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Meta normetanephrines in 24-hour urine. Normetanephrine and metanephrine in 24-hour urine

Many patients are interested in information about when and why they need to take a 24-hour urine test for intermediate products of the breakdown of adrenal hormones, represented by metanephrines and normetanephrines. Excessive levels of such substances indicate the development of dangerous diseases, serious health problems and the need to take urgent measures to eliminate them. Metanephrines and normetanephrines in daily urine, with concentrations exceeding established standards, are a sign of ineffective treatment or relapse of pheochromocytoma, malignant neoplasms of other glands of the endocrine system, damage to the hypothalamus, hypertensive crisis, myocardial infarction, angina pectoris.

A test for metanephrines in urine, aimed at confirming or denying tumor neoplasms, such as pheochromocytoma in adults, paraganglioma and neuroblastoma in children, is prescribed by an endocrinologist, cardiologist, oncologist, or therapist. The liver symptoms indicating the need for it include:

increased blood pressure and rapid heart rate;
increased indicator of the thermal state of the patient’s body;
the appearance of headaches and dizziness;
dryness in the mouth;
nausea;
increased sweat production;
tingling sensation in the lower and upper extremities.

The results of the diagnostic study are of great importance for monitoring the treatment of patients, as well as for the timely detection of benign tumors capable of synthesizing catecholamines in large quantities. These substances, under the influence of a specific enzyme, are converted into adrenaline, norepinephrine and intermediate products of their breakdown, which include metanephrine and normetanephrine, and are excreted from the body along with urine. Excessive levels of them in excrement excreted by the kidneys serve as the most important indicator of the development of dangerous diseases.

Proper preparation for collecting 24-hour urine

Urine analysis for metanephrines plays an important role in identifying benign malignant neoplasms in the patient's body. Correct collection of excrement excreted by the kidneys determines the reliability of the results. Two to three days before the test, patients are prohibited from:

take antibacterial drugs, MAO inhibitors, adrenergic blockers;
use potassium in the nose with a characteristic vasoconstrictor effect;
perform physical exercises;
smoke three hours before collecting excrement excreted by the kidneys during the day;
eat cheeses, bananas, chocolate, different types of desserts with vanilla, tomatoes, pineapples, avocados;
drink coffee, tea, Coca-Cola, beer, as well as drinks containing ethanol in any quantity.

In addition, it is also recommended to exclude eggs from your nutritional diet these days and avoid stressful situations and nervous disorders. To carry out the analysis, it is necessary to collect urine per day in a container with a volume of at least 3 dm³. Glass jars used for preservation are suitable for such purposes. After thorough washing and steam sterilization, they will be suitable for collecting excrement excreted by the kidneys during the day. Daily urine collection is carried out without the first and last portions. Then 100 ml is poured and delivered to the laboratory for analysis.

Ignoring such recommendations may result in increased levels of metanephrines and normetanephrines in daily urine, indicating the emergence of serious health problems for the patient. The need to collect urine throughout the day is due to the variability of the level of catecholamine breakdown products within 24 hours. This type of study is the main and reliable diagnostic method aimed at identifying the pathological condition of the adrenal glands.

Permissible content of breakdown products of adrenaline and norepinephrine

The established norms of metanephrine and normetanephrine in daily urine can be seen in the table.

Patient age	Metanephrine content,	Normetanephrine content,
Patient age	mcg/day	mcg/day
From birth to 3 months
From birth to 3 months	5,9 – 37,0	47,0 - 157
3 - 6 months	6,1 -42	31,0- 111,0
6 - 9 months	12,0 -41,0	42,0 -109,0
9 - 12 months	8,5 – 101,0	23.0 – 103, 0
12 - 24 months	6,7 – 52,0	32,0 – 118,0
From 2 to 6 years	11,0 – 99,0	50,0 – 111,0
From 6 to 10 years	54,0 – 138,0	47,0 – 176,0
From 10 to 16 years	39,0 – 243,0	53,0 – 290,0
From 16 years to old age
From 16 years to old age	74,0 – 297,0	105,0 – 354,0

The maximum permissible content of metanephrine in daily urine is 320.0 mcg, normetanephrine - 390 mcg. Exceeding these values indicates the presence of malignant tumors, the development of heart disease, serious pathologies of the nervous system, liver cirrhosis, and hepatitis. Violation of the rules when collecting daily urine for analysis also entails an increase in the level of metanephrine and normetanephrine. Timely seeking help from qualified specialists is the key to identifying serious health problems and effectively eliminating them.

There are factors that can significantly increase the level of metanephrines in the urine:

pheochromocytoma;
neuroblastoma;
ganglioneuroma;
pathologies of the cardiovascular system (myocardial infarction, angina pectoris, hypertensive crisis);
liver diseases (acute or chronic hepatitis, cirrhosis);
nervous system disorders (depression, frequent stress, chronic illnesses);
peptic ulcer of the stomach or duodenum;
bad habits, especially smoking;
heavy physical activity associated with prolonged acceleration of the heart rate.

It is worth knowing that free metanephrines in the urine, in addition to tumors, are found in hepatitis, myocardial infarction, peptic ulcer in the acute phase, hypothalamic syndrome, and alcohol intoxication.

Drugs that increase catecholamines in urine:

adelfan;
diuretics;
insulin;
antidepressants;
paracetamol;
antibiotics;
aminophylline.

The concentration of metanephrines in urine can be measured in two indicators: mcg/day or nmol/day.

Recalculation is carried out as follows:

metanephrine (adrenaline metabolite): mcg/day = “nmol/day” X 5.07;
normetanephrine (metabolite of norepinephrine): mcg/day = “nmol/day” X 5.46.

Note: laboratory analysis data does not allow us to determine the size of the tumor, the degree of malignancy, the number of tumor nodes and their exact location. The specialist can obtain this information from other diagnostic sources.

Factors influencing the result

Violation of diet before urine collection;
Violation of test preparation rules;
Violation of the biomaterial collection algorithm;
Smoking and drinking alcohol during the preparation and collection of material;
Physical activity and stress on the eve of the test;
Taking illegal drugs.

If the results of a general urine test show that an excessive amount of metanephrine is found in the body, then there is a high probability that a malignant tumor has formed in the endocrine glands. However, only 2 out of 10 people have such a diagnosis, so there is no need to panic ahead of time.

In this case, you will need to undergo a re-examination, taking into account all the standards that will indicate how to take the test. If an elevated reading is obtained again, the patient should visit the attending physician and undergo a course of accurate diagnosis of malignant tumors.

After receiving proper consultation, the patient will be prescribed a course of recovery that will stop the progression of the pathology and help return body functions to normal.

Is it possible to drink alcohol before donating urine?

If metanephrine levels have not decreased some time after starting treatment, other countermeasures will need to be considered. A constant increase in normetanephrine indicates diseases that affect the hypothalamus and problems with the heart and other internal organs.

metanephrine (metabolite of adrenaline): mcg/day = "nmol/day" X 5.07;
normetanephrine (metabolite of norepinephrine): mcg/day = "nmol/day" X 5.46.

An increase in the level of these indicators can occur both due to the presence of pathology, and in connection with violations of the rules for preparing for the test. At the same time, incorrect preparation or collection of material may lead to an underestimation of the results, which will also prevent an accurate diagnosis of the disease.

The level of metanephrine and normetanephrine in the urine can be increased by medications taken, foods, physical or psychological stress, hormone-producing malignant or benign tumors, and panic attacks.

