Metanephrines, Total (24hr Urine)

check icon Optimal Result: 224 - 832 mcg/24h.

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 believes 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.

Symptoms of pheochromocytoma or paraganglioma include:

- High blood pressure

- Paleness

- Headaches

- Sweating

- Heart palpitations

- Tremors

What does it mean if your Metanephrines, Total (24hr Urine) result is too high?

Total urinary metanephrines can be measured in micrograms (mcg). A level greater than 400 mcg over 24 hours is often considered positive.

Different labs have different ways of measuring catecholamine levels. 

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.

What is a pheochromocytoma?

A pheochromocytoma is a rare, usually noncancerous (benign) tumor that develops in an adrenal gland. You have two adrenal glands — one located at the top of each kidney. The adrenal glands are part of the body's hormone-producing (endocrine) system.

Usually, a pheochromocytoma develops in only one adrenal gland. But tumors can develop in both.

If you have a pheochromocytoma, the tumor releases hormones that may cause high blood pressure, headache, sweating and symptoms of a panic attack. If a pheochromocytoma is not treated, severe or life-threatening damage to other body systems can result.

Surgery to remove a pheochromocytoma usually returns blood pressure to normal.

What is a paraganglioma?

Paragangliomas are rare tumors that form near the carotid artery, along nerve pathways in the head and neck, and in other parts of the body. Some paragangliomas make extra catecholamines called adrenaline and noradrenaline. The release of these extra catecholamines into the blood may cause signs or symptoms of disease.

Signs and symptoms of pheochromocytoma and paraganglioma:

Signs and symptoms of pheochromocytoma and paraganglioma include high blood pressure and headache. Some tumors do not make extra adrenaline or noradrenaline and do not cause signs and symptoms. These tumors are sometimes found when a lump forms in the neck or when a test or procedure is done for another reason. Signs and symptoms of pheochromocytoma and paraganglioma occur when too much adrenaline or noradrenaline is released into the blood. These and other signs and symptoms may be caused by pheochromocytoma and paraganglioma or by other conditions. Check with your doctor if you have any of the following:

- High blood pressure.
- Headache.
- Heavy sweating for no known reason.
- A strong, fast, or irregular heartbeat.
- Being shaky.
- Being extremely pale.

The most common sign is high blood pressure that may be hard to control. Very high blood pressure can cause serious health problems such as irregular heartbeat, heart attack, stroke, or death.

- Signs and symptoms of pheochromocytoma and paraganglioma may occur at any time or be brought on by certain events. Signs and symptoms of pheochromocytoma and paraganglioma may occur when one of the following events happens:

- Hard physical activity.
- A physical injury or having a lot of emotional stress.
- Childbirth.
- Going under anesthesia.
- Surgery, including procedures to remove the tumor.
- Eating foods high in tyramine (such as red wine, chocolate, and cheese).

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