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Metanephrines Free Plasma Test

DNA Labs India | ISO 9001:2015 Certified

Metanephrines Free Plasma Test

Short Name: Free Metanephrines

Also known as: Free Plasma Metanephrines, Plasma Fractionated Metanephrines, Plasma Free Metanephrine and Normetanephrine, Free Catecholamine Metabolites Panel

Metanephrines Free Plasma Test test available at DNA Labs India for ₹8,500. Uses LC-MS/MS (Liquid Chromatography–Tandem Mass Spectrometry) on Plasma (EDTA) samples. Results in Sample accepted on Wednesday and Saturday by 9:00 AM. Reports delivered by Friday and Tuesday respectively via online portal, email, or WhatsApp.. Free home collection in 300+ cities across India.

Blood Test🏠 Home Collection

✍️ Written By

🩺 Medically Reviewed By

Dr Ramarao Paidisetty

Dr Ramarao Paidisetty

Consultant Biochemist · Reg: 21504

Last reviewed: September 7, 2026

Overview

The primary purpose of the Metanephrines Free Plasma Test is to screen for and aid in the diagnosis of catecholamine-secreting tumours, including pheochromocytoma (adrenal) and paraganglioma (extra-adrenal). The test measures the free (unconjugated) fraction of metanephrine, normetanephrine, and 3-methoxytyramine, which are the O-methylated metabolites of epinephrine, norepinephrine, and dopamine respectively. Elevated levels of these metabolites indicate autonomous, unregulated secretion of catecholamines, which is characteristic of chromaffin cell tumours. The test is also used in the context of neuroblastoma evaluation in paediatric patients and in the surveillance of individuals with hereditary syndromes predisposing to adrenal tumours, such as Multiple Endocrine Neoplasia Type 2 (MEN2).

Test Code
1241
CPT Code
83835
ICD Code
E27.5
Price
₹8,500
Sample Type
Plasma (EDTA)
Result Time
Sample accepted on Wednesday and Saturday by 9:00 AM. Reports delivered by Friday and Tuesday respectively via online portal, email, or WhatsApp.
Fasting Required
Yes (10 hours)
Method
LC-MS/MS (Liquid Chromatography–Tandem Mass Spectrometry)
Step 1

Sample Collection

Patient should fast overnight (minimum 10 hours). Patient must be in a supine position for a minimum of 30 minutes before sample collection. Strictly avoid Labetalol, Sotalol, Acetaminophen, Methyldopa, antidepressants, ephedrine, amphetamine, nicotine, and caffeine. Avoid foods such as banana, pineapple, nuts, and cereals at least 72 hours prior to sample collection. Inform the physician about all current medications.

Method: Venipuncture – Supine position after minimum 30 minutes of rest

Step 2

Laboratory Analysis

Blood is drawn via venipuncture from a vein in the arm while the patient remains in a supine position. Two Lavender top (EDTA) tubes are collected, yielding a minimum of 4 mL of blood. The specimen must be immersed in ice water immediately after collection.

Step 3

Report Delivery

Plasma must be separated from the whole blood within 30 minutes of collection and transferred into a sterile screw-capped vial. The specimen should be shipped refrigerated or frozen to the laboratory. A small bruise may appear at the venipuncture site, which typically resolves within a few days.

Timeline: Sample accepted on Wednesday and Saturday by 9:00 AM. Reports delivered by Friday and Tuesday respectively via online portal, email, or WhatsApp.

Patient Instructions

1
Before the Test:Fast overnight (minimum 10 hours). Remain in a supine position for at least 30 minutes prior to sample collection. Discontinue Labetalol, Sotalol, Acetaminophen, Methyldopa, antidepressants, ephedrine, amphetamine, nicotine, and caffeine as advised by your physician. Avoid banana, pineapple, nuts, and cereals for at least 72 hours before the test. Inform the phlebotomist and your physician about all current medications and supplements.
2
During the Test:A trained phlebotomist will collect blood from a vein in your arm using standard venipuncture technique while you remain lying down. Two Lavender top (EDTA) tubes will be filled. The blood sample will be immediately immersed in ice water to maintain analyte stability. The procedure typically takes less than 10 minutes.
3
After the Test:After blood collection, pressure will be applied to the venipuncture site with cotton and a bandage. You may resume normal activities unless advised otherwise. A minor bruise may form at the puncture site, which usually resolves within a few days. Plasma will be separated within 30 minutes and transported to the laboratory under controlled conditions. Your physician will contact you once results are available.

About This Test

Who Should Get This Test

The primary purpose of the Metanephrines Free Plasma Test is to screen for and aid in the diagnosis of catecholamine-secreting tumours, including pheochromocytoma (adrenal) and paraganglioma (extra-adrenal). The test measures the free (unconjugated) fraction of metanephrine, normetanephrine, and 3-methoxytyramine, which are the O-methylated metabolites of epinephrine, norepinephrine, and dopamine respectively. Elevated levels of these metabolites indicate autonomous, unregulated secretion of catecholamines, which is characteristic of chromaffin cell tumours. The test is also used in the context of neuroblastoma evaluation in paediatric patients and in the surveillance of individuals with hereditary syndromes predisposing to adrenal tumours, such as Multiple Endocrine Neoplasia Type 2 (MEN2).

