5-HIAA Urine Test – Indications, Procedures, Results

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Article Summary

HIAA; 5-hydroxy indole acetic acid; Serotonin metabolite 5-Hydroxyindoleacetic acid (5-HIAA) is the main metabolite of serotonin. In the chemical analysis of urine samples, 5-HIAA is used to determine serotonin levels in the body.5-HIAA is a urine test that measures the amount of 5-hydroxy indole acetic acid (5-HIAA). 5-HIAA is a breakdown product of a hormone called serotonin. 5-HIAA is a urine test that measures the amount of 5-hydroxyindoleacetic acid (5-HIAA). 5-HIAA is a...

Key Takeaways

  • This article explains How the Test is Performed in simple medical language.
  • This article explains How to Prepare for the Test in simple medical language.
  • This article explains How the Test will Feel in simple medical language.
  • This article explains Why the Test is Performed in simple medical language.
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Definition

HIAA; 5-hydroxy indole acetic acid; Serotonin metabolite

5-Hydroxyindoleacetic acid (5-HIAA) is the main metabolite of serotonin. In the chemical analysis of urine samples, 5-HIAA is used to determine serotonin levels in the body.5-HIAA is a urine test that measures the amount of 5-hydroxy indole acetic acid (5-HIAA). 5-HIAA is a breakdown product of a hormone called serotonin.

5-HIAA is a urine test that measures the amount of 5-hydroxyindoleacetic acid (5-HIAA). 5-HIAA is a breakdown product of a hormone called serotonin. This test tells how much 5-HIAA the body is producing. It is also a way to measure how much serotonin is in the body.

This test tells how much 5-HIAA the body is producing. It is also a way to measure how much serotonin is in the body. 5-HIAA is tested by 24-hour urine samples combined with an acidic additive to maintain pH below 3. Certain foods and drugs are known to interfere with the measurement. 5-HIAA levels can vary depending on other complications, including tumors, malfunction, and small bowel resection.

Since 5-HIAA is a metabolite of serotonin, testing is most frequently performed for the of carcinoid tumors of the enterochromaffin (Kultschitzsky) cells of the , which release large amounts of serotonin. Values greater than 25 mg per 24 hours (higher if the patient has ) are strong evidence of carcinoid. The normal range is 2 to 6 mg per 24 hours.[rx]

Low levels of 5-HIAA in the cerebrospinal fluid have been associated with aggressive behavior and suicide by violent means, correlating with diminished serotonin levels.[rx]

Elevated serotonin (hyperserotonemia) is one of the most common biological findings in autism[rx] and 5-HIAA may be elevated in patients with autistic spectrum disorders.

How the Test is Performed

A 24-hour urine sample is needed. You’ll need to collect your urine over 24 hours in a container provided by the laboratory. Your health care provider will tell you how to do this. Follow instructions exactly.

How to Prepare for the Test

Your provider will instruct you, if necessary, to stop taking medicines that may interfere with the test.

Medicines that can increase 5-HIAA measurements include acetaminophen (Tylenol), acetanilide, phenacetin, glyceryl guaiacolate (found in many syrups), methocarbamol, and reserpine.

Medicines that can decrease 5-HIAA measurements include heparin, isoniazid, levodopa, monoamine oxidase inhibitors, methenamine, methyldopa, phenothiazines, and tricyclic antidepressants.

You will be told not to eat certain foods for 3 days before the test. Foods that can interfere with 5-HIAA measurements include plums, pineapples, bananas, eggplant, tomatoes, avocados, and walnuts.

How the Test will Feel

The test involves only normal urination, and there is no discomfort.

Why the Test is Performed

This test measures the level of 5-HIAA in the urine. It is often done to detect certain tumors in the digestive tract ( carcinoid tumors ) and to track a person’s condition.

The urine test may also be used to diagnose a disorder called mastocytosis and some tumors of the hormone.

Normal Results

The normal range is 2 to 9 mg/24h (10.4 to 46.8 µmol/24h).

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

Abnormal results may be due to:

  • Tumors of the endocrine system or carcinoid tumors
  • Systemic mastocytosis

Risks

There are no risks with this test.

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Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

General physician, urologist, nephrologist, or gynecologist depending on symptoms.

What to tell the doctor

  • Write burning, frequency, fever, flank pain, blood in urine, pregnancy, diabetes, and previous UTI history.

Questions to ask

  • Is this UTI, stone, prostate problem, diabetes-related, or another cause?
  • Do I need urine culture before antibiotics?

Tests to discuss

  • Urine routine/microscopy
  • Urine culture for recurrent/severe infection or treatment failure
  • Blood sugar and kidney function when indicated
  • Ultrasound if stone/obstruction/recurrent symptoms

Avoid these mistakes

  • Avoid self-starting antibiotics; wrong antibiotic can cause resistance.
  • Seek urgent care for fever with flank pain, pregnancy, vomiting, confusion, or inability to pass urine.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider
Tests to discuss with doctor
  • Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
  • Relevant blood, urine, imaging, or specialist tests only after clinical assessment
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: 5-HIAA Urine Test – Indications, Procedures, Results

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.