For this test, you must collect your urine in a special bag or container every time you urinate for a 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 lab or to your provider as soon as possible.

Stress and heavy exercise may affect the test results.

Some foods can increase catecholamines in your urine. You may need to avoid the following foods and beverages for several days before the test:

• Bananas
• Chocolate
• Citrus fruits
• Cocoa
• Coffee
• Licorice
• Tea
• 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.

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

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

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

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: 71 to 485 micrograms (mcg)/24 hours [464 to 3167 nanomole (nmol)/24 hours]
• Epinephrine: 1 to 14 mcg/24 hours (5 to 76 nmol/24 hours)
• Metanephrine: 24 to 96 mcg/24 hours (some labs give the range as 140 - 785 mcg/24 hours)
• Norepinephrine: 14 to 120 mcg/24 hours (83 to 709 nmol/24 hours)
• Normetanephrine: 75 to 375 mcg/24 hours
• Total urine catecholamines: 14 to 110 mcg/24 hours
• VMA: 0 to 7 milligrams (mg)/24 hours (0 to 35 micromol/24 hours)

Normal value ranges may vary slightly among different labs. Talk to your provider about the meaning of your specific test results.

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

Elevated levels of urinary catecholamines may indicate:

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

The test may also be performed for:

• Multiple endocrine neoplasia (MEN) II

There are no risks.

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

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

Guber HA, Oprea M, Russell YX. Evaluation of endocrine function. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 25.

Young WF. Adrenal medulla, catecholamines, and pheochromocytoma. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 209.

Updated by: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.