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Epinephrine 24-hour Urine

Urinalysis

Adrenaline 24-hour urineEpi 24h urineUrinary epinephrine

Review status

Currently under review

Pending specialist review and validation.

What it shows

This test measures the amount of epinephrine (also called adrenaline) your body excretes into the urine over a full 24-hour period. Epinephrine is a hormone and neurotransmitter made mainly by the adrenal glands that helps your body respond to stress by affecting heart rate, blood pressure, and metabolism.

A 24-hour urine collection captures fluctuations that can occur during the day, providing a more complete picture than a single spot sample. The result reflects your total daily epinephrine output and can help your clinician evaluate conditions that affect adrenal hormone production.

Why it matters

Doctors order this test when symptoms suggest surges of stress hormones, such as episodes of severe headache, palpitations, sweating, anxiety, or hard-to-control blood pressure. It helps evaluate for catecholamine-producing tumors and other conditions that cause abnormal adrenal hormone release. It may be used alongside tests for related hormones and their metabolites to improve diagnostic accuracy.

Results can guide next steps, such as repeating testing with careful preparation, obtaining blood tests for related compounds, or imaging when appropriate. Understanding your epinephrine excretion can also help tailor treatment plans and monitor response if a condition is found and treated.

Understanding your results

Your clinician will interpret your result in the context of your symptoms, medications, and how the collection was performed. Higher-than-expected values can occur with certain tumors, but can also be seen with stress, intense exercise, some medications, or an incomplete preparation for the test. Lower values are usually not worrisome unless there are specific clinical concerns.

If your result is unexpected, your care team may confirm collection quality, review drugs and diet that can interfere, and consider repeat testing or complementary tests such as plasma or urine metanephrines. Follow-up is individualized, and many out-of-range results have non-tumor explanations. Discuss any questions with your clinician, who will integrate these findings with your overall health picture.

Reference ranges

-- nmol/d
All sexes
0 days – 18 years
0473 nmol/d
All sexes
18 years – 150 years

Reference intervals vary by laboratory, analyzer, methodology, population, and units. The ranges shown here are for education only. Always interpret your results against the reference interval printed on your own lab report.

Factors that could impact Epinephrine 24-hour Urine

  • Diet and beverages

    Caffeine, alcohol, and foods like bananas, chocolate, and vanilla can influence catecholamine measurements. Your clinician may advise dietary restrictions before and during the collection to reduce false positives.

  • Medications and supplements

    Decongestants, stimulants, antidepressants, beta blockers, monoamine oxidase inhibitors, and levodopa can alter results. Provide a complete list of prescriptions, over-the-counter products, and supplements so your clinician can advise on temporary holds if safe.

  • Stress, exercise, and illness

    Physical exertion, acute pain, anxiety, or illness can raise epinephrine output. Try to avoid strenuous activity and unusual stressors during the collection unless your doctor instructs otherwise.

  • Collection quality and timing

    Accurate 24-hour timing, using the provided container and preservative, and keeping the sample cool are critical. Missing voids, spilling, or incorrect start and stop times can lead to misleading results.

  • Smoking and nicotine

    Cigarettes, vaping, and nicotine replacement can increase catecholamine release. Avoid nicotine during the collection period if your clinician says it is safe to do so.

  • Kidney function and special populations

    Reduced kidney function can affect urinary excretion and interpretation. Pregnancy and childhood may require tailored interpretation or complementary tests; let your care team know if these apply to you.

2026

References

  1. McGill University Health Centre. (2021, November 12). Epinephrine 24 hr Urine (Task CD 699384). Laboratory reference ranges.
  2. McGill University Health Centre. (2022, April 12). Epinephrine 24 hr Urine (Task CD 699387). Laboratory reference ranges.
  3. Lenders, J. W. M., Duh, Q. Y., Eisenhofer, G., Gimenez-Roqueplo, A. P., Grebe, S. K., Murad, M. H., Naruse, M., Pacak, K., & Young, W. F. (2014). Pheochromocytoma and paraganglioma: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 99(6), 1915–1942.