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24-hour urinary metanephrines
This test measures the amount of metanephrines in your urine that your body makes over a 24-hour period.
Metanephrines are made when your body breaks down hormones called catecholamines. These hormones are made by the adrenal glands. Catecholamines help your body respond to stress. They are sometimes called "fight or flight" hormones. They also include epinephrine, norepinephrine, and dopamine.
You may need this test if your healthcare provider suspects you have a condition called pheochromocytoma or paraganglioma. These are rare tumors that make extra amounts of catecholamines. Pheochromocytomas are found in the adrenal glands. Paragangliomas are found outside the adrenal glands.
Signs and symptoms of pheochromocytoma or paraganglioma include:
High blood pressure
Your healthcare provider may also order a blood test that measures metanephrines, called a fractionated plasma metanephrine test. Other byproducts of catecholamines may also be measured.
Many things may affect your lab test results. These include the method each lab uses to do the test. Even if your test results are different from the normal value, you may not have a problem. To learn what the results mean for you, talk with your healthcare provider.
Total urinary metanephrines can be measured in milligrams (mg). A level of 1.3 mg or greater over 24 hours is often considered positive.
Different labs have different ways of measuring catecholamine levels. Your provider will discuss your results with you.
If your 24-hour metanephrine level is between 1 and 2 times the normal amount, there is about a 30% chance you have a pheochromocytoma or paraganglioma.
If your 24-hour metanephrine level is twice the normal level or higher, it's likely that you have a pheochromocytoma or paraganglioma. You may need to have imaging tests, including CT or MRI scans. These tests are done to confirm the diagnosis and find the tumor.
This test requires a 24-hour urine sample. For this type of urine sample, you must collect all the urine you make for 24 hours. Empty your bladder completely first thing in the morning without collecting it and note the time. Then collect your urine every time you go to the bathroom for the next 24 hours.
Your healthcare provider will probably give you specific instructions. Follow them carefully.
This test poses no known risks.
Certain medicines, foods, and conditions can cause metanephrine and catecholamine levels to be higher than normal. These include:
Antidepressants and amphetamines
Physical or emotional stress
Withdrawal from drugs or alcohol
Obstructive sleep apnea
Don't drink anything containing caffeine before or during the test. Tell your healthcare provider if you are taking medicine, and ask whether you have any food, medicine, or activity restrictions. Be sure your provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illicit drugs you may use.
Plan to be home for the 24 hours you do the test so you can store the urine sample properly.
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.