5-Hydroxyindoleacetate

Optimal result: 1.6 – 9.8 mcg/mg creatinine

High 5-HIAA can be caused by SSRI medication, 5-HTP supplementation, increased release of serotonin from the central nervous system, digestive system or platelets. Very high 5-HIAA levels can ironically indicated a tryptophan deficiency, as this may cause an increased conversion of tryptophan to serotonin.

Higher levels of 5-HIAA may mean you have:

- Carcinoid tumors

- Noncarcinoid tumors

- Cystic fibrosis

- Malabsorption

Increased urine 5-HIAA concentration is common and may be the result of improper specimen collection, consumption of serotonin containing foods or dietary supplements, drug interference, or malabsorption syndromes. Significant elevation (ten times the upper reference limit) of urine 5-HIAA may indicate the presence of a carcinoid tumor.

Eating certain foods containing serotonin can raise 5-HIAA levels. These foods include:

- Cheese

- Bananas

- Pineapple

- Kiwi

- Plums

- Tomatoes

- Eggplant

- Avocados

- Certain nuts, including walnuts and pecans

Strenuous exercise can also raise your 5-HIAA levels.

Foods and medications associated with increased urinary HIAA results:

- Acetaminophen

- acetanilide

- caffeine

- coumaric acid

- diazepam (Valium®)

- ephedrine

- fluorouracil

- glycerol guaiacolate (Guaifenesin)

- melphalan (Alkeran®)

- mephenesin

- methamphetamine (Desoxyn)

- methocarbamol (Robaxin®)

- naproxen

- nicotine

- phenacetin

- phenmetrazine

- phenobarbital

- phentolamine

- rauwolfia

- reserpine

Low 5-HIAA indicates inadequate production of serotonin. Symptoms include: constipation, depression, fatigue, insomnia, attention deficit and behavioral disorders.

Lower levels of 5-HIAA may mean you have:

- Depression

- Migraines

- What might affect the test results?

Foods and medications associated with decreased urinary HIAA results:

- Aspirin

- chlorpromazine (Thorazine)

- corticotropin

- dihydroxyphenylacetic acid

- alcohol

- gentisic acid

- homogentisic acid

- hydrazine derivatives

- imipramine (Tofranil®)

- isocarboxazid (Marplan)

- keto acids

- levodopa

- MAO inhibitors

- methenamine

- methyldopa (Aldomet®)

- perchlorperazine

- phenothiazines (Compazine®)

- promazine

- promethazine (Mepergan®)

5-Hydroxyindoleacetic acid (5HIAA) is a breakdown product of serotonin that is excreted in the urine. Serotonin is a hormone found at high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors.

5-Hydroxyindoleacetic acid (5HIAA) is a breakdown product of serotonin that is excreted in the urine. Serotonin is a hormone found at high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors.

5-Hydroxyindoleacetic acid is found to be associated with:

- Aromatic l-amino acid decarboxylase deficiency an inherited disorder that affects the way signals are passed between certain cells in the nervous system.)

- Celiac disease (an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine)

- Sepiapterin reductase deficiency (a condition characterized by movement problems)

- What are normal levels?

Normal results are 3 to 15 milligrams (mg) of 5-HIAA over 24 hours.

Women generally have lower levels than men.

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. Proper preparation before the test is essential. Medication and dietary restrictions are required to prevent false-positive results. If clinically feasible, discontinue the following medications at least 48 hours before specimen collection. 

- Acetaminophen (Tylenol or generic versions)

- Aspirin

- Antihistamines

- Cough syrups

- Cold and flu medications

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

Certain medicines can raise or lower your 5-HIAA levels. These include:

- Aspirin

- Acetaminophen

- Ethyl alcohol

- Some antidepressants

- Cough medicines or antihistamines

- Medicines to relax muscles

References:

- Urinary sampling for 5HIAA and metanephrines determination: revisiting the recommendations, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527357/

- Guidelines for the diagnosis and management of carcinoid tumours. Part 1: the gastrointestinal tract. A statement from a Canadian National Carcinoid Expert Group. (https://www.ncbi.nlm.nih.gov/pubmed/17576444)

- A single fasting plasma 5-HIAA value correlates with 24-hour urinary 5-HIAA values and other biomarkers in midgut neuroendocrine tumors (NETs). (https://www.ncbi.nlm.nih.gov/pubmed/23160483)

- Aromatic l-amino acid decarboxylase deficiency, https://ghr.nlm.nih.gov/condition/aromatic-l-amino-acid-decarboxylase-deficiency

- WHAT IS CELIAC DISEASE?, https://celiac.org/celiac-disease/understanding-celiac-disease-2/what-is-celiac-disease/

- Sepiapterin reductase deficiency, https://ghr.nlm.nih.gov/condition/sepiapterin-reductase-deficiency

5-Hydroxyindoleacetate
Healthmatters dashboard showing biomarker trend graph

Every lab result you’ve ever had, charted and explained.

Healthmatters is a tracker for your lab results. Upload a report from any lab, any country — every marker charted and explained.

Start with my report →
Beyond 5-Hydroxyindoleacetate — 10,000+ markers explained
One 5-Hydroxyindoleacetate result tells you where you are. Your history tells you where you’re heading. Upload your past lab reports and see this marker — and every marker on them —every marker charted against your own lab’s ranges.
Start with this report →
Healthmatters timeline preview showing biomarker trends over time
Clinical Sources & References

All our content is backed by peer-reviewed studies, academic research, and trusted medical sources. We’re committed to accuracy and transparency — see our editorial policy for details.

Article Review Log
Written by Healthmatters Editorial Team
Healthmatters Lifetime Plan

Pay $250. Track your health forever

One payment. No renewals. Yours for life.

10,000+ biomarkers explained · trends over time

See other plans →
Secure checkout via Stripe · GDPR & HIPAA
We accept results from any lab
LabCorp Quest Diagnostics Genova Diagnostics DUTCH Test Doctor's Data Vibrant America ZRT Laboratory Cyrex Labs + any other lab

What members are saying

★★★★★ 10,000+ happy members
★★★★★

"Watching my numbers move over the years — instead of forgetting last time's results — completely changed how I manage my health."

Daniel
Member since 2022
★★★★★

"Living across several countries made keeping my lab results organized a real challenge. Healthmatters brought my results from the USA, Spain, and Germany together — 20 years of history, with long-term trends instead of scattered reports."

Ben
Member since 2021 · tracks across countries
★★★★★

"Standard lab ranges are too wide for how I practice — 'normal' isn't optimal. I set my own bands, so a client sees yellow before a marker goes officially out of range. That's the conversation I want to be having."

Dr. Alexandra
Functional medicine · 6 yrs on Pro