Catecholamines, such as dopamine and adrenaline, are hormones that the brain, nerve tissues, and adrenal glands produce. They are responsible for the body’s “fight-or-flight” response.

Dopamine, adrenaline, and noradrenaline are all catecholamines. The body releases catecholamines in response to emotional or physical stress.

Unusually high or low levels of individual catecholamines can cause medical issues. High or low levels of multiple catecholamines can indicate a serious underlying medical issue.

This article outlines how catecholamines function and what high or low levels may indicate about a person’s health. It also discusses some ways in which a doctor may test a person’s catecholamine levels.

an abstract image of nerves in the brain where catecholamines are carried through the bodyShare on Pinterest
Dopamine, adrenaline, and noradrenaline are the main types of catecholamine.

Catecholamines are hormones that also function as neurotransmitters. The body produces them in the brain, nerve tissues, and adrenal glands. The adrenal glands are located just above the kidneys.

The main types of catecholamine are dopamine, adrenaline, and noradrenaline. These hormones function in the following ways:


This neurotransmitter sends signals throughout the nervous system. It helps regulate the following:

  • movement
  • emotions
  • memory
  • the brain’s reward mechanism

Adrenaline, or epinephrine

This neurotransmitter is responsible for the fight-or-flight response. When a person experiences stress, the body releases adrenaline to allow increased blood flow to the muscles, heart, and lungs.

Noradrenaline, or norepinephrine

This neurotransmitter helps the body respond to stress. Noradrenaline release increases a person’s heart rate and blood pressure. It is also involved in mood regulation and the ability to concentrate.

Catecholamine levels that are too low or too high can sometimes indicate an underlying health issue.

The main reason a doctor will test a person’s catecholamine levels is to check for the presence of certain tumors, such as a neuroendocrine tumor or a neuroblastoma. The following sections will look at these in more detail.

Neuroendocrine tumors

Neuroendocrine tumors are those that develop from cells in the hormonal and nervous systems. These tumors can produce high levels of catecholamines.

Pheochromocytomas are neuroendocrine tumors present in adrenal glands. Around 80–85% of pheochromocytomas grow in the inner layer of the adrenal glands, while the remaining 15–20% grow outside of this area.

Some possible symptoms of a pheochromocytoma include:

Although generally benign, some pheochromocytomas may continue to grow without treatment. The symptoms may worsen as the tumor grows, causing possible damage to the kidneys and heart.

Tumor growth also increases the risk of a stroke and heart attack.


A neuroblastoma is a type of cancer that occurs in specialized nerve cells called neuroblasts. Most of the time, this cancer develops in an adrenal gland or in the nerve tissues that run alongside the spinal cord. Neuroblastomas can cause increased levels of catecholamines.

Neuroblastomas are the most common cancer in infants and account for 6% of all childhood cancers. They are rare in people over the age of 10.

Some possible symptoms of a neuroblastoma include:

To test a person’s catecholamine levels, a doctor will order a blood or urine test.

A person having a catecholamine urine test will need to collect their urine in a bottle over the course of 24 hours. This bottle contains a small amount of acid that helps preserve the urine. The person should keep the urine sample cool until they can return it to their doctor.

A catecholamine blood test involves drawing blood from a person’s arm or hand and sending the sample for analysis.

Additional testing

Once a doctor receives a person’s catecholamine test results, they can determine whether or not further testing is necessary.

Tests for pheochromocytomas can produce false positives. This occurs when the test result indicates that a person has a pheochromocytoma when they do not.

Because of this possibility, the doctor will take into account other aspects of a person’s health, such as their:

  • physical condition
  • current medications
  • diet
  • emotional state

In some cases, the doctor may conduct additional or repeated tests to confirm a diagnosis.

If the doctor suspects that a person has a tumor, they will order an imaging test, such as an MRI or CT scan. If imaging tests confirm the presence of a tumor, the doctor may order a biopsy test to determine the tumor type.

High or low levels of individual catecholamines can lead to a range of symptoms. The sections below outline these in more detail.

Abnormal dopamine levels

High dopamine levels may lead to the following symptoms:

Chronically high levels of dopamine may be related to the following conditions:

Scientists have also linked a lack of dopamine to some degenerative conditions, such as Parkinson’s disease.

