Catecholamines are a group of similar substances released into the blood in response to physical or emotional stress. The primary catecholamines are dopamine, epinephrine (adrenaline), and norepinephrine. Catecholamine testing measures the amounts of these hormones in the urine and/or blood. Urine testing is recommended over blood testing. Just the stress of having blood drawn can increase catecholamine blood levels, so results from blood tests are not as reliable as results from urine tests.

Normally, catecholamines and their metabolites are present in the body in small, fluctuating amounts that only increase appreciably during and shortly after a stressful situation. However, rare tumors called pheochromocytomas and paragangliomas (collectively called PPGL) can produce large amounts of the hormones, resulting in increased concentrations in both the blood and urine. This can cause persistent or sudden bursts of hypertension, which may lead to severe headaches. Other symptoms include heart palpitations, sweating, nausea, anxiety, and tingling in the hands and feet.

What is it used for?

To help confirm or rule out a rare tumor of the adrenal gland called a pheochromocytoma or a rare tumor outside of the adrenal gland called a paraganglioma; these tumors (PPGL) produce excess catecholamines, which are broken down to metanephrines

What does the test result mean?

A high level of catecholamines in the blood and/or urine when you have signs and symptoms strongly suggests the presence of a tumor that produces catecholamines. It indicates that further investigation is needed. It is recommended that imaging studies be performed to locate the tumor once test results show clear evidence of such a tumor.

The test for catecholamines is very sensitive and false positives do occur. The test is affected by stress, drugs, smoking, and various foods such as caffeine-containing drinks and alcohol. If you have only moderately elevated levels, then your healthcare practitioner may re-evaluate your medications, diet, and stress level to look for interfering substances or conditions. Once these are resolved, you may then be tested again to determine whether the levels are still elevated and take appropriate action.

If catecholamine levels are elevated after you have been treated for such a tumor, then it is likely that either treatment was not fully effective or the tumor has returned and appropriate follow up is needed.

If the level of catecholamines is normal, then it is unlikely that you have a tumor that produces catecholamines. However, pheochromocytomas do not necessarily produce catecholamines at a constant rate. Therefore, if you have not had a recent episode of hypertension, your blood and urine catecholamine levels could be at normal or near-normal levels even when a pheochromocytoma is present. If suspicion remains high, testing may be repeated.

Why get tested?

Catecholamines testing may be ordered when tests for plasma free metanephrines and/or urine metanephrines are inconclusive and a healthcare practitioner needs more information about a possible tumor that produces catecholamines. It may be ordered when you have sudden bursts (paroxysms) of specific signs and symptoms (especially If you are younger than age 40). Signs and symptoms may include:

High blood pressure (hypertension), especially when you have hypertension that is not responding to treatment (people with PPGL are frequently resistant to conventional therapies)
Severe headaches
Sweating
Flushing
Rapid heart rate (palpitations)
Tremors

The tests may also be ordered when an adrenal or neuroendocrine tumor is detected during a scan conducted for another purpose or if you have a strong personal or family history of pheochromocytoma.

It may also be ordered at intervals when you have been previously treated for one of these tumors.

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Catecholamines Group of Tests (24 Hrs Urine) Lab Test

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