As before taking any tests, certain preparation is required before collecting urine to determine the level of metanephrines.

General information

The adrenal glands belong to the organs of the endocrine system, which synthesize bioactive substances (hormones) necessary for the body and participate in metabolic processes. The main hormones of the adrenal glands are corticosteroids (more than ten varieties) and catecholamines (adrenaline and norepinephrine).

Catecholamines regulate neuropsychological, muscular and cardiovascular adaptive reactions aimed at protecting the body. After performing their functions, adrenaline and norepinephrine are destroyed under the influence of specific liver and kidney enzymes.

During the breakdown process, metabolites (intermediate products) are formed - normetanephrine and metanephrine, which are excreted in the urine. By the amount of catecholamine metabolites in urine, the functional state of the adrenal glands and other internal organs can be determined.

Metanephrines are intermediate products of the metabolism of the catecholamines adrenaline and norepinephrine. Like catecholamines, metanephrines are filtered by the kidneys and excreted in the urine. Analysis of their concentration allows one to accurately determine the presence of hormone-secreting adrenal tumors, as well as differentiate hypertension.

The adrenal glands release catecholamines (adrenaline and norepinephrine) into the blood under the influence of an acute stressful situation (psycho-emotional stress, heavy physical activity, etc.).

Note: catecholamines promote the transmission of nerve impulses from the brain to the organs, release the main sources of energy (lipids, glucose) from tissues, accelerate metabolic processes and activate the work of the heart. Together, all these actions help the body regulate the functioning of the nervous system and effectively resist stress.

After natural breakdown (for catecholamines it takes only a few minutes), metanephrines are released, which are excreted by the kidneys and excreted in the urine within 24 hours. In addition, a small amount of free metanephrine is present in the urine, which tends to increase during a stressful situation and immediately after it.

Neuroendocrine tumors (pheochromocytoma, neuroblastoma, ganglioneuroma) can produce significant amounts of epinephrine and norepinephrine. This entails an increase in their concentration in blood plasma and urine. Catecholamines also affect blood pressure, sharply increasing it, which is manifested by the following symptoms:

headaches and dizziness;
nausea and vomiting;
panic attacks;
anxiety;
numbness and tingling in the limbs.

Most neuroendocrine tumors are localized in the adrenal glands and are characterized by a benign course. Such tumors are not aggressive, i.e. they grow quite slowly. However, as the shape of the tumor changes and the size increases, the symptoms of the disease become more severe:

blood pressure increases (chronic hypertension develops);
internal organs are affected, especially the heart and kidneys;
the risk of stroke and myocardial infarction increases.

A urine test for metanephrine and normetanephrine can detect malignant tumors in the kidneys and adrenal glands. Studies are prescribed for those patients who have characteristic symptoms. The detection of these substances in the body indicates that an inflammatory process occurs in the human endocrine glands, which poses a danger to the body.

A test to detect these substances can only be prescribed by a doctor due to the detection of certain symptoms. This study is prescribed to diagnose cancer and malignant formations in the patient’s internal organs.

The following symptoms are a significant reason to undergo an examination:

Constant high blood pressure in the arterial zone;
Increased sweating, mainly at night;
Increased pulse and heart rate;
Elevated temperature for a long period of time;
Dizziness and pain in the back of the head;
Nausea for no particular reason.

The presence of these symptoms for 1-2 weeks should be a reason to contact the clinic. The patient will need to undergo proper preparation and testing to identify or exclude the formation of malignant tumors.

The results that will be obtained after the test are sensitive to any changes in the body. Therefore, it is extremely important to comply with the rules and regulations that will contribute to obtaining reliable information about the body. When preparing for analysis, adhere to the following recommendations:

2-3 days before the scheduled test date, avoid taking any medications that damage the kidneys and other internal organs. You will also need to stop using antiviral antibiotics;
48 hours before the examination, give up drinks: cocoa, tea and coffee. In addition, the patient is contraindicated to consume any alcoholic or alcoholic substances;
5-6 hours before urine collection, the patient should avoid tobacco;
Eliminate any physical and psychological stress on your body. Take a day to rest;
Avoid products that contain preservatives or similar substances, as this will change the results obtained after testing.

The material for research is daily urine, because during this period of time it changes its composition due to many factors. Urine will need to be collected throughout the day.

You need to collect urine immediately after waking up. Go to the toilet and flush the initial urine into the toilet, fill the container with intermediate urine and send it to a cold place.

The next portion of urine is prepared after 13:00. Repeat the steps described above. The final stage occurs before bedtime.

The next morning, you will need to separate about 100 milliliters of collected urine for further research. Urine must be delivered to the laboratory as soon as possible so that it does not lose its properties and shows a reliable result of examining the body.

Having passed a 24-hour urine test, the patient will be able to understand the pathologies developing in his body and, if necessary, take measures to eliminate them.

In this case, you will need to undergo a re-examination, taking into account all the standards that will indicate how to take the test. If an elevated reading is obtained again, the patient should visit the attending physician and undergo a course of accurate diagnosis of malignant tumors.

After receiving proper consultation, the patient will be prescribed a course of recovery that will stop the progression of the pathology and help return body functions to normal.

If metanephrine levels have not decreased some time after starting treatment, other countermeasures will need to be considered. A constant increase in normetanephrine indicates diseases that affect the hypothalamus and problems with the heart and other internal organs.

An analysis to detect these elements in the patient’s urine is sensitive to any changes and non-compliance with the rules for collecting urine for research. The increase in metanephrine in the patient’s urine is affected by drinks that contain alcohol and caffeine. Smoking has a particular influence on the examination results.

Heavy loads on a person’s physical and psychological health will also affect the receipt of inflated indicators. Avoid eating these foods and try to just relax before taking the test. This technique will make your preparation correct and the information about the body reliable.

How soon can you receive analysis results?

After the patient provides the collected urine, it will undergo a comprehensive examination to identify malignant tumors in the body. This procedure most often takes around 14 days.

If the urine was donated to a private clinic, tests can be obtained much faster. Proper collection and preparation of urine will help speed up the test. To obtain reliable results, conduct an additional consultation with an endocrinologist or oncologist.

The values of these substances in urine change with age. Therefore, it is important to know what indicators are normal so as not to panic without reason.

In the urine of children under 3 months of age, the following are considered normal indicators:

Metanephrine from 5.9 to 37 units;
Normetanephrine from 47 to 156 units.

For infants whose age ranges from 3 to 6 months, the norm is as follows:

Metanephrine from 6.1 to 42 units;
Normetanephrine from 31 to 111 units.

In the urine of children under 9 months of age, indicators should be within the following limits:

Normetanephrine from 41 to 109 units.

In infants under one year of age, normal values look like this:

Metanephrine from 12 to 41 units;
Normetanephrine from 23 to 103 units.

In a child from 1 to 2 years old, the levels of the substance in urine should be within these limits:

Metanephrine from 6.7 to 52 units;
Normetanephrine from 32 to 118 units;

In people over 16 years of age, metanephrine levels should not exceed 320 units, normetanephrine should not exceed 390.

These indicators are considered normal. If the analysis showed such values, this is evidence that everything is fine with the body and the patient does not require drug intervention.

It seems that deciphering the tests can be done independently, but you will need to contact a specialist and get an accurate conclusion about your health. Self-diagnosis will be largely incorrect.

