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Catecholamine Urine Test

What are catecholamines?

Catecholamines are proteins that are neurotransmitters, moving signals in your body and brain. They include:

  • dopamine
  • norepinephrine
  • epinephrine

They are essential to the body’s “fight-or-flight” response and help control a variety of functions, including:

  • heart rate
  • blood pressure
  • glucose, or sugar, metabolism
  • lipid metabolism

Catecholamines are primarily produced in your adrenal glands and their levels fluctuate in response to physical and emotional stress. They can also change in response to:

  • outside temperature
  • blood loss
  • exercise
  • low blood sugar
  • moving from a sitting down to a standing up position, or vice versa

Catecholamine urine testing (CATU) is used to diagnose certain diseases that increase catecholamine production. Levels can fluctuate, so testing generally isn’t recommended if you aren’t showing symptoms. The chance of a false positive test is high.

Why is CATU used?

A doctor usually orders CATU to look for signs of pheochromocytoma, a type of tumor that grows on your adrenal glands and makes excess catecholamines. Most pheochromocytomas are benign, or noncancerous, but they should still be removed, as they can interfere with regular adrenal function and cause uncontrolled hypertension.

In children, a CATU may be ordered if a doctor suspects the presence of a neuroblastoma. This is an aggressive nervous system tumor that often starts in the adrenal glands and can increase catecholamine levels. The sooner a child is diagnosed with a neuroblastoma, the better their chances of survival.

What symptoms lead to ordering this test?

Your doctor will order a CATU to see if you have a pheochromocytoma, a neuroblastoma, or a paraganglioma, a rare nervous system tumor.

Symptoms of a pheochromocytoma are:

  • high blood pressure
  • rapid heartbeat
  • unusually hard heartbeat
  • heavy sweating
  • weight loss
  • severe headaches on and off for an extended period
  • pale skin
  • unexplained weight loss
  • strong, unexplained anxiety

It’s important to note that these symptoms don’t always indicate a pheochromocytoma. Pheochromocytomas are actually very rare tumors.

Symptoms of neuroblastoma include:

  • painless lumps of tissue under the skin
  • abdominal, chest, back, or bone pain
  • swelling in the legs
  • wheezing
  • high blood pressure
  • rapid heartbeat
  • diarrhea
  • bulging eyeballs and other changes to the shape or size of your eyes, including the pupils
  • dark areas around your eyes
  • fever
  • unexplained weight loss

What are the possible outcomes of this test?

CATU measures the amount of catecholamines in your urine. It’s usually performed over a period of 24 hours. Levels fluctuate greatly during the day.

Mayo Medical Laboratories list average levels by age as follows.


  • younger than 1 year: 0.0 to 2.5 mcg/24 hours
  • 1 year: 0.0 to 3.5 mcg/24 hours
  • 2 to 3 years: 0.0 to 6.0 mcg/24 hours
  • 4 to 9 years: 0.2 to 10.0 mcg/24 hours
  • 10 to 15 years: 0.5 to 20.0 mcg/24 hours
  • 16 years or older: 0.0 to 20.0 mcg/24 hours


  • younger than 1 year: 0 to 10 mcg/24 hours
  • 1 year: 1 to 17 mcg/24 hours
  • 2 to 3 years: 4 to 29 mcg/24 hours
  • 4 to 6 years: 8 to 45 mcg/24 hours
  • 7 to 9 years: 13 to 65 mcg/24 hours
  • 10 years or older: 15 to 80 mcg/24 hours


  • younger than 1 year: 0 to 85 mcg/24 hours
  • 1 year: 10 to 140 mcg/24 hours
  • 2 to 3 years: 40 to 260 mcg/24 hours
  • 4 years or older: 65 to 400 mcg/24 hours

CATU alone can’t diagnose. It’s only the preliminary step in diagnosis. Further tests will be needed if you have high levels of catecholamines. These tests may include checking for byproducts of catecholamine metabolism in the urine, such as metanephrines and vanillylmandelic acid, as well as imaging tests to look for tumors. There’s a high probability of a false positive test if you don’t have symptoms, and pheochromocytomas can be very hard to diagnose even if you do have symptoms.

How do I prepare for this test?

No preparation is necessary for this test, but several things can interfere with your catecholamine level, including:

  • coffee
  • tea
  • chocolate
  • allergy medicines

Your doctor will give you a list of what to avoid before taking your test. Make sure to tell them all the medicines you’re taking, both prescription and over the counter.

If your child is scheduled for CATU and you breast-feed, tell your doctor. Catecholamines pass from mother to child through breast milk. You may have to watch your food and medication intake.

How is the test performed?

CATU can take place in your home or at your doctor’s office. In either case, a “clean catch” urine sample is required.

You will be given a sterile container and a disposable, sterile wipe. Use the sterile wipe to clean your urinary opening. Women should gently wipe from front to back. Men should gently wipe the head of the penis.

Begin urinating into the toilet only and stop. Then put the open, sterile container in position to catch the stream of urine. Fill the urine container almost to the top and stop.

Move the container and finish urinating if you have to. Put the lid on the container and give it to your doctor.

To collect urine from an infant or young child, use a pediatric urine bag. This bag is placed inside your child’s diaper to collect urine. It will come with detailed instructions.

Sometimes a catheter will be used to collect urine from children. This involves placing a small tube into their urinary opening. It can cause temporary discomfort but it may be necessary to get accurate CATU results.

Test results

Your test results should be ready in a couple of days. Your doctor will discuss them with you when they are available. High levels of catecholamines in your body may indicate a tumor.

A CATU is usually accurate in diagnosing pheochromocytoma or neuroblastoma. However, further testing will be needed to determine the size and location of the tumor. In general, both conditions are highly treatable. 

Content licensed from:

Written by: Elea Carey
Medically reviewed on: Aug 29, 2017: [Ljava.lang.Object;@5177b621

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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