Newcastle Laboratories

5'-hydroxyindole acetic acid (5HIAA), urine

Clinical Background:

Intestinal carcinoid tumours along with neuroendocrine tumours can produce excess amounts of serotonin (5-hydroxytryptamine, 5-HT), which is a vasoactive, powerful smooth muscle stimulant. Serotoni...

Intestinal carcinoid tumours along with neuroendocrine tumours can produce excess amounts of serotonin (5-hydroxytryptamine, 5-HT), which is a vasoactive, powerful smooth muscle stimulant. Serotonin is metabolised to 5-hydroxyindoleacetic acid (5-HIAA) and excreted into urine. Elevated 5-HIAA levels are almost always associated with carcinoid syndrome while mildly elevated levels can occur in non-tropical sprue or from a dietary source such as walnuts, bananas and other serotonin containing fruits. 

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Test Details

  • Discipline:

    Biochemistry

    Biochemistry

  • Specimen Container Adult:

    24 urine collection: a 24 hour urine collected into a container with sand and sulphuric acid preservative.

    Overnight urine collection: an overnight urine collection into a container with sand and s...

    24 urine collection: a 24 hour urine collected into a container with sand and sulphuric acid preservative.

    Overnight urine collection: an overnight urine collection into a container with sand and sulphuric acid preservative.

    Random urine collection: white universal container  [Send to laboratory immediately].

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  • Specimen Container Paediatric:

    Random urine collection: white universal container [Send to laboratory immediately].

    Random urine collection: white universal container [Send to laboratory immediately].

  • Minimum Volume Adult:

    1 - 10 mL urine

    1 - 10 mL urine

  • Minimum Volume Paediatric:

    1 - 10 mL urine

    1 - 10 mL urine

  • Special Requirement:

    Screening: Overnight urine with sand/sulphuric acid preservative. Random urine acceptable if sent to lab immediately.
    Diagnosis and monitoring of known carcinoid: 24h urine with sand/sulphuric acid...

    Screening: Overnight urine with sand/sulphuric acid preservative. Random urine acceptable if sent to lab immediately.
    Diagnosis and monitoring of known carcinoid: 24h urine with sand/sulphuric acid preservative.

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  • Sample Stability:

    Once pH has been adjusted to 3.0-3.5, samples are stable at 4°C for up to 10 days.

    For long-term storage, store samples at –20°C.

    Once pH has been adjusted to 3.0-3.5, samples are stable at 4°C for up to 10 days.

    For long-term storage, store samples at –20°C.

  • Transport Requirements:

    Ambient temperature.

    Ambient temperature.

  • Interpretation:

    Elevated excretion of urine 5-hydroxyindoleacetic acid (5-HIAA) is a probable indicator of the presence of a serotonin-producing tumor, if pharmacological and dietary artifacts have been ruled out....

    Elevated excretion of urine 5-hydroxyindoleacetic acid (5-HIAA) is a probable indicator of the presence of a serotonin-producing tumor, if pharmacological and dietary artifacts have been ruled out.

    Intake of food with a high content of serotonin (avocados, bananas, plums, walnuts, pineapple, aubergine, tomatoes/tomato products, kiwifruit, dates, grapefruit, nuts, cantaloupe/honeydew melon) within 48 hours of the urine collection could result in falsely elevated 5-HIAA excretion.

    Numerous drugs affect the excretion of 5-HIAA by different mechanisms, including increased serotonin synthesis, metabolism, and release and inhibition of uptake.

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  • Reference Ranges:

    24-hour urine collection:
    Less than 40 µmol/24h


    Random (and overnight) urine collection:
    Less than 4.0 µmol/mmol creatinine

    24-hour urine collection:
    Less than 40 µmol/24h


    Random (and overnight) urine collection:
    Less than 4.0 µmol/mmol creatinine

  • Factors Affecting Result:

    Intake of food with a high content of serotonin (avocados, bananas, plums, walnuts, pineapple, aubergine, tomatoes/tomato products, kiwifruit, dates, grapefruit, nuts, cantaloupe/honeydew melon) wi...

    Intake of food with a high content of serotonin (avocados, bananas, plums, walnuts, pineapple, aubergine, tomatoes/tomato products, kiwifruit, dates, grapefruit, nuts, cantaloupe/honeydew melon) within 48 hours of the urine collection could result in falsely elevated 5-HIAA excretion.

     

    Drugs that can increase 5-HIAA secretion include paracetamol, caffeine, diazepam (Valium), nicotine, some cough medicines (containing ephedrine or glyceryl guaiacolate, and phenobarbital. Drugs hat can decrease 5-HIAA include aspirin, ethyl alcohol, imipramine, levodopa, MAO inhibitors, heparin, isoniazid, methyldopa, and tricyclic antidepressants. If possible, following discussion with a doctor, potential interfering drugs should be discontiued at least 48-hours prior to and during urine collection.

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  • Routine Contact Name:

    Duty biochemist

  • Routine Telephone:

    Freeman: 0191 244 8889
    RVI: 0191 282 9719

    Freeman: 0191 244 8889
    RVI: 0191 282 9719

  • Routine Email:

  • Specialist Test:

    Yes

    Yes

Availability:

Sample sent to an external laboratory for testing.

Send To:

Department of Blood Sciences

Freeman Hospital
Freeman Road
Newcastle upon Tyne
NE7 7DN

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