Why Do I Feel on Top of the World One Day and Then on Others I Feel It Resting on My Shoulders?

Why do I feel like two different people?

One of the most common things I hear from women struggling with severe PMS or PMDD is, “I feel like two different people.” One week they may feel clear, motivated, connected, patient, and calm. Then suddenly, often in the days before their period, everything feels heavier. Their mood drops, anxiety increases, irritability feels harder to control, sleep changes, and even small stressors feel overwhelming.

If this sounds familiar, I want you to know that you are not being dramatic, weak, or “too sensitive.” Your body may be giving us clues that something deeper is going on.

One test I may consider ordering in this situation is a urine kryptopyrroles test, especially when I suspect a vitamin B6 deficiency or an increased need for B6 and zinc.

What are kryptopyrroles?

Kryptopyrroles are compounds that can be measured in the urine. In some integrative and functional medicine settings, elevated kryptopyrroles are thought to be associated with increased loss or increased need for nutrients such as vitamin B6 and zinc.

This matters because vitamin B6 and zinc are both deeply connected to mood, stress tolerance, hormone metabolism, neurotransmitter production, and nervous system regulation.

The urine kryptopyrroles test does not diagnose PMS, PMDD, anxiety, depression, or a COMT variant. It also does not directly measure vitamin B6 levels. Instead, I look at it as one possible clue in the larger clinical picture.

Why would I think about this test in PMS or PMDD?

PMS and PMDD are not simply “bad periods.” PMDD, in particular, can feel like a major nervous system shift that occurs in the luteal phase, which is the second half of the menstrual cycle after ovulation.

Many women describe feeling emotionally steady earlier in the month and then suddenly feeling anxious, depressed, rageful, overwhelmed, tearful, or disconnected from themselves before their period starts.

When I see this pattern, I am thinking about several things at once. I want to understand hormone sensitivity, neurotransmitter shifts, stress load, sleep quality, blood sugar stability, inflammation, nutrient status, genetic tendencies, gut health, trauma history, and how well the nervous system is recovering between stressors.

For some women, vitamin B6 becomes especially interesting because it plays a role in neurotransmitter pathways, including the production of serotonin, dopamine, GABA, norepinephrine, and melatonin. These chemical messengers influence mood, motivation, calm, sleep, focus, and emotional regulation.

Why vitamin B6 matters for mood

Vitamin B6 is one of those nutrients that does a lot of quiet work behind the scenes. It helps support the conversion of amino acids into neurotransmitters, which means it helps your brain make the chemicals involved in calm, motivation, pleasure, and emotional steadiness.

B6 is also involved in the production of GABA, one of the brain’s calming neurotransmitters. When GABA support is low, some people may feel more anxious, wired, irritable, overstimulated, or unable to settle.

This is one reason I may think about B6 when someone says, “I don't feel like myself before my period.”

Why zinc matters too

Zinc is another nutrient that often comes up in this conversation. Zinc supports immune function, hormone metabolism, gut health, neurotransmitter function, and the stress response.

Low zinc status may show up in different ways, including poor stress tolerance, low mood, irritability, poor wound healing, frequent illness, acne, changes in taste or smell, or poor appetite. Of course, these symptoms can have many causes, which is why testing and clinical context matter.

Where does COMT fit in?

COMT stands for catechol-O-methyltransferase. It is an enzyme involved in breaking down catecholamines, including dopamine, epinephrine, and norepinephrine. These are stimulating neurotransmitters involved in focus, motivation, stress response, and emotional intensity.

Some people have SNPs, or genetic variations, in the COMT gene that may affect how efficiently this pathway works. This does not mean something is “wrong” with you. It simply gives us information about how your body may process stress chemistry, estrogen byproducts, and stimulating neurotransmitters.

When someone has severe PMS or PMDD symptoms and a COMT SNP, I may pay closer attention to nutrient support, methylation balance, estrogen metabolism, stress response, and whether B6 deficiency or increased B6 need could be contributing to the picture.

Why COMT is not the whole picture

COMT can be an important part of the conversation, but it is not the whole story. The body is beautifully adaptive, and it rarely relies on one pathway alone. When one pathway is slower or under strain, other systems often step in to help maintain balance.

This is why I do not look at COMT in isolation. A person who is COMT Met/Met may process catecholamines like dopamine, norepinephrine, and epinephrine more slowly, but that does not automatically mean they will have PMS, PMDD, anxiety, or mood instability. Genetics are not a diagnosis.