The obtained test results vary depending on the laboratory in which the research took place. In addition, the amount of elements in a patient’s urine changes due to the consumption of certain foods, as well as due to age and physical activity.

If the results were inflated, undergo a re-examination to establish an accurate diagnosis.

A urine test for metanephrine is comparable to blood tests. Therefore, it allows you to determine or exclude the presence of the following diseases:

Tumors of the brain and adrenal glands;
Liver cirrhosis;
Ulcers of the stomach and rectum;
Hypertension.

If you receive results that are outside the normal range, get tested to detect any developing disease in your body.

Cirrhosis of the liver

Only an accurate diagnosis will allow effective treatment and stop the progression of malignant tumors.

Where to get tested

You can get tested for metanephrine and normetanephrine in laboratories that are present in each region. No patient will have any difficulties with this.

Most often, such analysis is paid. The fee is conditional on the installation of high-quality equipment so that the results about the human body are reliable.

Acid is used to identify elements in urine, which increases the efficiency of analysis and detection of pathologies in the body in the early stages. Before you begin preparing for the study, you will need to obtain the appropriate referral. This can be done by an endocrinologist or oncologist.

Conclusion

By passing a urine test for metanephrine and normetanephrine, the patient will have the opportunity to detect the development of cancer in the early stages. This will get rid of tumors and save life, because if the disease has been advanced, treatment will be ineffective.

This should be a reason to make such examinations regular. You can take the test in any region. Specialized equipment and a team of specialists will help determine the exact amount of elements in urine, thereby identifying or eliminating many dangerous diseases.

During collection and preparation for analysis, remember the preparation rules and the fact that urine will need to be collected throughout the day. This technique will allow you to track changes in the patient’s urine and determine what is currently happening in the body.

This study can replace a general blood test and identify diseases with high accuracy. By making this examination permanent, each person will be able to exclude dangerous diseases and continue a normal lifestyle.

A blood or urine test for metanephrines is a specific type of diagnosis of endocrine diseases. Determining the amount of this substance in a patient's blood and urine is often necessary to identify an adrenal tumor or other neuroendocrine neoplasm.

The adrenal glands are responsible for the production of hormones - catecholamines. They come in three types: dopamine, adrenaline and norepinephrine. Dopamine is often called the hormone of joy, and adrenaline and norepinephrine are the hormones of fear. Indeed, under the influence of stress, the glands release a portion of catecholamines into the blood. They dilate the pupils, increase the heart rate, help the smallest capillaries of the lungs open, and accelerate the release of glucose from the body's reserves. Norepinephrine also increases blood pressure and helps skin blood vessels contract, reducing heat loss.

This hormonal reaction has developed evolutionarily, precisely thanks to the processes that are triggered by adrenaline and norepinephrine in the body: in critical situations, vision improves, hearing sharpens, and the ability to run quickly and for a long time appears. After the hormones have performed their function, they are metabolized to metanephrine and normetanephrine and excreted by the kidneys.

Pheochromocytoma

Tumors called pheochromacytomas sometimes form in the adrenal medulla. They are both benign and malignant. In any case, these types of neoplasms are capable of producing catecholamine hormones in huge quantities. At the same time, the content of the hormones themselves and their metabolites in the blood and urine increases significantly. Changes in the endocrine system are common even when pheochromacytoma is located outside the adrenal glands (approximately 10% of cases). This type of tumor is detected in patients aged 20 to 40 years. Among children, boys are more often susceptible to the disease.

Specific symptoms indicate increased levels of adrenaline and norepinephrine:

tachycardia;
increased blood pressure;
headaches and dizziness;
numbness and tingling sensation in the limbs;
sweating and hot flashes;
panic attacks.

More often, pheochromacytoma is a benign neoplasm that does not extend beyond the adrenal gland. It is easily treatable with medication or surgery and has no tendency to recur or degenerate. Only ten percent of pheochromacytomas are malignant. They most often have extra-adrenal localization. Tumors metastasize mainly to regional lymph nodes, bones, liver and lungs. Urine and blood tests for metanephrine and normetanephrine are mandatory for diagnosing and monitoring the progress of treatment of these neoplasms.

Metanephrines and indications for analysis

Adrenaline (epinephrine) is produced in the adrenal glands and circulates in the bloodstream, leading to various responses of the peripheral nervous system to stress. Fear, aggression, pain provoke the release of this hormone. After the irritating and stress-causing factor has disappeared, and the mobilization of all body systems is no longer necessary, the production of adrenaline stops, and the excess hormone is metabolized within a few minutes. Matanephrine is a breakdown product of adrenaline. Thanks to the filtration ability of the kidneys, metabolites that the body does not need will soon be excreted in the urine. The content of unbound metanephrine in urine is normal and is a natural human response to stress.

With dysfunction of the adrenal glands, tumors on them or other neuroendocrine neoplasms, the production of catecholamines increases. In other words, the endocrine system releases an excess dose of hormones into the blood, and the purification system cannot cope with the removal, so their concentration in the blood and urine remains consistently high. This leads to a number of physiological disorders. They, in turn, become the basis for analysis for metanephrines. Among the main indications:

Tachycardia, causeless increase in heart rate, sudden increase in temperature, excessive sweating, wave-like attacks of heat.
High blood pressure that cannot be treated for a long time, increased intraocular pressure.
Panic attacks, tremors of the limbs, causeless anxiety and excitement, sudden changes in mood.
Blood sugar surges, pale extremities, tingling and numbness.
Detection of changes in adrenal tissue, tumors, cyst-like neoplasms.
The presence of a diagnosed pheochromacytoma in close relatives.

Normal values in blood and urine

To establish an accurate diagnosis, it is necessary to take blood and urine tests for bound and unbound metanephrine and normetanephrine. Standards vary depending on age. At the same time, free unbound metanephrines in urine and blood plasma are the most indicative marker of developing pheochromacytoma.

Normal values in urine

If the value in the analysis is given in nanomoles (nmol), you can recalculate it using the formula:

Metanephrine (mcg/day) = metanephrine (nmol/day)*5.07

The normal value of adrenaline metabolites in blood plasma is up to 120 pg/ml.

How to get tested for metanephrines?

To determine adrenaline metabolites, you can take a urine or blood sample. To test urine for metanephrine content, you need to collect daily urine output. Correct collection method:

Drain the first portion of urine in the morning.
Before each subsequent urination, perform hygiene of the external genitalia, collect urine in a sterile container, after adding a preservative.
All daily urine is stored in the refrigerator.
After collection is complete, the total quantity is weighed, mixed, and then an arbitration sample (approximately 60 ml) is taken.
The container is marked (full name, age, amount of daily urine, date and time of sample collection) and delivered to the laboratory no later than 2 hours from the moment of sampling.

To analyze the content of metanephrines in the blood plasma, a sample of venous blood is taken from the elbow.

Preparation

Careful preliminary preparation is necessary to obtain relevant analysis values.

Two days before the test, exclude from food: cocoa, avocados, tomatoes, bananas, cheese, pineapples, eggs, alcohol, vanillin. Reduce your consumption of caffeine-containing products as much as possible.
2-3 days before the study, stop taking medications that affect the liver and kidneys (antibiotics, adrenergic blockers, antivirals, anticonvulsants). Before stopping medications, be sure to consult with a supervising specialist.
Do not smoke at least three hours before donating a blood sample and during urine collection.
Limit physical activity during the day and eliminate any stress.

