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TEST ID HIAAR 5-Hydroxyindoleacetic Acid, Random, Urine

Reporting Name

5-HIAA, Random, U

Specimen Type

Urine


Ordering Guidance


This test uses a random urine collection to assess 5-hydroxyindoleacetic acid concentrations. If a 24-hour urine collection is preferred, order HIAA / 5-Hydroxyindoleacetic Acid, 24 Hour, Urine.



Necessary Information


Patient's age and sex are required.



Specimen Required


Patient Preparation:

1. Some medications could interfere with test results. If medically feasible, for 48 hours before specimen collection, patient should not take the following medications:

-Acetaminophen (Tylenol or generic versions)

-Tryptophan containing supplements

2. For 48 hours prior to the urine collection, the patient should limit the following to one serving per day:

-Fruits

-Vegetables

-Nuts

-Caffeinated beverages or foods

 

Supplies: Urine Tubes, 10 mL (T068)

Container/Tube: Plastic, 10-mL urine tube

Specimen Volume: 5 mL

Collection Instructions:

1. Collect a random urine specimen.

2. Store and send refrigerate


Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time
Urine Refrigerated (preferred) 56 days
  Frozen  365 days

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Reference Values

99th percentile cutoff

Age

Female
mg/g creatinine

Male
mg/g creatinine

≤23 months

≤17.53

≤16.42

24-35 months

≤17.07

≤15.96

3 years

≤16.70

≤15.60

4 years

≤16.03

≤14.93

5 years

≤15.26

≤14.17

6 years

≤14.40

≤13.34

7 years

≤13.47

≤12.43

8 years

≤12.52

≤11.52

9 years

≤11.58

≤10.63

10 years

≤10.67

≤9.79

11 years

≤9.81

≤9.00

12 years

≤9.02

≤8.29

13 years

≤8.32

≤7.65

14 years

≤7.70

≤7.08

15 years

≤7.16

≤6.59

16 years

≤6.72

≤6.15

17 years

≤6.36

≤5.78

18 years

≤6.08

≤5.45

19 years

≤5.88

≤5.17

20 years

≤5.73

≤4.93

21 years

≤5.64

≤4.73

22 years

≤5.59

≤4.55

23 years

≤5.57

≤4.40

24 years

≤5.57

≤4.28

25 years

≤5.58

≤4.19

26 years

≤5.61

≤4.11

27 years

≤5.64

≤4.06

28 years

≤5.67

≤4.03

29 years

≤5.70

≤4.02

30 years

≤5.72

≤4.01

31 years

≤5.75

≤4.02

32 years

≤5.77

≤4.03

33 years

≤5.78

≤4.05

34 years

≤5.79

≤4.06

35 years

≤5.80

≤4.08

36 years

≤5.80

≤4.09

37 years

≤5.80

≤4.11

38 years

≤5.80

≤4.12

39 years

≤5.81

≤4.14

40 years

≤5.82

≤4.17

41 years

≤5.85

≤4.22

42 years

≤5.89

≤4.27

43 years

≤5.95

≤4.35

44 years

≤6.04

≤4.43

45 years

≤6.14

≤4.53

46 years

≤6.26

≤4.63

47 years

≤6.40

≤4.75

48 years

≤6.55

≤4.86

49 years

≤6.71

≤4.99

50 years

≤6.86

≤5.11

51 years

≤7.01

≤5.24

52 years

≤7.15

≤5.37

53 years

≤7.29

≤5.51

54 years

≤7.41

≤5.64

55 years

≤7.52

≤5.78

56 years

≤7.62

≤5.91

57 years

≤7.71

≤6.05

58 years

≤7.80

≤6.17

59 years

≤7.88

≤6.29

60 years

≤7.95

≤6.41

61 years

≤8.02

≤6.51

62 years

≤8.09

≤6.60

63 years

≤8.15

≤6.69

64 years

≤8.21

≤6.76

65 years

≤8.28

≤6.82

66 years

≤8.34

≤6.88

67 years

≤8.40

≤6.93

68 years

≤8.46

≤6.97

69 years

≤8.52

≤7.00

70 years

≤8.58

≤7.03

71 years

≤8.65

≤7.06

72 years

≤8.71

≤7.08

73 years

≤8.77

≤7.10

74 years

≤8.82

≤7.11

75 years

≤8.86

≤7.11

76 years

≤8.90

≤7.11

77 years

≤8.92

≤7.10

78 years

≤8.93

≤7.09

79 years

≤8.93

≤7.07

80 years

≤8.92

≤7.05

81 years

≤8.90

≤7.02

82 years

≤8.88

≤7.00

83 years

≤8.86

≤6.98

84 years

≤8.85

≤6.97

85 years

≤8.84

≤6.95

86 years

≤8.84

≤6.94

87 years

≤8.84

≤6.94

88 years

≤8.84

≤6.94

>or= 89 years

≤8.85

≤6.93

Day(s) Performed

Monday through Friday

Report Available

2 to 4 days

Specimen Retention Time

7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

83497

Useful For

Biochemical diagnosis and monitoring of intestinal carcinoid syndrome using random urine specimens

Clinical Information

5-Hydroxyindoleacetic acid (5-HIAA) is the major metabolite of serotonin and is excreted in the urine. Intestinal carcinoid tumors, along with neuroendocrine tumors, can produce excess amounts of 5-HIAA and serotonin, especially in individuals with carcinoid syndrome. Carcinoid syndrome is characterized by carcinoid tumors, flushing, heart disease, and hepatomegaly.

 

Measurement of 5-HIAA in a random urine specimen can diagnose carcinoid disease with a high specificity.

Cautions

Intake of food with a high content of serotonin (avocados, dates, eggplant, all fruit [including bananas, cantaloupe, grapefruit, kiwifruit, melons, pineapple, plantains, plums], all nuts [including hickory nuts, butternuts, pecans, walnuts], and tomatoes and tomato products) within 48 hours of the urine collection could result in falsely elevated 5-hydroxyindoleacetic acid (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. The following medications can interfere with 5-HIAA results.

-Acetaminophen (Tylenol or generic versions)

-Tryptophan containing supplements

 

Patient should also avoid caffeinated beverages, such as tea and coffee, or caffeinated foods, such as dark chocolate, for 48 hours before and during specimen collection.

Method Description

5-Hydroxyindoleacetic acid (5-HIAA) is measured by solid phase extraction of an aliquot from a random urine collection and liquid chromatography tandem mass spectrometry analysis. 5-HIAA is quantitated using a custom synthesized stable isotope labeled internal standard (d6-5-HIAA) from calibration over a concentration range 0.5 to 150 mg/L.(Kroll CA, Magera MJ, Helgeson JK, Matern D, Rinaldo P. Liquid chromatographic-tandem mass spectrometric method for the determination of 5-hydroxyindole-3-acetic acid in urine. Clin Chem. 2002;48[11]:2049-2051; Calanchini M, Tadman M, Krogh J, Fabbri A, Grossman A, Shine B. Measurement of urinary 5-HIAA: correlation between spot versus 24-h urine collection. Endocr Connect. 2019;8(8):1082-1088)