What Are Nomrmal Reference Ranges For Catecholamines

[blobbydodger]

Hi there i am currently undergoing tests for POTS through the hospital specialist, however i undertook a private blood test myself to measure my Catecholamines (i thought it would go well with the urine test they ordered)and the results have come back saying i have elevated Catecholamines.

Please can someone tell me what this means as the test was arranged by myself and not my POTS specialist who is doing their own 24hr urine test next week.

Plasma Catecholamines

Plasma Adrenaline 1.19 nmol/l

Plasma

Noradrenaline

2.84 nmol/L

Probability of

phaeochromocytosis:

NORMETADRENALINE

METADRENALINE

<1.3nmol/L <0.7nmol/L LOW

PROBABILITY

1.3-2.18nmol/l 0.7-1.2nmol/L

MED PROBABILITY

>2.19nmol/L >1.2nmol/L HIGH

PROBABILITY

I know i should have just let the hospital do the tests but now im confused. Can someone explain please.

My Pots specialist thinks i may have the hyperadrenergic state of PoTS. Does this test rule this out?

The whole POTS thing still baffles me sorry

[blobbydodger]

Should I forward these results to my Pots doctor or would it be best to wait until I have the 24 hr urine catecholamine test next week. I just wish I knew what was happening to me, I have symptoms of Pots and have had for years but it's really bad now and I'm desperate for help and info which is why I ordered my own test although in hindsight it may have been a silly thing to do.

[blobbydodger]

Below is what the email sent to me regarding my private test results....please be aware the private doctor performing the test wasn't aware of my possible POTS.

Please find attached your results in PDF format, and our Doctor's comments directly below.

The adrenaline and noradrenaline levels appear to be high in this sample. This may mean you have a condition known as phaeochromocytoma in which excessive amounts of adrenaline type compounds are manufactured by the body.

I advise you to make contact with your usual doctor to discuss this finding.

[kayjay]

So I cannot speak to your results specifically. I can tell you that I will test positive for a pheochromacytoma via labs.

I was diagnosed by Johns Hopkins with a pheo and sent to NIH for a full work up with one of the leading experts on "pheos"

I do not have a pheo. I have hyperadenergic POTS.

Hope this helps.

[sue1234]

Kjay, I remember you mentioning that before. It's amazing that you and maybe some other POTSies can have such high catecholamines to equal a pheo patient, and yet the pheo patient is able to remedy theirs through surgery. We, on the other hand, have to continue to have it wreak havoc in our bodies. Yes, I'm sure some are on alpha/beta blockers for it, but it is an unending issue none the less.

[kayjay]

Sue, unfortunately I think it depends on what type of doctor you see. I stay away from endo's. They always see "pheo".

Even after pheo was excluded as a diagnosis for me, a top endochronogist told me that he was sure I had a pheo it was just "too small to see".

That was almost 12 years ago. Hmmm... No pheo.

[sue1234]

Kjay, I'm sorry, I wasn't implying that you had a pheo, just that POTS can cause some to have such high catecholamines. Sorry if my wording wasn't clear!

[kayjay]

Oh no! Please don't apologize Sue! I only meant that to get a proper diagnosis we have to see the correct type of doctor.

I guess I don't write clearly. .

I had to get to a good EP and neurology department.

[sue1234]

I agree! And that is hard to find, for sure!

[corina]

Blobby, I would forward the results to my POTS doctor and email/call to discuss. I would like to have a pheo ruled out to move on and see wether it has to do with the Hyperadrenergic state. I think it's commonly seen in Hyperadrenergic POTS.

[POTLUCK]

They thought I had a Pheochromocytoma a few years ago. I even had an MIBG scan and CT. The doctor should be able to decide based on plasma metanephrines and normetanephrines. (If there si any question after he/she looks at your labs.) I am not as familiar with the urine test above in terms of normal ranges, but know it can also be an indication. Pheo is very very rare. The lab values should be at least 3-4 times above normal, and I would repeat them before going to expensive and fancy scans etc. The scans are NOT better at predicting the pheo than the labs which is important because one tends to feel they want the scan to be sure.

With me the lab Epinephrine and Norepinephrine came out sky high lying and standing like 10 times normal, so we thought it was pheo. Then to complicate it the MIBG showed pheo and the CT did not. In the end I did a plasma metanephrine and normetanephrine that were negative. I probably should repeat it since it has been over a year just to make absolutely sure. It would be nice to have a pheo, an operation and be well but I do not think that is to be my luck.

[blobbydodger]

Thanks everyone for all your input, I have forwarded my results to my POTs Doctor and will see what they say next week.

[kayjay]

Ok -hyjack to POTLUCK- did you get a pet scan?

I had a "shadow" or "spot" on my MIBG but it was nothing. Just wondering if a pet scan would put your mind more at ease.

[POTLUCK]

KJay- Thanks for the thoughts on the PET! It is supposed to be better diagnostically than the other scan tests. I have not been seeing docs much for a while and just made an appointment with a new primary. He mentioned PET in passing. I am seeing him again soon as it is overwhelming to the doctor when I see a new one there are so may docs and diagnosis and all for them to understand. Was thinking might be overkill to get PET, and just repeat plasma metanephrine and normetanephrine. I have read such an incredible amount on this subject. I will of course go with my doctors advice but he is likely to be interested in my opinion.

You are right the very tiny possibility that a Pheo was missed ( In light of several positive tests) is still worrisome to me as it is such a serious illness to overlook.