What is Norepinephrine (Noradrenaline), Urine?
Norepinephrine is synthesised from dopamine by dopamine-beta-hydroxylase (DBH) — an enzyme requiring ascorbic acid (vitamin C) and copper as cofactors — within sympathetic nerve terminals and the adrenal medulla. Urinary norepinephrine derives predominantly from peripheral sympathetic nervous system spillover into the circulation, reflecting sympathoadrenal tone at the time of collection. It is catabolised by MAO and COMT to normetanephrine and vanillylmandelic acid (VMA). Urinary norepinephrine is subject to diurnal variation and is significantly elevated by physical activity, psychological stress, and caffeine.