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Urine Total Porphyrins

Immunology & Autoimmune

Urinary Total PorphyrinsUTP

Review status

Currently under review

Pending specialist review and validation.

What it shows

This test measures the total amount of porphyrins in a urine sample. Porphyrins are natural chemicals your body uses to make heme, a key part of hemoglobin and other proteins. When the heme pathway is disrupted, porphyrins can build up and spill into the urine.

Your result is usually corrected for urine concentration by comparing porphyrins to creatinine, so it is reported as a ratio. The test serves as a broad screen and does not identify which specific porphyrins are present. If the total is increased, more detailed testing may be needed to pinpoint the cause.

Why it matters

Clinicians use urine total porphyrins to help evaluate possible porphyria, a group of conditions where heme production is altered. The test may be ordered if you have symptoms such as unexplained abdominal pain, nerve problems, darkening urine, or skin sensitivity to sunlight. It can also be used to support monitoring in people with a known porphyria.

Higher porphyrins are not specific to porphyria. They can also rise with liver disease, alcohol use, certain infections, or exposure to some drugs and toxins. Because of this, the test is often paired with other studies, such as urine porphobilinogen or fractionated porphyrin testing, to clarify the diagnosis and guide treatment.

Understanding your results

Many healthy people have very low porphyrins in urine. A higher result suggests increased production or decreased clearance of porphyrins, but by itself it does not confirm a particular type of porphyria. Your healthcare provider will interpret the result alongside your symptoms, medical history, medicines, and other lab tests.

If your result is elevated, the next steps may include repeating the test with careful light protection, doing a fractionated porphyrin profile, and adding tests such as urine porphobilinogen and delta‑aminolevulinic acid. Sometimes plasma, red blood cell, or stool porphyrins and genetic testing are recommended. Do not stop or start medicines on your own; review them with your clinician, who can also advise on avoiding potential triggers and when to seek specialist input.

Reference ranges

-- umol/mol creat.
All sexes
0 days – 16 years
043.7 umol/mol creat.
All sexes
16 years – 150 years

Reference intervals vary by laboratory, analyzer, methodology, population, and units. The ranges shown here are for education only. Always interpret your results against the reference interval printed on your own lab report.

Factors that could impact Urine Total Porphyrins

  • Light exposure and handling

    Porphyrins are light sensitive. Samples should be protected from light promptly, kept cool, and transported quickly to avoid breakdown that can falsely lower results.

  • Type of urine collection

    A random urine corrected for creatinine is commonly used, but a timed collection over a full day can be helpful in some cases. Incomplete collections can mislead interpretation.

  • Medications and substances

    Barbiturates, certain anticonvulsants, rifampin, estrogens, alcohol, and some herbal products can increase porphyrin excretion or interfere with interpretation. Always list all agents you take.

  • Liver and kidney function

    Liver disease can raise porphyrins, while kidney impairment can change excretion patterns and the creatinine ratio. Your provider may consider liver and kidney tests together with this result.

  • Intercurrent illness and stress

    Infections, fasting, dehydration, and physiologic stress can transiently alter porphyrin production. Testing during recovery or repeating when well may give a clearer picture.

  • Pregnancy and hormones

    Hormonal changes, including pregnancy or hormonal therapies, may influence porphyrin levels and clinical symptoms. Tell your clinician about pregnancy status and hormone use.

2026

References

  1. McGill University Health Centre. (2014, October 21). U Total Porphyrins (Task CD 11379916). Laboratory reference ranges.
  2. European Association for the Study of the Liver. (2017). EASL Clinical Practice Guidelines: Porphyrias. Journal of Hepatology.