Assessing the results of the analysis and the factors influencing it

If the patient followed all the recommendations regarding diet, lifestyle and activity during the period of preparation for the test, and also carried out the sample collection procedure correctly, then the result will quite accurately indicate the presence of disorders in the functioning of the adrenal glands. However, elevated levels of metanephrines do not always indicate pheochromacytoma. Increasing the values is possible in the following cases:

Neurochromaffin tumors such as neuroblastoma, paraganglioma and others.
Chronic stress.
Heart failure, myocardial infarction, chronic angina.
Chronic and toxic hepatitis, liver cirrhosis.
Hypertension in the acute phase or during the manifestation of the disease.
Peptic ulcer disease during exacerbation.
Hypothalamic syndrome.
Alcohol, nicotine or drug addiction in the patient.
Long-term treatment with certain drugs (mainly used in the treatment of endocrine or neurological diseases).

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In what cases is a person required to undergo a urine test for metanephrines and normetanephrines, and what symptoms and factors indicate an urgent need to submit urine for testing? First you need to figure out what substances we are talking about, and why are they so important? Metanephrine and normetanephrine are a transitional stage in the destruction of adrenaline and norepinephrine produced in the endocrine glands - the adrenal glands. Since these hormones can also be produced by malignant tumors, the concentration of metanephrines in the urine can indicate tumors of the adrenal glands and other components of the endocrine system.

The amount of metanephrine and normetanephrine in the urine can be used to judge the functioning of the adrenal glands and other human systems.

The examination is prescribed exclusively by a doctor (general practitioner, oncologist, endocrinologist, cardiologist) to detect cancer developing in the nervous system, as well as a malignant tumor called pheochromocytoma. It is formed in the endocrine glands - the adrenal glands. As this disease progresses, large amounts of a substance called catecholamine are produced, which can be found in the urine. The presence of pheochromocytoma may be indicated by a number of symptoms that give rise to examination:

high blood pressure;
elevated temperature;
headache and dizziness;
cardiopalmus;
nausea and feeling of dry mouth;
increased sweating.

Return to contents

If the results of a general analysis for metanephrine show that the level of these substances is elevated, then there is a high probability of the formation and growth of pheochromocytoma. However, this tumor is rare, so the alarm may be false. It is necessary to resort to analysis for total metanephrine and normetanephrines, which must be taken to accurately diagnose this formation. If the thresholds of the elements are still elevated, it is worth undergoing an examination (MRI of the adrenal glands) and then starting a course of treatment.

An increase in the concentration of metanephrine and normetanephrine in the urine in people who have already experienced treatment for pheochromocytoma indicates the ineffectiveness of the course or a relapse of the disease. High levels of these substances in the urine may indicate ailments that affect the hypothalamus and dangerous situations in the field of cardiology, such as:

Test results for metanephrine and normetanephrine are sensitive to different circumstances. Therefore, preparation before starting the survey is important to obtain reliable data. Preparing for the test includes several rules:

3-4 days before urine collection, avoid the use of certain medications (Quinidine, Reserpine, adrenergic blockers and tranquilizers, teracycline antibiotics);
2 days before collection, do not consume certain drinks (tea, coffee, cocoa and drinks containing caffeine and alcohol), fruits (avocado, pineapple and banana), cheese;
avoid smoking 3-4 hours before urine collection;
eliminate stress on the muscles and nervous system.

The material for analysis is daily urine, because every 24 hours the content of elements necessary for examination in urine changes for many reasons. Portions of urine are collected throughout the day, starting in the morning, into a common container and daily diuresis (all collected daily urine) is calculated. Then 100 ml of the total amount of material is separated into a separate jar for analysis and submitted to the laboratory center.

Indicators for urine testing for metanephrine and normetanephrine are sensitive to many factors that should be excluded before collecting material for analysis. An increase in the amount of these substances in the body is influenced by the consumption of drinks containing caffeine and alcohol. Smoking also has a great influence on the production of detectable elements. Increased stress on the muscles and nervous system increases the release of adrenaline during and after stress, which contributes to changes in the concentration of metanephrines in the urine.

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The role of the adrenal glands in the human body is invaluable, because these paired organs produce catecholamine hormones - dopamine, adrenaline and normadrenaline. These, in turn, accelerate the spread of nerve impulses throughout the body, increase metabolism, promote the release of reserve energy from fat-soluble acids and glucose, dilate the bronchi and eye pupils, increase blood pressure and increase heart rate.

Analysis of 24-hour urine for metanephrines is an opportunity to determine the content of intermediate metabolites formed in high concentrations in adrenal cancer and other neurotumors.

high blood pressure values that are difficult to reduce with medications;
rapid heartbeat;
high body temperature, but the presence of infection in the body has not been confirmed;
constant headaches;
chronic sleep disorder;
severe constant dizziness, sometimes to the point of fainting;
changes in blood glucose levels, but diabetes has not been diagnosed;
losing weight with a balanced diet;
dry mouth;
causeless nausea;
panic attacks;
hyperexcitability.

The test is mandatory for persons who have been diagnosed with an adrenal tumor by ultrasound or MRI, as well as for those with a genetic predisposition to pheochromocytoma.

Using a urine test for metanephrines, doctors can diagnose other diseases, for example, acute or chronic hepatitis, myocardial infarction, angina pectoris, cirrhosis, and stomach ulcers.

The authenticity of the analysis results is influenced by many factors, so the patient needs to carefully prepare before submitting the biomaterial. First of all, a special diet is recommended 2-3 days before the study, excluding foods rich in serotonin - bananas, tomatoes, cheese, baked goods with vanilla, chocolate. You should also avoid drinking cocoa-containing and alcoholic drinks, strong tea, chicory, coffee, and dishes with added milk or yogurt.

3-5 days before the test, it is prohibited to take the following medications: nitroglycerin, insulin, paracetamol, aminophylline, beta-blockers, vasoconstrictor nasal drops, dexamethasone, diuretics, salicylates. After a course of antibiotic therapy with tetracycline drugs, at least 10 days must pass.

The patient should also avoid heavy physical activity, stress and intimate relationships for 2 days. It is advisable to refrain from smoking for at least 3-4 hours before the study.

If the test must be taken to the laboratory on Friday, then the patient begins the process of preparing for its delivery on Monday morning. From 8.00 Thursday to 8.00 Friday, he collects absolutely all the excreted urine into a previously prepared clean, dry container, for example, a glass jar. You must first pour a preservative taken from the laboratory into it. Store the biomaterial in a closed container in the refrigerator at a temperature of +2-+8 degrees.

After completing the collection, mix the contents of the jar, accurately measure and pour 100 ml into a special sterile container purchased in advance at the pharmacy. urine. It is this portion, along with the direction, that is taken to the laboratory.

Normal values for urinary metanephrine and normetanephrine levels vary slightly depending on the laboratory chosen for testing. The following indicators are considered acceptable:

in children 3-8 years old – 47-210 mcg/24 hours;
adolescents – 39-243 mcg/24 hours;
adult women – 140-320 mcg/24 hours;
adult men – 190-390 mcg/24 hours.

Only a specialist can decipher the results of the analysis in more detail, taking into account the characteristics of your health, age and other factors.

A blood test for metanephrines and normetanephrines can also be used to diagnose pheochromocytoma, neuroblastoma or ganglioneuroma. In this case, the biomaterial is taken from the ulnar vein. Preparation for it is the same as described above. The norm is a metanephrine level of no more than 120 picograms per 1 ml of plasma, and a normetanephrine level of up to 200 pg/ml.

