HVA (homovanillic acid), a dopamine metabolite, and VMA (vanillylmandelic acid), a metabolite of epinephrine and norepinephrine, are often elevated due to stress increasing catecholamine output from the adrenal gland, or from lead toxicity. Elevated HVA may also result from the intake of L DOPA, dopamine, phenylalanine, or tyrosine, or due to Clostridia metabolites.
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