Plasma catecholamines - Adrenaline and Noradrenaline

Catecholamines are very important substances for our body, participating in the transmission of nerve impulses and being responsible for the "fight or flight" mechanism.

The most important catecholamines I'm there noradrenaline, also called norepinephrine, and theadrenaline, or epinephrine. They are compounds produced starting from the amino acid tyrosine, soluble in water, which circulate in our blood largely bound to plasma proteins.

Normal values of catecholamines

Adrenaline (epinephrine): <0.5 pg / ml or <2.7 nmol / nl

Noradrenaline (norepinephrine):

Plasma catecholamines are hormones that are continuously synthesized and secreted by the adrenal medulla, with production increases in response to stressful conditions. They are partly catabolized (processed and broken down into other products) in the liver and excreted by the kidney in the form of homovanyl acid, vanilmandelico, metanephrine is normetanephrine, and to a small extent in an unchanged state.

Adrenaline and noradrenaline act in different ways on different organs and systems. Here are some functions of these catecholamines:

  • cardio-circulatory system: adrenaline increases heart rate and systolic output, ie the amount of blood pumped into the circulation by the heart after each beat, while noradrenaline decreases it; adrenaline increases the systolic pressure (i.e. the maximum pressure), noradrenaline increases the systodiastolic pressure, i.e. both the maximum and the minimum.
  • Sugar or carbohydrate metabolism: adrenaline causes an increase in blood sugars (hyperglycemia) as it increases the activity of hepatic glycogenolysis, i.e. the destruction of the carbohydrate reserve in the liver, glycogen, with the release of large amounts of sugars into the circulation. Noradrenaline does not cause changes in blood sugar.
  • Oxidative metabolism: adrenaline increases oxygen consumption in the peripheral tissues by 20%, noradrenaline does not significantly change it.

Elevated plasma catecholamines

There are several conditions that result in an increase in blood adrenaline and noradrenaline. Below is a list of the main conditions responsible for high norepinephrine and high adrenaline.

  • Pheochromocytoma (usually higher noradrenaline than adrenaline): The diagnosis of pheochromocytoma is often made with suppression or provocation tests in the suppression test clonidine or small pan are administered intravenously, which normally cause blood catecholamine levels to drop: the reduced or absent suppression of catecholamines in the blood after the test is strongly indicative of the presence of pheochromocytoma. The provocation test instead it consists in the intravenous injection of histamine or colon glucagon these substances increase the plasma and urinary catecholamines in 90% of patients but a very consistent increase, i.e. greater than 2000 pg / ml (picograms per milliliter) in a short time in less than 3 minutes is strongly suggestive for the presence of pheochromocytoma.
  • Neuroblastoma
  • Ganglioneuroma
  • Paraganglioma
  • Physical and psychic stress
  • Acute myocardial infarction chronic cardiac ischemic disease
  • Orthostatism
  • Drugs (theophylline, vasodilators, suspension of treatment with clonidine)
  • Volume depletion
  • COPD
  • Heart failure
  • TIA
  • Encephalitis
  • Hypotroidism
  • Hypoglycemia
  • Diabetic ketoacidosis
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2 Comments
  1. Vito Nuzzolese 4 years ago

    I would like to know how much alpha lytic intake can affect the finding of elevated plasma catecholamines

    • Testlevels 4 years ago

      Hi, alpha lytics do not seem to be among the drugs that can interfere with the result of catecholamines. The substances interfering with the catecholamine test are: paracetamol, aminophylline, clonidine (Catapresan), amphetamine, xanthine derivatives such as coffee, tea and other forms of caffeine, chloral hydrate, dexamethasone, diuretic drugs, epinephrine, ethyl alcohol, insulin, imipramine, lithium, methyldopa (Aldomet), MAO inhibitors (monoamine oxidase), nicotine, nitroglycerin, nasal decongesant drops, propafenone (Rytmonorm), resurpina, ac. acetylsalicylic such as aspirin and Cardioaspirin, theophylline, tetracyclines, tricyclic antidepressants and vasodilators. The effect of these drugs on the catecholamine test can vary from person to person and is often not predictable.

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