Adrenaline

Adrenaline (epinephrine) is the fight-or-flight hormone of the adrenal gland. It mobilises energy immediately, raises heart rate and blood pressure and inhibits digestion and the immune system. With ongoing stress, release can change; studies have observed both raised and reduced values. Measured in urine over 24 h or as a spot urine sample.

What adrenaline does in the body

Adrenaline is made in the adrenal medulla: tyrosine is converted via L-DOPA and dopamine first into noradrenaline and then, with a methyl group from S-adenosylmethionine, into adrenaline. The enzyme for this last step is stimulated by cortisol from the adrenal cortex. Under strain, cold, pain, fear or low blood sugar, nerve impulses release adrenaline into the blood. Via β1 receptors the heart beats faster and more forcefully, via β2 receptors the airways and the vessels in the muscles widen, and via α1 receptors the vessels of the skin and digestive tract narrow. The liver releases glucose from glycogen and makes new glucose, fat tissue releases fatty acids and insulin release is slowed – so blood sugar rises. Adrenaline is broken down via the enzymes COMT and MAO into metanephrine and vanillylmandelic acid.

Low adrenaline – what happens in the body?

When little adrenaline is released, the rapid counter-regulation is weaker. When blood sugar falls, the liver releases glucose more slowly, and typical warning signs of low blood sugar such as trembling, palpitations and sweating are less pronounced. The heart and circulation adapt more slowly to exertion and to standing up. Low values occur when the adrenal medulla is damaged, when cortisol is lacking and the enzyme for the last production step is stimulated less, with disorders of the autonomic nerves, for example in long-standing diabetes, and in calm phases without strain.

High adrenaline – what happens in the body?

When adrenaline rises, its effects on the heart, vessels and metabolism predominate: the heart beats faster, blood pressure rises, blood flow to the hands and feet decreases, blood sugar and free fatty acids rise, sweat glands become active and the muscles can tremble. Digestion and readiness for sleep recede. Higher values arise with physical and emotional strain, low blood sugar, pain, cold, from caffeine and nicotine and with some medications. Very high or episodically raised values are clarified by a doctor.

The interpretation is given in your report.