Catecholamine Tests

What are catecholamine tests?

Catecholamines are hormones made by your adrenal glands, two small glands located above your kidneys. These hormones are released into the body in response to physical or emotional stress. The main types of catecholamines are dopamine, norepinephrine, and epinephrine. Epinephrine is also known as adrenaline. Catecholamine tests measure the amount of these hormones in your urine or blood. Higher than normal levels of dopamine, norepinephrine, and/or epinephrine can be a sign of a serious health condition.

Other names: dopamine, norepinephrine, epinephrine tests, free catecholamines

What are they used for?

Catecholamine tests are most often used to diagnose or rule out certain types of rare tumors, including:

• Pheochromocytoma, a tumor of the adrenal glands. This type of tumor is usually benign (not cancerous). But it can be fatal if left untreated.
• Neuroblastoma, a cancerous tumor that develops from nerve tissue. It mostly affects infants and children.
• Paraganglioma, a type of tumor that forms near the adrenal glands. This type of tumor is sometimes cancerous, but usually grows very slowly.

The tests may also be used to see if treatments for these tumors are working.

Why do I need a catecholamine test?

You or your child may need this test if you have symptoms of a tumor that affect catecholamine levels. Symptoms in adults include:

• High blood pressure, especially if it is not responding to treatment
• Severe headaches
• Sweating
• Rapid heartbeat

Symptoms in children include:

• Bone pain or tenderness
• An abnormal lump in the abdomen
• Weight loss
• Uncontrolled eye movements

What happens during a catecholamine test?

A catecholamine test may be done in urine or blood. Urine testing is done more often because catecholamine blood levels can change quickly and may also be affected by the stress of testing.

But blood testing can be useful in helping to diagnose a pheochromocytoma tumor. If you have this tumor, certain substances will be released into the bloodstream.

For a catecholamine urine test, your health care provider will ask you to collect all urine during a 24-hour period. This is called a 24-hour urine sample test. For 24-hour urine sample test, your health care provider or a laboratory professional will give you a container to collect your urine and instructions on how to collect and store your samples. Test instructions usually include the following steps:

• Empty your bladder in the morning and flush that urine away. Record the time.
• For the next 24 hours, save all your urine passed in the container provided.
• Store your urine container in the refrigerator or a cooler with ice.
• Return the sample container to your health provider's office or the laboratory as instructed.

During a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You may be asked to avoid certain foods for two to three days before the test. These include:

• Caffeinated foods and drinks, such as coffee, tea, and chocolate
• Bananas
• Citrus fruits
• Foods that contain vanilla

You may also be asked to avoid stress and vigorous exercise before your test, as these can affect cathecholamine levels. Certain medicines may also affect levels. Be sure to tell your provider about all the medicines you are taking.

Are there any risks to the test?

There is no risk to having a urine test.

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

If your results show high levels of catecholamines in your urine or blood, it may mean you have a pheochromocytoma, neuroblastoma, or paraganglioma tumor. If you are being treated for one of these tumors, high levels may mean your treatment is not working.

High levels of these hormones does not always mean you have a tumor. Your levels of dopamine, norepinephrine, and/or epinephrine can be affected by stress, vigorous exercise, caffeine, smoking, and alcohol.

If you have questions about your results or your child's results, talk to your health care provider.

Is there anything else I need to know about catecholamine tests?

These tests can help diagnose certain tumors, but they can't tell whether the tumor is cancerous. Most tumors are not. If your results showed high levels of these hormones, your provider will probably order more tests. These include imaging tests such as a CT scan or an MRI, which can help your provider get more information about a suspected tumor.

Learn more about laboratory tests, reference ranges, and understanding results.