Catecholamines (Fractionated) & VMA 24‑Hour Urine With Creatinine Biomarker Testing
It checks 24-hour urine stress hormones and VMA to evaluate episodic high blood pressure and related symptoms, with easy ordering through Vitals Vault.
With Vitals Vault, you have access to a comprehensive range of biomarker tests.
This test measures stress hormones (catecholamines) and one of their breakdown products (VMA) in a full 24-hour urine collection, and it also reports urine creatinine to help confirm the collection was complete.
It is most often used when symptoms come in episodes, such as sudden spikes in blood pressure, pounding headaches, sweating, tremor, or a racing heartbeat. Because these symptoms can have many causes, the goal is to add objective data that you and your clinician can use to decide what to do next.
A single result rarely “diagnoses” anything by itself. It is one piece of a stepwise evaluation that may include repeat testing, medication review, and sometimes blood testing or imaging if results are clearly abnormal.
Do I need a Catecholamines Fractionated And Vma 24 Hour Urine With Creatinine test?
You may consider this test if you have episodes that feel like sudden adrenaline surges—especially if they come with high blood pressure, severe headaches, sweating, palpitations, tremor, or anxiety-like symptoms that appear out of proportion to your situation.
Clinicians also use 24-hour urine catecholamines/VMA as part of an evaluation for rare catecholamine-secreting tumors (pheochromocytoma or paraganglioma), particularly when symptoms are intermittent or when an initial screening test needs confirmation. It can also be used when you have resistant hypertension (blood pressure that stays high despite treatment) or unexplained spells that mimic panic attacks.
You may not need this test if your symptoms are steady rather than episodic, or if there is an obvious trigger such as medication side effects, stimulant use, untreated sleep apnea, or uncontrolled thyroid disease. In those situations, your clinician may prioritize other labs first.
Testing supports clinician-directed care rather than self-diagnosis, because preparation, medication holds, and follow-up choices can change how accurate and actionable your result is.
Urine catecholamines and VMA are measured in a CLIA-certified laboratory; results are not a standalone diagnosis and should be interpreted with your symptoms, medications, and collection adequacy.
Lab testing
Order the 24-hour urine catecholamines (fractionated) & VMA test when you’re ready to collect.
Schedule online, results typically within about a week
Clear reporting and optional clinician context
HSA/FSA eligible where applicable
Get this test with Vitals Vault
Vitals Vault lets you order a 24-hour urine catecholamines (fractionated) and VMA test with creatinine so you can move from “I’m not sure what’s going on” to a clearer next step with your clinician.
After you order, you complete a 24-hour urine collection using the lab-provided container and instructions. Because timing and handling matter, you will want to follow the collection directions closely and ask about any medications or foods you should avoid beforehand.
When results are ready, PocketMD can help you understand what “high,” “in-range,” or “borderline” patterns may mean, what common interferences to check, and what follow-up questions to bring to your next appointment. If you and your clinician decide to retest, trending the same method can make changes easier to interpret.
- Order online and complete testing through a national lab network
- PocketMD helps you translate results into practical next steps
- Clear retest planning when results are borderline or preparation was imperfect
Key benefits of Catecholamines Fractionated And Vma 24 Hour Urine With Creatinine testing
- Captures hormone output over a full day, which can help when symptoms come and go.
- Separates epinephrine, norepinephrine, and dopamine to give a more specific pattern than a single total number.
- Adds VMA as a downstream metabolite that can support interpretation when catecholamines are borderline.
- Includes urine creatinine to assess whether the 24-hour collection was likely complete and interpretable.
- Helps evaluate episodic hypertension, palpitations, sweating, and severe headaches when routine workups are unrevealing.
- Provides objective data to guide whether follow-up testing (often metanephrines) or specialist referral is warranted.
- Supports consistent retesting after medication or lifestyle changes when an initial result is unclear.
What is Catecholamines Fractionated And Vma 24 Hour Urine With Creatinine?
Catecholamines are hormones made primarily by your adrenal glands and certain nerve cells. The main catecholamines are epinephrine (adrenaline), norepinephrine (noradrenaline), and dopamine. Your body releases them to help you respond to stress by increasing heart rate, tightening blood vessels, and raising blood sugar.
A “fractionated” urine catecholamines test reports each catecholamine separately rather than combining them into one total. VMA (vanillylmandelic acid) is a breakdown product formed as your body metabolizes catecholamines. Measuring both catecholamines and VMA over a 24-hour period can help detect sustained or intermittent overproduction.
The creatinine portion is not there to diagnose kidney disease in this context. It is mainly used as a quality check: if urine creatinine is unexpectedly low or high for your body size and sex, it can suggest the collection was incomplete or over-collected, which can make catecholamine and VMA results harder to trust.