However, when COMT is combined with other genetic patterns, such as MAO variants and MTHFR polymorphisms, the clinical picture may become more meaningful. MAO is also involved in neurotransmitter metabolism, while MTHFR plays a role in folate metabolism, methylation, homocysteine regulation, and downstream neurotransmitter support.

For example, if a woman is COMT Met/Met, has an MAO polymorphism, and is also heterozygous for an MTHFR SNP or homozygous for C677T, I may become more curious about how well her body is handling stress chemistry, estrogen shifts, methylation demand, and neurotransmitter turnover throughout the menstrual cycle.

This does not mean these SNPs “cause” PMDD. It means they may lower resilience in certain seasons of the cycle, especially when combined with chronic stress, poor sleep, inflammation, blood sugar swings, gut issues, trauma history, nutrient depletion, or low B6, zinc, folate, B12, magnesium, or iron status.

In other words, genes may load the gun, but environment, hormones, nutrition, stress, and nervous system regulation often pull the trigger.

This is one reason I may consider a urine kryptopyrroles test in someone with severe PMS or PMDD symptoms, especially when the symptom pattern suggests possible B6 and zinc depletion or increased need. I am not using the test to diagnose PMDD. I am using it to better understand whether nutrient-related stress may be one piece of the larger puzzle.

Why this topic matters to me

On a personal level, this is also why this topic matters to me. As someone who is COMT Met/Met and also has other SNPs that may influence neurotransmitter and methylation pathways, I understand how dramatic hormone-related mood shifts can feel. I also understand how empowering it can be to stop blaming yourself and start asking better questions about what your body may need.

That does not mean every woman with these SNPs will develop PMS or PMDD. But it does mean that, for some women, these patterns may offer useful clues. When the nervous system feels more sensitive, when stress feels harder to clear, and when mood shifts follow a predictable luteal-phase pattern, I want to look deeper than the surface.

When I may consider ordering a urine kryptopyrroles test

I may consider this test when someone has symptoms such as severe PMS or PMDD, anxiety that worsens before the period, irritability or rage in the luteal phase, poor dream recall, inner tension, stress intolerance, mood swings that feel out of proportion to the situation, or a known pattern of COMT, MAO, or MTHFR SNPs combined with significant hormone-related mood symptoms.

I may also consider it when someone has a history that suggests poor nutrient absorption, chronic stress, inflammation, restrictive eating, gut issues, or increased nutrient demand.

Again, this test is not used by itself. It is one piece of the puzzle.

What this test can and cannot tell us

A urine kryptopyrroles test may give us information about whether elevated kryptopyrroles could be contributing to an increased need for B6 and zinc support.

What it cannot do is diagnose PMDD, prove a B6 deficiency, or explain every mood symptom. PMDD is complex. It often involves hormone sensitivity, neurotransmitter shifts, stress physiology, inflammation, genetics, and life context.

This is why I never want one lab result to define a person. I want the lab to help us ask better questions.

Why I do not guess with supplements

Many people assume that because vitamins are “natural,” they are always safe. But more is not always better.

Vitamin B6 can be helpful for some people, but excessive dosing over time may cause side effects, including nerve symptoms. Zinc can also cause problems if taken in high doses without monitoring, including nausea and copper imbalance.

That is why I prefer a thoughtful approach. We look at your symptoms, your cycle pattern, your labs, your history, your medications, your genetics when available, and your overall clinical picture.

The bigger picture

If you feel incredible one week and then crushed by the weight of your own mood the next, your body is not betraying you. It is communicating.

My goal is not to label you as “hormonal.” My goal is to understand why your nervous system feels so different across the month.

For some women, a urine kryptopyrroles test may help us identify a possible nutrient-related piece of the puzzle, especially when B6 and zinc need support. For others, we may need to look more closely at thyroid function, iron status, B12, folate, vitamin D, inflammation, cortisol patterns, gut health, medication effects, trauma history, sleep, blood sugar, or hormone sensitivity.

You are not supposed to white-knuckle your way through half the month. There are reasons you feel the way you do, and there are ways to support your body more intentionally.

Work with me

If you recognize yourself in this pattern, there is a different way to approach it.

In my practice, we look at:

• your genetic predisposition

• how your body processes hormones

• your nervous system

• and how your system has been adapting over time

From there, we build a plan that supports your body—not just during your cycle, but consistently.

If you’re ready to feel more stable and understand what’s driving your symptoms, reach out to schedule a consultation.

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Disclaimer: This content is for educational purposes only and is not a substitute for personalized medical or psychiatric care. Individual needs vary. Please consult with a qualified healthcare provider before making changes to your treatment.