Update date: 07/29/2018, next update date: 06/29/2019

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The need to test urine for the content of metanephrine in it does not arise so often. However, it occupies its “niche” in the diagnosis of a number of diseases, as well as the presence of specific patient complaints or characteristic symptoms. Correct preparation on the part of the patient and parallel assessment of the level of hormones and their metabolites in the blood will help to adequately interpret the analysis.

The adrenal glands are paired triangular-shaped endocrine glands. As the name suggests, they are directly adjacent to the top of the kidneys. The role of these glands in the process of adaptation of the human body to stress (physical or psychological) is the production of catecholamine hormones - dopamine, adrenaline and normadrenaline. They perform functions such as:

acceleration of the transmission of nerve impulses and metabolism;
release of additional energy from fatty acids and glucose;
dilation of the bronchi and pupils of the eyes;
increased blood pressure and heart rate.

Having carried out these functions, catecholamines are converted into inactive substances, including metanephrine and normetanephrine - intermediate products of the breakdown of adrenaline and norepinephrine, respectively. Normally, a small amount of unchanged hormones, as well as their metabolites, are excreted in the urine. Therefore, their presence in urine in small quantities, or an increase due to a stressful situation, is normal.

Excessive production of catecholamines in the blood (and, consequently, their breakdown products in the urine) is possible in the presence of pheochromocytoma and a number of neuroendocrine neoplasms. Indications for testing for metanephrine and normetanephrine will be:

symptoms that allow one to suspect the presence of pheochromocytoma - consistently high and sharply fluctuating blood pressure without obvious reasons, rapid pulse, profuse sweating, palpitations, high temperature;
arterial hypertension, difficult to correct with conventional medications;
neoplasms of the adrenal glands identified during ultrasound or MRI examination;
assessment of catecholamine-secreting tumors over time, as well as monitoring of their surgical or conservative therapy;
the patient has a genetic predisposition to pheochromocytoma.

The appearance of the listed symptoms is a reason to take an analysis for total (free plus bound) metanephrine and normetanephrine. Its norms for children and adults can be presented in the following table:

Age	Total metanephrine, mcg/day	Total normetanephrine, mcg/day
up to 3 months	5,9-37	47-156
3-6 months	6,1-42	31-111
6-9 months	12,0-41	42-109
9-12 months	8,5-101	23-103
1-2 years	6,7-52	32-118
2-6 years	11-100	50-111
6-10 years	54-136	47-175
10-16 years	39-243	52-290
adults	0-320	0-390

If the results are presented in other units of measurement, then the following calculation formula will help:

metanephrine (mcg/day) = nmol/day X 5.07;
normetanephrine (mcg/day) = nmol/day X5.46.

A more accurate diagnosis of pheochromocytoma or the effectiveness of its therapy can be achieved by measuring free metanephrines in the blood plasma. The rules will be as follows:

metanephrine – 120 picograms per 1 ml of plasma or 0.5 nmol/l;
normetanephrine – 200 picograms per 1 ml of plasma or 0.9 nmol/l.

The norms of free (unbound) hormone breakdown products in daily urine will be respectively:

metanephrine – 6-115 mcg/day;
normetanephrine – 10-146 mcg/day.

Reference values may vary slightly depending on the laboratory where the study is carried out.

Since hormone-secreting neuroendocrine tumors are rare, deviations from the norm can be caused by reasons such as:

stress – physical or psychological;
drinking alcohol or smoking;
features of the patient’s diet;
taking medications of various groups (diuretics, antihypertensive drugs (Adelfan), antiarrhythmic drug Propafenone (and other adrenergic blockers), insulins, Paracetamol, Eufillin, Tetracycline, vasoconstrictor nasal sprays and drops, tricyclic antidepressants).

If these factors are excluded and/or severe symptoms are present, as well as an increased level of free metanephrines in the urine, one should expect identification/confirmation of one of the following pathologies:

pheochromocytomas are tumors of the adrenal glands that produce excessive amounts of catecholamines. This is one of the most common reasons for conducting analysis;
benign and malignant neurotumors – ganglioneuromas, paragangliomas, symtoganglioblastomas, neuroblastomas;
disturbances in the functioning of the hypothalamus, accompanied by a malfunction of the symtoadrenal system;
hepatitis and cirrhosis of the liver - due to disruption of the breakdown process of catecholamines with adequate production;
exacerbation of hypertension (crises) and angina pectoris, myocardial infarction, heart failure;
acute manifestations of gastric or duodenal ulcers.

The study requires labor-intensive collection of 24-hour urine. You can get the most correct result and eliminate the possibility of a retake by paying a little attention to the following nuances of the preliminary stage:

Avoid taking medications that could affect the result (increase metanephrine levels) for 4 days before the day of urine collection. You can leave only the medications necessary for life, having warned the doctor about this.
2 days before the test, make some changes to your diet - give up chocolate and cocoa, tomatoes, bananas, pineapples, avocados, coffee, tea and alcohol (including beer), cheese, confectionery with the addition of vanillin.
Avoid nervous and physical overload - stress or heavy physical work.
Refrain from intimacy for 2 days before the test.
Do not smoke for at least 3-4 hours before and during urine collection.

Naturally, all these rules are also relevant during the process of donating biomaterial – throughout the day.

The sensitivity and accuracy of metanephrine tests may vary depending on the laboratory and the patient's body. However, on the recommendation of a doctor, it can be supplemented with tests for hormone metabolites in the blood or free metanephrines. As a result, this study will successfully cope with its main functions - identifying and monitoring pheochromocytoma and other hormone-secreting neoplasms.

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Metanephrines are metabolites that are formed as a result of the destruction of adrenal hormones (adrenaline, norepinephrine, dopamine)

Catecholamines are hormones that are produced in the adrenal medulla and act throughout the body. The release of catecholamines into the blood by the external environment is regulated, that is, they are all stress hormones. For example, a strong fear or some good event immediately leads to the release of catecholamines into the blood.

All organs of our body have their own receptors. Adrenergic receptors act on adrenaline and norepinephrine. There are two types of adrenergic receptors, alpha and beta. Norepinephrine is more related to alpha adrenergic receptors, and beta adrenaline, on the contrary. These two hormones are antagonists; they act on the same organ with opposite effects. For example, adrenaline increases and increases heart rate.

Norepinephrine is a mediator in nerve synapses, or more precisely in the postganglionic fiber of the sympathetic nervous system. Norepinephrine is located in the vesicles of the synapse. When an impulse passes along a nerve fiber, vesicles with norepinephrine break, and it enters the synoptic space, where it connects with receptors, and then a response occurs.

All catecholamines, after their preparation in the body, break down into metabolites. Dopamine breaks down to homovanillic acid, norepinephrine is converted to normetanephrine, and adrenaline is converted to metanephrine. All these substances are excreted in the urine and this is the norm.

A general urinalysis usually contains almost no metanephrine. Its amount can be increased through stress.

To accurately and correctly submit urine for this test, you need to adhere to several rules:

Two days before the test, you should not eat fruit, drink beer, or drink coffee.
You cannot take any antibiotics or adrenergic blockers.
You should not smoke three hours before taking tests.
It is advisable to collect a chronological history of the disease.

