What is the VMA Excretion test?

The VMA (Vanillylmandelic Acid) Excretion test measures the amount of VMA eliminated in urine, usually over a 24-hour urine collection. VMA is the main end-product of adrenaline and noradrenaline metabolism.

Because catecholamines fluctuate throughout the day, urine testing provides a more reliable assessment than a single blood sample. Elevated VMA levels suggest increased catecholamine production in the body.

Clinically, this test is most commonly used in the investigation of pheochromocytoma, paraganglioma, and neuroblastoma, as well as in the evaluation of unexplained hypertension or adrenergic symptoms.

Why do I need a test for VMA Excretion?

Excess catecholamine production can cause significant cardiovascular and neurological symptoms and may indicate an underlying tumour of the adrenal glands or sympathetic nervous system.

VMA testing helps identify or exclude these conditions and supports further diagnostic pathways when symptoms are suggestive but non-specific. It is often requested alongside other catecholamine or metanephrine tests.

You may need a VMA Excretion test if you experience:

• Persistent or episodic high blood pressure
• Severe headaches
• Palpitations or rapid heartbeat
• Excessive sweating
• Anxiety or panic-like episodes
• Unexplained weight loss
• Suspected neuroendocrine tumours
• Monitoring of known catecholamine-secreting tumours

Benefits of the VMA Excretion test

1. Supports tumour investigation
   Useful in assessing suspected pheochromocytoma or neuroblastoma.
2. Assesses catecholamine metabolism
   Reflects breakdown of adrenaline and noradrenaline.
3. Non-invasive testing method
   Uses urine rather than blood sampling.
4. Reduces diagnostic uncertainty
   Helps differentiate hormonal causes of symptoms.
5. Supports hypertension evaluation
   Useful when high blood pressure is unexplained.
6. Monitors disease progression
   Can be used to track treatment response in known cases.
7. Provides integrated metabolic insight
   More stable measurement than single blood catecholamines.
8. Guides further specialist testing
   Helps determine need for imaging or endocrine referral.

Step-by-step – How we offer this test

Option 1: Clinic-based test (UK-wide)

• Choose your nearest UK clinic
• Collect your urine container
• Complete a 24-hour urine collection at home
• Return the sample to the clinic for analysis

Option 2: Home or hotel service (+£60, UK-wide)

• A phlebotomist delivers the collection kit
• Instructions provided for 24-hour urine collection
• Sample collected from your location
• Sent to the laboratory for analysis

Your results explained

Low VMA levels

Low VMA levels are generally not clinically significant and usually indicate normal or low catecholamine turnover.

UK reference range (low):

• < 10 µmol/24 hours

Low results rarely require further investigation.

Normal VMA levels

Normal levels suggest typical catecholamine metabolism with no biochemical evidence of excess production.

UK reference range (normal):

• 10 – 35 µmol/24 hours

Within this range, catecholamine-secreting tumours are unlikely.

High VMA levels

High VMA levels indicate increased catecholamine breakdown and may suggest a hormone-secreting tumour or severe physiological stress.

UK reference range (high):

• > 35 µmol/24 hours

Elevated results usually prompt further endocrine testing and imaging.