecotoxicol Environ Saf. 2001 Jan;48(1):11-7.
[Doss2000] Doss MO, Kuhnel A, Gross U. Alcohol and porphyrin metabolism. Alcohol Alcohol. 2000 Mar-Apr;35(2):109-25.
[Elder1972] Elder GH, Gray CH, Nicholson DC. The porphyrias: a review. J Clin Pathol. 1972 Dec;25(12):1013-33.
[Shaw] Shaw W. Porphyrin testing and heavy metal toxicity: unresolved questions and concerns Web page accessed September 22, 2008.
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