Vanilmandelic Acid

Optimal result: 0.4 – 3.6 mmol/mol creatinine

Genova Diagnostics

By Healthmatters Editorial Team

Peer-reviewed sources

Centrally-acting medications, such as antidepressants and stimulants used for ADHD can elevate overall catecholamines and therefore urinary metabolites.

Urinary levels have been shown to correlate with generalized anxiety disorder.

VMA is sometimes used in the work up of pheochromocytoma, neural crest tumors, renovascular hypertension, and neuroblastoma in the right clinical context.

Elevations in catecholamine urinary metabolites have been shown to correlate with the physiologic stress response, exercise, and PTSD.

Low levels of catecholamine metabolites can reflect insufficient amino acid precursors for neurotransmitter production, nutrient cofactor insufficiencies for enzymatic conversion, and genetic abnormalities in enzyme function. Methylation is required for neurotransmitter creation and metabolism. Thus, methylation defects or lack of methylation cofactors may contribute to abnormal levels. Copper is an important cofactor for dopamine beta-hydroxylase, which forms norepinephrine from dopamine. In copper deficiency, norepinephrine formation can be impaired and potentially lower VMA levels. Manganese released into the synaptic cleft may influence synaptic neurotransmission. Dietary manganese deficiency, which may enhance susceptibility to epileptic functions, appears to affect manganese homeostasis in the brain, probably followed by alteration of neural activity.

There are studies which evaluate the neurotoxicity of manganese. Elevated levels of VMA and HVA have been seen in manganese toxicity from occupational exposure which induces a CNS condition similar to Parkinson’s disease.

Vanilmandelic acid (VMA) is formed in the liver by the oxidation of 3-methoxy-4-hydroxyphenylglycol.

As a downstream metabolite of tyrosine-derived catecholamines, levels of VMA can reflect the overall synthesis and metabolism of catecholamines.

Whether norepinephrine or epinephrine are metabolized into VMA or 3-methoxy-4-OH-phenylglycol (MHPG) depends on the presence and specificity of various available aldehyde reductase and dehydrogenase enzymes.

Vanilmandelic acid (VMA) is formed in the liver by the oxidation of 3-methoxy-4-hydroxyphenylglycol.

As a downstream metabolite of tyrosine-derived catecholamines, levels of VMA can reflect the overall synthesis and metabolism of catecholamines.

References:

- Eisenhofer G, Kopin IJ, Goldstein DS. Catecholamine Metabolism: A Contemporary View with Implications for Physiology and Medicine. Pharmacol Rev. 2004;56(3):331.

- Kopin IJ. Evolving views of the metabolic fate of norepinephrine. Endocrinol Exp. 1982;16(3-4):291-300.

- Maas J. MHPC: Basic Mech Psychopathol. Academic Press; 2012.

- Grouzmann E, Lamine F. Determination of catecholamines in plasma and urine. Best Pract Res Clin Endocrinol Metab. 2013;27(5):713-723.

- Alam N, Wasi N, Naeem S, et al. Methylphenidate increases the urinary excretion of vanillylmandelic acid in rats that is attenuated by buspirone co-administration. Pak J Pharm Sci. 2019;32(2 (Supplementary)):895-898.

- Garvey MJ, Noyes R, Jr., Woodman C, Laukes C. The association of urinary 5-hydroxyindoleacetic acid and vanillylmandelic acid in patients with generalized anxiety. Neuropsychobiology. 1995;31(1):6-9.

- Williams CM, Greer M. Homovanillic Acid and Vanilmandelic Acid in Diagnosis of Neuroblastoma. JAMA. 1963;183(10):836-840.

- Sunderman FW, Jr. Measurements of Vanilmandelic Acid for the Diagnosis of Pheochromocytoma and Neuroblastoma. Am J Clin Pathol. 1964;42(5):481-497.

- Gregianin L, McGill A, Pinheiro C, Brunetto A. Vanilmandelic acid and homovanillic acid levels in patients with neural crest tumor: 24-Hour urine collection versus random sample. Ped Hematol Oncol. 2009;14:259-265.

- Januszewicz W, Wocial B. Urinary excretion of catecholamines and their metabolites in patients with renovascular hypertension. Jap Heart J. 1978;19(4):468-478.

- Helin P, Kuoppasalmi K, Laakso J, Harkonen M. Human urinary biogenic amines and some physiological responses during situation stress. Int J Psychophysiol. 1988;6(2):125-132.

- Brantley PJ, Dietz LS, McKnight GT, Jones GN, Tulley R. Convergence between the Daily Stress Inventory and endocrine measures of stress. J Consult Clin Psychol. 1988;56(4):549-551.

- Dikanovic M, Kadojic D, Demarin V, et al. The effect of stress hormones on cerebral hemodynamics in patients with chronic posttraumatic stress disorder. Acta Clin Croat. 2009;48(4):405-411.

- Pequignot JM, Peyrin L, Mayet MH, Flandrois R. Metabolic adrenergic changes during submaximal exercise and in the recovery period in man. J Appl Physiology. 1979;47(4):701-705.

- Takeda A. Manganese action in brain function. Brain Res Rev. 2003;41(1):79-87.

- Ai LB, Chua LH, New AL, et al. Urinary homovanillic acid (HVA) and vanillymandelic acid (VMA) in workers exposed to manganese dust. Biol Trace Elem Res. 1998;64(1-3):89-99.

- Chen P, Chakraborty S, Mukhopadhyay S, et al. Manganese homeostasis in the nervous system. J Neurochem. 2015;134(4):601-610.

Organize and understand all your lab results

Start organizing — $15/mo →

For Health Professionals Healthmatters Pro Multiple clients’ results in one dashboard. See Pro plans →

Vanilmandelic Acid

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 →

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

Organize and understand all your lab results

Start organizing — $15/mo →

For Health Professionals Healthmatters Pro Multiple clients’ results in one dashboard. See Pro plans →

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