Ordering Recommendation

Use to diagnose carcinoid tumors and monitor disease.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

Patients should abstain, if possible, from medications, over-the-counter drugs, and herbal remedies for at least 72 hours prior to the test. Foods rich in serotonin (avocados, bananas, eggplant, pineapple, plums, tomatoes, walnuts) and medications that may affect metabolism of serotonin must be avoided at least 72 hours before and during collection of urine for HIAA.

Collect

24-hour or random urine. Refrigerate 24-hour specimens during collection.

Specimen Preparation

Transfer 4 mL aliquot from a well-mixed 24-hour or random collection to an ARUP Standard Transport Tube. (Min: 1 mL) Record total volume and collection time interval on transport tube and test request form.

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Any sample except urine.

Remarks

Please see Note for a more comprehensive list of dietary restrictions.

Stability

Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 2 months

Methodology

Quantitative High Performance Liquid Chromatography -Tandem Mass Spectrometry

Performed

Sun-Sat

Reported

1-5 days

Reference Interval

Test Number
Components
Reference Interval
  5-HIAA Urine - per 24h 0.0-15.0 mg/d
  5-HIAA Urine - per volume The HIAA-to-creatinine ratio will be reported whenever the urine collection is random or other than 24 hours, or the urine volume is less than 400 mL/24 hours.

0-14 mg/g crt
  Creatinine, Urine - per 24h
Age
Male (mg/d)
Female (mg/d)
3-8 years 140-700 140-700
9-12 years 300-1300 300-1300
13-17 years 500-2300 400-1600
18-50 years 1000-2500 700-1600
51-80 years 800-2100 500-1400
81 years and older 600-2000 400-1300

Interpretive Data

5-Hydroxyindoleacetic acid (5-HIAA) results are expressed as a ratio to creatinine excretion (mg/g CRT). No reference interval is available for results reported in units of mg/L. 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. 

Per 24h calculations are provided to aid interpretation for collections with a duration of 24 hours and an average daily urine volume. For specimens with notable deviations in collection time or volume, ratios of analytes to a corresponding urine creatinine concentration may assist in result interpretation.

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Compliance Category

Laboratory Developed Test (LDT)

Note

Foods and medications associated with altered urinary HIAA results:

Decreased HIAA: 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®).

Increased HIAA:
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.

Hotline History

N/A

CPT Codes

83497

Components

Component Test Code* Component Chart Name LOINC
0020207 Creatinine, Urine - per volume 2161-8
0020208 Creatinine, Urine - per 24h 2162-6
0080238 5-HIAA Urine Interpretation 44909-0
0080320 5-HIAA Urine - per 24h 1695-6
0080321 5-HIAA Urine - per volume 31203-3
0081343 5-HIAA Urine - ratio to CRT 44288-9
0097110 Total Volume 19153-6
0097111 Hours Collected 30211-7
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • 5-HIAA
  • 5-OH-Indoleacetic Acid
  • Hydroxyindoleacetic Acid
  • Serotonin Metabolite
5-Hydroxyindoleacetic Acid (HIAA), Urine