5-OH-indoleacetic Acid is a breakdown product of serotonin that is excreted in the urine. Serotonin is a hormone found at high levels in many body tissues. Serotonin and 5-OH-indoleacetic Acid are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors.
5-OH-indoleacetic Acid is found to be associated with:
- Aromatic l-amino acid decarboxylase deficiency an inherited disorder that affects the way signals are passed between certain cells in the nervous system.)
- Celiac disease (an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine)
- Sepiapterin reductase deficiency (a condition characterized by movement problems)
Women generally have lower levels than men.
Numerous drugs affect the excretion of 5-OH-indoleacetic Acid by different mechanisms, including increased serotonin synthesis, metabolism, and release and inhibition of uptake. The following medications can interfere with 5-OH-indoleacetic Acid results. Proper preparation before the test is essential. Medication and dietary restrictions are required to prevent false-positive results. If clinically feasible, discontinue the following medications at least 48 hours before specimen collection.
- Acetaminophen (Tylenol or generic versions)
- Aspirin
- Antihistamines
- Cough syrups
- Cold and flu medications
One should also avoid caffeinated beverages such as tea and coffee or caffeinated foods for 48 hours before and during specimen collection.
Certain medicines can raise or lower your 5-OH-indoleacetic Acid levels. These include:
- Aspirin
- Acetaminophen
- Ethyl alcohol
- Some antidepressants
- Cough medicines or antihistamines
- Medicines to relax muscles
References:
- Urinary sampling for 5HIAA and metanephrines determination: revisiting the recommendations, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527357/
- Guidelines for the diagnosis and management of carcinoid tumours. Part 1: the gastrointestinal tract. A statement from a Canadian National Carcinoid Expert Group. (https://www.ncbi.nlm.nih.gov/pubmed/17576444)
- A single fasting plasma 5-HIAA value correlates with 24-hour urinary 5-HIAA values and other biomarkers in midgut neuroendocrine tumors (NETs). (https://www.ncbi.nlm.nih.gov/pubmed/23160483)
- Aromatic l-amino acid decarboxylase deficiency, https://ghr.nlm.nih.gov/condition/aromatic-l-amino-acid-decarboxylase-deficiency
- WHAT IS CELIAC DISEASE?, https://celiac.org/celiac-disease/understanding-celiac-disease-2/what-is-celiac-disease/
- Sepiapterin reductase deficiency, https://ghr.nlm.nih.gov/condition/sepiapterin-reductase-deficiency
Low 5-OH-indoleacetic Acid indicates inadequate production of serotonin. Symptoms include: constipation, depression, fatigue, insomnia, attention deficit and behavioral disorders.
Lower levels of 5-OH-indoleacetic Acid may mean you have:
- Depression
- Migraines
- What might affect the test results?
Foods and medications associated with decreased urinary HIAA results:
- Aspirin
- chlorpromazine (Thorazine)
- corticotropin
- dihydroxyphenylacetic acid
- alcohol
- gentisic acid
- homogentisic acid
- hydrazine derivatives
- imipramine (Tofranil®)
- isocarboxazid (Marplan)
- keto acids
- levodopa
- MAO inhibitors
- methenamine
- methyldopa (Aldomet®)
- perchlorperazine
- phenothiazines (Compazine®)
- promazine
- promethazine (Mepergan®)
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High 5-OH-indoleacetic Acid can be caused by SSRI medication, 5-HTP supplementation, increased release of serotonin from the central nervous system, digestive system or platelets. Very high 5-OH-indoleacetic Acid levels can ironically indicated a tryptophan deficiency, as this may cause an increased conversion of tryptophan to serotonin.
Higher levels of 5-OH-indoleacetic Acid may mean you have:
- Carcinoid tumors
- Noncarcinoid tumors
- Cystic fibrosis
- Malabsorption
Increased urine 5-OH-indoleacetic Acid concentration is common and may be the result of improper specimen collection, consumption of serotonin containing foods or dietary supplements, drug interference, or malabsorption syndromes. Significant elevation (ten times the upper reference limit) of urine 5-OH-indoleacetic Acid may indicate the presence of a carcinoid tumor.
Eating certain foods containing serotonin can raise 5-OH-indoleacetic Acid. These foods include:
- Cheese
- Bananas
- Pineapple
- Kiwi
- Plums
- Tomatoes
- Eggplant
- Avocados
- Certain nuts, including walnuts and pecans
Strenuous exercise can also raise your 5-OH-indoleacetic Acid levels.
Foods and medications associated with increased urinary 5-OH-indoleacetic Acid results:
- Acetaminophen
- acetanilide
- caffeine
- coumaric acid
- diazepam (Valium®)
- ephedrine
- fluorouracil
- glycerol guaiacolate (Guaifenesin)
- melphalan (Alkeran®)
- mephenesin
- methamphetamine (Desoxyn)
- methocarbamol (Robaxin®)
- naproxen
- nicotine
- phenacetin
- phenmetrazine
- phenobarbital
- phentolamine
- rauwolfia
- reserpine
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2-Hydroxyphenylacetic Acid, 3-Hydroxyisovaleric Acid, 3-Hydroxyphenylacetic Acid, 3-Hydroxypropionic Acid, 3-Methyl-4-OH-phenylglycol, 4-Hydroxyphenylacetic Acid, 5-OH-indoleacetic Acid, a-Hydroxyisobutyric Acid (from MTBE), a-Keto-b-Methylvaleric Acid, a-Ketoadipic Acid, a-Ketoglutaric Acid (AKG), a-Ketoisocaproic Acid, a-Ketoisovaleric Acid, a-Ketophenylacetic Acid (from Styrene), Adipic Acid, Arabinose, B-OH-B-Methylglutaric Acid (HMG), Benzoic Acid, Beta-OH-Butyric Acid (BHBA), Cis-Aconitic Acid, Citramalic Acid, Citric Acid, Dihydroxyphenylpropionic Acid (DHPPA), Formiminoglutamic Acid (FIGlu), Glutaric Acid, Hippuric Acid, Homogentisic Acid, Homovanillic Acid, Indoleacetic Acid (IAA), Isocitric Acid, Isovalerylglycine, Kynurenic / Quinolinic Ratio, Kynurenic Acid, Lactic Acid, Malic Acid, Methylmalonic Acid, Orotic Acid, Phenylacetic Acid (PAA), Pyroglutamic Acid, Pyruvic Acid, Quinolinic Acid, Suberic Acid, Succinic Acid, Tartaric Acid, Vanilmandelic Acid, Xanthurenic Acid