Understanding Vanilmandelic Acid (VMA): Normal vs Optimal Ranges

?What is Vanilmandelic Acid (VMA)?

Vanilmandelic acid (VMA) is the major urinary metabolite of the catecholamines norepinephrine (noradrenaline) and epinephrine (adrenaline). It results from the combined action of MAO and COMT on these stress hormones. VMA is measured in a 24-hour urine collection or spot urine creatinine-adjusted sample.

!Why It Matters

Markedly elevated urinary VMA (often 3-fold or more above reference range) is the hallmark of pheochromocytoma (adrenaline-secreting adrenal tumour) and neuroblastoma. Pheochromocytoma causes episodic hypertension, headache, sweating, and palpitations — and can be life-threatening if undiagnosed. VMA is used alongside plasma metanephrines and HVA for comprehensive catecholamine assessment.

Reference Ranges

Lab normal ranges may vary between laboratories. Optimal and longevity targets are based on research literature and should be interpreted with your physician.

Symptoms of Imbalance

• Phaeochromocytoma: episodic severe headache, hypertension, diaphoresis, palpitations
• Neuroblastoma (children): abdominal mass, bone pain, periorbital ecchymoses

How to Improve Your Levels

• 1Confirmed phaeochromocytoma or neuroblastoma: surgical resection is curative
• 2Alpha-blockade (phenoxybenzamine) prior to surgery to control blood pressure
• 3Avoid dietary sources that elevate VMA before testing: coffee, tea, vanilla, chocolate (24-hour urine tests)

When to Test

Suspected pheochromocytoma (episodic hypertension); neuroblastoma workup in children; adrenal incidentaloma evaluation.

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