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Catecholamines in Urine

Test Overview

Catecholamines (say "kat-uh-KOH-luh-meens") are hormones made mostly by your adrenal glands as a reaction to stress.

When you feel stressed, these hormones increase heart rate, blood pressure, breathing rate, muscle strength, and mental alertness. They also lower the amount of blood that goes to the skin and intestines. They increase blood going to the major organs, such as the brain, heart, and kidneys. This helps your body prepare for "fight-or-flight" reactions.

Your body breaks down these hormones and passes them into your urine. This test measures how much of these hormones are in your urine over a 24-hour period.

Why It Is Done

A catecholamine test is done to help diagnose a rare tumor in the adrenal glands called a pheochromocytoma.

Tumors like this can cause your adrenal glands to release too many hormones. And that can cause high blood pressure, excessive sweating, headaches, fast heartbeats, and tremors.

How To Prepare

You may be asked to avoid certain foods and fluids for 2 to 3 days before the test. They include:

  • Caffeine, such as coffee, tea, cocoa, and chocolate.
  • Amines. These are found in bananas, walnuts, avocados, fava beans, cheese, beer, and red wine.
  • Any foods or fluids with vanilla.
  • Licorice.

Do not use tobacco at all during the 24-hour urine collection.

Be sure to keep warm during the 24 hours. Being cold can raise your catecholamine levels.

Drink plenty of fluids during the 24 hours to avoid dehydration.

Many medicines can change the results of this test. Be sure to tell your doctor about all the over-the-counter and prescription medicines you take.

Your doctor may ask you to stop certain medicines, such as blood pressure medicines, before the test. Do not take cold or allergy remedies, aspirin, or diet pills for 2 weeks before the test.

Talk to your doctor about any concerns you have about the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?).

How It Is Done

This test is usually done at home. You must collect all the urine you produce in a 24-hour period.

  • You start collecting your urine in the morning. When you first get up, empty your bladder. But do not save this urine. Write down the time that you urinated to mark the beginning of your 24-hour collection period.
  • For the next 24 hours, collect all your urine. Your doctor or lab will usually provide you with a large container that holds about 1 gal (4 L). The container has a small amount of preservative in it. Urinate into a small, clean container. Then pour the urine into the large container. Don't touch the inside of the container with your fingers.
  • Keep the large container in the refrigerator when you aren't using it.
  • Empty your bladder for the last time at or just before the end of the 24-hour period. Add this urine to the large container, and record the time.
  • Do not get toilet paper, pubic hair, stool (feces), menstrual blood, or other foreign matter in the urine sample.

How It Feels

Taking a 24-hour urine sample does not cause pain.

Risks

A 24-hour urine sample doesn't cause any problems.

Results

A test for catecholamines measures the amount of the hormones epinephrine, norepinephrine, and dopamine in the urine. The test also usually measures the amounts of vanillylmandelic acid (VMA), metanephrine, and normetanephrine.

Normal

These numbers are just a guide. The range for "normal" varies from lab to lab. Your lab may have a different range. Your lab report should show what range your lab uses for "normal." Also, your doctor will evaluate your results based on your health and other factors. So a number that is outside the normal range here may still be normal for you.

Catecholamines in a 24-hour urine sample 1
Free catecholamines

Less than 100 micrograms (mcg) or less than 591 nanomoles (nmol)

Epinephrine

Less than 20 mcg or less than 109 nmol

Norepinephrine

15–80 mcg or 89–473 nmol

Dopamine

65–400 mcg or 420–2612 nmol

Normetanephrine

105–354 mcg or 573–1933 nmol

Metanephrine

74–297 mcg or 375–1506 nmol

Vanillylmandelic acid (VMA)

Less than 9 milligrams (mg) or less than 45 micromoles (mcmol)

Normal urine values vary in children depending on their age.

High values

  • High levels of free catecholamines, vanillylmandelic acid (VMA), or metanephrine can mean an adrenal gland tumor or other type of tumor is present.
  • Any major stress, such as burns, a whole-body infection (sepsis), illness, surgery, or traumatic injury, can cause high levels.
  • Many blood pressure medicines can also cause high levels.

Low values

Low values may be caused by diabetes or some nervous system problems.

What Affects the Test

You may not be able to have the test, or the results may not be helpful, if you:

  • Do physical exercise.
  • Have extreme emotional stress.
  • Have surgery, injury, or illness.
  • Take certain medicines, such as aspirin, nitroglycerin, tricyclic antidepressants, tetracycline, theophylline, or some blood pressure medicines.
  • Use nicotine, alcohol, or cocaine.
  • Take cough, cold, or sinus medicines.
  • Eat or drink foods with caffeine.

What To Think About

  • The 24-hour urine test is better than a blood test for finding high levels of catecholamines. To learn more about a catecholamine blood test, see the topic Catecholamines in Blood.

References

Citations

  1. Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.

Other Works Consulted

  • Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
  • Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
  • Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.

Credits

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Alan C. Dalkin, MD - Endocrinology

Current as ofSeptember 9, 2014

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