Used as an auxiliary test to fractionated plasma and urine metanephrine measurements for the diagnosis of pheochromocytoma and paraganglioma. Used in the diagnosis and follow-up of patients with neuroblastoma and related tumors. Work up palpitations, severe headache, and diaphoresis.

Avoid emotional and physical stress and vigorous exercise as they can increase catecholamine release and the levels of their metabolites. Diet may also influence biochemical tests of catecholamine excess. During collection avoid caffeine containing foods such as coffee; tea; cocoa; chocolate; and other caffeinated beverages. Nicotine and alcohol use should also be avoided prior to and during sample collection. Avoid consuming food products that contain significant quantities of biogenic amines (e.g., fruits; nuts; cheeses; tomatoes, beans and other vegetables; processed meat products; and fermented foods) as they may produce falsely-elevated test results. Patients should also talk to their healthcare provider about prescription medications and over-the-counter drugs and supplements they are using. It may be necessary to discontinue medications for some time prior to the test. Medications which may physiologically elevate the concentration of catecholamines and their metabolites include: alpha-adrenergic receptor blockers; dopamine antagonists; calcium channel blockers; centrally acting anti-hypertensive drugs; monoamine oxidase inhibitors (MAOI); sympathomimetic drugs; and tricyclic antidepressants. Patients MUST contact their healthcare provider before restricting their diet, fasting or discontinuing any prescription or non-prescription medications.