Elevated Vanillylmandelic Acid

An increased urinary excretion of vanillylmandelic acid (a catecholamine metabolite) above the reference range (adults: ~1-10 mg/24 hours or ~0-6 mg/g creatinine in a random urine sample; children: ~0-4 mg/24 hours), reflecting increased metabolism of epinephrine and norepinephrine.

Causes

• Catecholamine-secreting tumors

  • Pheochromocytoma

  • Paraganglioma

  • Neuroblastoma

• Physiological stress and critical illness

  • Major trauma

  • Burns

  • Sepsis

  • Severe physical stress

• Medications

  • Levodopa

  • Amphetamines

  • Tricyclic antidepressants

  • Monoamine oxidase (MAO) inhibitors

• Dietary factors

  • Bananas

  • Coffee

  • Vanilla

  • Tea

  • Chocolate