Other common triggers are exposure to paints, formaldehyde, glycol ethers, dioxins or metal dusts and fumes. Major sites of heme synthesis are red blood cells, liver, and blood forming cells in the marrow. Forty percent of total body heme is used for building P450 enzymes found in the liver, gut, kidneys, adrenal glands, ovaries, testes, placenta. During a porphyria attack, the body is unable to assemble prophyrin rings or heme, so the individual develops deficiencies of hemoglobin, cytochromes and enzymes seen above that require a prophyrin ring. As should be evident, this is a very complex, whole body syndrome.
Porphyria is probably the most under-diagnosed health problem today.
CNS and GI symptoms are the most common. Symptoms are caused not by high or toxic levels of chemicals but by the metabolic effects triggered by the exposure even to low levels of chemicals. The body thinks it needs more porphyrin rings in order to construct cytochrome P450 enzymes to breakdown the incoming chemicals, pushing porphyrin synthesis into overdrive and raising levels of ALA, from the first committed enzyme step. As seen below, the elevated ALA sets off a self-perpetuating loop that can inflame neurogenic inflammation described above. See ADHD article.