Ratio: Norepi/Epi

Optimal result: 5.2 – 13.7 µg/g creatinine

Elevated Ratio: Norepi/Epi may be consistent with poor conversion of norepinephrine to epinephrine. This conversion is driven by the phenylethanolamine N-methyltransferase (PNMT) enzyme that requires SAMe, magnesium and cortisol (adequate HPA axis function) as cofactors.

- Consider the actual levels of both neurotransmitters, and interpret in the ratio in context of cortisol levels/HPA axis function.

- Optimization of HPA axis function may be clinically warranted.

Norepinephrine and epinephrine are catecholamine messengers that play important roles in the regulation of diverse physiological systems by acting through adrenergic receptors. 

Epinephrine and norepinephrine are two neurotransmitters that also serve as hormones, and they belong to a class of compounds known as catecholamines. As hormones, they influence different parts of your body and stimulate your central nervous system. Having too much or too little of either of them can have noticeable effects on your health.

Both epinephrine and norepinephrine can affect your heart, blood sugar levels, and blood vessels. However, norepinephrine can also make your blood vessels become narrower, increasing blood pressure.

Epinephrine, also called adrenaline, has powerful effects on the body. These include:

- increased blood sugar levels

- increased heart rate

- increased contractility (how hard the heart squeezes)

- relaxation of smooth muscle in the airways to improve breathing

Norepinephrine, also called noradrenaline, has effects similar to those of epinephrine, such as:

- increased blood sugar levels

- increased heart rate

- increased contractility

Norepinephrine can also cause your blood vessels to narrow, which increases blood pressure.

Ratio: Norepi/Epi
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