If you do a urine test correctly and there is an increased level of metanephrine, there is one reason for this - pheochromocytoma.

Pheochromocytoma is a tumor that is most often localized in the adrenal glands. Doctors have different opinions about which category to classify this tumor into, benign or malignant. Pheochromocytomas grow very slowly all the time, but do not extend beyond the adrenal glands.

If you do nothing about this terrible disease, then characteristic symptoms appear: increased blood pressure, mechanical damage to the adrenal glands, kidneys and even the heart, which can cause myocardial infarction.

A metanephrine test is done only to determine whether there is a pheochromocytoma or not.

Treatment is carried out in two ways: surgically or medicinally. Surgical treatment of pheochromocytoma consists of surgical resection of the adrenal glands or complete removal of the adrenal glands. During drug treatment, drugs are taken that inhibit or completely stop the release of catecholamines into the blood.

There are false positive tests, since this disease is very rare, and not everyone follows the rules for taking the test. Even if you follow all the rules, it is not a fact that you will not have some kind of stressful situation before the analysis.

If the test is positive against the background of symptoms of pheochromocytoma, then an MRI is prescribed to determine its location and size.

People who once had pheochromocytoma are required to get tested for metanephrines at least once a month, as this disease may return. Drug treatment simply inhibits the production of hormones, but the tumor does not go away. When performing operations, one cannot be sure either, since surgeons may not have removed part of the tumor that is growing.

The cause of increased metanephrine in urine can be, in addition to pheochromocytoma, damage to nervous tissue (paraganglioma, neuroblastoma).

Paraganlioma is a tumor that can be localized in any nerve. An increase in metanephrine is provoked by a tumor located in the sympathetic nerve fibers, as it synthesizes adrenaline and increases chemoreception.

Unlike pheochromocytoma, paraganglioma is almost always malignant, that is, it will metastasize throughout the body.

The symptoms of paraganglioma are very similar to various diseases. These are headaches, hypertension, tachycardia, shortness of breath, cyanosis of the hands and feet.

Diagnosis consists of blood and urine testing. There is an increased content of metanephrine in the urine. Well, in the blood, accordingly, there are catecholamines.

Treatment of paraganglioma, like all tumors, consists of surgery, but there is also a conservative method. This is radiation therapy. The operation is much more effective. Radiation therapy is used only when the tumor is located in a hard-to-reach place or the risk of surgery is too high.

Neuroblastoma, unlike pheochromocytoma and paraganglioma, is always malignant.

This is a tumor that is localized in the sympathetic nerve fibers, where it synthesizes adrenaline. It develops at the highest speed and gives metastases. In rare cases, it can turn into a benign tumor.

The symptoms are very pronounced. The main symptoms include: bone pain, general weakness, anemia, swelling, and sometimes fever. If the tumor is localized in the mediastinum, cough, pain in the chest cavity, and shortness of breath are added to the general symptoms. Subsequent symptoms are characterized by the organ damaged by metastases.

In the diagnosis of neuroblastoma, in addition to a general blood and urine test, MRI, CT, scintigraphy, and biopsy of the tumor itself and its metastases are used.

Similarly, the main treatment method is surgery. In addition, radiation and chemotherapy are used. Since neuroblastoma metastases often affect the bone marrow, a bone marrow transplant is required.

In most cases, neuroblastoma is diagnosed very late, that is, at the fourth stage, in which the survival rate of patients is no more than 20%. Normally, annual examination reduces the risk of developing tumors if they are diagnosed in the early stages of development.

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The adrenal glands play an important role in the body - they secrete two special hormones that regulate the cardiovascular, muscular and nervous systems. These are adrenaline and norepinephrine. After their natural breakdown, intermediate substances are released, which are gradually eliminated by the urinary organs. A urine test for metanephrine and normetanephrine helps determine the functional health of the kidneys and liver and promptly identify malignant tumors. The reliability of the result depends on the accuracy of preparation for the study and the correct collection of material, which involves changing the diet and stopping taking medications.

The adrenal glands are paired glands of the endocrine system adjacent to the top of the kidneys. They play an important role in the process of adaptation of the body to stressful situations (heavy physical activity, psycho-emotional stress). Their main function is considered to be the production of catecholamine hormones adrenaline, dopamine and norepinephrine, which contribute to the following reactions:

acceleration of metabolism and transmission of nerve impulses;
release of additional energy from fatty acids and glucose;
dilation of the pupils of the eyes, as well as the bronchi;
increased blood pressure;
increase in heart rate.

Upon completion of the above actions, the substances become inactive and break down into intermediate products - metanephrine and normetanephrine. Both are excreted by the kidneys and excreted in urine.

Metanephrines and normetanephrines are intermediate products of the breakdown of catecholamines. They are actively released into the blood during any stressful situations, so their presence in tests under these conditions is considered a variant of the norm. As a rule, in a calm state of the body, the amount of free substance in urine is small, which in no way affects a person’s well-being.

The concentration of metanephrines in urine can be monitored in two systems of change. In the first case, the norm indicators can be realistically presented in the form of a table.

If the results are presented in another measurement system, the concentration of intermediate degradation products can be calculated using the following formulas:

To more accurately diagnose pheochromocytoma or evaluate its therapy, the determination of free metanephrines in blood plasma is used. The following indicators are considered the norm:

M – 120 pg/1 ml of plasma or 0.5 nmol/l;
N – 200 pg/1 ml of plasma or 0.9 nmol/l.

Since neuroendocrine tumors capable of secreting specific stress hormones are considered a rare phenomenon, obvious abnormalities should alert both the patient and the doctor. In most cases, they can be caused by the following factors:

stress – physical or psycho-emotional;
excessive alcohol consumption or smoking;
features of the diet (meager, unbalanced, monotonous);
taking diuretic, antihypertensive, antiarrhythmic, vasoconstrictor drugs.

If the above factors are absent, or specific symptoms arise against their background, and the results of the analysis reveal an increased content of free metanephrines, it makes sense to expect the identification of one of the following pathologies.

Pheochromocytoma. The most common type of adrenal tumor, diagnosed primarily in adults. Characterized by excess production of catecholamines.
Tumoral neuroplasms of benign or malignant nature. This type includes paragangliomas, symptomtoganglioblastomas, and ganglioneuromas.
Impaired functioning of the hypothalamus, accompanied by a malfunction of the symptoadrenal system.
Exacerbations of angina pectoris, coronary artery disease, heart failure, hypertensive crises, myocardial infarction.
Hepatitis, liver cirrhosis. They are considered a consequence of a disruption in the process of catecholamine breakdown during their normal production.
Acute manifestations of gastric or duodenal ulcers.

Many patients are interested in knowing where, why, for what purpose and when it is necessary to analyze daily urine for intermediate products of the breakdown of adrenal hormones. They are interested in the procedure for preparing and performing the procedure, as well as its cost. And if a urine test for metanephrines has already been scheduled, then it makes sense to find out how to properly submit biomaterial. This curiosity is not considered idle, but is due to the rarity of the use of analysis in the traditional diagnosis of various diseases and the lack of adequate information.

Analysis of 24-hour urine for metanephrines has a high diagnostic value. It can be prescribed by specialists such as a therapist, endocrinologist, cardiologist, or oncologist if the formation of tumors in the form of neuroblastoma or paraganglioma in children and pheochromocytoma in adults is suspected.

The main indications for performing a urine test for metanephrines are the following.

