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Catecholamines in Urine

Test Overview

A test for catecholamines measures the amount of the hormones epinephrine, norepinephrine, metanephrine, and dopamine in the urine. These catecholamines are made by nerve tissue, the brain, and the adrenal glands. Catecholamines help the body respond to stress or fright and prepare the body for "fight-or-flight" reactions.

The adrenal glands make large amounts of catecholamines as a reaction to stress. The main catecholamines are epinephrine (adrenaline), norepinephrine (noradrenaline), and dopamine. They break down into vanillylmandelic acid (VMA), metanephrine, and normetanephrine, which are passed in the urine. The amounts of VMA, metanephrine, and normetanephrine also are usually measured during a catecholamine test.

Catecholamines increase heart rate, blood pressure, breathing rate, muscle strength, and mental alertness. They also lower the amount of blood going to the skin and intestines and increase blood going to the major organs, such as the brain, heart, and kidneys.

Certain rare tumors (such as a pheochromocytoma) can increase the amount of catecholamines in the blood and urine. The increased amount can cause high blood pressure, excessive sweating, headaches, fast heartbeats (palpitations), and tremors.

Why It Is Done

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

How To Prepare

You may be asked to avoid the following foods and fluids for 2 to 3 days before having this test:

  • 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
  • Aspirin

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

Be sure to keep warm during the 24-hour urine test because being cold can increase your catecholamine levels.

Drink plenty of fluids during the 24-hour time period to avoid dehydration.

Many medicines may change the results of this test. Be sure to tell your doctor about all the nonprescription 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, including aspirin, or nonprescription diet pills for 2 weeks before the test.

Talk to your doctor about any concerns you have regarding 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

24-hour urine sample

  • 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 and then pour the urine into the large container. Do not touch the inside of the container with your fingers.
  • Keep the large container in the refrigerator for the 24 hours.
  • Empty your bladder for the final 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

There is no pain while collecting a 24-hour urine sample.

Risks

There is no chance for problems while collecting a 24-hour urine sample.

Results

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

Normal

The normal values listed here—called a reference range—are just a guide. These ranges vary from lab to lab, and your lab may have a different range for what's normal. Your lab report should contain the range your lab uses. Also, your doctor will evaluate your results based on your health and other factors. This means that a value that falls outside the normal values listed here may still be normal for you or your lab.

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 may 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 (pheochromocytoma) or another type of tumor that makes catecholamines is present.
  • Any major stress, such as burns, a whole-body infection (sepsis), illness, surgery, or traumatic injury, can cause high catecholamine levels.
  • Many blood pressure medicines can also cause high catecholamine levels.

Low values

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

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

  • Doing physical exercise.
  • Having extreme emotional stress.
  • Having surgery, injury, or illness.
  • Taking certain medicines, such as aspirin, nitroglycerin, tricyclic antidepressants, tetracycline, theophylline, or some blood pressure medicines.
  • Using nicotine, alcohol (ethanol), or cocaine.
  • Taking nonprescription cough, cold, or sinus medicines.
  • Eating or drinking foods with caffeine.

What To Think About

  • The 24-hour urine test is better for finding high levels of catecholamines than a blood test. For more information on 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

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Alan C. Dalkin, MD - Endocrinology
Last Revised June 20, 2012

Last Revised: June 20, 2012

Author: Healthwise Staff

Medical Review: E. Gregory Thompson, MD - Internal Medicine & Alan C. Dalkin, MD - Endocrinology

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