Abnormal adrenaline levels

A person with high levels of adrenaline may experience the following symptoms:

Having low adrenaline levels could inhibit a person’s ability to respond appropriately to stressful situations.

Abnormal noradrenaline levels

High levels of noradrenaline can cause the following symptoms:

  • panic attacks
  • hyperactivity
  • shaking
  • sweating
  • high blood pressure
  • an irregular heartbeat
  • a pale face
  • severe headaches
  • heart or kidney damage

Low levels of noradrenaline may cause the following symptoms or conditions:

There are a number of medications that can interfere with catecholamine levels and catecholamine testing. These include:

  • epinephrine
  • amphetamines
  • acetaminophen
  • aspirin
  • insulin
  • appetite suppressants
  • diuretics
  • clonidine
  • vasodilators
  • blood pressure medications, including ACE inhibitors, methyldopa, and reserpine
  • the heart medication nitroglycerin
  • propafenone, which helps treat heart rhythm issues
  • the asthma medications aminophylline and theophylline
  • the steroid dexamethasone
  • tricyclic antidepressants
  • the antidepressant imipramine
  • monoamine oxidase inhibitors
  • lithium
  • the sedative chloral hydrate
  • the antibiotic tetracycline

Caffeine, alcohol, and nicotine can also affect catecholamine levels, as can certain foods, including bananas, pineapples, and peppers. A person who is due to undergo a urine test should avoid these foods for 24 hours beforehand.

Treatment options for low or high catecholamine levels depend on the cause.

Generally, a doctor will only check a person’s catecholamine levels if they suspect that the person has a tumor or if they want to rule out this possibility.

The sections below outline some possible treatment options.

Treatment for pheochromocytoma

A person who has a pheochromocytoma may need one or more of the following treatments:

  • surgery to remove the tumor and possibly the adrenal glands
  • radiation therapy
  • chemotherapy
  • ablation therapy, which uses very hot or cold substances to target and destroy abnormal cells
  • targeted therapy, which is a treatment that uses drugs or other substances to attack specific cancer cells while leaving normal cells untouched
  • embolization therapy, which blocks blood flow to the affected adrenal gland, thereby killing the tumor

Treatment for neuroblastoma

A person who has a neuroblastoma may need one or more of the following treatments:

  • surgery to remove the tumor
  • radiation treatment
  • chemotherapy
  • targeted therapy
  • immunotherapy, which is a treatment that helps the body’s own immune system destroy cancer cells
  • iodine 131-MIBG therapy, in which a doctor injects radioactive iodine into the bloodstream to kill cancerous cells

In most cases, pheochromocytomas are benign and tend not to spread beyond the place where they originally developed. This type of tumor also tends not to reoccur after removal.

Treatment success rates for neuroblastomas depend on the level of risk the tumor presents. A doctor will use the following factors to determine the risk:

  • the stage of the neuroblastoma, which is a measure of how advanced the tumor is
  • the biology of the neuroblastoma, which includes:
    • the pattern of the tumor cells
    • the genes involved in the tumor’s growth
    • the rate at which the tumor cells are growing
  • the histology of the neuroblastoma, which is a measure of how abnormal the cancer cells look under a microscope and how quickly the cells are likely to grow and spread
  • the person’s age

A doctor will use the above factors to determine the risk group to which the neuroblastoma belongs.

Low risk and intermediate risk neuroblastomas have a good chance of resolving. However, high risk neuroblastoma may be more difficult to treat.

A person should see a doctor if they experience any of the following symptoms:

  • persistent high blood pressure
  • a fast or irregular heartbeat
  • tremors
  • excessive sweating
  • severe headaches

Though rare, high catecholamine levels can indicate a tumor, such as a neuroendocrine tumor or neuroblastoma.

Extreme levels of individual catecholamines are also associated with certain conditions, such as schizophrenia, ADHD, depression, and Parkinson’s disease.

A person should see a doctor if they experience any symptoms of abnormal catecholamine levels.

A doctor may order a blood or urine test to determine whether a person’s levels are normal or abnormal. The results of either test will help the doctor determine whether or not further tests and treatments are necessary.