Since the study is classified as atypical, it requires the presence of certain symptoms, in particular:

the appearance of headaches and dizziness;
dryness of the mucous membranes of the oral cavity;
nausea, sometimes ending in episodes of vomiting;
cardiopalmus;
increased blood pressure;
increased sweating, mainly at night;
tingling feeling in the limbs.

The reason for contacting a medical institution should be the persistence of these symptoms for 1-2 weeks. The patient is prescribed a general clinical examination of daily urine, and at the preliminary stage the laboratory assistant instructs in detail about the rules of preparation for the procedure.

The authenticity of the data obtained during the study is influenced by many factors, therefore the patient is required to be as focused as possible and strictly adhere to the rules and regulations for the collection and delivery of biomaterial. Before conducting a urine test for metanephrine and normetanephrine, according to the advice of specialists, proper preparation is needed. It involves performing the following actions:

For 2-3 days, completely eliminate the use of all medications, including antibacterial and antiviral drugs, adrenergic blockers, MAO inhibitors, vasoconstrictors and sedatives.
You should give up caffeine-containing drinks – strong tea, cocoa, coffee – 48 hours in advance.
During this period, you should avoid any physical and psycho-emotional stress, and devote it to rest and relaxation.

For two days, it is necessary to lighten your diet as much as possible, in particular, refrain from consuming products that contain stabilizers, preservatives and synthetic coloring pigments that can cause changes in the basic characteristics of urine. The following foods should be excluded from your diet:

In some medical institutions, the patient is given a preservative - a substance that ensures the safety of biological material. This point should be clarified in advance with your doctor or laboratory assistant who will conduct the study.

The material for the study is urine collected in one day, but at different times. Each portion has a different composition, which allows you to get maximum information about the state of the body. If the procedure is scheduled for Tuesday, then urine collection should be performed on Monday morning. Preparing biological fluid for analysis involves a certain algorithm of actions.

The first morning urine is highly concentrated, so it is not used, but is flushed into the toilet.
All subsequent urine discharges during bladder emptying, produced within 24 hours, that is, a day, must be collected in one container. For this purpose, you need to prepare a sterile glass jar and add a preservative provided by the laboratory to it.
Before each act of urination, it is recommended to thoroughly clean the external genitalia.
After urine collection is completed, the next morning, the patient is instructed to measure the volume of fluid obtained - daily diuresis.

Next, the contents of the jar should be mixed, and part of it, approximately 60-100 ml, should be poured into a sterile container. Paste a sticker on its surface, where the basic information is written: Full name. patient's age, daily diuresis, date and time of collection. The material is sent to the laboratory. The shelf life of urine is 4 hours from the moment of the last bowel movement. After the specified period, all properties lose their relevance.

In addition to tumors, metanephrines can be found in myocardial infarction, hepatitis, peptic ulcer disease in the acute stage, and alcohol intoxication. In the presence of leukemia, collagenosis, Addison's disease, connective tissue pathologies, acute or chronic infectious processes, as well as against the background of degenerative changes in the chromaffin cells of the adrenal cortex, a reduced level of metanephrine is noted. In this case, even correctly collected material can produce false results.

An increase in the concentration of metabolites is often due to the presence of the following factors:

dietary disorders;
drinking alcoholic beverages;
smoking;
sepsis;
taking narcotic substances.

It is carried out when a positive response is received in order to determine the level of stress hormones in the blood. If the repeated results coincide with the first ones, the patient is sent for a consultation with an oncologist and to the laboratory for a hemotest.

As a result of urine testing for metanephrine and normetanephrine, the patient has the opportunity to identify the hidden development of malignant processes at an early stage. Everyone knows that in advanced cases, therapeutic treatment for oncological pathologies is ineffective. Early diagnosis will allow you to get rid of tumor formations in a timely manner and save not only life, but also health. Despite the limited application, this study is considered highly informative and as accurate as possible. With its help, any patient can be attentive to their well-being and lead a normal lifestyle.

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A urine test for metanephrines is carried out for diagnostic purposes, as well as to assess the activity of tumors that provoke the release of catecholamines. This test can also be prescribed for pathologies accompanied by high blood pressure.

Functions of catecholamines:

glucose release;
dilated pupils;
opening of small bronchi;
vasoconstriction.

The presence of meta- and normetanephrines in a urine test indicates tumors of the adrenal glands, as well as neoplasms of the nervous system. Tumors commonly diagnosed using this test include:

pheochromocytoma;
paraganglioma;
neuroblastoma;
Symtoganglioblastoma.

They are often used to diagnose hypertension.

To do this, exclude the following products:

The test tube must be delivered for testing no later than four hours after the last collected portion. Analysis of 24-hour urine for metanephrines is carried out in a laboratory, for example, Hemotest, using ELISA.

Drugs that increase catecholamines in urine:

adelfan;
diuretics;
insulin;
antidepressants;
paracetamol;
antibiotics;
aminophylline.

The reduced level is due to the presence of acute leukemia, collagenosis, due to degenerative changes in the chromaffin cells of the adrenal cortex. Even a properly collected urine test for metanephrines can give false-positive results.

An increase in metanephrine concentration may be due to:

sepsis;
violation of diet;
smoking;
consumption of alcoholic beverages;
taking drugs.

The diagnosis, especially of tumors, if the patient has symptoms, is not rejected, but is clarified by further examination. Even with proper decoding, it is impossible to find out the size, good quality, and number of tumor nodes.

As a rule, after the first positive result, another control study is carried out. A test for total metanephrines and normetanephrines in the urine may also be ordered. Next, the patient is sent for an MRI.

A metanephrine test is prescribed to determine the level of stress hormones in the blood. For the “purity of the experiment,” it is necessary to avoid mental shocks before collecting urine for analysis. If in this case the indicators turn out to be high, consultation with an oncologist is necessary.

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The following symptoms are a significant reason to undergo an examination:

Constant high blood pressure in the arterial zone;
Increased sweating, mainly at night;
Increased pulse and heart rate;
Elevated temperature for a long period of time;
Dizziness and pain in the back of the head;
Nausea for no particular reason.

2-3 days before the scheduled test date, avoid taking any medications that damage the kidneys and other internal organs. You will also need to stop using antiviral antibiotics;
48 hours before the examination, give up drinks: cocoa, tea and coffee. In addition, the patient is contraindicated to consume any alcoholic or alcoholic substances;
5-6 hours before urine collection, the patient should avoid tobacco;
Eliminate any physical and psychological stress on your body. Take a day to rest;
Avoid products that contain preservatives or similar substances, as this will change the results obtained after testing.

The material for research is daily urine, because during this period of time it changes its composition due to many factors. Urine will need to be collected throughout the day.

You need to collect urine immediately after waking up. Go to the toilet and flush the initial urine into the toilet, fill the container with intermediate urine and send it to a cold place.

The next portion of urine is prepared after 13:00. Repeat the steps described above. The final stage occurs before bedtime.

Having passed a 24-hour urine test, the patient will be able to understand the pathologies developing in his body and, if necessary, take measures to eliminate them.

After receiving proper consultation, the patient will be prescribed a course of recovery that will stop the progression of the pathology and help return body functions to normal.

After the patient provides the collected urine, it will undergo a comprehensive examination to identify malignant tumors in the body. This procedure most often takes around 14 days.

The values of these substances in urine change with age. Therefore, it is important to know what indicators are normal so as not to panic without reason.