How to Prepare

  • Patient must fast overnight (minimum 10 hours) before sample collection
  • Patient should be in supine position for at least 30 minutes prior to venipuncture
  • Collect 4 mL (minimum 2 mL) plasma from 2 Lavender top (EDTA) tubes
  • Immerse specimen immediately in ice water after collection
  • Separate plasma within 30 minutes and transfer into a sterile screw-capped vial
  • Ship specimen refrigerated or frozen to the laboratory
  • Strictly avoid Labetalol, Sotalol, Acetaminophen, Methyldopa, antidepressants, ephedrine, amphetamine, nicotine, and caffeine before testing
  • Avoid banana, pineapple, nuts, and cereals at least 72 hours prior to sample collection

Doctor's Notes

Reviewed by — MBBS, MD (Biochemistry) · Reg. No. 21504

"Pheochromocytomas and paragangliomas, though rare, carry significant cardiovascular morbidity if undiagnosed. Plasma free metanephrines measured by LC-MS/MS offer the highest sensitivity for these catecholamine-secreting tumours and should be the first-line biochemical test in patients with suggestive symptoms, incidental adrenal masses, or hereditary predisposition syndromes such as MEN2, VHL, or SDHx mutations. Always interpret results in the context of the patient's medication list, posture during collection, and overall clinical presentation. Moderately elevated values warrant repeat testing under strictly controlled conditions before further imaging or surgical planning."

Last medically reviewed: September 7, 2026

Test Parameters & Specifications

Sample TypePlasma (EDTA)
Sample Volume4 mL (2 mL minimum)
Container2 Lavender top (EDTA) tubes
Collection MethodVenipuncture – Supine position after minimum 30 minutes of rest

Sample Stability

Room Temperature
Refrigerated (2–8 °C)
Frozen (−20 °C or below)
Sample Rejection Criteria:
  • Sample not collected with patient in supine position after a minimum of 30 minutes of rest
  • Specimen not immersed in ice water immediately after collection
  • Plasma not separated within 30 minutes of collection
  • Patient did not fast overnight or consumed restricted foods within 72 hours
  • Patient did not discontinue interfering medications as advised
  • Insufficient sample volume (less than 2 mL plasma)
  • Sample received at room temperature beyond 6 hours post-collection
  • Hemolysed or lipemic sample

Understanding Your Results

The Metanephrines Free Plasma Test results are interpreted by comparing measured values of free metanephrine, free normetanephrine, and 3-methoxytyramine against established reference ranges. Results must always be correlated with the patient's clinical symptoms, medication history, and posture during sample collection. Persistently elevated levels above the reference range are highly suggestive of catecholamine-secreting tumours and warrant further imaging and clinical evaluation.
📊

All three analytes (free metanephrine, free normetanephrine, 3-methoxytyramine) are within the established reference ranges. This effectively rules out a functioning pheochromocytoma or paraganglioma with high negative predictive value when the test is performed under proper pre-analytical conditions.

📊

One or more analytes are moderately above the reference range. This may be due to pre-analytical factors such as recent medication use, stress, or improper positioning. Repeat testing under strictly controlled conditions and correlation with clinical findings is recommended.

📊

Markedly elevated free metanephrine (typically > 3–4 times the upper reference limit) is highly suggestive of a pheochromocytoma (adrenal chromaffin cell tumour). Anatomical imaging (CT/MRI of the abdomen) and referral to an endocrinologist or endocrine surgeon is recommended.

📊

Markedly elevated free normetanephrine may indicate a paraganglioma (extra-adrenal catecholamine-secreting tumour) or norepinephrine-producing pheochromocytoma. Further anatomical and functional imaging is advised.

📊

An isolated or concurrent elevation of 3-methoxytyramine may be associated with dopamine-secreting paragangliomas, neuroblastoma (particularly in paediatric patients), or certain hereditary syndromes. Clinical correlation and additional workup are essential.

⚠️ When to Consult a Doctor:

Consult your doctor or endocrinologist if your Metanephrines Free Plasma Test results show any analyte above the reference range. Significantly elevated values require urgent clinical evaluation and further imaging studies. Even mildly elevated results warrant a repeat test under controlled conditions and clinical correlation. If you are experiencing persistent or episodic hypertension, unexplained headaches, excessive sweating, palpitations, or anxiety, seek medical evaluation regardless of test results.

