Fatigue syndromes revisited: the possible role of porphyrins.

The author sees many patients with chronic oral problems of unknown etiology. It has been noticed that many of these patients also have complex medical histories. Fatigue and pain are two of the most common features observed. Some, but not all, also have other definitive medical diagnoses. Those patients with appropriate symptoms have been tested for porphyrins and porphyrin enzyme activity. Advances in molecular biology have led to the availability of a number of porphyrin enzymes for routine testing. The results are interesting and suggest abnormal porphyrin metabolism may be more prevalent than is currently thought.