In the urine of children under 3 months of age, the following are considered normal indicators:

Metanephrine from 5.9 to 37 units;
Normetanephrine from 47 to 156 units.

For infants whose age ranges from 3 to 6 months, the norm is as follows:

Metanephrine from 6.1 to 42 units;
Normetanephrine from 31 to 111 units.

In the urine of children under 9 months of age, indicators should be within the following limits:

Normetanephrine from 41 to 109 units.

In infants under one year of age, normal values look like this:

Metanephrine from 12 to 41 units;
Normetanephrine from 23 to 103 units.

In a child from 1 to 2 years old, the levels of the substance in urine should be within these limits:

Metanephrine from 6.7 to 52 units;
Normetanephrine from 32 to 118 units;

In people over 16 years of age, metanephrine levels should not exceed 320 units, normetanephrine should not exceed 390.

These indicators are considered normal. If the analysis showed such values, this is evidence that everything is fine with the body and the patient does not require drug intervention.

It seems that deciphering the tests can be done independently, but you will need to contact a specialist and get an accurate conclusion about your health. Self-diagnosis will be largely incorrect.

If the results were inflated, undergo a re-examination to establish an accurate diagnosis.

A urine test for metanephrine is comparable to blood tests. Therefore, it allows you to determine or exclude the presence of the following diseases:

Tumors of the brain and adrenal glands;
Liver cirrhosis;
Ulcers of the stomach and rectum;
Hypertension.

If you receive results that are outside the normal range, get tested to detect any developing disease in your body.

Only an accurate diagnosis will allow effective treatment and stop the progression of malignant tumors.

You can get tested for metanephrine and normetanephrine in laboratories that are present in each region. No patient will have any difficulties with this.

Most often, such analysis is paid. The fee is conditional on the installation of high-quality equipment so that the results about the human body are reliable.

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If the level of catecholamines in the blood suddenly increases, what does this mean: this is how the body reacted to stress, in most cases caused by a physical or psychological process, emotional stress.

At this time, norepinephrine promotes vasoconstriction, as a result of which blood pressure rises, an excessive dose of adrenaline increases the heart rate, and metabolic processes accelerate.

But when there is a constantly impaired metanephrine and normetanephrine in the urine, such a symptom warns of the development of a tumor - pheochromocytoma. It is distinguished by the fact that it periodically produces large amounts of adrenaline and norepinephrine and is benign. There are no metastases in this case.

Also, an overestimated level of these hormones in a child’s body can reveal neuroblastoma, a tumor that develops before the age of 5. It arises from primitive nerve cells and can be found in the abdominal cavity, on the adrenal glands.

These are intermediate products in the metabolism of adrenaline and norepinephrine (catecholamines). They actively enter the blood during any stressful situations or physical strain, so their presence in tests under these conditions is a variant of the norm.

glucose release;
transmission of nerve impulses from the sympathetic nervous system;
dilated pupils;
opening of small bronchi;
vasoconstriction.

The catecholamines are then converted to vanillylmandelic acid. Then they are filtered by the kidneys and excreted in the urine.

increased blood pressure and rapid heartbeat,
increased indicator of the patient’s body thermal state,
the appearance of headaches and dizziness,
dryness in the mouth,
nausea,
increased sweating,
tingling sensation in the lower and upper extremities.

The results of the diagnostic study are of great importance for monitoring the treatment of patients, as well as the timely detection of benign neoplasms and cancerous tumors capable of synthesizing catecholamines in large quantities.

These substances, under the influence of a specific enzyme, are converted into adrenaline, norepinephrine and intermediate products of their breakdown, which include metanephrine and normetanephrine, and are excreted from the body along with urine.

Metanephrine and normetanephrine are substances that are intermediate products of the breakdown of adrenaline and norepinephrine. These hormones are produced by the adrenal gland. Every person's urine contains these compounds.

Under what circumstances should their exact level be determined? A urine test for metanephrines and normetanephrines is required if there is concern about the presence of pheochromocytoma disease. This disease is characterized by the formation of a malignant tumor in the adrenal gland. In addition, this test may help detect cancer in the nervous system.

frequent dizziness and headaches;
increased body temperature;
hypertension;
problems with water balance. Here you can note increased sweating and a frequent feeling of dry throat;
nausea;
cardiopalmus.

And if a urine test for metanephrines has already been scheduled, then it makes sense to find out how to properly submit biomaterial. This curiosity is not considered idle, but is due to the rarity of the use of analysis in the traditional diagnosis of various diseases and the lack of adequate information.

In fact, the analysis is carried out in the CityLab network of institutions, the Invitro laboratory, and the clinic for molecular diagnostics of SMD. On their websites you can ask a question and officially receive an adequate answer.

Determination of the level of metanephrine and normetanephrine in urine is carried out in cases where the patient has a suspected or already established presence of the disease:

Tumor of the adrenal medulla;
Paraganglioma;
Neuroblastoma;
Panic attacks (sympathoadrenal crises).

Symptoms of these pathologies may include:

Attacks of tachycardia (acceleration of heart rate);
Malignant arterial hypertension (high blood pressure that does not respond to antihypertensive drugs);
Tides;
Sweating;
Sudden attacks of fear of death.

This study is also carried out for any neoplasms detected by CT or MRI in the area of the kidneys or adrenal glands.

A urine test for metanephrine and normetanephrine is prescribed by an oncologist, endocrinologist, therapist, cardiologist, neurologist. You need to start preparing two days before the test.

To do this, exclude the following products:

Antibiotics, adrenergic blockers and some other medications are also discontinued. On the day of urine collection, you should not smoke, you should avoid stress.

It is necessary to collect daily urine output in a container with a preservative, excluding the first morning urine. The next morning, the contents of the container are carefully mixed, then up to sixty milliliters are separated into a sterile container indicating the full name, year of birth, measured daily volume of urine, date, and time of collection.

Analysis of metanephrines in urine has a high diagnostic value. It is quite sensitive - it clearly identifies the disease even at small concentrations and is specific - it allows an accurate diagnosis, while testing for catecholamines is not always advisable, since these substances are destroyed very quickly.

The main indications for determining metanephrines in urine are as follows:

Diagnosis and observation of catecholamine-secreting tumors: neuroblastoma, ganglioneuroma, pheochromocytoma, paraganglioma, etc.;
Monitoring the effectiveness of the therapy and predicting the patient’s condition during the rehabilitation period after removal/conservative treatment of the tumor;
Establishing the causes of hypertensive conditions. If arterial hypertension does not respond well to conservative treatment, then it should be assumed that the pathology is associated with the activity of pheochromocytoma;
Suspicion of a neuroendocrine disease (based on ultrasound or MRI results);
Screening of patients at risk (hereditary predisposition).

The results of the analysis are prescribed and interpreted by specialists: oncologist, endocrinologist, general practitioner.

Drugs that increase catecholamines in urine:

adelfan;
diuretics;
insulin;
antidepressants;
paracetamol;
antibiotics;
aminophylline.

Proper preparation for collecting 24-hour urine

Permissible content of breakdown products of adrenaline and norepinephrine

General information

How soon can you receive analysis results?

Where to get tested

Conclusion

Pheochromocytoma

Metanephrines and indications for analysis

Normal values ​​in blood and urine

Normal values ​​in urine

How to get tested for metanephrines?

Preparation

Assessing the results of the analysis and the factors influencing it

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Normal values in blood and urine

Normal values in urine