Limitations

  • ⚠Cannot distinguish between benign and malignant tumours; imaging and histopathology are required
  • ⚠Moderately elevated values may require repeat testing under strictly controlled conditions
  • ⚠Results should always be interpreted in the context of the patient's clinical presentation and medication history
  • ⚠This test does not replace anatomical imaging (CT/MRI) for tumour localisation

Risks & Considerations

  • ●Minor bruising or swelling at the venipuncture site
  • ●Temporary lightheadedness or dizziness during blood draw
  • ●Rare risk of infection at the puncture site
  • ●Slight discomfort during needle insertion

Interfering Factors

  • ●Labetalol, Sotalol, Acetaminophen (Paracetamol), Methyldopa, and antidepressant medications can cause false elevation
  • ●Sympathomimetic agents such as Ephedrine and Amphetamine interfere with catecholamine metabolism
  • ●Nicotine and caffeine stimulate catecholamine release and may elevate levels
  • ●Dietary items including banana, pineapple, nuts, and cereals consumed within 72 hours of testing
  • ●Physical or emotional stress during or shortly before sample collection
  • ●Upright (seated or standing) posture during blood draw instead of supine position

Compare With Similar Tests

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Frequently Asked Questions

What is the Metanephrines Free Plasma Test?
The Metanephrines Free Plasma Test is a blood test that measures the levels of free metanephrine, free normetanephrine, and 3-methoxytyramine in blood plasma. These are metabolites of catecholamines produced by the adrenal glands. The test is primarily used to screen for catecholamine-secreting tumours such as pheochromocytoma and paraganglioma.
Why has my doctor ordered this test?
Your doctor may have ordered this test if you have resistant or episodic hypertension, recurrent episodes of headache, sweating, and palpitations, an incidentally discovered adrenal mass, a family history of hereditary syndromes like MEN2, or if a catecholamine-secreting tumour is clinically suspected.
How should I prepare for the Metanephrines Free Plasma Test?
You must fast overnight for at least 10 hours before sample collection. You should lie down in a supine position for a minimum of 30 minutes before the blood draw. Avoid certain medications (Labetalol, Sotalol, Acetaminophen, Methyldopa, antidepressants) and substances (caffeine, nicotine, ephedrine, amphetamine) as advised by your physician. Avoid banana, pineapple, nuts, and cereals for at least 72 hours before the test.
What medications must I avoid before this test?
You must avoid Labetalol, Sotalol, Acetaminophen (Paracetamol), Methyldopa, antidepressant medications, ephedrine, amphetamine, nicotine, and caffeine for at least 72 hours before sample collection. These substances can interfere with catecholamine metabolism and cause falsely elevated results. Always consult your physician before stopping any medication.
What does an elevated metanephrine level indicate?
Significantly elevated levels of free metanephrine and/or free normetanephrine are highly suggestive of a catecholamine-secreting tumour such as a pheochromocytoma (in the adrenal gland) or paraganglioma (outside the adrenal gland). Mild elevations may occur due to medications, stress, or improper sample collection and usually require repeat testing.
Is fasting required for this test?
Yes, overnight fasting for a minimum of 10 hours is mandatory before sample collection. You should also avoid specific foods such as banana, pineapple, nuts, and cereals for at least 72 hours before the test, as these dietary items may interfere with assay results.
What is the cost of the Metanephrines Free Plasma Test at DNA Labs India?
The cost of the Metanephrines Free Plasma Test at DNA Labs India is INR 8,500. This includes free home sample collection across India. The test is performed using the highly accurate LC-MS/MS (Liquid Chromatography–Tandem Mass Spectrometry) method.
How long does it take to receive the results?
Samples collected on Wednesday by 9:00 AM will have reports available by Friday. Samples collected on Saturday by 9:00 AM will have reports available by Tuesday. Reports are delivered via the online portal, email, or WhatsApp.
What sample type is required for this test?
The test requires 4 mL (minimum 2 mL) of plasma collected from 2 Lavender top (EDTA) tubes. The blood is drawn via venipuncture with the patient in a supine position. The specimen must be immersed in ice water immediately and plasma separated within 30 minutes.
Can this test diagnose pheochromocytoma?
The Metanephrines Free Plasma Test is the gold-standard screening test for pheochromocytoma and paraganglioma. Significantly elevated levels have a high positive predictive value. However, a definitive diagnosis requires confirmation through additional biochemical tests, anatomical imaging (CT or MRI), and in some cases, histopathological examination of tissue.
Are there any risks associated with this blood test?
The risks are minimal and are the same as any routine venipuncture. These include minor bruising or swelling at the collection site, temporary lightheadedness, and very rarely, infection at the puncture site. Serious complications are extremely uncommon.
What happens if my test results are abnormal?
If your results show elevated levels of any of the three analytes, your physician will correlate the findings with your clinical symptoms and may recommend repeat testing under strictly controlled conditions, anatomical imaging of the adrenal glands and abdomen, or referral to an endocrinologist for further evaluation and management. Early detection and treatment of catecholamine-secreting tumours significantly improve patient outcomes.
Worried about the process? Our certified phlebotomists collect thousands of samples every month across India. The process takes under 5 minutes and is virtually painless. Questions? Message us on WhatsApp — we're here 7 days a week.

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