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Alias Names: VMA / 3-methoxy-4-hydroxy-manelic acid, VMA, Urine
Methodology: High Performance Liquid Chromatography (HPLC)
Edit Date: 6/11/2010
Performed: Sunday, Tuesday-Saturday
Released: 24-72 hours after setup at PeaceHealth Laboratories’ reference lab.
CPT Code: 84585-90
Specimen Collection Details
Collection: 24-hour or random urine. Refrigerate during and after collection. NOTE: Patient to abstain from medications for 72 hours prior to collection.
Handling: 5 mL aliquot from a well-mixed 24-hour or random collection. Refrigeration is the preferred method of preservation. Record total volume and collection time interval on transport tube and requisition.
Stability: 7 days refrigerated or 14 days frozen. Specimen unstable ambient.
Standard Volume: 5 mL urine.
Minimum Volume: 1 mL urine.
Transport: Refrigerated.
Comments: Moderately elevated VMA (vanillylmandelic acid) can be caused by a variety of factors such as essential hypertension, intense anxiety, intense physical exercise, and numerous drug interactions (including some over-the-counter medications and herbal products).

Medications that may interfere with catecholamines and their metabolites include amphetamines and amphetamine-like compounds, appetite suppressants, bromocriptine, buspirone, caffeine, chlorpromazine, clonidine, disulfiram, diuretics (in doses sufficient to deplete sodium), epinephrine, glucagon, guanethidine, histamine, hydrazine derivatives, imipramine, levodopa (L-dopa, Sinemet®), lithium, MAO inhibitors, melatonin, methyldopa (Aldomet®), morphine, nitroglycerin, nose drops, propafenone (Rythmol), radiographic agents, rauwolfia alkaloids (Reserpine), tricyclic antidepressants, and vasodilators. The effects of some drugs on catecholamine metabolite results may not be predictable.

Reference Interval
Vanillylmandelic acid (VMA) results are expressed as a ratio to creatinine excretion (mg/g cr). VMA mass per day (mg/d) is not reported on specimens from patients younger than 18 years of age, the urine collection is random or other than 24-hour, or the urine volume is less than 400 mL/24 hours.

The VMA-to-creatinine ratio wil be reported when the patient is under 18 years, the urine collection is random or other than 24-hours, or the urine volume is less than 400 mL/24 hours.

VMA Urine ≥18 years 0.0-7.0 mg/d

PeaceHealth Laboratories