Why a 24-hour urine collection is used
Catecholamine release can spike for minutes to hours and then return to baseline. A single blood draw or spot urine sample may miss those swings. A 24-hour collection averages secretion across the day and night, which can be helpful when symptoms are episodic.
How this test fits into a typical workup
Many clinicians start with plasma free metanephrines or urine fractionated metanephrines because they are often more sensitive for pheochromocytoma/paraganglioma screening. Urine catecholamines and VMA may be used as complementary tests, for confirmation, or when metanephrines are not available or results are difficult to interpret.
What do my Catecholamines Fractionated And Vma 24 Hour Urine With Creatinine results mean?
Low catecholamines or low VMA
A low result is usually not concerning and often reflects normal day-to-day variation, especially if your symptoms are not strongly suggestive of catecholamine excess. Low values can also happen if the urine collection was incomplete or if the sample handling was not ideal. If your clinician still suspects a catecholamine-secreting tumor based on your history, they may repeat testing with careful preparation or use plasma/urine metanephrines.
In-range (expected) results
In-range catecholamines and VMA make clinically significant catecholamine overproduction less likely, particularly if the collection was complete and you avoided major interferences. However, normal results do not explain every episode of palpitations, sweating, or blood pressure spikes. If symptoms persist, your clinician may look for other causes such as panic disorder, thyroid disease, medication effects, sleep apnea, arrhythmias, or autonomic dysfunction.
High catecholamines and/or high VMA
High values can occur with true catecholamine excess, including pheochromocytoma or paraganglioma, but false positives are common. Stress, pain, acute illness, nicotine, heavy exercise, and several medications can raise catecholamines or VMA. Mild elevations often lead to a careful review of preparation and medications, followed by repeat testing or metanephrines; larger or consistent elevations are more likely to prompt specialist evaluation and additional testing.
Factors that influence urine catecholamines, VMA, and creatinine
Collection quality matters: missing urine during the 24 hours, collecting longer than instructed, or not keeping the specimen as directed can skew results. Foods and drinks (for example caffeine and some vanilla-containing foods) and substances such as nicotine can increase catecholamine output in some people. Medications that may interfere include certain antidepressants, decongestants, stimulants, and blood pressure medicines; you should never stop a prescription without clinician guidance. Kidney function, hydration status, and muscle mass can affect urine creatinine and may change how “complete” a collection appears.
What’s included
- Calculated Total (E+Ne)
- Creatinine, Urine
- Dopamine, 24 Hr Urine
- Epinephrine, 24 Hr Urine
- Norepinephrine, 24 Hr Ur
- Vma, 24 Hr Urine
Frequently Asked Questions
Do I need to fast for a 24-hour urine catecholamines and VMA test?
Fasting is usually not required for a 24-hour urine collection, but preparation still matters. Your lab instructions may ask you to avoid certain foods, caffeine, nicotine, and strenuous exercise for a period before and during the collection. Follow the specific directions that come with your kit and confirm medication guidance with your clinician.
What symptoms prompt testing for pheochromocytoma or paraganglioma?
Testing is often considered when you have episodes of very high blood pressure, pounding headaches, sweating, palpitations, tremor, or a sense of “adrenaline rush” that comes in spells. Family history of these tumors or certain genetic syndromes can also raise suspicion. Because these symptoms overlap with many common conditions, the test is used to clarify risk rather than to label symptoms on its own.
How do I do a 24-hour urine collection correctly?
You typically start by discarding the first morning urine, then collect all urine for the next 24 hours, including the first urine the following morning. Missing even one void can lower measured totals and make results unreliable. Keep the container stored exactly as instructed (often refrigerated or kept cool) and return it promptly.
Why is creatinine included with the 24-hour urine test?
Creatinine helps assess whether the collection was likely complete. If creatinine is far lower or higher than expected for you, it can suggest under-collection, over-collection, or unusual dilution, which can make catecholamine and VMA totals hard to interpret. Your clinician may use this information to decide whether a repeat collection is needed.
What can cause a false high catecholamines or VMA result?
Common contributors include acute stress, pain, illness, heavy exercise, nicotine, and caffeine. Some medications can also raise results or interfere with measurement, including certain antidepressants, decongestants, and stimulants. If your result is only mildly elevated, your clinician may focus first on preparation, medication review, and repeat testing.
Is this test the same as urine metanephrines?
No. Metanephrines are metabolites of catecholamines and are often used as a first-line screening test because they can be more sensitive for detecting catecholamine-secreting tumors. Urine catecholamines and VMA can still be useful, especially as complementary information or when confirming an abnormal pattern, but the best choice depends on your situation and your clinician’s approach.