Norepinephrine — blood; Epinephrine — blood; Adrenalin — blood; Dopamine — blood

This test measures the levels of catecholamines in the blood. Catecholamines are hormones made by the adrenal glands.

Catecholamines are more often measured with a urine test than with a blood test.

How the Test is Performed

A blood sample is needed.

How to Prepare for the Test

You will likely be told not to eat anything (fast) for 10 hours before the test. You may be allowed to drink water during this time.

The accuracy of the test can be affected by certain foods and medicines. Foods that can increase catecholamine levels include:

• Coffee
• Tea
• Bananas
• Chocolate
• Cocoa
• Citrus fruits
• Vanilla

You should not eat these foods for several days before the test. This is especially true if both blood and urine catecholamines are to be measured.

You should also avoid stressful situations and vigorous exercise. Both can affect the accuracy of the test results.

Medicines and substances that can increase catecholamine measurements include:

• Acetaminophen
• Albuterol
• Aminophylline
• Amphetamines
• Buspirone
• Caffeine
• Calcium channel blockers
• Cocaine
• Cyclobenzaprine
• Levodopa
• Methyldopa
• Nicotinic acid (large doses)
• Phenoxybenzamine
• Phenothiazines
• Pseudoephedrine
• Reserpine
• Tricyclic antidepressants

Medicines that can decrease catecholamine measurements include:

• Clonidine
• Guanethidine
• MAO inhibitors

If you take any of the above medicines, check with your health care provider before the blood test about whether you should stop taking your medicine.

How the Test will Feel

When the needle is inserted to draw blood, some people feel slight pain. Others feel a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon goes away.

Why the Test is Performed

Catecholamines are released into the blood when a person is under physical or emotional stress. The main catecholamines are dopamine, norepinephrine, and epinephrine (which used to be called adrenalin).

This test is used to diagnose or rule out certain rare tumors, such as pheochromocytoma or neuroblastoma . It may also be done in patients with those conditions to determine if treatment is working.

Normal Results

The normal range for epinephrine is 0 to 900 pg/mL.

The normal range for norepinephrine is 0 to 600 pg/mL.

Note: Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

Higher-than-normal levels of blood catecholamines may suggest:

• Acute anxiety
• Ganglioblastoma (very rare tumor)
• Ganglioneuroma (very rare tumor)
• Neuroblastoma (rare tumor)
• Pheochromocytoma (rare tumor)
• Severe stress

Additional conditions under which the test may be performed include Shy-Drager syndrome .

Risks

Veins and arteries vary in size from one patient to another, and from one side of the body to the other. Taking blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight, but may include:

• Excessive bleeding
• Fainting or feeling lightheaded
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

Catecholamines – urine

Dopamine-urine test; Epinephrine-urine test; Adrenalin-urine test; Urine metanephrine; Normetanephrine; Norepinephrine-urine test; Urine catecholamines; VMA; HVA; Metanephrine; Homovanillic acid (HVA)

Catecholamines are chemicals made by nerve tissue (including the brain) and the adrenal gland.

The main types of catecholamines are dopamine, norepinephrine, and epinephrine. These chemicals break down into other components, which leave your body through your urine.

A urine test can be done to measure the level of catecholamines in your body. Separate urine tests may be done to measure related substances.

Catecholamines can also be measured with a blood test .

How the Test is Performed

For this test, you must collect your urine in a special bag or container every time you urinate for 24-hour period.

• On day 1, urinate over the toilet when you wake up in the morning and discard that urine.
• Urinate into the special container every time you use the bathroom for the next 24 hours. Keep it in the refrigerator or a cool place during the collection period.
• On day 2, urinate into the container in the morning again when you wake up.
• Label the container with your name, the date, the time of completion, and return it as instructed.

For an infant, thoroughly wash the area where urine exits the body.

• Open a urine collection bag (a plastic bag with an adhesive paper on one end).
• For males, place the entire penis in the bag and attach the adhesive to the skin.
• For females, place the bag over the labia.
• Diaper as usual over the secured bag.

This procedure may take a few tries. An active baby can move the bag causing urine to go into the diaper.

Check the infant often and change the bag after the infant has urinated into it. Drain the urine from the bag into the container provided by your health care provider.

Deliver the sample to the laboratory or to your provider as soon as possible.

How to Prepare for the Test

Stress and heavy exercise may affect the test results.

Some foods can increase catacholamines in your urine. You may need to avoid the follow foods for several days before the test:

• Coffee
• Tea
• Bananas
• Chocolate
• Cocoa
• Citrus fruits
• Vanilla

Many medicines can interfere with test results.

• Your provider will tell you if you need to stop taking any medicines before you have this test.
• DO NOT stop or change your medicines without talking to your provider first.

How the Test will Feel

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

Why the Test is Performed

The test is usually done to diagnose an adrenal gland tumor called pheochromocytoma . It may also be used to diagnose neuroblastoma . Urine catecholamine levels are increased in most persons with neuroblastoma.

The urine test for catecholamines may also be used to monitor those who are receiving treatment for these conditions.

Normal Results

All of the catecholamines are broken down into inactive substances that appear in the urine:

• Dopamine becomes homovanillic acid (HVA)
• Norepinephrine becomes normetanephrine and vanillylmandelic acid (VMA)
• Epinephrine becomes metanephrine and VMA

The following normal values are the amount of the substance found in the urine over a 24-hour period:

• Dopamine: 65 to 400 micrograms (mcg)/24 hours (425 to 2610 nmol/24 hours)
• Epinephrine: 0.5 to 20 mcg/24 hours
• Metanephrine: 24 to 96 mcg/24 hours (some laboratories give the range as 140 to 785 mcg/24 hours)
• Norepinephrine: 15 to 80 mcg/24 hours (89 to 473 nmol/24 hours)
• Normetanephrine: 75 to 375 mcg/24 hours
• Total urine catecholamines: 14 to 110 mcg/24 hours
• VMA: 2 to 7 milligrams (mg)/24 hours (10.09 mcmol/24 hours)

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

Elevated levels of urinary catecholamines may indicate:

• Acute anxiety
• Ganglioneuroblastoma (very rare)
• Ganglioneuroma (very rare)
• Neuroblastoma (rare)
• Pheochromocytoma (rare)
• Severe stress

The test may also be performed for:

• Multiple endocrine neoplasia (MEN) II

Risks

There are no risks.

Considerations

Several foods and drugs, as well as physical activity and stress, can affect the accuracy of this test.