Antioxidant nutrients - oxidative stress is always involved; some researchers wonder to what degree it is causal. Take into account copper content in some antioxidant nutrients.
Essential fatty acids - with significant pyroluria, GLA is often more helpful than omega 3.
See Bibus/Walsh article at: http://www.biobalance.org.au/articles/15
Adrenal support - pyroluria is a stress disorder, taxing the adrenals. Adrenal support includes such nutrients as B5, C, B vitamins, etc., and attention to blood sugar issues.
Therapy for Candida or other illnesses (often fostered by the low B6 and zinc, critical nutrients for immune function).
Even the mildest stress (e.g., leaving the house) can produce major deterioration in some pyrolurics. Not all stressors can be avoided. Increased support with relevant nutrients is imperative when anticipating or undergoing, and for some time after, mental or physical stress (illness, fatigue, toxicity, psychosocial stress, etc).
Similarly, limiting exposure to toxins is important, to the degree possible. Consider also,
metal metabolism functionality.
Medication issues - particular care is warranted, as pyrolurics often react intensely to mediation, and to changes in med intake.
We have only skimmed the surface here. For further discussion on pyroluria, and for references, see my book, Natural Healing for Bipolar Disorder.
Reminder: The material in this blog is for educational purposes only. Actual treatment must be fine-tuned to each patient's unique biochemical requirements. So, if you need treatment for bipolar disorder or any other medical condition, consult a knowledgeable physician.