Pyrrole Questionnaire • Britt Barkman Naturopathy

Filling in the following questionnaire will give us a good indication of whether you may need to be tested or treated for what is known as Pyrolle disorder. Please tick yes or no for the following questions.

Name *

First

Last

Email *

Strong Indicators

Do you feel anxious, shy or fearful? Have you experienced inner tension since childhood, but hide this from others?

Yes
No

Do you have periods of depression or nervous exhaustion?

Yes
No

Do you experience poor dream recall, stressful or bizarre dreams, or nightmares (low vitamin B6)

Yes
No

Do you find that taking small amounts of tranquillisers, barbiturates, alcohol or other drugs give you a strong response? (low vitamin B6)

Yes
No

Do you prefer not to eat breakfast, experience light nausea in the morning, or tend to get motion sickness (low vitamin B6)

Yes
No

Do you tend to have white spots or flecks on the fingernails, or opaquely white or paper-thin nails? (low zinc)

Yes
No

Have you had a zinc taste test that resulted in a mild taste or tasting like water? This can be performed in clinic if you haven't had it done (low zinc)

Yes
No
Have never taken the challenge

Do you have poor appetite or a poor sense of smell or taste? (low zinc)

Yes
No

Do your joints pop, crack, or ache? Do you experience pain or discomfort between the shoulder blades; or cartilage problems? (low zinc)

Yes
No

Do you have pale or fair skin? Are you the palest in the family? Do you sunburn easily, now or when you were younger?

Yes
No

Do you dislike protein or have you ever been a vegetarian or vegan?

Yes
No

Are you sensitive to bright sunlight or noise?

Yes
No

Have you ever experienced upper abdominal pain on your left side under the ribs or, as a child, had a stitch in your side as you ran?

Yes
No

Do you have, or have you had frequent fatigue?

Yes
No

Do you tend to have iron anaemia or low ferritin levels?

Yes
No

Do you tend to have cold hands or feet?

Yes
No

Do you get frequent colds or infections, or unexplained chills or fevers?

Yes
No

Did you reach puberty later than normal or do you have irregular menstruation or PMS?

Yes
No

Do you have allergies, adrenal issues, or problems with sugar metabolism (low blood sugar)?

Yes
No

Do you know if you have neurotransmitter imbalances, especially low serotonin?

Yes
No

If you are a woman: do you belong to an all-girl family or have look-alike sisters?

Yes
No

If you are a man: did your mother come from an all-girl family; have a mother with look-alike sisters; or did all the females in your mother’s family bear a strong resemblance to each other?

Yes
No

Do you avoid stress because it upsets your emotional balance?

Yes
No

Do you tend to become dependent on one person whom you build your life around?

Yes
No

Do you prefer the company of one or two close friends rather than a gathering of friends and are you becoming more of a loner as you age?

Yes
No

Do you feel uncomfortable with strangers?

Yes
No

Are you bothered when you are seated in the middle of the room in a restaurant?

Yes
No

Do you find that you are easily upset by criticism?

Yes
No

Other Indicators

Do you have stretch marks or poor wound healing? (low zinc)

Yes
No

Are your upper front teeth crowded; do you have many cavities; inflamed gums or wear braces? (low zinc)

Yes
No

Do you experience bad breath and body odour (or a sweet, fruity odor), especially when ill or stressed? (low zinc)

Yes
No

Do you tend to get acne, eczema, herpes, or psoriasis?

Yes
No

Is the hair on your head, eyebrows, or eyelashes decreasing or prematurely greying?

Yes
No

Do you have difficultly recalling past events and people in your life?

Yes
No

Do you have a tendency to focus internally, on yourself, rather than on the external world?

Yes
No

Do you experience morning constipation?

Yes
No

Do you get tingling sensations or muscle spasms in your legs or arms?

Yes
No

Are you stressed by changes in your routine, such as travelling or being in new situations?

Yes
No

Does your face look swollen when you’re under a lot of stress?

Yes
No

Do you get cluster or blinding headaches?

Yes
No

Do you experience one or more of the following: a psychiatric disorder; schizophrenia; high or low histamine; alcoholism; learning or behavioural disorders; autism or Down syndrome?

Yes
No

This questionnaire is based on Trudy Scott's work on pyroluria and includes information from Chapter 7 of The Antianxiety Food Solution: How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood and End Cravings; Depression-Free Naturally (2001), by Joan Mathews-Larson; Nutrition and Mental Illness (1987), by Carl Pfeiffer, and Natural Healing for Schizophrenia and Other Common Mental Disorders (2001), by Eva Edelman.

Strong Indicators

Other Indicators

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